Reflection On Health And Social Care

One of the assessments I was conducted was of an 85-year-old male who had been admitted to the hospital due to a fall. The referral was made to social work for transition planning and emotional support regarding hospital admission. Before meeting with Mr. L I reviewed his chart for medical and social history which revealed that he had a previous stroke and been managing well at home for the past 80 years. I thought this would be a great way for me to build a report with him and utilize the strengths based perspective to guide my intervention. This approach reminds the social worker to build on the individual’s strengths, resiliency and resources (Fraser Health, 2016). I wanted to acknowledge and respect his independence. At first Mr. L was
quite reserved in discussing his living situation, however as the assessment progressed he started to open up more. Mr. L shared that he used to drive a lot work, but in the last year he’s been asked to give up his licence. I was able to provide emotional support around that and appreciated his right to self-determination and autonomy. Mr. L reported that he supportive family and he’s been living alone for many years. I advocated for Mr. L and suggested that we put in home supports upon discharge. We also discussed his long term goals of moving to an assisted living facility and what that experience would look like. Another assessment I conduct was with Ms.
M an 85-year-old woman who lives in an independent living facility. She was brought into the hospital due to a fall she had from tripping over her walker. Ms. M’s history revealed that she was known to social work and has a history of alcohol use. Her medical history includes diabetes and the last admission reported she had been found unconscious due to the drop in her sugar levels. On review of previous social work notes, the impression was that Ms. M was choosing to drink at risk; and she had expressed that she was aware of the resources and supports that were available for her. I decided to use the harm reduction approach in my intervention and provided education on the use of alcohol and diabetes. The approach was appropriate in this case as it is non-confrontational, holistic, nurturing and respectful of the individual’s desires and capabilities (Centre for Addiction and Mental Health, 1998). I also utilized the client centered approach to gain insight of the patient perspective on alcohol use and how it’s been impacting her physical and mental health. Based on my assessment, Ms. M did not identify drinking as a problem. She did express that drinking is a part of social life and she enjoys having wine with the other residents. I wanted to respect her autonomy and come up with creative solutions for risk management. Ms. M was able to openly discuss ways she could keep safe, such as drinking with a friend or asking someone to
guide her back to the room. We also discussed the use of Lifeline in case she ever needed to call for help. Another assessment I was involved in was of Mr.
B, a 90-year-old man who he had been admitted to the hospital due to changes in health status due to an underlying diagnosis of colorectal cancer. When Mr. B was admitted it was noted that he had cognitive impairment. Based on that our assessment would entail providing emotional support and gathering collateral information from the family around the patient’s previously expressed health wishes. According to the health care consent act, the temporary substitute decision maker is Mr. B’s wife. She informed us that Mr. B wanted comfort measures in the last stages of his life. Based on our discussions, a palliative approach would be applied to Mr. B’s care needs. This approach “sees palliative care as less of a discrete service offered to dying persons when treatment is no longer effective and more of an approach to care that can enhance quality of life throughout their illness” (The Way Forward, n.d., p. 8). The social worker also provided counselling around anticipatory grief. An important dimension discussed during regional training was to encourage the patient and families to say what needs to be said, express appreciation and resentment so as not to leave important things
unsaid.