Carla Washburn: Loss, Aging, and Social Support

Carla Washburn: Loss, Aging, and Social Support

Develop a micro-level intervention aimed at ameliorating the client issues or problem (or aspects of) that you have identified as important. Considering client strengths and challenges, you will identify the specific (measurable) actions and objectives in order for the client goals to be attained. You will describe what you imagine execution of the identified plan would entail; the rationale and process for your micro/mezzo-level intervention, services identified to accomplish client goals; the key outcomes you hope to achieve for your client, and the key activities involved. Remember that the client system may be influenced by social, physical, economic and environmental sources. Consider the client’s perception of the problems or needs. Explain why you think the selected activities and/or services from these sources will result in the desired outcomes, using research evidence to back up your claims.

Next, you will propose an Evaluation Plan aimed at measuring the effectiveness of your intervention(s). You will describe the intervention being measured, how success (meeting of goals) will be determined and measured, the data needed and the process for collecting it.

Lastly, you will discuss in detail how you will end/terminate your relationship with the client. The ending phase occurs when goals are reached, the specified time for working together has ended, or the client is no longer interested in working with you. Address when you will begin the termination process and why.

 

Instructions on the paper format MUST be as the following listed:

Based on the case Study with Carla Wasburn (please use the link to access the case study:

Carla Washburn | New Directions in Social Work (routledgesw.com)

Please be sure you paper includes the following:

 

Assessment

  • Describe the micro-level issues/problems you and your client system you find most relevant and pressing when assessing their overall well-being. What is/are the micro-level issues/problems? (Identify at least 2)
  • How does it affect the client? Why is this important to client well-being?
  • Using outside evidence/research discuss the issues/problems, their incidence, background, and associated knowledge in the real world.

 

Intervention

  • Based on the problems you identified, describe your micro-level solutions to the issues/problems and the identified goals and services. Be sure to identify your interventions in time-limited/ measurable goals (e.g., The client will engage in a support group by 7/1/2017.) How will you address the issues/problems you and the client have identified? Be specific.
  • How would you work with the client to identify these solutions and to create needed change?
  • What would be your role as a change agent? (e.g., broker, advocate, etc.)

 

Evaluation

  • How will you measure the success of your interventions. Discuss what you envision success to look like and why (based on the interventions used).
  • How will you specifically measure success? (Which goals would have been met?)
  • What data will you need to collect and what is your plan/the process for collecting it?

 

Ending/Termination

  • Consider how you have planned to end your relationship with your client. Discuss when you will begin the termination process and why you have chosen this time.
  • Develop an aftercare plan or “toolbox” to help the client have supports and resources once your relationship has ended.

Answer

Carla Washburn’s Micro-Level Intervention Plan

The client, Carla Washburn, is an African American woman aged 74. She has lost her close family members over the last two decades. The client lives alone with little to no social support. Her sister lives in a different city. Carla has only a few friends and is dealing with certain health concerns. Carla has diabetes that may not be effectively managed, is isolated, has difficulty coping with her loss, and recently had a fall that has made walking difficult. The client refuses to seek medical attention. Her sister Anna contacted the agency since Carla insists that she does not need help.

Assessment

Carla is exposed to diverse issues that impact her life positively and negatively. Many issues need to be addressed to help improve Carla’s quality of life and promote her overall wellbeing. There are two critical micro-level issues affecting the client. These are accessibility and acceptability of healthcare and social support. Various health conditions affect Carla’s physical and mental wellness. Her diabetes may not be effectively managed. She has also been experiencing pain following a fall and may be depressed (Routledge, n.d.). Addressing these issues will help better her physical and mental state.

Access to healthcare is a cause of concern for many older persons. Rosnu et al. (2022) elaborate that accessibility and acceptability are the two most important enablers or barriers to healthcare for older adults. Other factors such as family and social support, finances, and transportation also impact healthcare access among older adults. Besides being an older adult, Carla’s racial background may hinder healthcare access. Older African American adults face disparities in healthcare. Aaron et al. (2021) explain that, unlike their white counterparts, older African American adults are likely to have insufficiently managed chronic illnesses and die from the same.

Another important micro-level problem is Carla’s lack of social support. The client has lost her close family members, lives alone, and has no connections to her neighbors (Routledge, n.d.). This issue affects Carla since she lacks social support to help her cope with her losses. It is critical to the client’s wellbeing because it affects her mental wellness, causing her to experience depression, isolation, and grief. Mohd et al. (2019) establish a relationship between social support and depression among older adults. The lack of social support remains a persistent problem among many elderly individuals. In a study, Czaja et al. (2021) established that approximately one-quarter of adults above 65 living within communities are socially isolated. However, community organizations are keen on offering social support to members of this population.

Client Ecogram/Ecomap

 

Intervention

Several interventions will help address the identified problems. First, for the client’s health concerns, the interventions will include; the client will check into a medical facility by 6/26/2023 for treatment to manage the pain in her foot, and Clara will also schedule and attend a preventive medical appointment by 6/28/2023 to manage her diabetes and keep it under control. For the second issue of concern, the lack of social support, the client will engage in a support group by 7/4/2023. I will also help the client create an ecomap by 7/2/2023 to establish and visualize her social and personal relationships with the environment. The eco-map will help foster her social relations and rebuild her relationship with her sister. These interventions will help improve the client’s physical and mental well-being, improve her social life, and increase her social support.

The attainment of these goals will require the client’s involvement and cooperation. To identify necessary solutions and create the needed change, I would engage the client and seek her ideas on what she believes could help her situation. I would use motivational strategies to strengthen her commitment to change and help her set clear goals. I would design interventions that align with the client’s goals and talk to her about them. As a change agent, I will gather information and source resources that may help the client, engage her through milestones, help her embrace change, and support and encourage her.

Evaluation

Based on these interventions, I expect the client’s diabetes to be under control and the pain in her limb to be managed, allowing her to walk without a limb. I also expect her to engage more with people her age, be socially engaged, and overcome her grief and depression. I will thus use the patient’s physical, mental, and social state to measure the success of the interventions. I will specifically measure the success of the three interventions in several ways. I will engage a healthcare expert to measure the client’s blood sugar levels. I will use the numeric rating scale before and after the intervention to assess pain levels. Additionally, I will consider her interactions with other members of her community and her relationship with her sister, especially their communication patterns, to determine the efficiency of the ecomap strategy. Finally, I will use the Beck Depression Inventory to determine the impact of social support on her mental wellness.

Some of the information I will need to collect for the evaluation include health records, behavioral patterns, and the client’s emotions. I intend to coordinate with the client’s healthcare providers to access some of this information. I will also observe the client’s behaviors, engage in conversations, and use questionnaires to gain in-depth information. The plan is to gain the client’s consent and engage her through the process.

Ending/ Termination

I intend to terminate the relationship with the client once her diabetes has been well-managed and she has gained adequate social support. I will also ensure progress in other areas and measure the client’s readiness. I believe this will be an ideal moment for termination for two reasons. First, with her diabetes under control, her physical health will improve, and any arising issues can be easily addressed. Secondly, adequate social support will mean she gets people to look up to for help, her social life will be reignited, and her mental wellness will be assured. I plan to discuss the termination with the client in advance. I will also be thoughtful and sensitive, ensuring she does not feel neglected or abandoned. Based on the client’s problems, the aftercare plan will include selfcare, grief counseling, embracing a healthier diet, interacting and maintaining social ties, monitoring blood sugar, and taking medications. The plan aims to ensure the client sustains the changes over time.

References

Aaron, S. P., Gazaway, S., Harrell, E., & Elk, R. (2021). Disparities and Racism Experienced Among Older African Americans Nearing End of Life. Current Geriatrics Reports, 10(4), 157–166. https://doi.org/10.1007%2Fs13670-021-00366-6

Czaja, S. J., Moxley, J., & Rogers, W. (2021). Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial. Frontiers in Psychology, 12, 1-14. https://doi.org/10.3389/fpsyg.2021.728658

Mohd, T. A., Yonus, R. M., Hairi, F., Hairi, & Hairi, N. N. (2019). Social support and depression among community dwelling older adults in Asia: a systematic review. BMJ Open, 9(7), 1-12. doi:10.1136/bmjopen-2018-026667

Rosnu, N. S., Singh, D. K., Ludin, A. F., Ishak, W. S., Rahman, M. H., & Shahar, S. (2022). Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review. International Journal of Environmental Research and Public Health, 19(12). https://doi.org/10.3390%2Fijerph19127351

Routledge. (n.d.). Carla Washburn Case Files. Retrieved from Routledge New Directions in Social Work: https://routledgesw.com/interactive-cases/washburn//engage/case-files

 

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