1962 Words |
Themes and theories relating to service users and social work practice in a chosen scenario
Scenario 3 |
will writing service or solicitor
This essay will look at scenario 3, that of Yasmin a 79 year old woman that has been diagnosed with dementia. The essay will identify and discuss themes relevant to the service user and for the social work practice. Some of these including culture, religion and aging.it will look at areas of oppression and discrimination and the importance of relationships to promote well-being.
Yasmin and her family were forced out of Uganda and moved to Leicester in 1973.It can be deduced, however not taken for certain, that Yasmin and her family are from an Asian culture (BBC, 2010). It should also be understood that within this culture a variety of religions are practiced (Bonney & Le Goff, 2006). For Yasmin and her family these will be important to as it can have an effect in all areas of the situation that they find themselves in and their relationship with care services. A social worker needs to be converse with the ideology of a service user and their families??™ culture and religion as it could be a factor in any discussions with the service user their families and the social worker themselves. They must be aware that we live in a diverse society that has different views and preconceptions. The social worker also needs to be aware of their own values so they can be taken into consideration, though fore making sure that these do not impact on their practice (Thompson, 1998).
Yasmin is female and historical it has been seen that there has oppression and discrimination of females in society, though this situation is changing it this has to be taken into account within the influences of Yasmin??™s life course, the impact within the family but also the social worker have been influenced in their thinking. The social worker practice must of an anti-oppressive and non- discriminatory nature with an understanding of how being female has influenced Yasmin growing up in what has been said is a patriarchal society. A theory that would help in this situation is the feminist theory. It is concerned with understanding and transforming the subordinate position of women in society. However black feminists have indicated that within their cultural family structures ideas of oppression were different then these of a western society (Featherstone, 2000).
Yasmin is 79 years old this area brings up some interesting themes. There are a number of physiological effects of ageing. The body becomes less elastic; there is a decline in muscle and strength. There is a reduction in eyesight and hearing although these two conditions can be off set with the use of glasses and hearing aid. There have been longitudinal research studies that have shown that there is a loss of tissue in the brain as it ages (Passer & Smith, 2007).
It has also been shown that a person??™s intellectual abilities can decline as a person ages. Fluid intelligence which reflects the ability to perform mental operations (e.g. abstract and logical reasoning) declines faster than crystallized intelligence, which reflects the accumulation of verbal skills and factual knowledge. Though the decline of both can be offset by continued use of the abilities associated with intelligence (Passer & Smith, 2007).
Though these are factors in that do have to be of concern to the social worker the whole of Yasmin??™s life should be taken into account. A prominent theory in this area is Erikson??™s life cycle theory. With its eight stages of development, it is very much a psychosocial approach with the importance of relationships as a central factor in the development of personality. Erikson theory explains human development as the process of forming identity through the interaction between the individual, the society and the situations in which we live. He suggests that people comfort a series of developmental challenges or conflicts at predictable stages in their lives, these situations can be met successfully or unsuccessfully.
Stage seventh of Erikson??™s theory is that of generativist versus stagnation, generativist being the concepts of productivity and the rewards of psychotically wellbeing for adults that it brings and the eighth stage which Erikson describes as the process of Ego integrity, the acceptance of one??™s past life and the valuing of a person??™s individual self. The favourable part of this stage in life suggests maturity and wise adulthood. However, this stage can also produce despair with ideas of things not done and the fear of death. A critique of this theory is that there is no empirical evidence for this theory , however Lefrancois (1999) cited Gibson 2007 confirms that the theory is helpful as a framework for interpreting changes experienced during a person??™s life ( (Gibson, 2007) (Salkind, 2004)).
Other theories that can be used by the social worker in this case could be. Role theory, this emphasises that a person??™s identity is influenced by their relation to those around them ??“ be it siblings, partners, the employment environment they are in or their social standing. A set of mutual expectations define the role of a person and a ???role conflict??™ can occur when the expectations of two or more groups are incompatible. Though this is a useful theory as it describes the effect of external influences on a person it has been said that role theory only see a person that has been created by the social roles they enact and does not take account of a person??™s own Idea of self. (Salkind, 2004).
Disengagement In this theory of ageing a person is supposed to have an intrinsic tendency to cut their bonds from society and turn inward to them. With this theory, it is also a two-way process from the individual and society itself. This disengagement does not, according to this theory produce dissatisfaction with both parties as it is a natural process and promotes satisfaction of society and inner harmony of one??™s self (Tornstam, 2005, p. 35).
Gerotranscendence theory developed by Tornstam in the 1990 and considers human development as a process continuing into old age. This theory is that people become less self-occupied and more selective in their social activities moving from a materialistic and rational view to one of life satisfaction in a redefinition of self, and relationships the theory is that this should not be regarded as disengagement or apathy but about self-discovery and perspective (Tornstam, 2005).
Also With the increase of life expectances, for 2007-2009, this was 77.7 for males and 81.9 for females (Office for National Statistics, 2010); the third age theory or that of a second growth. That of individual fulfilment of personal goals, dreams and life plans. Of challenging the old social ideas of the elderly with a regeneration and sense of wellbeing (Sadler, 2000). Though some of these might not relate to Yasmin herself the social worker should consider these when considering the family and social structure that Yasmin is in.
Yasmin has been very active in her retirement, teaching art classes, walking, cycling and attending U3A activities. An issue of relevant to this case is fear of loss of independence, control over their own lives, identity and self-esteem. She may have concerns that because of the effects of the diagnosis of dementia and the involvement of the care services Yasmin will loss control of her life. In recent studies of ethnic minority mental health service users they mention their apprehensions of engaging with mental health services Some being the loss of control and enforcement of treatments, potential of detention under the Mental Health Act 198.some thought there was little or limited knowledge of either the persons personal and cultural perspectives also being miss understood because of language issues. There is also the fear of shame, dishonour or stigma of the person that has a mental illness (Fountain & Hicks, 2010).
Another factor in this area is the diagnosis of dementia. There are a number of illnesses that are classed under the world health Organization ICD-10, F00-F03 (World Health Organization, 2007). Dementia is a progressive and largely irreversible condition that is characterized by a wide spread impairment of mental function. the progress of the condition can included memory loss, language impairment, disorientation, difficulties with doing normal daily activities, such as washing and can result in self-neglect. Dementia can also produce psychiatric symptoms such as depression, apathy, and psychosis. It can lead to out of character behaviour for example aggression and sleep disturbance ((Davison & Neale, 2001, pp. 462-467), (Sudbery, 2010)).
In a survey of service user by Mind, some felt there was discrimination and exclusion of people who use mental health services and this was triggered by the diagnosis and the subsequent treatment. Some also felt that the diagnosis itself made them feel like a non-citizen, with no rights and no credibility (Dunn, 1999). Kitwood citied Mills (2003) suggested two theories of social discrimination and oppression in the area of dementia. First was that that the person was labelled as the illness not as a person and secondly that there was an assumption that there must be something wrong with the person in the first place to produce the illness in the first place (Mills, 2003).Discrimination and mental health are closely linked and this can have an effect on self-esteem and a person??™s expectations of life (Mental Health Foundation, 2006, pp. 23-24).
The social worker should follow the principles of person-centred care of people with dementia these include; that the person has a unique personality and life experience that will influence their perspective and responsive to dementia. They should value the person with dementia, regardless of age or cognitive impairment. There must also be a consideration of the relationships and interactions that the person with dementia with their family, friends and carers, and their potential for promoting well-being (Nice, 2006).
It can be seen that social isolation is a strong risk factor for the poor mental health and is said to be experienced by one million older people in the UK. Relationships that are secure and supportive are important for mental health and well-being. These can be with the family the persons friends and with other people within the person??™s life. Part of the work of the social worker is to promote and strengthen positive relationships in later life (Mental Health Foundation, 2006).
A psychological theory, that of, Attachment theory can be used within this area as it can help the social worker understand the relationships within the family. with this four patterns of attachment; secure, ambivalent, avoidant and disorganised, this theory can help the social worker to understand part of the affectional behaviour within the family and assist in promoting psychological well-being, esteem, confidence and resilience (Lishman, 2007).
Another theme of the case is the death of Yasmin??™s husband, Mazoor, eighteen months ago. The social worker may need to understand how this has impacted on Yasmin. Two of the theories of grieving could be used in this situation are; Kubler- Ross??™s model of dying and has also been applied to grieving. It describes the process in five stages which include shock, anger, denial and finally acceptance. Though Kubler-Ross did not see these as a fixed sequence. And Stroeb and Schut model where the grieving person alternate between two contrasting orientations; one looking backwards with sadness and bewilderment because of the loss of the relationship and the meaning less of their life in the future with the ending of the relationship the future. The other orientation being the practical arrangements and the idea of new life choices in the future. Yasmin??™s cultural and religious background should also be taken into account, as there are different outlooks on death and to ignore these differences would be discriminatory and oppressive (Salkind, 2004).
It can be seen with this case study that culture and religion are importance within all parts of service care and social work practice. The rights and opinions of the service user should be taken into account within each discussion and decision made. That a person??™s life development can have an effect on a person??™s outlook and their relationships.
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