Description
Discussion: Systems Perspective and Social Change
Zastrow and Kirst-Ashman (2016) stated, “Clients are affected by and in constant dynamic interactions with other systems, including families, groups, organizations, and communities” (p. 35-36). As a social worker, when you address the needs of an individual client, you also take into account the systems with which the client interacts. Obtaining information about these systems helps you better assess your client’s situation. These systems may provide support to the client, or they may contribute to the client’s presenting problem.
For this Discussion, review “Working With People With Disabilities: The Case of Lester.”Consider the systems with which Lester Johnson, the client, interacts. Think about ways you might apply a systems perspective to his case. Also, consider the significance of the systems perspective for social work in general.
Post a Discussion in which you explain how multiple systems interact to impact individuals. Explain how you, as a social worker, might apply a systems perspective to your work with Lester Johnson. Finally, explain how you might apply a systems perspective to social work practice.
Please use sub headings when answering and use 2 peer reviewed references.
References
Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA: Cengage Learning.
- Chapter 1, “Introduction to Human Behavior and the Social Environment” (pp. 11-54)
Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].
- “Working With People With Disabilities: The Case of Lester” (pp. 31–33)
Lester is a 59-year-old, African American widower with two adult children. He lives in a
medium-sized Midwestern city. Four months ago, he was a driver in a multiple vehicle crash while
visiting his daughter in another city and was injured in the accident, although he was not at fault.
Prior to the accident he was an electrician and lived on his own in a single-family home. He was
an active member in his church and a worship leader. He has a supportive brother and sister-inlaw who also live nearby. Both of his children have left the family home, and his son is married
and lives in a nearby large metropolitan area.
When he was admitted to the hospital, Lester’s CT showed some intracerebral hemorrhaging,
and the follow-up scans showed a decrease in bleeding but some midline shift. He seemed to have
only limited cognition of his hospitalization. When his children came to visit, he smiled and
verbalized in short words but could not communicate in sentences; he winced and moaned to
indicate when he was in pain. He had problems with balance and could not stand independently
nor walk without assistance. Past medical history includes type 2 diabetes; elevated blood pressure;
a long history of smoking, with some emphysema; and a 30-day in-house treatment for binge
alcoholism 6 years ago following his wife’s long illness with breast cancer and her subsequent
death.
One month ago he was discharged from the hospital to a rehabilitation facility, and at his last
medical review it was estimated he will need an additional 2 months’ minimum treatment and
follow-up therapies in the facility.
As the social worker at the rehab center, I conducted a psychosocial assessment after his
admission to rehabilitation.
At the time of the assessment, Lester was impulsive and was screened for self-harm, which was
deemed low risk. He did not have insight into the extent of his injury or changes resulting from
the accident but was frustrated and cried when he could not manipulate his hands. Lester’s children
jointly hold power of attorney (POA), but had not expressed any interest to date in his status or
care. His brother is his shared decision making (SDM) proxy, but his sister-in-law seemed to be
the most actively involved in planning for his follow-up care. His son and daughter called but had
not visited, but his sister-in-law had visited him almost daily; praying with him at the bedside; and
managing his household financials, mail, and house security during this period. His brother kept
asking when Lester would be back to “normal” and able to manage on his own and was eager to
take him out of the rehabilitation center.
Lester seemed depressed, showed some flat affect, did not exhibit competency or show interest
in decision making, and needed ongoing help from his POA and SDM. His medical prognosis for
full recovery remains limited, with his Glasgow Coma Scale at less than 9, which means his injury
is categorized as catastrophic.
Lester currently has limited mobility and is continent, but he is not yet able to self-feed and
cannot self-care for cleanliness; he currently needs assistance washing, shaving, cleaning his teeth,
and dressing. He continues with daily occupational therapy (OT) and physical therapy (PT)
sessions.
He will also need legal assistance to apply for his professional association pension and benefits
and possible long-term disability. He will also need help identifying services for OT and PT after
discharge.
He will need assistance from family members as the determination is made whether he can
return to his residence with support or seek housing in a long-term care facility. He will need longterm community care on discharge to help with basic chores of dressing and feeding and self-care
if he is not in a residential care setting.
A family conference is indicated to review Lester’s current status and short-term goals and to
make plans for discharge.
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