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Introduction

The assessment took place after an initial referral from social services that Mrs P was entitled to day-care at the Apna Ghar daycentre. A NHS single adult overview was provided which I referred to, however the agency has to carry out there own assessment to gain a broader understanding of the services users needs in order to facilitate appropriate care for them. I liased with my line manager and social services for additional information before evaluating it all and arranging a home visit to carry out the contact assessment. Mrs P is a very vulnerable elderly lady with severe physical and emotional needs, which consist of depression, social isolation, communication and poor mobility. Mrs P is also fed through a peg and is on various medications. Mrs P cannot communicate at all due to a major stroke. Mrs P's daughter in law is her main carer however she is no longer able to provide care for Mrs P, as she has five children and is having great difficulty in caring for both an managing the household. Therefore a referral was made to the day centre. Due to Mrs P's communication problems she is unable to communicate her needs, wishes and feelings. Consequently the assessment and care plan were carried out with the family. Assessment is a key element in social work practice and without it practitioners would be left to react to situations and intervene in an unplanned and disorganised way. The Oxford English dictionary 2002 defines assessment as " The process of judging or valuing the worth of something". Assessment is a skilled activity carried out by someone who is competent to judge between things of different value. One thing this definition leaves out is the human and interactive context, which feature in social work assessments. The debate about whether assessments are of art or science has caused several conflicts. However a balanced approach suggests that social work assessments are an art and a science. ...read more.

Middle

Therefore older people are widely oppressed and discriminated against. Comfort 1997 argues that ageism discrimination against old people on the grounds of there being old. Assumptions about older people include older people are poor. Lonely, are ill, no longer contributing to the economy and seen as a burden. When working with older people it is important not to make these stereotypical assumptions and to generalise. Not all the elderly have the same characteristics e.g. a 60yr old may have the same characteristics of a 30 year old, and why should people in there sixties and nineties be classed as one group. We must acknowledge that each individual will be at a different stage in his or her life and needs and circumstances will vary, including with different ethnic minority groups. Therefore throughout my work with the family I did not make ageist assumptions and avoided all stereotypes and stigmas. To work effectively with older people we must develop anti ageist practice. Midwinter 1990 says that old age is like having returned to a second childhood where others will make decisions for you. When working with the family I made sure that Mrs P wishes needs and circumstances were the focus of my assessment and intervention and that she was involved in decisions about herself. When working with service users we need to be aware of power issues. In reality other professionals and service users see social workers function as agents of social control who are paid by the state to do so. Therefore power imbalances need to be separated out and a partnership approach should be implemented. When working in partnership with the family I took account of Trevthick's (2001) fifteen points to effective partnership working. These included explaining to the family my role and power to intervene. I feel a clear mandate is the basis of a partnership-based intervention. Sensitivity was given to power imbalances and the family were not just consulted but had full participation in decision-making and problem solving (Bray 2001). ...read more.

Conclusion

Also when communicating I gave particular attention to the language being used, making sure it was jargon free, understandable and sensitive. I felt I had a balance of professionalism and being myself. Throughout the intervention I maintained a positive relationship with the family as well as demonstrating the following skills as articulated by Rogers (1951). Empathy, I felt I had the ability to experience Mrs P's world and circumstances and adjust my understanding accordingly. I feel I showed warmth and accepted the family's circumstances and showed respect and created a trusting environment. I was also genuine in my approach. I was open and clear about my role and power to intervene. I feel a clear mandate is the basis of a partnership-based intervention. When working with the family I also realised there were other people involved who were in need such as Mrs P's daughter, however I did not lose focus of my main priority which was Mrs P. Towards the end of the intervention I gradually reduced contact with the family, and explained that I was only a student on placement and that I had enjoyed working with them. Mrs P was unable to participate in any form due to her inability to communicate. However I am aware that in my future work I would like to see the service user as the expert on their circumstances and to participate in decision them selves. If there is a communication barrier then sign language can be implemented and also written methods of communication, to enable service user participation. A second area for improvement is the implementation of the care plan. The care plan was discussed, produced and reviewed over the phone with a family member. In future I hope to work in person, with the individual rather than over the telephone. This will enable clearer communication and will also cause less confusion. By taking all these learning needs into consideration it will enable me to practice in a more efficient way in my future practice. ?? ?? ?? ?? 1 ...read more.

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