Zastrow and Kirst-Ashman (2016) stated, “Clients are affected by and in constant dynamic interactions with other systems, including families, groups, organizations, and communities” (p. 35-36). As a social worker, when you address the needs of an individual client, you also take into account the systems with which the client interacts. Obtaining information about these systems helps you better assess your client’s situation. These systems may provide support to the client, or they may contribute to the client’s presenting problem.

For this Discussion, review “Working With People With Disabilities: The Case of Lester.”Consider the systems with which Lester Johnson, the client, interacts. Think about ways you might apply a systems perspective to his case. Also, consider the significance of the systems perspective for social work in general.

By Day 3

Post a Discussion in which you explain how multiple systems interact to impact individuals. Explain how you, as a social worker, might apply a systems perspective to your work with Lester Johnson. Finally, explain how you might apply a systems perspective to social work practice.

Case of  Lester Johnson

 

Working With Clients With Disabilities: The Case of Lester

Lester is a 59-year-old, African American widower with two adult children. He lives in a medium-sized Midwestern city. Four months ago, he was a driver in a multiple vehicle crash while visiting his daughter in another city and was injured in the accident, although he was not at fault. Prior to the accident he was an electrician and lived on his own in a single-family home. He was an active member in his church and a worship leader. He has a supportive brother and sister-in-law who also live nearby. Both of his children have left the family home, and his son is married and lives in a nearby large metropolitan area.

When he was admitted to the hospital, Lester’s CT showed some intracerebral hemorrhaging, and the follow-up scans showed a decrease in bleeding but some midline shift. He seemed to have only limited cognition of his hospitalization. When his children came to visit, he smiled and verbalized in short words but could not communicate in sentences; he winced and moaned to indicate when he was in pain. He had problems with balance and could not stand independently nor walk without assistance. Past medical history includes type 2 diabetes; elevated blood pressure; a long history of smoking, with some emphysema; and a 30-day in-house treatment for binge alcoholism 6 years ago following his wife’s long illness with breast cancer and her subsequent death.

One month ago he was discharged from the hospital to a rehabilitation facility, and at his last medical review it was estimated he will need an additional 2 months’ minimum treatment and follow-up therapies in the facility.

As the social worker at the rehab center, I conducted a psychosocial assessment after his admission to rehabilitation.

At the time of the assessment, Lester was impulsive and was screened for self-harm, which was deemed low risk. He did not have insight into the extent of his injury or changes resulting from the accident but was frustrated and cried when he could not manipulate his hands. Lester’s children jointly hold power of attorney (POA), but had not expressed any interest to date in his status or care. His brother is his shared decision making (SDM) proxy, but his sister-in-law seemed to be the most actively involved in planning for his follow-up care. His son and daughter called but had not visited, but his sister-in-law had visited him almost daily; praying with him at the bedside; and managing his household financials, mail, and house security during this period. His brother kept asking when Lester would be back to “normal” and able to manage on his own and was eager to take him out of the rehabilitation center.

Lester seemed depressed, showed some flat affect, did not exhibit competency or show interest in decision making, and needed ongoing help from his POA and SDM. His medical prognosis for full recovery remains limited, with his Glasgow Coma Scale at less than 9, which means his injury is categorized as catastrophic.

Lester currently has limited mobility and is continent, but he is not yet able to self-feed and cannot self-care for cleanliness; he currently needs assistance washing, shaving, cleaning his teeth, and dressing. He continues with daily occupational therapy (OT) and physical therapy (PT) sessions.

He will also need legal assistance to apply for his professional association pension and benefits and possible long-term disability. He will also need help identifying services for OT and PT after discharge.

He will need assistance from family members as the determination is made whether he can return to his residence with support or seek housing in a long-term care facility. He will need long-term community care on discharge to help with basic chores of dressing and feeding and self-care if he is not in a residential care setting.

A family conference is indicated to review Lester’s current status and short-term goals and to make plans for discharge.

ETHC 445 Principles of Ethics 

All Assignments

 

 

Week 1 Assignment:

Week 1 Assignment; Ethics Paper ( 650 Words)

 

 

Week 2 Assignment:

Week 2 Assignment; Ethics Paper (750 Words)

 

 

Week 3 Assignment:

Week 3 Assignment; Ethics Paper (800 Words)

 

 

Week 4 Assignment:

Week 4 Assignment; Ethics Paper (650 Words)

 

 

Week 5 Assignment:

Week 5 Assignment; You Decide Scenario and Response Solution Paper (800 Words)

Please read-

 R.H. is a 74-year-old black woman, who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, some-times going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard. She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occur-ring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep. On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.

1. In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.
2. Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.
3. Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?

Endocrine Function:
C.B. is a significantly overweight, 48-year-old woman from the Winnebago Indian tribe who had high blood sugar and cholesterol levels three years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed that her fasting blood sugar was 141 and her cholesterol was 225. However, she felt “perfectly fine at the time” and could not afford any more medications. Except for a number of “female infections,” she has felt fine until recently. Today, she presents to the Indian Hospital general practitioner complaining that her left foot has been weak and numb for nearly three weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. However, she reports that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 65 pounds since her last pregnancy 14 years ago, 15 pounds in the last 6 months alone.

1. In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.
2. If C.B. develop a bacterial pneumonia on her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.
3. What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?

Instruction: complete both case studies.

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.

Due at the end of week 7 (not eligible for late policy unless an approved, documented exception is provided)

*In the workplace, incomplete work is not accepted. The professional experience assignments are designed to help prepare you for that environment. To earn credit, make sure you complete all elements and follow the directions exactly as written. This is a pass/fail assignment, so no partial credit is possible. Assignments that follow directions as written will be scored at a 22. Assignments that are incomplete or do not follow directions will be scored as a zero.

This week’s Professional Experience requires you to create a speaking outline for your upcoming presentation (Assignment #4).

Steps to Complete Professional Experience Four

Create an outline (Refer to the Outline Guidelines, below, for details) for your Week 8 presentation based on Week 6’s PowerPoint presentation (a video preview is available under the Week 7 tab in Blackboard

Outline Guidelines

• Use Microsoft Word or Excel only to complete your outline.
• Use short bullet points, rather than long paragraphs.
• Focus only on the key points in your Week 6 presentation; avoid discussing less important details
• Refer to the example outline posted for you in the Week 7 OneDrive folder
• Base your submission on the outline format in the example or create your own for this Professional Experience

A EXAMPLE OF THE OUTLINE IS ATTACHED