Being a caregiver to your spouse is one of the essential gifts one can be blessed to offer, most men and women at their old age tend to live longer when they experience emotional, social, spiritual and even physical support from their partners. With plans of growing old together, holding hands and enjoying each other company, a caregiver spouse is as sweet as enjoying beautiful moments with the loved one grand kid. Having interacted with most couples, this is every couple dreams; every partner wants to grow old together and enjoy spouse support, be it emotional, physical or any other support that a care giver spouse can offer.
However, for many couples who have found themselves in the position of being a caregiver to their partners, chronic diseases affecting the old age has changed the story. According to National family caregiver association, statistics has made it clear that 56% of the fifty million of family caregivers are spouse caregivers. Furthermore, the shift in the relationship to some extent can be difficult, and many spouses find themselves uncertain on how to tackle difficulties that are associated with the new role. This paper will hence analyze a case study of an elderly client, develop an assessment plan and recommend an intervention to bring a solution to difficulties and different challenges faced.
Analysis of case study of an elderly client (Case study 2 Ms. M)
This is one of the scenarios of an 80-year-old woman, Ms. M, ending up to be a window after fifty-three years of marriage. However, for the last 15 years of her marriage, things have not been easy on her side as she acted the role of a primary caregiver of Mr. M (Husband) who was paralyzed after suffering from an unexpectedly massive stroke. It is identified that as a result of the stroke, Mr. M experience limited speaking ability, physical mobility and suffered from a significant memory loss in the past five years. This made him to time refer to his wife by his mothers name which created an emotional challenge to Ms. M.
The challenge of loneliness while being a caregiver
Since Mr. M was partially paralyzed after unexpectedly going through a massive stroke, he faced serious difficulties in performing most of the task, their sexual intimacy as a wife and husband came to an end and only holding of hand was their deepest extent of their physical intimacy. As a woman, the satisfaction of emotional needs and sexual intimacy is an important element in driving away loneliness and as a caregiver spouse for fifteen years; Ms. M. has been experiencing serious loneliness. Even though the spouse was right there with her, the relationship was full of loneliness since as a man he was not able to bond intimately, and things got worse when he could call the wife with his mothers name. When the person you are married to is not in a position of being present socially, emotionally and intimately, the loneliness can be extremely challenging than if the spouse is not there at all(Vasileiou et al.,2017). Often there tends to be a sense of anger and resentment that their end of the bargain was not held, and with sexual intimacy, as husband and wife came to an end, Ms. M felt the pain of loneliness and was largely affected.
Grief and guilt after a loved one passes
When one becomes a caregiver, the care giving role becomes part and parcel of one's identity, its like becoming someones mother: one suddenly is responsible for other individual life other than their own life(Dekel, Solomon, & Polliack, 2005). This is through ensuring scheduling and attending doctors appointments, preparation of the patients meal and ensuring compliance with medication prescriptions. The major question that arises is what do you do when your care giving role comes to an end?
One of the sad moments in Ms. M life is when her husband died after she had struggled with him for 15 years of a chronic illness. This was the end of her care giving role and the beginning of a new journey that involved grieving, trying to search for what is the new normal and going through the healing process. She started to imagine how the life will be without the husband, about waking up to help him take his medication and staying the late night just to make sure he is okay.
Additionally, this identity crisis is followed by should haves and what ifs (Ryan, Bannister & Anas, 2009), what if a proper treatment option was adopted on Mr. M? What if I could have done a much better job when he was a live? Regarding confusing my name with that of his mother, I should have understood and listened to him instead of getting mad; I should have been a better wife from the day we got married. The fact remained that she gave her best even though it was not my 100% best.
One year after Mr. M had passed away, now hours can move without Ms. M thinking about him. She is experiencing the need to be in a relationship with a gentle she met at the senior center in her area. Even though she has the strong urge to move on with her life, one major challenge is that her three adult children are of their mother having another relationship. The children are becoming obstacles to their mother plan of getting into a new relationship; they are unsupportive and expressive about their mother joining a new relationship.
Assessment plan
Being that Ms. M is facing a great challenge and now its a great rock to crush, the decision of moving to the senior social worker about her marriage experience, the illness, loss, and death of her husband is important. Having expressed feeling guilty about the thoughts and the feelings she had for her friend which on the contrary has lead to great conflict with her children. It is important for the senior center social worker to come up with a proper assessment plan which in return will yield a result of various interventions to be adopted.
As a senior social worker, client system assessment is one of the major skills that a social worker makes use of during interventions with the client's system. After initially meeting with Miss A, as a senior social worker, I was able to access her case and tuned into the life issues she was facing. Additionally, I gathered information on how best I can offer my support to her with a role of providing reassessment since the death of Mr. M and changes in her circumstances. My major role is to identify what support she needed to include her feelings and wishes and to identify the support that she may need.
Through the past studies, history has always shown that there has been great importance in social work assessment, though since 1990s categorically, there has been a particular importance to a different form of assessment that involves risk (Devine, 2015). On the other hand, according to National Health and Community Care Act 1990, the significance of inter- agency multi disciplinary assessment process has been stressed(Hardy, 1999). The assessment goals may be evident through assessing individuals needs especially those who need support and help. However, in the recent history, assessment is viewed to be a relationship that is existing between available resources and needs.
When it comes to the purpose of assessment, it significant to consider elements like need assessment, risk assessment, implementing agency and government policy and to acting as an advocate for the one being assessed. In the case of Ms. M, the initial preparation involved studying her case file and visiting her social worker. This gave me the opportunity of gathering information and doing away with any perceptions. On the other hand, the social worker passed information and his knowledge about Ms .M, such as the family circumstance, any previous challenge that might have occurred in the past, financial issues and her medical condition. As a senior social worker, I felt the importance of working in partnership with Ms. M social worker to keep him informed and offer any technical advice.
Additionally, Ms. A assessment was guided by different legislation such as the Disabled and the chronically Sick Person Act which put the responsibility for social service and health to determine the health condition, personal social service and the level of need (Duffy, Basu, & Pearson, 2017).As assessment model, I made use of Smale,(2005) model of professional care which was important regarding gathering significant information in Miss Ms life. I adopted the questioning and procedural model in collecting information about Ms. M and how she felt about some of the issues that were happening in her life, for example, the broken relationship with her children, issues she felt are working or not working, bereavement of her husband and finally the financial issues. On the other hand, I made use of the model professional care in gaining a holistic understanding of information and also adopted the model of exchange in the assessment process after considering Ms. M to be an expert in managing her own life.
One notable piece of information that was significant in the assessment was the Human rights Act of (1998) which offered Ms. M right of having a family (Dupuis, Smale, & Wiersma, 2005). Since Miss M husband death and lack of support from the children as a result of getting involved in another relationship, Ms. M has been going through family disintegration losing support that is related to it. According to the Human Rights Act, the rights could be of great significance as Ms. M needs physical and emotional support for the children to pay a visit to her which has not been happening of late, therefore expressing that, her right to family life is being undermined. Since the husband is dead, Ms. M has full rights to engage in another relationship, and this should be made clear to the children. Therefore, as a result, my goal and an important role were to facilitate Ms. M rights, offering her with support in retaining a family contact and moving on with a new relationship.
Planning
After carrying out the initial assessment, it was important to work on formulating the good care plan that offered elaborate information for important aspect and everyone who was involved in Ms. Ms life. According to Thompson (2008), a support plan is developed by an individual to offer help where it is necessary, describing how a person is intended to be supported to improve their own life. In improving Ms. M. life, the use of support plan is more important than a care plan. It is important for Ms. M to write down all his objectives and all that she desired so that this can be used in formulating an intervention. It s quite clear that Ms. M is going through relationship difficulties more so after the death of her husband and how the chronic disease impacted her life for 15 years. Throughout the assessment, it is important to note that Ms. M had lack support in having to discuss her feeling of grief. This is made her have the urge of getting into a new relationship even before two years. Since the children are not available for her, Ms. M needs emotional support when it comes to discussing her grief hence it is also important to have someone close to him.
Intervention
After carrying out the care plan, assessment and building a good relationship with Ms. M, the best help that can be offered to her is counseling intervention. Having played the role of caregiver for her spouse in the past fifteen years, Ms. M went through emotional problems and lack of emotional touch and even sexual intimacy from the husband. Additionally, with the death of Mr. M, she needs emotional support, and I felt that her children should offer her an opportunity to discuss her feelings. Through this, it will be of great help since she will go through a peaceful grieving process and helps her to cope in a much better way.
In social work, there exist, tw...
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