Community care management and planning
1. You are asked to identify key contemporary legislation and social policy issues in relation to Nora and Elvis.
In the field of society and life, issues concerning moral ethics and values are often the most usual topics. Morality governs every person’s move. But just why are people so caught up in morality and norms? What are social policies and their implications to social work practice? To be able to grasp these ideas, we must first shed light on the terms. What are norms? Norms are unspoken bylaws to which people adhere to. It’s an understood law. It is sometimes socially enforced. According to The Emergence of Norms, she contests that norms allow people to act and coordinate their behavior in certain situations. But the emergence of self-interest will prevent such coordination and cooperation (1977). Morality is an idea which pertains to the concept of right and wrong. Many arguments have been filed for this concept, arguing that it is maladaptive in certain aspects. But as of the moment, we shall use the definition given above. Social policy refers to the guidelines created for the betterment and wellbeing of the human society. The guidelines aim to meet the needs and the welfare of the people.
Assessing the health status of people experiencing neurological and physical disorders has three main assessment components: (1) Interview, (2) physical examination, (3) general and special social, physical and medical diagnostic treatments and studies. People’s individual reactions to crisis are psychologically necessary and grief reactions occur. Social work values are values which concerns itself with the moral and social clauses of the given work. In the context of this paper, we shall apply and discuss all of these terms to be able to arrive at a conclusion.
It is a fact that culture will not be successful and effective in its ways and processes without the presence of communication as the ‘culture of goodness and excellence’, can be reflected through leaving out in communication. This is only possible if people within the society comprising of different sectors from the academia, government, private sectors and business firms attest that communication is vital for the development of goodness and excellence in culture from within Nations, from putting substance to the government laws and regulations so that the education to be imparted and inculcated to the students will be of greater function to those who respect it as exercised properly by the authorities from various academic fields that can be of relevant factor in promoting the goodness of culture and the excellence of culture through communication as the latter provides the clear emphasis and justification of certain rules and principles to be applied in everyday living. Moreover, in the Language of Morals notes that uses of the word, “good,” are meaningless unless there is a stipulation that “x” is “good with respect to y.”
Often, textbooks make comparisons between poor examples of student prose with revised versions that are “better” and offer seemingly cogent explanations of what makes writing effective. The tendency in these books is to ignore the contingent character of language and to concentrate on essential zed forms, implying that if students mimic these forms; their writing will also manifest traits of excellence. Even teachers who complicate the lessons in these books by focusing on the ways that language produces knowledge and prompts social action must consider whether and how to teach students to become more effective rhetors. Should students be expected to learn the conventions of academic discourse by mimicking pre-established forms that signify one is writing “academically” and presumably, “intellectually”? What gets left out of the picture is that the specified criteria implies a particular idealized type of writer whose speech patterns bear little resemblance to the modes of communication to which most students are accustomed. The idealized author is often an academic whose prose is an instance of one type of discourse that suits a specific rhetorical context that implicates the academic’s needs.
These things make a bad impression upon people and often lead to the social issues like social exclusion. Social exclusion is a phenomenon in which a person or a group of persons are discriminated by society due to a certain factor that they posses or lack.
In the case of Nora and Elvis, it is highly recommended for them to receive government aid due to their lack of capacity to go about their everyday life. Nora, having been recently widowed, is prone to dementia. Furthermore, having been recently diagnosed with bone cancer, care for Elvis is suddenly put aside since she needs care herself. Elvis, on the other hand, is diagnosed with down syndrome.
A number of legislations can be attributed for the betterment of Nora and Elvis. According to the National Assistance Act of 1948, Elvis and Nora are eligible for assistance in residential accommodations. This is due to the fact that Nora and Elvis are both over 18 years of age and are both impaired physically, mentally and financially. Furthermore, Elvis and Nora are also eligible for services under the CHRONICALLY SICK AND DISABLED PERSONS (SCOTLAND) ACT 1972. According to this act, the local authorities are to make sure that mentally and physically incapacitated citizens in their area are rendered certain services to make their life all the more manageable. According to a circular that was given out in 1972 (CIRCULAR SWSG12/72 5456 6 September 1972), the following are the duties of the authorities with regards to the person(s) concerned:
“(a) the provision of practical assistance for that person in his home;
(b) The provision for that person of, or assistance to that person in obtaining, radio, television, library or similar recreational facilities;
(c) The provision for that person of lectures, games, outings and other recreational facilities outside his home or assistance to that person in taking advantage of educational facilities available to him;
(d) the provision for that person of facilities for, or assistance in, traveling to and from his home for the purpose of participating in any services provided under arrangements made by the authority under the 1968 Act, or, with the approval of the authority, in any service provided otherwise than as aforesaid which is similar to services which could be provided under such arrangements;
(e) the provision of assistance for that person in arranging for the carrying out of any works or adaptation in his home or the provision of any additional facilities designed to secure his greater safety, comfort or convenience;
(f) Facilitating the taking of holidays by that person, whether at holiday homes or otherwise and whether provided under arrangements made by the authority or otherwise;
(g) The provision of meals for that person whether in his home or elsewhere; and
(h) The provision for that person, or assistance to that person, to obtain a telephone and any special equipment necessary to enable him to use a telephone. “(Scotland.gov database, 2007).
According to the Care in the Community policy, passed by the government under Margaret Thatcher in the 1980’s, mentally ill people can be treated at home. Medical paraphernalia and drugs were easily available, thus, making it easier for the patient to be taken care of at home. The National Health Service and Community Care Act of 1990, says that a mentally ill person can be assigned with a specific social worker who can meet their needs.
2. As a social worker how would you address issues of ethical social work practice with this family within the context of working with other professionals while recognizing the rights of the service users?
When working with vulnerable families, such as Nora’s and Elvis’, controversies are bound to come up, especially in the field of social work practice. There are many issues to be considered in the care of Nora and Elvis. For example, as Elvis is autistic, he needs to be cared for in a proper institution. However, the Care in the Community policy says that a person who may be mentally or physically ill can be treated in the comfort of their own home. Now, as a social worker, I need to make sure that the authorities grant that service to Elvis, no matter how mentally deranged he may seem to be. According to some researches, people tend to think that mentally ill people have the capacity to hurt normal people. This is true in few cases. Cases wherein normal people are hurt by mentally incapacitated people are relatively few. However, cases where mentally ill patients are hurt by normal people are high. Therefore, it would be better for the person to be treated at his own home under the supervision of a social worker.
When it comes to the care of the mental health patient, a social worker collaborates with the patient, family, and others in the conduct of nursing practice; however, ethical issues must also be taken into consideration.
Mental health can be a very challenging area to work in and as an experienced social worker, I have a great admiration for the skills and commitment social workers give. There are many qualities that a social worker must possess.
A social worker must adopt a quality of mental health practice. The social worker systematically enhances the quality and effectiveness of social work practice. As a social worker, I have demonstrated quality by documenting the application of mental health nursing process in a responsible, accountable, and ethical manner. I also use creativity and innovation in social work practice in order to improve the delivery of care. When I feel that the desired outcomes of quality are not achieved, I start to plan that I should incorporate new knowledge to initiate the desirable changes that are needed in the mental health area.
The social worker should communicate with the mental health patient, family, and other health care professionals regarding the care of the patient and the social worker’s role in the provision of that care. The social worker must know when to ask and collaborate with other people because handling a mental health patient is very difficult. Especially when it comes to creating a documented plan for the mental health patient, the social worker’s role becomes more difficult. Thus the social worker must collaborate with the patient, the family, or other health care professionals in creating a documented plan focused on outcomes and decisions related to care and delivery of services appropriate for the mental health patient.
Aside from collaboration with health care professionals in the hospital or other health care setting, the social worker also has to collaborate with other people outside of the health care field. Collaboration among the social worker, school nurses, and medical practitioners is also advised and can result in establishment of multi-focused violence and suicide prevention programs with evaluation criteria and the ability to be replicated. These programs should include staff training in violence and suicide awareness and crisis intervention as well as group leadership instruction. The social worker can also join or establish support groups to decrease isolation and increase coping skills among patients that are at risk for depression and suicide.
Certain social, political, and economic actions on behalf of a patient’s mental health are inherently compatible with professional values, and should be considered by all social workers. Social workers can be excellent participants and leaders on community action boards, bringing to them special healthcare system knowledge.
In the aspect of resource utilization, the social worker must utilize organizational and community resources to formulate multidisciplinary or interdisciplinary plans of care for the mental health patient. Additionally, the social worker must develop innovative solutions for the mental health care patient’s problems that would address effective utilization of resources and the maintenance of quality.
Furthermore, the patients should be subjected to therapy. The purpose of therapy is to help people with physical, mental or developmental disabilities achieve a maximum level of independent living by developing the ability to perform the activities of daily life. Therapists work with patients of all ages, most of whom have suffered from a stroke, arthritis, hand injuries, schizophrenia or depression. Therapists work in a variety of health care and educational settings including general or acute care hospitals, physical and psychiatric rehabilitation facilities, mental health centers, long-term care institutions such as human development centers and nursing homes, schools, doctors’ offices and private practices .
3. Choosing either Nora or Elvis how would you evaluate the care management role from the perspective of service users and providers taking account of the financial management and planning in social work practice.
The goals of the overall service program are to identify areas of actual or potential risk, prevent, as much as possible, injuries to patients, visitors, and to prevent or limit financial loss to the government. Financial loss can occur in a number of ways. From a management perspective, the primary concerns are those financial losses associated with the inherent risks that exist in providing health care services, which can result in a patient instituting a medical malpractice claim or lawsuit against the practitioner, or the inability to receive the service.
Management in practice typically involves some mixture of anticipation-“looking forwards”, and resilience-“bouncing back” (1996). Misjudging risk can be very costly. Human intuition and past experience are no longer adequate guideposts for handling new exposures. Risks are emerging at an increasing pace and across a broader spectrum-from global Internet liability and hidden construction defects to ever-present terrorism threats (2005).
The active management of capital structure requires that financial executives determine the optimal mix of debt and equity financing, traditional versus nontraditional financing employed, and the appropriate levels of fixed rate and variable rate debt. Financing options available to tax-exempt healthcare organizations, including interest rate swaps and other derivatives, have increased dramatically in recent years. These mechanisms can significantly decrease an organization’s all-in cost of capital without requiring the issuance of additional debt ( 2006).
A comprehensive policy that addresses the strategic issuance and management of debt and derivatives can provide a roadmap to guide a health system toward achieving increased capital access, added financial flexibility, and the lowest possible cost of capital, all within board-approved risk guidelines (2006).
Measuring risk for a return to the organization is a revolutionary new approach. Risk managers, C-suite leaders and consultants agree: the business of risk management has changed radically in recent years. The days when the job simply meant buying a risk transfer policy for a competitive price are over. How well an organization the government handles today’s ever-increasing complexities of risk–especially compared to other organizations in its space–is about much more than the simple mitigation of loss. When risk is managed and reduced, the results are not only internal financial and operational advantages, but a measurable competitive advantage that affects every area of the company, from the costs of risk in the marketplace, to social worker’s morale and retention, to the government’s position in the global economy . Today’s complex challenges require a new approach. With the right system, process and tools, risk can be fundamentally turned around from its traditional role as a “necessary evil” of business to a positive center of opportunity and gain for organizations of every size ( 2005).
Organizations in every industry can also apply and benefit from a return-on-risk approach. For example, a hospital that improves risk management in clinical operations will be able to see measurable improvements in medical outcomes as a result of these enhancements. Better outcomes will, in turn, result in reductions in medical liability costs, improved nurse retention, enhanced patient safety and patient satisfaction, lower workers compensation costs and a stronger reputation in the community (2005).
A hypothetical example of a government that is especially vulnerable to adverse effects of risk can be used to illustrate how return on risk can deliver on its promise. Suppose that a medical error in the operating room results in a million malpractice case. When the verdict is handed down, the government can expect a huge malpractice insurance premium hike. But with a return-on-risk approach, that government has not just been waiting for the proverbial shoe to drop. Immediately after the incident, a systems-wide analysis of the risk drivers behind the incident would begin. A team including representatives of finance, clinical care, marketing and human resources would be assigned to evaluate both the potential causes of the incident and the risk implications for patient care, for finance, for marketing and for risk and retention of staff.
Knowing the hazards of a certain situation is the starting point of every process of risk management. It is also the most important since every succeeding phase of the risk management program depend on it. Hazards must therefore first be detected; then possible risk scenarios analyzed and assessed in reference to past and present history.
To foster that understanding, emphasis is placed on educating employees about risk management and their role in helping control losses. The education starts when an employee comes to work at the facility. On a monthly basis, nurses new to the facility and those who want a risk management update on issues such as claims and legal issues are brought together for a meeting. The concept here has been to involve all employees in the risk management program. It doesn’t get done by itself. Everyone within the government should help set direction, coordinate and plan.
Ironically, today’s risk-filled world demands that organizations develop good capabilities to handle risk, even as chaos and complexity make it difficult to implement effective risk management policies. At a minimum, they need to implement a structured approach to managing risk. Efforts to identify risk, assess its impacts, prepare to handle it, and control it must be carried out explicitly. While the employment of formal risk management processes may not allow you to estimate the likelihood of specific risk events accurately, it will increase the risk sensitivity of managers and employees and reduce the number and impact of the surprises the organization is likely to encounter. Leaders within organizations must act ethically while working to resolve legal dilemmas in ways that are beneficial to the organization’s finances and public image.
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