It is the duty of and a requirement for social workers to maintain the highest standards of ethics when carrying out their duties towards those who they are concerned with. While doing this, they should always keep in mind that the best interests of their clients are put above all else even if that specific client does not wish for the intervention of the social worker in their lives (Berkman, Chauncey, Holmes, Daniels, & et al, 1999, 9 – 16). In all of the situation that they are confronted with, the social worker should always strive to look for all possible solutions to a problem before choosing to take a person into the direct care of the state because not many people willingly come into the system and in fact, most prefer to deal with all their problems privately (especially the elderly). Even if they are forced to take the latter action, the social worker should make sure that their client is treated with the dignity that they deserve and that they have been made aware of and understand the circumstances under which they are being taken into the care of the state (Gregory, P, 2003, 369 – 371). A good social worker should also ensure that he or she follows up on the people who have been under their care to make sure that they have been placed under the best care available and that they are being treated well and with dignity by those who are caring for them. In this paper, we shall look into a case study of an elderly man and the various options which are available to him that the social worker has to present to him and to decide the best course of action to be taken in this case.
This case involves a seventy eight year old man who lives alone in an apartment and has recently been discharged from a hospital having broken a hip after a fall in his home. He has a brother who lives in an apartment within the same building. The social worker in this situation is put on a tight spot because the old man, Mr. P, seems to be a very alert person who I yet to lose his faculties at his age. Although he is having difficulty in getting out of bed on his own and has as a consequence neglected his personal hygiene, he still insists that he needs no help and that his brother, who lives within the same building should not be informed of his situation. He declares that he is just fine on his own despite the fact that the social worker clearly sees that the old man is not doing well at all. The dilemma which faces the social worker at this moment is what exactly to do in the best interests of the old man so that his inability to take care of himself does not in any way affect his health. There are several options open to the social worker on how to deal with Mr. P’s situation and all of these options have their pros and cons because one way or another, there is going to be a negative effect on the old man, whether physical or psychological. The social worker must therefore consider all the options open to him very carefully so that no mistakes are made in the final decision concerning the old man (Johnson, 2000, 19 – 25). However, he should not be afraid to do what is ethically the best thing for the old man no matter the consequences of his actions.
The first option open to the social worker is to respect the principles of confidentiality and self – determination and do nothing about the situation in which Mr. P finds himself in. at first glance, this might be the best idea considering that the old man seems to be in control of all his mental faculties and knows exactly what he wants (Vinton, 1995, 431). However, his insistence that he is well able to take care of himself does not seem to be correct because it has been noted that he can barely get out of bed without assistance and that he has neglected his personal hygiene because of it. This shows that if he continues to be left alone, then the consequences of such an action would be very detrimental to Mr. P’s health. The social worker’s doing nothing about Mr. P’s situation would be an equivalent of neglecting his duties and this would amount to ignoring the ethics which are the guiding tools of all social workers (Wang, Xiong, Levkoff, & Yu, 2010, 72 – 84). The best thing for the social worker to do is to weigh all the other alternative options available for the caring of the old man until such a time as he is well enough to go back to living his life alone in his apartment. The social worker should not bow down to the insistence by Mr. P that he can take care of himself and should instead do what he thinks is right not only for the old man but also in his conscience. In relation to this, the next step would be the next best option in dealing with the old man’s situation.
The social worker would decide that the best thing to do for Mr. P would be for him to be put under involuntary placement due to the fact that he has an impaired judgment about the current circumstances of his life. This would be the best course to take in the immediate moment considering that neither of his siblings know about his current situation and that he has yet to inform them about it. Even if they were to be informed now, it would be days until they made the necessary arrangements to cater for their brother who would have by them turned for the worse due to neglect. It is the duty of the social worker to place Mr. P in a nursing home or a similar facility until other arrangements about his care can be made. This should be done despite the insistence by the old man that he does not wish to be placed under assisted care because in this situation, the social worker has to take into account not only what the old man thinks is best for him, but also what he himself thinks is the best thing to do for the old man. In this case, the social worker should take it upon himself to decide on behalf of Mr. P what is the best thing to do for him because it would be ethically irresponsible of him to leave the old man in the state in which he found him just because he wishes to respect Mr. P’s wished.
Another option open to the social worker in dealing with the old man’s situation in what can be considered as the least restrictive route would be to contact Mr. P’s brother who would check on him over the weekend to make sure that he is alright. This would be the best course of action for the social worker to take as long as he does it discreetly because Mr. P has specifically requested that his brother be not informed of his situation. It is the duty of the social worker to inform Mr. P’s brother of his condition because he is the only close relative the old man has at the moment and the brother’s knowledge of this situation would more likely than not ensure that he regularly checks on Mr. P and by doing so, there would be an assurance the he is well taken care of until other arrangements can be made for him. However, telling his brother about his condition would be breaking the principle of confidentiality and self determination to which Mr. P has a right. Furthermore, if Mr. P were to find out that the social worker had told his brother about his condition against his wishes, then he would lose any confidence he had in the social worker and this would make getting any future cooperation from him very difficult to get. Moreover, perhaps there was a specific reason why Mr. P did now want the social worker to inform his brother of his condition, perhaps because the brother also has a serious medical condition which may be fatal if he is given such news, or perhaps they have been estranged for some time and the brother would likely even bother to show up to check on Mr. P’s condition. All this should be put into account before the social worker can go ahead and inform the old man’s brother about his condition (Hoskins, I. 1993, 347).
The final step which a social worker should be taken when making a decision concerning what to do about Mr P is telling him that he is not convinced that the old man can attend to his own needs and that the best thing for him to do for the time being would be contact his brother and explain the situation to him. It is most certain that Mr P will protest the social worker’s decision and it is the duty of the social worker to convince him that it is the best option for the old man for the time being. The social worker should make sure that the old man completely understands his situation and that he is agreeable with the arrangements which are to be made for him until such a time as he gets better (Tremethick, 1997, 27 – 31). The social worker should also assure the old man that the situation will only temporary and that Mr P can get back to living his life as he used to once he gets better. After doing this, the social worker should then personally meet Mr P’s brother and explain to him all that he has noted about Mr P and the type of care which he requires in order to remain comfortable as well as put him on a fast road to recovery (Russell, 2004, 121). It would further be best if the social worker continued to keep monitoring Mr P’s ondition under his brother’s care and if he notes that he is not getting any better, then he should consider other options that will ensure that old man’s well being, even if it means places him involuntarily into a nursing home where he will get the necessary care he needs.