Part 1 — Care Situation
Sophia is a widow of Eastern European descent who lives with her son, Peter (age 37
years), in a single family home. They seem to have limited resources, and the house
is in poor shape and is cluttered inside and out. This is mainly because of the items
Peter collects; cans, bottles, various containers and newspapers. Peter is diagnosed
with autistic spectrum disorder (ASD) and lives upstairs in the home. He is the
caregiver for Sophia, who lives on the main floor. Sophia has many medical
conditions, including cardiac disease, poor mobility and vision impairment. She
takes a number of medications. Sophia has been taking medication irregularly and
she recently has been adjusting the dosages based on her own judgment about her
health. Sophia is cautious of people that she does not know well and is somewhat
suspicious of their intentions.
She has devoted her life to Peter and his needs. Peter tries to help his mother by
filling the dosette box, but he gets the medication mixed up. Peter is supposed to be
on atypical psychotropic and selective serotonin reuptake inhibitors (SRRI’s)
medication for irritability, angry outbursts, anxiety and obsessional behaviors but he
does not take them regularly. Due to her advanced cardiac conditions, Sophia often
gets into trouble medically, and then Peter has to call 911. This happens frequently
lately. In the past, the care manager, geriatrician, and emergency staff have tried to
put in home support, an occupational therapist, and a physiotherapist, but Peter’s
behavior and Sophia’s suspiciousness have prevented any continuity of support.
Sophia has refused any continued service because the service providers want to
remove some of the clutter and this upsets Peter.
Answer the following questions:
- If you were Sophia’s care manager, what values, assumptions, and beliefs
might you bring to this situation? How would you deal with these to ensure
that you are being client-directed in your practice? - Describe the risks that are present for Sophia and for Peter in this situation.
Comment on the degree of risk present for these people. REFER TO ATTACHED FILES FOR CITATIONS AND REFERENCES* - What type of legislation would guide your practice in this care situation? In
your answer, describe the decisions that Sophia and Peter are making, and
then list the categories of legislation that would support your practice, and
then name specific statutes (either BC statutes or the corresponding statutes
from your own province). Refer to the Turner and Uhlemann (2009) course
text, as well as other researched resources for Module 2.
Part 2 — Care Situation
Sophia has had a serious fall when she apparently tripped over clutter (bottles and
rubbish that Peter had collected) on the front stairs when they were returning from a
late night ER visit. Sophia sustained a concussion, a head laceration, severely
bruised ribs, a badly sprained ankle and a fractured elbow; she is now admitted to
hospital. Sophia seems to be “borderline capable of person” as assessed by geriatric
psychiatry, but she currently requires total care and cannot transfer herself alone.
Sophia wants to go home, however team members believe the risks are too great.
Peter is irritable and angry; sometimes he tells providers that he cannot cope with
his mother’s care and other times he states that his mother would never want to be
placed in a ‘home’ because she does not like strangers. Questions are also raised
regarding what would happen to Peter if Sophia were to be placed in a residential
care facility (i.e., does he have to move out of house, how will he cope if he does not
have Sophia to care for any more?)
Answer the following questions
- What is the most important decision(s) that must be made now? How has
degree of risk affected decision-making? Who would be involved in the
decision-making? - Use the five phases of the ethical decision-making framework to analyze the
care situation and address the ethical dilemma. SEE CLASS NOTES “MODULE 2 LESSON 1” IN ATTACHED FILES!!!! - Do all facts point to a single course of action? Why or why not? Explain and
justify your answer. - Why do you believe the activities Phase 5 are important? Explain your
reasoning in context of the care situation. - Advocacy is a core competency of client-directed care managers. How will you
as a care manager advocate on behalf of your client to achieve the best
outcomes possible?
Sample Solution
