Journal 4-enmu

Field Experience:

The social worker’s (SW) experience during this encounter with the client can be described as a learning experience. During this encounter, the supervisor had a firsthand encounter with the client’s challenges that hinder them from accessing quality care. The core roles of the SW were to act as an observer, advocate, and counselor.

Significant Information:

The client, in this case, is an older woman who is widowed. She has extensive chronic health challenges that have seriously affected her ability to perform daily tasks, her mobility, and her endurance. The chronic COPD has made her entirely dependent on oxygen, which she needs continuously (Faronbi et al., 2019). This client also struggles with arthritis, back pain, and bipolar disorder, among other conditions. Her physical limitations, like shortness of breath, fatigue, and difficulty with gripping, affect her ability to handle self-care, such as preparation and domestic tasks.

Relevant Factors:

The first relevant factor is the client’s medical condition, which is characterized by COPD, asthma, chronic pain, cardiovascular issues, arthritis, and diabetes, which limit her daily functioning and increase her risk of falling as well as her inability to move.

Psychological health is another relevant factor, and in this case, the client has bipolar disorder that affects her emotional stability and affects her moods. As a result, her motivation is affected, impacting her ability to deal with complex tasks.

The client’s physical state is also a relevant factor. Her illness has affected her mobility and ability to perform essential domestic tasks as well as self-care. She may have some level of independence but still rely on assistance from others.

Social and cultural surroundings are significant. As an elderly widow, the client lacks consistent social support. As such, she needs IHSS support for her daily aid. Her independence is also important for her dignity and well-being in general.

Further, the client’s life cycle stage is in late adulthood. At this stage in life, individuals are susceptible to unique physical and mental health challenges that need a holistic healthcare approach (Corey et al., 2018). This intervention should maintain her autonomy, quality of life, and home environment. The intervention should also coordinate support from different healthcare professionals and enhance her ability to be independent.

Economic factors show that the client has limited finances, which may limit her ability to get private care, medical aid, and resources that IHSS may not provide. Also, since she entirely depends on IHSS for her self-care needs, household needs, and financial limitations, it means that her ability to obtain comprehensive in-home care is also limited (Corey et al., 2018).

Environmental factors indicate that the client needs more safety because she lives alone but relies on oxygen, which she needs constantly. Moreover, she has a high risk of falling, and since she experienced a fall recently, there were indicators that her home safety required modification. One primary adjustment is code management, which should be made to prevent any other fall (Faronbi et al., 2019). Discrimination is yet another relevant factor that attracts the concern of the SW. Elderly individuals, especially those with chronic health issues, face marginalization in society (Corey et al., 2018). Also, due to their age, they get limited services and have limited autonomy in their decision.

Strengths identified include the client’s alertness, ability to communicate her needs, resilience, ability to undertake some tasks independently, ability to adapt to her physical constraints, and ability to use assistive devices well. Nonetheless, the client needs safety because she stays alone and is at a high risk of falling often. Also, as a widow, she needs emotional and social support, which is relevant for a wholesome recovery. The client also needs coordinated care from IHSS, mental health providers, and medical professionals.

More information on her financial status is needed to help see if she can access better healthcare. The SW also needs to get more information on her mental health, mainly because she has bipolar. In addition, information concerning the involvement of her family is required to determine the support she needs.

Integration of Theory & Practice:

The course in human behavior, the social environment, and Aging Social Work Practice offers insight into understanding the bio-psycho-social challenges of late adulthood. It also helps in understanding health and physical issues emerging during that late stage in life (van Wormer & Link, 2018). Notably, the system theory can be used in this case since it holds that physical limitations, mental health, and social factors are interconnected and may affect a patient. Moreover, Strength-Based Practice highlights the importance of using the client’s strengths and resilience to build on their recovery. All these theories align with the client’s desire to be independent.

This case involves engagement as one of the stages of problem-solving. This stage involved connecting with the client and building a relationship of trust to help collect information.

Information gathering is another stage involving collecting the information needed to form healthcare decisions. Next, the diagnostic stage of problem-solving involved in this case is the stage where the SW evaluates the strengths and limitations of the client, while the evaluation stage is where her ability to perform tasks on her own is assessed. Finally, the referral stage is where the SW decides if the client can be given further care from other health institutions, such as referring her to a mental health institution and changing her environment to reduce falls.

Applicable Paradigm(s):

In this case, the social systems paradigm can help explain human behavior because it explains the interconnectedness of factors affecting a client’s health. Some of these factors include the environment, independence, and support systems (van Wormer & Link, 2018). The paradigm also explains how these interactions with the systems impact health management, autonomy, and well-being.

Another applicable paradigm is the medical paradigm. This model focuses on the client’s chronic health issues, her overdependence on oxygen, and scheduled surgery. This paradigm highlights the need for ongoing intervention, supportive care, and coordination of medical aid between experts to manage the complex health profile.

Paradigm	Medical	Social Systems	Psychoanalytic	Humanistic	Behavioristic
Past/ Present Emphasis	History/symptoms used to diagnose	Here & now solutions sought	Strong historical emphasis, intergenerational	Here & now emphasized	Present relearning
Assumed Cause of Condition	Physical, bodily malfunctions	Unmet human needs	Internal conflicts, defenses, instincts vs. morals	Experiences that block self-actualization	Determined by previous conditioning
Therapeutic Approach	Medication, surgery, physical treatments & education	Connect person with source of need satisfaction	Make conflict conscious	Create climate for growth, self-exploration	Change specific behaviors, habits, & thoughts
Length of Treatment	Varies depending on diagnosis	Short term preferred	Long term (years)	Short to intermediate (months)	Usually short term

Social Work Values Involved:

The social work values involved in this case were dignity and the client’s self-worth. The SW had to respect the client’s autonomy and desire to be independent (van Wormer & Link, 2018).

Another value applied was integrity, which the SW achieved by maintaining clear and open communication and encouraging transparent discussion about her health. Competence as a value was employed to enhance a rigorous understanding of the client’s medical needs through applying relevant social work health knowledge (van Wormer & Link, 2018).

Personal reactions:

The SW admired the client’s resilience and independence despite her chronic illness. At first, the SW was concerned about her safety and how she managed her autonomy. Also, the SW saw that with proper and holistic care, the client’s health can improve, and with the aid of devices like canes, she can achieve independence.

Outcome:

The intervention was effective because it reinforced the importance of safety protocols and offered the client the necessary help. Through this experience, the SW learned the importance of direct and indirect advocacy and to focus more on regular check-ins to ensure client safety (National Association of Social Workers, n.d). The experience helped the SW develop significant behaviors that allowed them to advocate for vulnerable clients. The SW also learned the importance and approaches needed to implement person-centered care and demonstrate cultural competence when dealing with different clients (National Association of Social Workers,n.d). The next step for the SW is to include coordination between medical and supportive care teams, which will ensure that the client is safe and that her personal goals are met.

References

Corey, M.S., Corey, G. & Corey, C. (2018). Groups: Process and practice. Thomson/Brooks/Cole.

Faronbi, J. O., Faronbi, G. O., Ayamolowo, S. J., & Olaogun, A. A. (2019). Caring for the seniors with chronic illness: The lived experience of caregivers of older adults. Archives of gerontology and geriatrics, 82, 8–14. https://doi.org/10.1016/j.archger.2019.01.013

National Association of Social Workers (n.d). NASW Code of Ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

van Wormer, K., & Link, R. J. (2018). Social Work and Social Welfare: A Human Rights Foundation. United States: Oxford University Press.

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Select a field experience and use this outline for your journal report. Be concise and protect the confidentiality and privacy of clients, groups, providers, supervisors, field instructors and staff. Submit a copy of your journal report to your Field Liaison through Blackboard.   Final version should be filed in the field portfolio. This is a professional report, you are to use third person in all areas except your personal reactions section.  You will be graded on grammar and professionalism.

Field experience:   Select a key experience with a client, client group, community, agency, supervisor, other field students, or staff.  Describe what happened and your role(s) in the situation e.g. (mediator, planner, enabler, observer, counselor, manager, broker/advocate, facilitator, catalyst, activist, teacher, trainer, mentor, outreach worker, monitor, or researcher).

Significant information:  Provide some brief background information such as, client data, presenting problem, or referral information.

Relevant Factors: Include assessment information gathered that helped you understand the situation or plan your intervention.  What individual, family, community, social, cultural, spiritual, medical, physical, developmental, psychological, and/or mental health factors influenced the situation. Explain the life cycle stage, group development stage, community program development stage, or research process step that applies.

Describe any of the following factors that are relevant: economic, political, environmental, discrimination, or oppression.  What strengths and needs were identified?  What additional information is needed?

Integration of Theory & Practice:  What have you learned in your courses that helped you understand the situation or plan your intervention?  What theory, practice model, approach, strategy, method, technique, intervention, or research method was used? Consult textbooks, course materials, journal articles, and/or instructors and provide citation of materials referenced.

What stage(s) of the problem solving process were involved in this key experience? (engagement, gathering information, assessment/diagnostics, intervention and review, evaluation, termination, aftercare/referral). Explain.

Choose the paradigm(s) that helps you understand human behavior in this key experience:

___Medical     ___Social Systems      ___Psychoanalytic     ___Humanistic      ___Behavioristic

Explain your choices by discussing how behavior in this key experiences is viewed or understood.

Paradigm	Medical	Social Systems	Psychoanalytic	Humanistic	Behavioristic
Past/ Present Emphasis	History/symptoms used to diagnose	Here & now solutions sought	Strong historical emphasis, intergenerational	Here & now emphasized	Present relearning
Assumed Cause of Condition	Physical, bodily malfunctions	Unmet human needs	Internal conflicts, defenses, instincts vs. morals	Experiences that block self-actualization	Determined by previous conditioning
Therapeutic Approach	Medication, surgery, physical treatments & education	Connect person with source of need satisfaction	Make conflict conscious	Create climate for growth, self-exploration	Change specific behaviors, habits, & thoughts
Length of Treatment	Varies depending on diagnosis	Short term preferred	Long term (years)	Short to intermediate (months)	Usually short term

Social work values involved:  Describe core social work values, ethical principles, or ethical standards that were applied in this situation.  Indicate from the NASW Code of Ethics which value or ethic you chose and how it applies to the situation.

Personal reactions:  Write about your reactions.  How comfortable were you with your actions; what was surprising; what emotions did you experience; or how did you deal with your reactions?

Outcome:  How effective was the intervention? How will you use what you learned? What will you do differently in the future? What will your next actions be? What practice behaviors from your Learning Contract did this key experience help you develop?