Mrs. Camilleri is a woman who had a difficult life. She suffered the loss of her father at an early age and had to help her mother in bringing up the family. In order to support her family she left school after completing primary level and because of this she does not have a high level of education. She worked as a cleaning lady until she started to suffer back pains. As Mrs. Camilleri herself admits, the fact that she and her husband did not have children caused them a lot of emotional pain.

Later, the death of her husband caused her another emotional distress. However, she learnt to cope with her situation.

I concluded that Mrs. Jane camilleri’s present problem is that she is afraid of losing her independence, not being able to live in her house(which is her pride and joy), no longer capable of providing for her own needs. I think that Mrs. Camilleri is aware that because of her health situation she will not be as much as self sufficient as she used to be. This change was traumatic for her, she is not willing to face another loss; that of her independence.

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In my opinion Mrs. Camilleri would like to continue living in her house and this would be my primary objective.

The first and most important thing at this early stage is to establish a good relationship with Mrs. Camilleri; a relationship of trust and respect. As a client, Mrs. Camilleri needs to feel that she is being cared for and that I’m willing to help her and seeing that her needs and wants are being safeguarded.

According to Erikson’s stage of the ‘Ego Integrity versus Despair’, an older individual needs to establish a strong sense of ego integrity. Such person needs to accept the positive and negative aspects of oneself, be able to look at one’s past and present and therefore this will allow the person to look upon the future. On the other hand when an old individual feels that death will come too soon so as to make it possible to pay for previous wrongs, such individual would be experiencing despair. The individual in a state of despair feels discontent with life.

I believe that ‘despair’ is unfortunately a common aspect among old individuals. This is why I think that building self-confidence and self-esteem is an important task for the social worker. Old individuals need to be taught coping skills that would allow them to live life as healthy as possible and enhance their quality of life. Mrs. Camilleri experienced a drastic change from being fully independent to being confined to hospital. As Erikson’s stage suggests, she may now be feeling that death is near when perhaps she had never thought about this before. However Mrs. Camilleri does not seem she has given up on her independence and is looking forward to returning to her house.

Empathy is an essential skill that needs to be used. Mrs. Camilleri could be a quite irritable and petulant person. As a social worker, I would need to be patient with her and understand that her situation is a difficult one. Being conscious that Mrs. Camilleri who was until some weeks ago been so capable to do her things well, now has to rely on the help of others who may not be disposed. She feels uncomfortable having to wait for others to do things for her like for example to wash.

As part of the assessment phase, as a social worker I would explore the possible recourses available. I would see if her house is accessible and take steps if it is not. The use of steps might be a detriment for her safety for example. A bed could be brought downstairs so as to avoid stairs in case the bedroom is not on the first floor. An important aspect would be that of seeing if there is someone willing to help her in the day to day needs. A neighbour or a friend could do her shopping for example.

Mrs. Camilleri might have family members who are willing to help her. I would probably not suggest bringing a maid in, knowing that she had been one herself. I could also explore the idea of having a friend come to live with her. Day care centers might also be a good idea. Such a place would permit Mrs. Camilleri to meet others of her same age and therefore keeping her active through socializing with others, sharing her feelings and involving herself in activities.

However, Mrs. Camilleri might not be willing to have others do things for her, for example she might not be comfortable with having another women living with her in her house or would be reluctant to move out of her house if her friend agrees to live together with the condition that they live in her house instead of that of Mrs. Camilleri. I need to be aware that it might not be an easy task to negotiate with a woman who used to be very self-sufficient.

I find that in the case of Mrs. Camilleri a good thing to do would be to allow her to express herself, allowing her to come up with ideas while informing her of other sources and services which she may not be aware of or may have never thought about such as telecare, meals on wheels and homehelp.

Involving her in carrying out the action plan would empower her and make her feel that she is not helpless and powerless.

Let’s say that Mrs. Camilleri agreed that she would have her friend brought to her house to live with her and taken all the necessarily precautions so a to make her house as safe as possible, then the next step would be that of seeing that the action plan is being carried out as agreed. I would show Mrs. Camilleri that the changes she has suffered were difficult but not impossible to deal with and this is exactly why it is so important that she keeps to the plan agreed. She now has to adapt herself to her new situation if she is to maintain a good quality of life in a healthy environment.

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