Alzheimer’s Case Study in Social Work

According to Maurer & Smith (2005), organizational policies and practices are influenced a lot by the national rules, legislation and service standards. There are many rules, legislations and services like care standard act, care quality commission, commission for social care inspection, , age relation act, which aims to ensure the best quality care for the people with all age groups. From the scenario, we have seen that Mr. Frazer is suffering from Alzheimer disease and he needs both long term and short term care as he is passing his days with lots of difficulty.

Hamm (2007) has stated that, people with Alzheimer disease need more likely long term cares. The UK legislations have set up lots of policies and standards so that organizations can give the best the possible care to their clients. Among them, the care standard act 2000 describes that, all the care homes or residential homes must fulfill some specific requirements which are necessary to take care of their patients or clients. For example, it describes a category of people who are not suitable to work with vulnerable adults. In addition, it reforms a regulatory system for the care service organizations such as care homes, childrens homes, nursing homes, domiciliary agencies, voluntary adoption agencies, fostering agencies. While providing service to a patient like Mr. Frazer, they have to maintain the legislations. So, a service provider will must check whether they have employees with sufficient knowledge on Alzheimer disease before involving him/her to give him care. For example, whether she/he has got knowledge for the reason of this disease, medication, clinical trials, first aids, communication method, special needs etc. Thus legislation and national service standards influence organizational policies and practices for achieving best possible outcomes for people like Mr. Frazer.

Factors that may affect the achievement of best possible outcomes for Mr. Frazer

According to Gauthier (2000), there are many factors that can affect the achievement of best outcome of people with Alzheimer disease as they usually need both long term and short term care. Some of the factors are given below:

Problems in communication:Communication problem creates severe problems while providing care as sometimes they can not understand both written and spoken language because of the damage of corresponding nerve. In addition, patients may speak native language where care giver does not speak the same. In this case, misunderstanding may occur that leads to negative outcome for both groups. Sometimes they may not understand proper language, sign language, body language or meaning of normal picture. In these cases, doctors or care workers may fail to realize their needs and may not the best care.

Aggression:Aggressiveness is common often among the Alzheimer patients. So, they may feel irritated if they are asked to describe about their present health condition. In the same time, care givers or doctors will not know patients needs if he/she does not tell them. If they are requested to explain more than once, they become aggressive other than helping them by giving answer.

Culture, attitude and beliefs:Health care providers may fail to realize the cultural needs of patients. People from different culture have different cultural norms, beliefs, attitude and expectation. So, lack of cultural knowledge and about their belief can obstacle in the way of achieving best compliance. (Treatment and lack of adherence to medication for TB among Hispanic immigrants is one example)

Education and income:Sometimes, patient may think that, they are being asked for unnecessary information by taking the chance of their lower education and income. Also, they might need to pay them for any particular type of treatment though they are reluctant. This can create barrier to achieve the best outcome as well.

National rules and legislations:According to McHale & Gallagher (2003), a mature patient has the right to refuse treatment. Sometimes, they can say that the information which asked for will strike on their confidentiality or respect. So, information may not be available though that is essential for their safeguarding. In these cases, doctors or social workers may take decision against their wishes which will not let them to achieve best outcome.

Communication between care workers and individuals contribute to the delivery of outcomes

According to Rabins et al (2006), usually people with Alzheimer disease face difficulty while communicating with someone. They may not realize even the simple words. In some cases, their understanding can be fully reverse from the speakers and they may react violently. So, we must be very careful while presenting something to them. A few ways are given below for effective communication to achieve the best outcome.

Awareness while speaking:Cayton et al (2008) have stated that, the care givers must be aware of their body language and voice of tone while talking with them. They must communicate very politely otherwise patients may feel threatened, undermined or confused which can rise the feeling of isolation, agitation and undermine the trust.

Mentioning name:Cayton et al has noted that, care givers must introduce themselves clearly before starting conversation with a patient. If patients condition is critical then we may tell them our address as well to make the better feelings of the patients. Care giver or doctors should speak quickly, loudly or distinctly by no way.

Questioning:Obviously care providers or doctors need to ask questions to know patients condition but they must not use long sentences to ask them any question as they need longer time than others to understand the meaning even sentence is not big enough. In addition, they should not be asked more than one question at a time. Also, they should be asked question that require answer only yes or no (Sadowski & Wisniewsk, 2004). Thus any individual can ensure the best outcome for the patients like Mr. Frazer.

Question 2

2.1 Factors that may have contributed to loss of independence, non-participation and social exclusion for Ellen

According to Arber & Evandrou (1993), there are many factors which can contribute to loss of independence, non-participation and social exclusion and these can be being dependent to someone including care workers, not given time to make choice for them, constraint, changing something related to them without taking their permission, not giving chance to participate in decision-making.

Dependency:Most of the cases, vulnerable adults like Mrs. Ellen loss their independency and social exclusion because of being dependant to someone such as care workers. Sometimes the patients may not be permitted to carry their day to day activities because of lack of ability or risk. Service users physical and mental conditions may be considered strictly. They may not be given permission to choose how they will spend their times, how they spend their money, where will they spend their leisure time, what will be their regular diet etc. because of lack of skills. As a result, they will loss their minimum capacity to lead a life of their own. So, they may be reluctant to participate in social events as it may be insulting for them that they are dependant.

Keeping away from decision making:From the scenario, we have seen that Mrs. Ellen was given chance to make her own decision. But, usually service users in the care homes or nursing homes may not be given this opportunity because they may cause a problem. This can cause frustration and they become more dependant.

Constraint:this is one of the major ways for what service users become dependants. It can cause threat as they may be forced to think as other people think. Mrs. Ellen was not forced to do anything while staying in the care home. She was encouraged to perform her all day to day activity and as a result she become a role model in that care home. Basically, adults should be assisted to carry their day to day activity but not doing the total thing for themselves. They may think about their inability but they should be encouraged to work by themselves assessing the risks. Otherwise, they will be dependant, frustrated and will lose their taste of life.

2.2 Processes and support mechanisms to maximize independence and choice for individuals like Ellen

Sussex & Scourfield (2004) describe that empowerment of social, physical, emotional needs, intellectual factors, access to information, maintaining confidentiality, participation in decision-making and choice can maximize the independence and choice for individuals. These are given below:

• Promoting rights of them. For example, letting them to maintain their confidentiality, safety and security
• Allowing them to take risks. But risk must be assessed. If that can , they might be encouraged restrain from certain things.
• Allowing them to communicate and make relationships with anyone that they want.
• Allowing them to individualised care, involving responsibilities etc. Everyone has responsibility not to infringe on the rights of other people.
• Individuals must be given chance to take their own decision and make choices for them.
• Individuals will get full access to gather information.
• They must be given right to carry out their religion and cultural activities.
• Providing a range of options from which they can make choices
• Encouraging them to solve problems in the future on their own successfully.

2.3 Organisational systems to promote participation and independence for individuals

According to Sussex & Scourfield (2004), empowering individuals potentiality, ensuring performance of workers, proper guidelines and inspirations to work by own initiatives, staff training, getting feedback, inspection and opinion sources of information for each and every individuals can be a few examples to promote participation and independence for individuals by organizational systems. These are described below:

Empowering individuals:Heumann et al (2001) state that, each and every employee of any organization may be promoted to participation and independence by empowering their sleeping potentiality. According to him, the development of service delivery and service quality may be increased significantly by the empowerment of employees. To implement this, proper guidelines to let them work by themselves will be necessary. Thereafter, they can be told the benefits so that they can realize the necessity of the empowerment.

Ensuring performance of individuals:Huber (2006) has shown that, organizational participation can be developed by ensuring performance of individuals. The organizational management will make sure that all the employees are up-to-date with changes so that they can perform in a better way. When they will find out their good performance, they will intend to take part extra organizational activities and feel free to work independently.

Sources of information:Employees from all the organizations should have free access to information so that they can solve their basic problems by themselves. In addition, they will know the pros and cons of the organization. As a result, they will think themselves as an individual and important part of the organization which results them to participate and involve throughout the organizations. (Anderson & Aydin, eds., 2005)

2.4 Tensions that arise when balancing the rights of the individual to independence and choice against the care providers duty to protect

According to Thompson et al (2006), there are many factors which cause dilemma while providing care to the vulnerable adults e.g. Safety vs. independence, safety vs. rights and responsibilities of individuals etc. For example, if patients with dementia or frail people want to go somewhere by themselves, then care providers are in trouble. People with dementia may loss their way and find it difficult to retrieve it. In addition, they can cause harm to others and themselves by their aggressive behavior. Frail people may fall down easily and cause serious harm to them. So, the relatives or even the person himself/herself may complain against the care providers when they are in trouble. Considering these factors, care providers are reluctant to let them do anything which can harm their clients. In the same time, each and every individual has right to live independently but it can cause conflict between relative vs. client, client vs. employee, employee vs. relative, children vs. parent, parent of children vs. service providers and staff vs. staff. Thus, tensions can arise while balancing the rights and choice against the care providers duty. Overall, care providers will first consider and ensure their clients safety and then independence.