Safeguarding Adults in Social Work - Essay Example

Social Work  Report The paper deals with a case where Mrs. A, a Pakistani woman living in a foreign land suffers considerable miseries including her widowhood and her totally disabled state. It introduces one to the serious plight, which a self-dependent and active woman like Mrs. A can fall in.       Part A a) Analysis of Mrs. A’s situation and needs According to Section 47 of the National Health Services and the Community Care Act 1990, the local authorities are entrusted with the responsibility to take care of people living in a community who truly need some external help. Thus, two things should be kept in mind while extending help to the community people. Firstly, it must be assessed whether the person really needs help. Secondly, observation of the circumstances must be made with regard to the person needing help. Further if the person assessed turns out to be a disabled person such person is entitled to additional benefits in regards to Section 47 (2) of the National Health Services and the Community Care Act 1990. The Carers and Disabled Children Act 2000 states, “carers aged 16 or over are eligible for an assessment of their ability to provide and continue to provide care where: The carer does not provide or intend to provide the care under a contract or as a volunteer for a voluntary organization; they provide or intend to provide a substantial amount of care on a regular basis for another individual aged 18 or over; the local authority is satisfied that the person cared for is someone for whom it may provide or arrange for the provision of community care services; and the carer asks the local authority to conduct an assessment” (Department of Health, 2010, p. 16) In the current case the daughter of Mrs. A had voluntarily undertaken the responsibility of her disabled mother who is aged over 18 years off course and the daughter is 34 years old (above 16 years). Hence under the Carers and Disabled Children Act 2000, Mrs. A’s daughter is liable to assessment by the local authority. The psychotherapist in this case at last decides to send social services to take care of this state of depression. If assessment proves that she was not capable of taking care of her mother then some social worker or an organization should interfere. In this regard, an assessment needs to be made on the amount of care given by the carers to the patients. It must also be seen that the person being cared for falls under the category of Section 47 of the National Health Services and the Community Care Act 1990 in regards to the nature of circumstances, which has compelled such patients to receive external care. The right of assessment of the care services given by the person rendering care will exist even if the person being cared for has refused the services provided by the community authorities (The law in relation to the Assessment and Provision of Community Care Services, N.D.). In this case, it is found that Mrs. A, a woman of Pakistan origin had long left her motherland. She used to live with her husband at their daughter’s house in England. Mrs. A has two sisters in Pakistan whom she often used to visit. Unfortunately, the death of Mr. A had made Mrs. A feel very desolate. To add to this effect Mrs. A on suffering a stroke had to be hospitalized for a duration of nine months. She is now totally confined to her bed and has to take resort of her daughter for any event. She even longs to visit her home in Pakistan but is simply unable to because of the circumstances. Adding to the grave circumstances to which Mrs. A has been subjected her daughter because of increased tension has started behaving rudely with her. She abuses and even goes for committing physical assault on her mother. Mrs. A has been left with no money for her daughter held it. Her accessibility to the telephone is also restricted. Her mid carer hesitates to clean up the commode regularly. In the light of the given circumstances, it is quite evident that Mrs. A falls within the realm of the beneficiaries as observed in the Section 47 of the National Health Services and the Community Care Act 1990. She desperately needs outside assistance because neither her mid day carer nor her daughter is able to take proper care of her. Hence only an external influence might help sort this problem out She needed to interact with people form her community and required constant care and company. Even the children, with whom she was happy, were not allowed to stay with her for long. The room was smelly and she wished the commode were cleaned more often. Only a professional social worker or anyone with more responsibility and understanding would be more suitable. Hence, she is entitled to receive benefits from the community authorities. Moreover, Mrs. A is also a disabled person. Thus, she is entitled to receive additional benefits in regards to Section 47 (2) of the National Health Services and the Community Care Act 1990. In regards to Mrs. A’s daughter, she being an adult is eligible for community assessment services in regards to serving her mother who is eligible to the community benefits. Community benefits can help both the mother and daughter by arranging a special carer to take care of the situation. The carer can help Mrs. A to be introduced to community centers for disabled like the stroke club or to regional centers like the center for Pakistani women. On one hand it will help reduce Mrs. A’s sense of loneliness and on the other hand will help parting with Mrs. A’s caring duties. (Case Study, N.D.). b) Hazards/strengths The case of Mrs. A is filled up with real hazards. First she was living in a foreign nation where she has no possession of wealth and for each of her action, she has to depend on her daughter who has become rude and violent with her. Secondly, she was struck by a stroke, which made her even more disabled. She continually feels herself as a burden to her daughter’s family. Thirdly, she being a widow is now going to live depending on her daughter alone for being disabled. Her daughter because of the increasing stress and a sight of continual ill health and financial strain has become all the more repulsive to the situation. Thus, fourthly Mrs. A is observed to fear her own daughter for reasons of being beaten up which adds to her hazards. Risks involve that Mrs. A because of the grave situation to which she has been subjected can commit an act of suicide. It may also happen that due to turbulence of miserable activities faced by her she can turn insane or become the subject of psychic diseases like Alzheimer’s disease. She is now subject to her bed and wheel chair. The increased amount of mental and physical torture can even lead to an event of a second stroke, which can turn fatal. Michael Oliver has identified the problems of disability as a consequence of society’s failure instead of associating this with the ‘medical model’. She rather speaks on the ground of the individual model. The model has two components “it locates the ‘problem’ of disability within the individual, and it sees the causes of this problem as stemming from the functional limitations or psychological losses which are assumed to arise from disability” (Cooper, 13) It has also been argued that only when the medical application is stable, the social model is effective and workable. She had the medical care but regular diet and social care were missing form her schedule, which could endanger her situation. However, her living in her daughter’s house also acts as a protective factor in her life. It can be observed that it was Mrs. A’s daughter who had admitted Mrs. A to the hospital on the event of her stroke. Further, it is clear that Mrs. A’s daughter had taken up the responsibility of visiting her mother to the hospital in a frequent manner despite of her increasing family and professional responsibility. From the above fact, it can be inferred that Mrs. A because of her daughter had been saved from being homeless in such a grave situation. Had her daughter not been in England Mrs. A would have been subjected to condition much remorse than now. She would have been left uncared for in her house and may have succumbed to a painful death. c) Recommendations During the post 1945 period, social services in Britain was catered and structured on the basis of crisis in funding and conventional beliefs that people suffering from disabilities need to be taken care of. There was a common agreement about moving disabled people out of their home to the community where better and suitable services could be delivered. The Chronically Sick and disabled Persons (CDSP) Act of 1970 required the disabled people to take part more in the community service delivery. There have been several instances of people undergoing a dehumanizing experience in their residential institutions. Also community care is less expensive than such institutional care which is risky as well. Disabled people are often found to cause their own attacks. Mrs. A did not interact with the outside world and was too proud too receive service form another other than her daughter and the housemaid. (Barnes, Mercer & Shakespeare, 2000, p.141) Also Mrs. A because of her grave circumstances is entitled to receive benefits from the community authorities as per Section 47 of the National Health Services and the Community Care Act 1990. Moreover, she being disabled is entitled also to further benefits in accordance to Section 47 (2) of the National Health Services and the Community Care Act 1990. In the light of increasing risks of Mrs. A taking resort to some unwanted activity on account of the ill-treatment and feeling of loneliness the community authorities can provide consulting services. Consultants can help Mrs. A recover from her psychic trauma and even can encourage a dialogue with her daughter. The treatment of disabled and old persons needs proper care and patience. To this end, the community authorities can help arrange a full time carer who can stay with her always rather than depending on a mid day carer. The carer thus appointed by the local authorities can help in cleansing and other activities, which thereby can save Mrs. A from the wrath of her daughter. Moreover, the carer appointed can help Mrs. A to take a stroll on the wheelchair to help introduce her to the several community centers like the stroke club, day center and the center for Pakistani women. The above activity can help reduce Mrs. A’s feeling of loneliness and also install in her the confidence. Meeting with people at the stroke club will make her knowledgeable of her situation and make her learn of how to cope with such impediments. Moreover, her acquaintance with the center for Pakistani women might help in eroding her loneliness and help her feel as if she is at home. It would also remove her feeling of shyness and pride. The installation of a permanent daylong carer for Mrs. A would also help Mrs. A’s daughter in focusing on her family and profession in a better way. It would also help in mending the situation at home, which has become all the more inhospitable owing to insensitive activities and unhygienic conditions. The children of the family must not be made the center of such abusive and dirty climate, of the house. The carer would help in arranging better diet and care facilities for Mrs. A which is greatly needed in times of such illness. The most important task is to make her feel cared for. The sense of loneliness tends to be extremely strong in such times. If she were mental at peace, things would perhaps improve with respect to her health. Part B Reflective analysis In the previous section the social model of disability proposed by Oliver has been mentioned. She proposed the ‘personal tragedy’ theory implying some ‘“terrible chance event which occurs at random to unfortunate individuals” who have to adapt themselves to society’ (Cooper, 2000, p.14). This is evident in the case of Mrs. A, who has to adapt to her surroundings, which make her feel like a burden. Different approaches have been undertaken to deal with this situation. These include voluntary hospitals along with enhanced therapies in drug, therapies rendered by communities without any routines maintained by the wards or uniforms worn by the staffs, day hospitals with supports provided to the patients within the domestic environment. Promoting equal opportunities is very important with respect to children, adults and elderly people. The idea is to popularize optimistic practices like equal access and consequences to all irrespective of sex, race and physical or mental health. From this equal opportunity principle one might bring up the anti-disablist movement, which obviously implies absence of discrimination on the basis of disabilities or any kind of impairment. (Malik, 2003, p. 61) Although the disability acts mainly pertain to the workplace relations, this is applicable in a family as well. In this case Mrs. A was clearly not treated on equal grounds. She did not get access to a clean commode and could not ask for the phone lest her daughter would get angry. She also could not ask for arranging a visit to Pakistan. The only difference was her disabled state and therefore like other normal people she could not ask for the basic emotional and daily requirements. Her dependence on others was increasing everyday and she was made to feel like an unwanted addition to the family. While other disable people were visiting the community service centers and stroke clubs, owing to her pride and sense of shyness and her daughter’s lack of time, she did not have the option of accessing such centers and receiving the social atmosphere which other normal people were entitled to. When she was able to help her daughter and work on the household chores, she was not treated in this manner. Only when she developed the disabilities the changes occurred in her surrounding and began to affect her life deeply. Her emotions were still alive and she longer for some company from near ones but her conditions ensure that she was strictly alone and not able to meet the simple needs of her life. Building up self-confidence is a part of empowerment practices of the social workers while treating disabled people. In this respect, communication is important to the process of assessment. As per Adams the process of empowerment is propelled by self advocacy, “where the worker seeks to enhance the person’s access to services by consciousness raising, by user-led practice and by reflective practice, which looks at current practice and reformulates goals and methods of working….This can be especially informative and facilitative as a form of counseling to improve confidence.” (Cooper, 200, p. 19) However the author identifies between needs-led and service-led provision. In the first case, the empowerment of the user actually happens and this leads to self-determination. This refers to the idea of having supervision over one’s life. Certain pieces of treating disability “do not blend well into the domestic setting, are hard to accept and can lead to a feeling of loss of control over one’s own environment” (Cooper, 2000, p. 20). This would be essential in Mrs. A’s life because she needs to grow her self confidence the lack of which is making her feel helpless and like a burden. She is feeling like a misfit to the environment around her. Her daughter admitted her to the hospital but when discharged, she offers to take care of her mother. After she brings her back in her house the process of care planned for her is not enough and this treatment is making her condition worse. The social worker during his/her visit is supposed to therefore, ensure that she is having proper access to all kinds of facilities. The housing departments of local authority do not seem to develop the strategies, which favor the main elements of community care. The appropriate atmosphere entails one where the service user can participate in the decision-making processes of daily life. It was therefore important for the old woman to feel being included in the family decisions and day-to-day activities (Cooper, 2000, p.21) Such instances makes her vulnerable to further depression and worsening of health conditions. Vulnerability applies to a large number of adults who undergo the risk owing to the process of caring, state of being dependent or taking up family responsibilities. The idea is to emphasize on the empowerment of the adults “who are or may be eligible for community care services to retain independence well being and choice and have access to their human rights to have a life that is free from abuse and neglect” (Mantell & Scragg, 2009, p.11). Assessment of the harm undergone by the victim is important in order to help the practitioner understand the severity of the condition of the patient. The patient here is subject mainly to psychological and emotional ill treatment and abuse including humiliation, mental cruelty or manipulation leading to psychological distress. In this case Mrs. A is subject to such mental distress and pressure that she was even denied the access to fundamental rights including those of “choice, dignity, individuality and self expression” (Mantell & Scragg, 2009, p. 12). The social carer has to look into that apart from helping her with her daily activities. The carer should win the trust of the user such that the latter could confide in the former and hence feel lighter. This would enable the carer to help the user in a better manner and assist the latter in leading a life with reduced dependence on others with entitlement to equal opportunities. If Mrs. A can confide in her carer and communicate well about her feelings and experiences then things could be handled in an easy manner. Again, communication entails the importance of language and in this case that should not be a problem because Mrs. A knew how to speak English and hence native social carer could help her. In fact the social worker “obtains power by gaining the confidence of the service user” (Fook, 2000, p. 62). The service user is empowered by “having her or his story listened to and legitimated” (Fook, 2000, p.62). Again, the power of social worker diminishes by “creating the impression that she or he is a ‘soft touch’” (Fook, 2000, p. 62). Therefore Mrs. A would be empowered if she could relate her story to someone who would really care to listen and help her. Old age is often vulnerable to severe illnesses most of which have a prolonged effect on the mind and body. More than the physical issue the mental troubles bother an old man or woman especially when he or she is staying away from most of her relatives and friends. Mrs. A had her daughter to take care of her but even she has her problems to take care of. She provides the finances for her treatment and her daughter also loses temper often. So the only person she depended upon is neglecting her and she needs constant assurance that she is not alone. The strange thing is that before her illness she was more or less a lonely person, but this period of illness and seclusion perhaps makes her feel like wanting to be with her friends and relatives back at home. She even wants some companion, for instance she enjoys the children’s company but again they are taken away from her. No one has time for her. Previously she was busy in the household chores but now she is stuck in the bed and feeling useless. On one hand she needs her self-confidence and independence to restore and on the other she needs to feel like a part of the family or be back with her relatives in Pakistan. Therefore the social carer should first listen to her problems and take her into confidence. Then by judging the situation the carer would speak to her daughter and enroll her for community services. Equal opportunity and anti-disability approach should be adopted urgently for every person like Mrs. A. the case does not reveal the role of her son in law much. It is however apparent that having a sick old woman and spending a share of earnings on her is not coveted by him. This is leading to the family problems in her daughter’s life. The case also highlights a common social issue where old people become a burden even to their own children once they are physically useless. The carer also needs to advice the daughter about ways of treating her mother. Spending some quality time with her everyday could help. References Barnes C, Mercer G and Shakespeare T. (2000) Exploring Disability: A Sociological Approach, Polity Press; Cambridge Cooper J (ed) (2000) Law, Rights and Disability, Jessica Kingsley Publishers; London Department of Health (2010), Carers and Disabled Children Combined Policy Guidance Act 2000 and Carers (Equal Opportunities) Act 2004, Carers, available at: http://www.carersnet.org.uk/acts/equalact/combined.pdf (accessed on October 16, 2010) Fook, J. (2000), Social Work: Critical Theory & Practice, Sage, London Mantell, A & Scragg, T C. (2009). Safeguarding Adults in Social Work: Learning Matters, Exeter. Malik, H. (2003), A Practical Guide to Equal Opportunities, Nelson Thomes “The law in relation to the Assessment and Provision of Community Care Services”, (N.D.). Devon County Council, available at: http://www.devon.gov.uk/index/socialcare/assessment-and-eligibility/facs-documents/facs-law-community-care-services.htm (accessed on October 16, 2010) Read More