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Old 09-02-2006, 12:26 AM   #1
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Question Help Me Please! About Social Workers...

Hi Everyone and All,

I need any help that yall can give me. If I did not already tell you, my dads dr. had home health care start coming to his house. This is mainly to have him evaluated and to be helped also. There is a RN who is the patients manager and comes to see him 1 x week. There is also a physical therapist who comes 2 x week. And an occupational therapist who also comes 2 x week. They all stay less than an hour. Just depends on what comes up that particular day.

So, my mom did not like this too much in the beginning. The dr. just told us at my dads last appt., that he was going to be starting on that. They have had 1 session, of about 2 mo. And has now been started on his second session, for about a week or two. They evaluate him and report to the dr. and other people (who - I do not know!).

Anyway, the head lady, RN, called me (she and the other therapists call me a lot). She was nicely informing me that she and the other therapists and possibly the dr. (not sure), want to send a social worker to my parents house in a week or 2. Of course I will not talk to the social worker til next week, and then we will set up an appointment at my parents home. The social worker, me, my mom and my dad. Possibly my sister can come in to town also. I sure would like the support. And possibly our parents might respect her ideas more as she is older and not around as much.

This is what I need help on: What does a social worker do? Who does she work for? (like who pays her?) How much power does she have (as in where and if my parents are made to go to another place to live - like an assisted living and/or alzheimers place). Just in general everthing yall know about social workers. I have generally heard good things about them, so I expect them to help me and my dad (and my mom too, whether she knows it or not).

The home health people believe that my mom can no longer take good care of my dad in their home. She is trying and really wants to keep living there, but there house is very old, about 50 yrs. The door ways are too small for a wheelchair and there is a very long hall. So I know that is part of the meeting. Plus they know that my mom has early dementia and uncontrolled diabetes. Thus, she sometimes does not act "right" to and with the workers. And of course all the other people in the world. We put up with her because we love her. We just ignore her weird sayings or I tell her she needs to take some hormones!!! :>

Also, Is there the possibility of "someone or some group of people" making my dad move into a good alzheimers care place? By their findings and a couple of meetings and the family doctor also? I would love for that to happen, buy now that there is a slight chance that it might, I feel weird... My mom just leaves too much to chance, with my father and his needs and sometimes leaves him alone for up to 3 - 4 hours. I think she just freaks out and leaves (but tells him or the health person). She knows that I would come and give her a break, if she would just ask!

One more thing(?)! :> I was just thinking of writing the dr. a letter or talking to him on the phone, to ask that he have my dad made incompetent. Only trouble with that, is that then my mom would have his POA. And my sis and I are not sure that my moms dr. would give him her POA, which would then go to me. I think?????????

So I shall wait and see what happens next week. Keep my finger crossed, that my dad can go to a very good alzheimers place and that my parents will not have too much of a heart attack - or hate us forever.

Plus, there is also the thought of my mom living in that house by herself??? I hope that if and when this happens, that she will go looking for an assisted living place for herself????? I just do not know what, if any thing will happen?

Take care and thanks for listening.

Love, Wannabe

 
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Old 09-02-2006, 05:19 AM   #2
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Re: Help Me Please! About Social Workers...

Dear Wannabe,

Sorry you are feeling so upset about this.

When the RN called you should have asked her who the social worker works for. What organization sends the nurse, physical therapist etc? That will be the same organization that wants an evaluation from the social worker.

They are usually women, so I'll say 'she.' She will make a family visit and evaluate the situation. How does she see the family functioning. Does it look to her as if the patient is being cared for well. Does she suggest a nursing home or an assisted living type of situation. SWs do not have any power to force anyone to do anything. They only make suggestions, recommendations. The agency she works for will relay her suggestions to you, and you the family will decide what to do.

A doctor cannot declare a person incompetent. That is a job for the courts of the state you live in. He can testify at that court hearing but the final decision goes to a judge.

We never had to have my Mom ruled incompetent, she just got sick, went into the nursing home, etc. My brother had POA before she was obviously incapable although she really didn't know for sure what she was signing.

I think you can probably trust the judgment of the social worker - they have a lot of experience helping famiies in distress and solving problems.

Good luck.

Love,

Martha

Last edited by Martha H; 09-02-2006 at 05:21 AM.

 
Old 09-02-2006, 11:51 AM   #3
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Re: Help Me Please! About Social Workers...

Hi Martha,

Thanks for replying. I appreciate the info and the advice. For some reason I thought that I had heard or read that a dr. could write a letter or a form, declaring a patient incompetent. Then it would probably have to go to a lawyer or somewhere like that?!

I guess when the Social Worker calls me Tues or Wed., I can ask my questions then. I am afraid that my dad will "put on a show" for the social worker. He can for a few hours. My mom cannot, she just gets more upset.

Yeah, we have talked with some social workers in the hospital, when my MIL was sick. They are a great help and can direct you/me and possibly get things done faster than a regular person could.

Thanks for the help Martha. If there are any other helpful people out there, just speak right up!!! :>

Love, Wannabe

 
Old 09-02-2006, 12:45 PM   #4
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Re: Help Me Please! About Social Workers...

I think Martha said it all so eloquently.

I just want to add though that the health care workers and social workers are looking at the whole picture. That means they're also looking at your mom. It's possible that they'll reccomend some type of services or assisted living for her too if they see that she's not capable living alone.

I think it's great that these people are involved because when a decision or reccomendation is made, it won't fall on your shoulders. They'll be the fall guys and maybe your parents won't be upset with you at all.

And your mom might be a bit better with taking her meds and such if the stress of taking care of your dad is off of her shoulders. Things don't always go the way we think they will and sometimes that's good. Remember how I got a few weeks ago when I thought my dad was coming back home? I was so frazzled I was literally shaking at the thought.

You might want to write down your questions for the social worker ahead of time. I know it helps me because I get so caught up in trying to remember important questions that I tend to forget the "not very important but want to know" ones.

Love, Barb
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Old 09-02-2006, 04:13 PM   #5
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Re: Help Me Please! About Social Workers...

We have a similar team working with SIL and us and they are great. Having said that, they have been ‘on the case’ for nine months now and SIL is still in her home – she has a lot more help which has taken a lot of the burden off us – but essentially the situation is the same in terms of worry and risk.

I have learned a few things that might help:

Yes, find out who the social worker works for – in our case she is working for an agency contracted by the health authority. So there is a case worker at the health authority who is the overall coordinator and that is the person we can escalate things to.

Find out what the overall goal of this help is (that may sound stupid – but it wasn’t immediately obvious to us – like you, we were hoping that they would see just how dire the situation was becoming and recommend assisted living). Turns out the overall goal is to keep SIL at home for as long as possible – that is part of their policy – both for financial and social reasons. What this means is that they tend to look at smaller things that can improve the situation, but they aren’t inclined to take a big step back and look at the overall picture.

Build up good relationships with the team (you are already doing this). Otherwise things can happen that you are not aware of/not having input into.

Find out what exactly the assessments are that they are doing. We got terribly excited at one point when we were told an assessment was being carried out – but it turned out to be only a safety assessment from the occupational therapist. That’s great of course, but all the handrails and non-slip mats in the world aren’t going to address the big problems – kind of like moving the deckchairs around on the Titanic. By letting the case worker know what our broader concerns are, we have had much higher level assessments carried out.

When you know they are carrying out the right kind of assessments, make sure that you and your sis get separate input (there are things you need to say that you cannot say in front of your mother), and ask to be there when they are talking to your parents (SIL can present a very convincing front, all of it fictitious, and, unless we know what is being portrayed, we aren’t able to correct any misleading impressions).

The team only gets to see your parents in hour-long bites, so they can miss the bigger-picture things (although they and your doctor do seem to be on to things). So yes, document those bigger things that you worry about so they won’t be missed – medication, nutrition, food hygiene, personal hygiene, medical conditions, finances, lack of supervision, would your mother be capable of recognizing a situation that requires medical (or other) attention and does/can she ask for help where appropriate?

Hope some of this helps

love Georgie

 
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