Discussion 1:Self-Determination Discussion 1:Self-Determination

Discussion 1:Self-Determination

Discussion 1:Self-Determination

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SOCW 6111 Discussion Wk 6

Discussion 1:Self-Determination

In the Christ & Diwan (2008) article, the authors list seven domains that social workers should address in order to fully assess an older client’s needs. Each domain is considered equally important. This comprehensive evaluation fits well with the social work perspective that it is important to not only address the internal concerns of clients but also their environment. Making decisions for older adults without their input occurs often. In society people sometimes treat their elders like children—making decisions for them based on what they think is best rather than from the client’s perspective. While at times this may be well intentioned, the potential for infantilism and, in turn, compromised self-determination, occurs.

For this Discussion, review the program case study for the Petrakis family. You will focus not on Helen, but on her mother-in-law, Magda. What decisions were made about Magda’s treatment without a formal assessment and/or her input? Consider how Christ & Diwan’s (2008) seven domains relate to Magda’s case. Complete an assessment for Magda and identify the choices that were made without her feedback.

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· Post a summary of your assessment of Magda’s situation that addresses the seven domains.

· Fill in the gaps in content as necessary. 

· Describe ways you would have included Magda in the original assessment and treatment plan. 

· Include questions you would have asked Magda and her professional support system (doctors, nurses, etc.) to gain further insight into the situation.

References (use 2 or more)

Christ, G., & Diwan, S. (2008). Chronic illness and aging: The role of social work in managing chronic illness care. Council on social work education. Retrieved from http://www.cswe.org/getattachment/Centers-Initiatives/CSWE-Gero-Ed-Center/Teaching-Tools/Gero-Competencies/Practice-Guides/Assignments-Measurments/CI-Sec2-Role-SW.pdf.aspx

Paveza, G. J. (2013). Assessment of the elderly. In M. J. Holosko, C. N. Dulmus, & K. M. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 177–195). Hoboken, NJ: Wiley.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014a). Sessions: case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

  • The Petrakis      Family (pp. 20–22)

Discussion 2: Elder Abuse

Each year on or around June 15, communities and municipalities around the world plan activities and programs to recognize World Elder Abuse Awareness Day, a day set aside to spread awareness of the abuse of the elderly (Center of Excellence on Elder Abuse & Neglect, 2013). The abuse of older adults is a growing concern and statistics suggest that the number of elders experiencing abuse is an alarmingly high number. Research suggests that close to half the people diagnosed with dementia experience some form of abuse (Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G., 2009; Wiglesworth, A., Mosqueda, L., Mulnard, R., Liao, S., Gibbs, L., & Fitzgerald, W., 2010, as cited on http://www.ncea.aoa.gov/Library/Data/index.aspx). Elder abuse takes on many forms and can include physical, emotional, psychological, and economic abuse. The legendary American actor, Mickey Rooney, spoke to the United States Senate, describing his own experiences of pain and neglect at the hands of his stepson, asking legislators to take seriously the abuse of the elderly.

For this Discussion, find a scholarly article that presents some of the most salient psychosocial issues related to elder abuse.

· Post a summary of the article you found. 

· How does the article reinforce the importance of assessing potential abuse and neglect when working with the elderly?

· Describe prevention and/or intervention strategies on the micro, mezzo, and macro levels that can be used to address the issue of abuse and neglect of the elderly.

References (use 2 or more)

Paveza, G. J. (2013). Assessment of the elderly. In M. J. Holosko, C. N. Dulmus, & K. M. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 177–195). Hoboken, NJ: Wiley.

Discussion 1:Self-Determination

WAL_SOCW6111_06_A_EN-wk6.pdf

CI-Sec2-Role-SW-Wk6.pdf

Petrakis Family Episode 3

Petrakis Family Episode 3 Program Transcript

FEMALE SPEAKER: And you’re sure Alec is stealing from her? Pills. From his own grandmother.

FEMALE SPEAKER: I can’t call the police. He’s still on probation! Possession.

FEMALE SPEAKER: Have you spoken to him about it?

FEMALE SPEAKER: He denied it. But I found them. He got her oxy prescription refilled so he could take them himself. How old are you?

FEMALE SPEAKER: Excuse me?

FEMALE SPEAKER: I said, how old are you?

FEMALE SPEAKER: I don’t see what that has to do with anything.

FEMALE SPEAKER: You’re too damn young to be doing this job. That’s it. You don’t know what you’re doing! None of this would have happened! It was your bright idea! You’re the one who told me to have him move in with her and take care of her!

FEMALE SPEAKER: I did tell you to do anything! I only suggested it. And we talked about it together.

FEMALE SPEAKER: No, no. That’s not true. I followed your advice. You’re going to have to fix this. You have to do something. I don’t know what else to do. I can’t call the police. He can’t go back to jail. Awful things will happen to him. I can’t let that happen. I won’t!

Petrakis Family Episode 3 Additional Content Attribution

MUSIC: Music by Clean Cuts

Original Art and Photography Provided By: Brian Kline and Nico Danks

©2013 Laureate Education, Inc. 1

CHRONIC ILLNESS AND AGING

SECTION 2: THE ROLE OF SOCIAL WORK IN MANAGING CHRONIC ILLNESS CARE

Grace Christ and Sadhna Diwan*

Synopsis

Managing chronic illness presents a profound challenge to the social work profession, not only because of the myriad formal and informal services required by the increasing number of chronically ill elders, but also because the caregivers, too, require our support and empowerment. As professionals, social workers experience first‐hand the effects of the met and unmet patient needs, which brings with it a responsibility to insure that practice and policy decisions give full recognition to the impact of psychosocial aspects and services that provide total care to chronically ill older adults and their caregivers.

This section describes some of the most recent literature addressing the role of social workers in managing chronic illness care specifically related to conducting biopsychosocial assessments, providing interventions, and in designing and implementing effective models of health services delivery such as care coordination.

Characteristics of Chronic Illness as They Impact the Social Work Role

Three important characteristics of chronic illnesses among older adults need to be considered as they affect the social work role and function.

1. The trajectory for many serious illnesses has changed from an acute terminal course to a much longer chronic period, with episodes of exacerbations and remissions interspersed with extended periods of good functioning.

2. The trajectory of advanced chronic and terminal illnesses has changed from a relatively brief period to a longer period in which both curative and palliative treatments are combined. Research suggests that a long, advanced chronic illness can be highly stressful for both patients and their families.

Christ & Diwan Chronic Illness—Role of Social Work

3. The increase in the total number of older people with advanced chronic and terminal illnesses will require more curative and palliative care being provided in the home, with greater reliance on provision by family members.

Advances in medical care have changed the illness trajectory in ways that dramatically alter the older adult’s experience of chronic illness. Facilitating and enhancing positive health behaviors at all stages of life as well as effective management of chronic illness is central to the social worker’s role, knowledge, value, and skill base in health care.

The specific role of social workers in health care is to address psychological, behavioral, and social factors by (1) assessing patient and family psychosocial health needs, (2) providing interventions required to address their psychosocial needs and promote their adaptation to illness and disability, and (3) developing and implementing effective models of health services delivery. The following sections provide an overview of issues related to Biopsychosocial Assessment of older persons with chronic conditions; a description of the range of social work interventions relevant to the management of chronic conditions; and a description of the evidence base of one model of service delivery: care coordination for older persons.

Psychosocial Assessment of Older Adults with Chronic Conditions

Because of the frequency of multiple chronic conditions in older adults, a comprehensive biopsychosocial assessment of needs and resources has become the most important part of service delivery and is the beginning of the intervention process to address the management of chronic conditions among them. The National Association of Social Workers (NASW, 2005) and the American Geriatrics Society (AGS, 2005) recommend a biopsychosocial approach to the assessment of older adults. This section reviews the evidence supporting comprehensive geriatric assessments and, using a biopsychosocial framework, describes the rationale or evidence supporting seven typical domains of psychosocial assessment for social workers in the management of chronic illnesses.

Comprehensive Assessments

Comprehensive geriatric assessment (CGA) and geriatric evaluation and management (GEMs) programs have shown positive impact on improving or maintaining cognitive and physical function (Urdangarin, 2000).

These programs have shown increased likelihood of patients living at home, decreased likelihood of hospitalization during follow‐up, and a reduction in mortality.

The primary component of CGA and GEM programs is an interdisciplinary team consisting primarily of physicians, nurses, and social workers.

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