Peer Responds
Writing
Your substantive responses of approximately 100-200 words
Peer 1
Depression is the Dilemma I have chosen for week 4 discussion. Depression is one of the most undiagnosed and undertreated mental health problems of Elders. Depression can be due to major life change, loss of a partner/spouse, retirement or major physical illness (McInnis-Dittrich, 2005). Depression in older adults may be difficult to recognize because they may show different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They may have other, less obvious symptoms of depression, or they may not be willing to talk about their feelings. This makes it very difficult for doctors to recognize that their patient has depression Sometimes depression in elders present as fatigue, insomnia, loss of appetite or irritability. These symptoms may be overlooked as depression and attributed to numerous other physical conditions (National Institute on Aging).
In order to correctly diagnose depression our task as future clinicians will be to assess and evaluate the entire picture. I believe that means also engaging family and healthcare workers if client is receiving services to identify life changes and sometimes medication changes that may affect patient’s mood. As this relates to Hispanic elders, I believe our task is the same. There will come a time when resources may be limited because of legal status but this is our opportunity as Social Workers to shine and identify resources.
References:
https://www.nia.nih.gov/health/depression-and-older-adults
McInnis-Dittrich, K. (2005). Social work with older adults: A biopsychosocial approach to assessment in intervention. (4th edition). California: Pearson.
Lesly James
Peer 2
When I was interning with hospice I came across many complex dilemmas, but there was a patient and his family that really stuck with me. This man came into our care from GOP (general out-patient care) where it had been found just weeks earlier that he had stomach cancer. The family was not only coping with the news of the cancer, but also the idea that their husband, father, grandfather, and brother would no longer be with them in a few weeks. During the psychosocial assessment that must be done for admittance the family let on that this was all a shock to them, he had just had some stomach pain, they thought he had a little bug and needed antibiotics, they had no idea he was dying and did not know how to mentally or spiritually cope with this news. The complex dilemma in this case was not only dealing with the terminal illness, but also navigating through hospice and the terminal illness.
As the social work intern I had to determine the best intervention and potential resolution so during my next meeting with my internship coordinator we discussed this case and my ideas. I thought it would be best to have the chaplain and myself make more frequent visits as the family seemed high risk because of how fast everything was progressing. While nothing any of us said or did was guaranteed to resolve the problems, there were things we could do to assist the family through this crisis and make it to where all they had to do was grief. I sat with the wife and daughter while assisting with the funeral and service arrangements, also being sure that they were able to have the proper military burial that the patient deserved. I also discussed with the family the different options that were available in their area for grief counseling as they had no time to grief the cancer before having to grieve the idea of immediate death which could potentially cause delayed grief (Doughty et al., 2013). I made a list of counselors for the wife, daughter, and grandchildren, providing at least six counselors. As for the intervention I did life review with the patient promoting the idea of meaning in and throughout his life. The reason we do life review is because reviewing someone’s life can assist the patient with coming to terms with the idea of death in the near future (Kleijn et al., 2018). In the first few days the family was not open to all of the care and the idea of planning a funeral, but instead of making one visit a week I had it approved to make three visits a week. One week into our care the patient went on CC and passed roughly six days later.
References
Doughty Horn, E. A., Crews, J. A., & Harrawood, L. K. (2013). Grief and Loss Education: Recommendations for Curricular Inclusion. Counselor Education & Supervision, 52(1), 70–80. https://doi.org/10.1002/j.1556-6978.2013.00029.x
Kleijn, G., Lissenberg-Witte, B. I., Bohlmeijer, E. T., Steunenberg, B., Knipscheer- Kuijpers, K., Willemsen, V., Verdonck-de Leeuw, I. M. (2018). The efficacy of Life Review Therapy combined with Memory Specificity Training (LRT-MST) targeting cancer patients in palliative care: A randomized controlled trial. PLoS ONE, 13(5), 1–13. https://doi-org.ezproxy.ollusa.edu/10.1371/journal…
