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Respond to two colleagues and explain how their assessments reflect the NASW Code of Ethics. Include two values and/or guiding principles to support your explanation.
Use the Learning Resources to support your posts. Make sure to provide APA citations and a reference list.
1-JAN-
Physical Well-Being and Health:
Currently, Magda is an 81-year-old woman who recently broke her hip and suffers from chronic pain because of this (Hung et al., 2019). She was recently diagnosed with dementia which is negatively impacting her cognitive ability. I would want to know how her mobility is, and if she is going to physical therapy to regain movement. I would also want to know her typical daily meals, and ensure she is receiving proper nutrition.
Cognitive capacity:
Magda has recently been diagnosed with dementia which will negatively impact her decision-making abilities and memory. It raises the question whether Magda will be able to take care of herself independently. It will be important to monitor her cognitive status and as her memory declines, adjust her plan as necessary.
Social functioning:
Since she broke her hip, Magda has limited ability to leave the house, which has significantly decreased her social activities. Her children seem supportive of her, and her grandson did move in with her, though this caused more strain on her. I would want to ask her what activities she enjoys doing with her children and who her support person is when she is upset. I would also want to know about her church activities.
Physical environment:
I would want to look at the accessibility in Magda’s apartment, and if we could make modifications to help prevent falls (e.g., tripping hazards, grab bars, electric chair to get up easier). I would ask her if there were any areas in her home that make her uncomfortable or that she doesn’t feel safe in.
Assessment of family caregivers:
Currently, they have her grandson Alec as her caregiver. He recently has been caught stealing money and pills from Magda to help support his substance use disorder. It raises the question what level of care he was providing her, and how often Magda would go without her medications or food because she did not want to be a bother. As she also said he was never home. Helen and John initially helped Magda pay for a caregiver, but realized they could not afford to have someone come into the home more. Helen wanted to hide the missing money and pills from Magda and wanted to keep this information from her husband and the police. Her plan was to remove valuables and medications from the home. I would want to talk with Magda and explain everything that happened and file a report again Alec. I would ask John and Magda what supports they feel that they need to make this situation more manageable.
Psychological weel-being and health:
Magda feels that she is a burden, these feelings may lead to depression or anxiety, and because of her limited capability of leaving the home, social isolation. I would want to ask her what activities she does enjoy doing, and how she feels about her current living situation.
Ability to perform ADLs:
Magda struggles with performing daily care tasks (e.g., dressing, toileting, bathing, etc.). Magda cannot drive which limits her ability to attend appointments and social functioning’s. It will be important to ask the family what their plans to assist and monitor Magda on a daily basis would be. This maybe a good time to have a conversation surrounding assisted living or a nursing home for Magda (Hung et al., 2019).
While conducting this assessment, to help with Magda’s self-determination, it will be important to gain informed consent (Tampi, 2020). If Magda is not capable of making these decisions for herself, we should find out if she has a medical power of attorney, if not we would want to establish someone. We also should empower Magda throughout our conversations with her, to make her feel that she is in charge of her treatment plan (e.g., what activities she enjoys, her social interactions, etc.). We will also need to ensure we are using basic social work skills to foster open communication and ensure that Magda feels heard and validated. If she is interested in having her children there, we will need to be considerate of these requests and allow it.
Other questions I would want to ask medical professionals are:
What strategies would you recommend helping manage her declining cognitive abilities and her ongoing chronic health?
What would your recommendations be for independent living at this point? When will we know that she is no longer capable of independent living (Tampi, 2020)?
2-LUA-
Magda, an 81-year-old widow of Greek origin, experiences numerous problems that can be analyzed using the biopsychosocial approach. This model has seven domains of biopsychosocial assessment that can be used to determine her current status (Christ & Diwan, n.d.).
Physical Well-Being and Health
Magda’s physical wellbeing has worsened after she suffered a fall that saw her break her hip. Later on, she complains of chronic pain which may hinder her mobility or even interrupt her day-to-day activities (Plummer et al. 2014). She is showing early signs of dementia that affects her cognitive and physical functions.
Psychological Well-Being and Health
Magda has recently suffered physical deterioration and the loss of autonomy, which might induce psychological stress. Such feelings indicate that she could be experiencing anxiety or depression, both of which are not uncommon in elderly people who experience major life transitions (Brandell, 2020). Lack of autonomy is further evidenced by her anger over not being asked where she wanted to live next.
Cognitive Capacity
Magda’s early dementia impairs her memory and ability to make sound decisions. For instance, she lost medications and was also unaware that her grandson Alec was exploiting her financially (Plummer et al., 2014). Because of the growing old, the cognition of such patients tends to deteriorate and thus they require close monitoring to determine their safety.
Ability to Perform ADLs
Magda’s ability to perform activities of daily living (ADLs) is limited. Her need for assistance in taking her medication, help with mobility, as well as with chores such as cleaning shows how she is much more dependent as compared to before.
Social Functioning
Formerly, Magda was socially active, went to family gatherings and church, but now she is lonely. Alec’s neglect to fulfill his promise of companionship worsens her loneliness altering her social wellbeing for the worse (Plummer et al., 2014).
Physical Environment
The once accessible environment of Magda’s apartment is unsafe due to lack of close supervision. Alec’s action contributes to environmental risk level; therefore, it is vital to consider changing her living environment for her safety.
Assessment of Family Caregivers
Helen is the daughter-in-law of Magda, and she is the primary caregiver, but she is struggling to cope up with the financial difficulties and the pressure of dealing with an alcoholic husband. Helen acted unilaterally by making decisions for Magda’s care hence worsening her autonomy (Plummer et al., 2014).
In the case of Magda, to promote her self-determination, I would have involved her more in decisions related to her living arrangements, and care. Questions such as “How do you feel about Alec moving in?” and “What activities or support would help you feel more independent?” would have given valuable information. Moreover, I would have engaged healthcare providers to ensure that her pain and dementia were well controlled and participated with them in the frequent assessment of her health status.
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