Reference no: EM133879676

Question 

Describe ways you would have supported Magda's self-determination through the assessment and treatment-planning process. Include questions you would have asked Magda and her professional support system (doctors, nurses, etc.) to gain further insight into the situation.

Magda is an 81-year-old widowed female of Greek descent who lives in an apartment in a suburban area. Until recently, Magda was self-sufficient, attending weekly family dinners at her son's home 30 minutes away and driving herself shopping and to the Greek Orthodox Church. But 5 months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Following her surgery and rehabilitation, she frequently complained of chronic pain. Through the church, Magda's son John and daughter-in-law Helen hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen went to see Magda on the other days, sometimes twice in one day, depending on her needs. She bought food, cleaned the home, paid bills, and kept track of medications. Helen wanted to have the helper come in more often, but she could not afford it. The money to pay for help was coming out of her and her husband's vacation and retirement savings. Helen and John's son, 27-year-old Alec, offered to help care for his grandmother by moving in with her, thus taking the burden off of Helen. Alec and his grandmother had always been very fond of each other, and Helen thought she could give Alec, who was currently unemployed, the money that was currently going to Magda's helper. John agreed with the plan, which seemed to be a good one. Intake and Assessment Generations Mental Health is a social work agency providing care for elderly/aging adults who have been discharged from the hospital within the past 6 months. The program was set up because of poor outcomes associated with geriatric surgical patients' mental health and the complexities of aftercare. Helen called Generations because she remembered the program being offered at Magda's discharge. Intake With Magda During the intake, Magda stated that the day before Alec moved in, Helen informed her that it would happen. She had not been consulted about changing the living arrangements and was upset about the helper leaving. However, she loved Alec. She was optimistic about having someone around who could drive her to appointments, church, and other social outings, as she had not been getting out much since the surgery. That didn't happen because Alec was "always gone." Magda reported feeling like a burden and like no one wanted to care for her. Helen's Perspective In order to get a full perspective on the events that followed, the gerontological social worker talked with Helen. Helen recounted that Magda called her at work the day after Alec moved in to request a refill of her medications. Helen asked to speak to Alec, and 2 © 2022 Walden University, LLC. Adapted from Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Sessions: Case histories. Laureate International Universities Publishing. Magda said he had gone out with two friends the night before and had not come home yet. Helen left work immediately and drove to Magda's home. She assumed that Magda had misplaced the medications. When she searched the apartment, however, Helen noticed that the cash box was empty and that Magda's checkbook was missing two checks. Helen determined that Magda had been robbed, but because she did not want to frighten her, she decided not to discuss it with Magda or report the crime. Instead, Helen phoned the pharmacy and explained that her mother-in-law, who has dementia, had accidentally destroyed her medication and would need refills. She called Magda's bank and learned that the checks had been cashed. Helen cooked lunch for her motherin-law and ate it with her. When a tired and disheveled Alec arrived back in the apartment, Helen quietly told her son about the robbery and reinforced the importance of remaining in the building with Magda at night. The events in Magda's apartment were repeated 2 days later. Jewelry from Greece, which had been in the family for generations, was now gone. Helen said she now realized Alec was stealing from his grandmother to support his drug addiction. Alec had struggled with maintaining sobriety since he was a teen. He was currently on 2 years' probation for possession and had recently completed a rehabilitation program. She could not possibly tell her husband because he would hurt and humiliate Alec, and she would not consider telling Magda or the police. Helen's solution was to remove the valuables and medications from the apartment and to visit twice a day to bring supplies and medicine and to check on Alec and Magda.