Introduction to the case study of Ivanka, an Alzheimer’s patient

Discuss About The Study Of Use Social Work Assessment Framework.

This case study is about Ivanka who a 63 year old aged woman diagnosed with Alzheimer’s. Ivanka became a single mother after the tragic demise of her husband, Jason. After being diagnosed with Alzheimer’s she was admitted in the local hospital by her son Jason. Her symptoms of leaving the food unattended or locking herself in the room has been an issue of grave concern for the hospital authority as well as her son. Her son Alex and daughter-in-law Janet opine that residential nursing home is the most pragmatic decision given her worsening condition. However, Ivanka does not want to part with her home and is concerned about the missing of a lump sum amount from her bank account.

This case study report aims to document the issues of short-term and long-term concerns for Ivanka, knowledge of social work in the treatment of the Alzheimer’s patients, professional values and beliefs, ethical measures for the care of Ivanka and ethical dilemmas.

Ivanka’s declining mental health demands immediate attention and concern. According to the Alzheimer’s Association, Alzheimer is considered to be the most common cause of dementia. The immediate issues that needs to be taken care of is having a person always with Ivanka as it has been found she has left food unattended on the stove. There have also been situation of locking herself in the room. Adult guardianship is both a long-term and short-term goal. In case of Alzheimer, the self-perception of an adult is informed by the social context s/he is placed (Backhouse et al., 2017). The critical event in Ivanka’s life is that she lost her husband and that left a profound impact on her mental health. Therefore, adult guardianship and decision-making domain can determine and inform work. A person-

centred approach is the need of the hour. The thrust of this model is to understand the subjectivity of the individual like the history, experiences, endowments, cultural moorings and so on (Pickett et al., 2018). Studies have shown that people with Alzheimer have the ability to articulate their feelings and preferences. Therefore, the objective should be to provide quality care to Ivanka through a consonant collaboration with her son and any other concerned party. The long-term concern would be to provide a friendly environment where Ivanka would feel secured, loved and have someone to talk. Care processing is about acknowledging the individual needs that also includes the opportunity to provide as well as receive the care. Another long-term goal would be to provide a compatible social and physical environment (Haggerty, 2016). The setting should be such that it promotes autonomy, socialization and meaningful activities that render the feeling of community comfort, privacy, safety and dignity for Ivanka.

A social worker can play a pivotal role in the enabling the access to healthcare. They can provide guidance to the Alzheimer’s patients and their families on how to cope with disease (Kaplan & Andersen, 2013). A social worker would encourage the Alzheimer’s patient to adhere to a balanced diet and engage in physical activities. It is because a crucial dimension of living with Alzheimer’s is the maintenance of the physical health of the person (Ashby-Mitchell, Burns, Shaw & Anstey, 2017). The concerned person and their family members are bound to experience a range of emotions during this phase as a result of which it is the onus of the social worker to employ a variety of coping mechanisms for the family. The discourse of social work have witnessed a metamorphosis from being service-oriented to relationship approach to case management and assessment with a special focus on the

Short-term and long-term concerns for Ivanka

regulation and management of aged population. The spectrum of ethics pertaining to social work has also changed in the last 30 years (Hutchinson et al., 2016). Therefore, ethical decision-making in the context of dealing with power-laden relationships has propelled a better understanding of the care-giving associated with Alzheimer patients. The highlight of the discourse of social work lies in providing a picture that may remain invisible to others. This sets apart social work from other professions. The study of Mills (2017) demonstrates that in the present context of healthcare and social welfare, the practice of social work has meaningful contributions through its confluence of interpretation, negotiation and parties who do not have such rights.

Ivanka’s Alzheimer and the plight that she is facing can be understood through the multi-dimension approach along with the person-centred approach that have been discussed in the first section.The multi-dimensional approach to social work has been propounded by Harms. This approach is instrumental in understanding the different aspects of the Ivanka’s life that may have an impact on her condition.

The information tabulated from the case of Ivanka is not adequate to provide proper explanation to her situation. It can be seen that certain gaps and information is missing.

Through the multidimensional approach it can seen inferred that the major issue concerning Ivanka is her symptoms of forgetfulness and disoriented nature. It is important that Ivanka is is kept under supervision without making her feel that her privacy si being invaded. Since oot is found that Ivanka does not have any friends, a supportive group of people who drives away her loneliness can be an effective move. Since her husband’s death has triggered her Alzheimer, it is important for someone to listen to her pain and help her ease her pain.

The primary intervention strategy at this stage would be to provide quality of life. It is important to understand the person with Alzheimer and provide support to the family, carers of the family, emotional succor needs to be provided to the concerned family members to cope with the deplorable state of the patent, in this case Ivanka. As a social worker it is important to ensure that Ivanka gets proper diagnosis (Heller, Gibbons & Fisher, 2015). There should also be an examination to ensure proper diagnosis that should include psychiatric history, neurological and physical examination that should incorporate brain imaging, evaluation of the ability of the person and also emphasize on the family environment during the diagnostic process. In the year, 2010 Alzheimer’s was considered to be the highest cause of death for 83, 494 people in the USA. Another disease associated with Alzheimer’s is Pneumonia (Groenewoud et al., 2015). It has also been found that underreporting is the common cause of death for the Alzheimer’s patients. Since the individuals who know the patient well be the first one to identify the changes, in this case

leaving the food unattended in the stove or locking in the room. There is also a need to educate the family members about the intensity and implications of the disease. The family members and peer group can be encouraged to provide formal support services in the management of the emotional needs of the different stakeholders and also physical activities.

The role of social work in the treatment of Alzheimer’s patients

A social worker is informed by the principles of universal moral values, equality, solidarity among human beings, mutual respect and care for other individuals. According to Giurgio and Marica (2013) social work includes four fundamental values. The first is the value of community or society in which the social worker operates and the social worker should ensure that the dignity of the client is taken into account, with the aim to preserve dignity of the client, there are certain code of ethics that is to be followed by the social worker. Thirdly, it is the personal values possessed by the social worker. Fourthly, the value of the clients comprises of their beliefs, attitudes and convictions. In Romania, the code of Social Workers Ethics has led to the chartering of seven key principles and standards- provision concerning client-oriented social services, respect for personal dignity and the associated uniqueness, acknowledgement of self-determination, endorsement of social justice, competence for benevolent relationship between human beings and an emphasis on dignity of the client (Dowding et al.,2016). The codes of ethics concerning the profession of social work is ensues that that there should be unconditional acceptance of the client (Dyer et al., 2016). This is a very pertinent value in respect to the case of Ivanka. As a social worker, the responsibility would be to treat Ivanka with dignity and be sensitive towards her mental

illness. Since Ivanka has shown symptoms of forgetfulness, the responsibility should be to treat her with care, not to lose patience or make her feel guilty about her condition.

It has been found that for the welfare of the clients, social workers have to resort to decisions that curtail the freedom of the clients. This propels towards a paternalistic situation in the exercise of professionalism. Social workers need to be continuously aware of the multiple challenges that may surface during the course of practice and therefore, the social workers need to generously and sensibly use the tools and strategies acquired and imbibed during their training period. My focus would be treat Ivanka not as a case but as an autonomous individual who needs more love and care. The client-oriented approach of social work underscore on understanding the needs of the client and communicating coherently with the family members of the client about the various means of addressing their demands (Sorokin, 2017). In case of Ivanka’s condition, since I would be acting as an adult guardian, it is my responsibility to ensure that I do not transgress the boundaries as a care-giver. There is a need to provide appropriate assistance to Ivanka during her physical tasks.

The ethical concerns that emerged in the light of the case is related to decision-making. Some of the challenges related to the social workers are woven around the issue of responsibility and protection. Including the concerned person with Alzheimer as part of the research involves seeking the informed consent of the person which can be become problem keeping in mind the state of mental health of people with Alzheimer’s. some other ethical aspects are that whether the participants being approached at an appropriate time, allowing the participant the right to decline the interview during anytime, ensuring anonymity of

Ethical measures and professional values to consider in care-giving for Ivanka

Ivanka and her family so that they are not stigmatized (Congress, 2017). There should be an attempt to explain Ivanka about the purpose of the interview. The issue of inherent power play between Ivanka, the Alzheimer patient in need of perpetual care, surveillance, and me as a professional social worker also needs attention. The nature of the relationship between Ivanka and me is embedded multiple layer of hierarchies. As part of my profession, I have the power to monitor her activities that may lead to invasion of her privacy. After studying her symptoms it can be inferred that there will emerge situations where I will may have to be stricter with her. This poses the challenge to what extent I have the right to control and regulate Ivanka. Since Ivanka has lost her husband and is also a single mother, she might feel depressed pondering over her plight. As an adult guardian although I am trained to cater to the special demands for Alzheimer patients however there is a need to maintain professional distance. The crux of the ethical concern is that there is an imperative to unravel the underlying power dynamics, acknowledge it and consequently make informed decision premised on egalitarian values.

Conclusion

The case study report of Ivanka brought out the struggles of the aged population and the urgency to pay attention to the mental health illness of the patients. It is important to adopt a patient-oriented approach that would empower the patient and emphasize on treating them with dignity. The agency of the Alzheimer patients need to be respected and in case they do not want to be taken to the residential nursing homes, it is better to listen and understand their viewpoint. Treating Alzheimer patient with love and care would enable them feel included and wanted. As an adult guardian trained in professional social work, it is important to understand the unique biography of each patient and devise strategies based on

their distinctive needs. There is also the need to involve the family and pursue a collaborative approach keeping the ethical issues at the backdrop during planning, practice and exercise of professional duties.

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