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Services to the Family

In Case 1, due to Roger’s power of attorney not being signed by witnesses as required by law, the document is not legally binding. One service I would provide to Roger’s family would be education on how to obtain guardianship of Roger and referrals to legal resources in the area. If there are financial restraints, I would provide referrals to low-cost or pro-bono attorney services in the area. Additionally, I would social and emotional support services as well as assistance with navigating the guardianship process.

Education on Legal Issues

In this specific case, the only family member identified is Roger’s wife, so I assume she is the main relative involved in his care. I would focus on giving her general information on seeking guardianship of Roger, while being careful not to cross the boundary of giving legal advice. If my agency had brochures on the topic, I would provide those, or pull information from the state of Missouri website for her reference. The other part of the education would be helping her understand why the doctor may be hesitant to take Roger off of the ventilator without the proper legal documents. If there are multiple family members involved, I would talk with Roger’s wife about holding a family meeting to discuss legal issues with everyone at once.

Purpose, Benefits, and Legal Ramifications of Documents

Advance Directive: Advance directives are documents drawn up by an individual that give guidance in regard to health care decisions if they are to become unable to speak for themselves (Gehlert & Browne, 2012). These documents detail a person’s desire in regard to treatment procedures and end of life care (Gehlert & Browne, 2012). Common advance directives include the durable power of attorney for health care and the living will.

Medical Power of Attorney: The power of attorney allows a patient to legally appoint an individual to speak on the patient’s behalf should they become incapacitated (Gehlert & Browne, 2012). The power of attorney, if completed correctly, is a legal document and avoids family members having to petition the court for guardianship of an incapacitated person.

Living Will: A living will is a document competed by the individual that states what their desires are in regard to types of treatment (Gehlert & Browne, 2012). This document differs from a power of attorney as it is directive to the health care team rather than giving an individual the authority to speak on the patient’s behalf (Gehlert & Browne, 2012). This document guides the doctor to ensure he or she provides care in accordance with the patient’s wishes (Gehlert & Browne, 2012). This also avoids legal issues by making clear early on what the patient would want and avoids disagreements between the doctor and family members.

Advocacy Role

In this case, I see the advocacy role as helping Roger’s wife getting the legal assistance she needs. I also see a role of talking with the interdisciplinary team about Roger’s wife and the need to be sensitive to her stress when talking to her about Roger.

Reference

Gehlert, S., & Browne, T. (Eds). (2012). Handbook of health social work (2nd ed.). Hoboken, NJ: Wiley.

Services to offer family in Case 2

                Based on the information given on the case of Margaret, this medical situation happened out of nowhere.  The family and patient may unprepared with no advance directive or living will as medical staff are requesting to have a do not resuscitate order in place in case Margaret has experiences cardiac issues.  Services that a social worker could provide to the patient and her family: physical and psychological comfort throughout this hard time, spirituality referral to chaplain services, education on grief and loss process, DNR orders, and to be there when/if the family are in need (Gehlert& Browne, 2012).

Methods and practices employed to education family of legal issues

Living wills- Lets others know the end-of-life medical care wishes of the patient, in case they are unable to communicate their own decisions.  There is no power after death.  Benefits are that family does not have to guess at what actions the patient may have wanted for their care.  Also, takes the burden off the family to know if they made the right choice (Gehlert& Browne, 2012).

Medical power of attorney- Legal document that authorizes someone the patient can trust to make medical decisions on their behalf.  Benefit is that it helps to take the guess work out of the family’s hands.  A limitation may be if the family does not agree with the decision of the identified person, which may cause tension (Gehlert& Browne, 2012).

Advance directives-  Written statement of the patient’s wishes regarding their medical treatment, which often includes a living will.  Allow for a clean, clear, and concise description of the what patient’s wishes are so there are no guesses. (Gehlert& Browne, 2012).

Advocacy role

                An advocacy role that a medical social worker could play is to assure that the family members, no matter the decision, made the correct decision.  Also, to be a liaison between medical staff and family members.  End of life is a trying time which needs to a strong advocate to promote a compassionate environment (Cagle & Kovacs, 2009).  This may be an emotionally trying time for the social worker too, where the social worker may experience compassion fatigue.  Being present in the client  and family’s personal presents can be a very rewarding time yet challenging at times (Gehlert& Browne, 2012).

References:

Cagle, J. G., & Kovacs, P. J. (2009). Education: A complex and empowering social work intervention at the end of life. Health and Social Work, 34(1), 17–27.

Gehlert, S., & Browne, T. (Eds.). (2012). Handbook of health social work (2nd ed.). Hoboken, NJ: Wiley.