Chapter 9 Reflection

Chapter 9 discusses how social work plans to move forward in the future. I think this is very important to understand when trying to access what we need to do to help social workers reach their full potential. When doing my interview the other day, I discussed with my interviewee, Penny Robinson, about how it felt to work in her profession and if it was moving forward. Penny explained that she felt as though social workers are getting more limelight and respect as the times are changing in health care facilities. This chapters discusses short term and long term solutions; insurance companies are loving this because that is less money they have spend depending on the situation. Short term solutions reduce frequency with hospital visits, enables families to help with care, and speed up the discharge process (Cowles, 2003, p. 350). I personally think that moving forward positively and with heath care facilities support is the main contributing factor in building social workers future.

Cowles, L. A. Fort (2003). A Vision of Future Social Work Practice in Health Care. Social work in the health field: a care perspective (2nd ed., pp. 343-364). New York: Haworth Social Work Practice Press

Ch 9 Weekly Reflection

The final chapter of this book discusses the past and future of social work in the health field. There are many changes occuring in the health care field. " Volland and colleagues identified three groups of social work skills especially needed in light of the trends in health care affecting social work in the field: 1) Basic Skills, 2) Population-specific skills, and 3) Autonomy-building skills" (Fort Cowles. 2003, p.354-355). Health care education at the graduate social work level should be offered in more schools of social work and be more extensive in terms of the number and range of courses offered. The education materials used should be more current and relevant to the reality of the health care system in which social workers will be employed. We need to develop effective supportive interventions to address the needs of the aged and others with chronic impairments, temporarily impaired, teminally ill, and those who need care to grow and develop. The essence of care or caring is to strengthen the ability of people to cope with the challenges they face, so they can have an improved quality of care.

Reference:
Fort Cowles, L.A.(2003). Social Work in the Health Field: A Care Perspective ( 2nd Ed.) Binghamton, Ny: The Haworth Press.

Weekly Reflection 9

Weekly Reflection 9

The final chapter summarizes the whole book and gives us the overall idea of the social work field.  It points out the emerging trends in health care delivery.  One of the important changes made in the health care in the United States is shifting from the hospital to the community as the center of health care delivery (Cowles, 2003).  This country understands that people with various health care situations need professionals who understand their not only physiological status, but also psychological, and social status.   Therefore, social workers are in demand in all kinds of health care field and because of them, the country is able to reduce the use of both mental hospitals and general hospitals and to increase the use of ambulatory care setting.  Three groups of social work skills are identified to be needed in the care affecting social work in the field: Basic skills, population-specific skills, and Autonomy-building skills.  Health care social workers should be prepared to work with little or no supervision, be able to take the leadership roles on a team and be able to advise the patient and family about their options.  The research for social work field should be done more in order to develop a body of practice.  The need for a technology of caring is also important in health care.  Because caring is prevention, professionals should more focus on all three levels of health service: Promotion of health and prevention of disease onset, prevention of compounding already existing health problems, and prevention of avoidable suffering and impairment of function.

Reference

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Reflection 9

Chapter 9 discusses “A vision of future social work practice in health care”. In other words, it relates to comparing the past and present of social work, the changes that have and are taking place throughout social work in the health care field, and also the research, skills, and values that are needed in order to be a social worker in the professional world. Many changes have taken place throughout the health care field along with the duties of a social worker. A few include; “Shift from hospital to the community as the center of health care delivery, increase in health problems with social and environmental etiology, growing expectation that families will have to do more of the care giving of their own members, at all levels of caring, gradual transformation of once-terminal health problems, into more chronic long-term care ones, etc.” (Cowles, p. 343).  While these different trends are introduced or become adapted, it is important that a social worker keep up to date and also always remember their primary goal; and that is to help people and try to keep them happy no matter the circumstances. “In light of values and ethics of the profession, it seems that health care social workers ought to consider what is really needed to make fundamental improvements in our nation” (Cowles, p. 353). This is stated in order to equal out populations and its health status, diminish social inequality, raise money along with increasing programs that are used for health advertising and prevention for disease, etc. “Whether the supports are interpersonal or concrete, the essence of care or caring is to strengthen the ability of people to cope with the challenges they face, so they can have an improved quality of life” (Cowles, p. 364). In my opinion this statement is a perfect for a social worker in the health care field, and describes every aspect of what they do on a day to day basis. Social work is about caring and providing, although there are many changes, patients still need to be happy.

Resource:

Fort Cowles, L. A. (2003). Social Work in the Health Field: A Care Perspective ( 2nd Ed.) Binghamton, NY: The Haworth Press.

weekly reflection 8

Weekly Reflection 8

Economic access to health services, types of health service organization, the quality of health care, cost, and managed care are discussed in chapter eight.  The United States health care system involves Medicare, Medicaid, and private health insurance (Cowles, 2003).  Recently, the uninsured population and the underinsured population are growing depending on the area, ethnicity, and employment status. There are different health service organizations such as hospitals, nursing homes, home care agencies, outpatient clinics and non-profit organizations in America.  One can get the best health care service in America only he or she can afford it.  Despite of the fact that the United States has the best health care system in the world, population health status is lower than some countries like Japan.   It may be because of the shortage of nursing and emergency room stuff, shortage of physicians who tend to retire earlier.  Although the annual rate of increase in health care costs has generally declined, the total health care cost continues to exceed compared to other countries.  To control health care costs, one method called managed care has emerged in the United States.  The chapter also points out about the CEOs of profit-making managed care organizations being awarded with multimillion dollar annual salaries and benefits packages in a nation where about over 40 million citizens have no health insurance.  Cowles believes that we need more health maintenance organization (HMOs) of the Kaiser Permanente type, nonprofit, health care providers because they make their own decisions about choice of  interventions and assume the financial risk of exceeding the capitated prepayment. 

 

Reference

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

chapter 8 discussion

Chapter eight talks about how the U.S. and how they have three economic accesses to health services. The three economic accesses to health service are Medicare, Medicaid and private health insurance. Medicare is where for selected groups only. They are for the elderly and disabled who are eligible for social security. Medicaid is for children and adults who need help when it comes to insurance. Private health insurance is where an employer provides for their workers. These three economic accesses do not “fit” together but they do help people in today’s society. Social workers can help people understand what the protocol is when it comes to health insurance. I believe that if you have a medical social worker there at hospitals to explain insurance to the patients then it will clear a lot of questions that they might have.  One thing that is not fair is that not everyone can afford insurance and sometimes people have a hard time to be seen by a doctor because they do not have insurance. More people are becoming uninsured and health care cost is becoming more and more expensive. It is really sad in my opinion. One good direction we could do is to make sure we inform everyone on how to live a healthy lifestyle and try to exercise when they can. That can help them by not getting sick as often. Hopefully one day we will have a society where everyone was eligible for health care and we can all make sure that everyone gets the help that they need.

Fort Cowles, L. A. (2003). Social Work in the Health Field: A Care Perspective (2nd Ed.) Binghamton, NY: The Haworth Press.

Weekly Reflection Ch 8

Chapter eight in this book discusses the U.S. health care system's strengths and problems. "The U.S. "nonsystem" of economic access to health care services represents a mixed model with the following features: 1) Medicare, which amounts to national health insurance for selected groups (elderly and disabled who are eligible for Social Security 2) Medicaid, a public assistance program financed from state and federal general revenue for person who qualify and 3) private health insurance" (Fort Cowles, 2003, p. 319). Unfortunately these three basic sources of health insurance coverage do not include all Americans. They leave gaps and the amount of people without insurance coverage has increased in recent years. In addition to the uninsured population there are many people that have only partial health insurance coverage, requiring out of pocket contributions such as deductibles, coinsurance, and uncovered services. Health care cost is very expensive and its sad that people with no insurance get the worst treatment involving health care if any at all. It was interesting to read that the United States is the only industrial nation in the world, besides South Africa, without a national system for ensuring universal economic access to basic health care, yet the United States also spends more than any of these other industrial societies.

Reference:
Fort Cowles, L. A. (2003). Social Work in the Health Field: A Care Perspective ( 2nd Ed.) Binghamton, NY: The Haworth Press.

Chapter 8 Weekly Reflection

Medicare, Medicaid, and private health insurance coverage are the three economic accesses to health service. Unfortunately these three basic sources of health insurance coverage do not fit together in such a way that all American are included in 1998, 16.3 per. Of the United States population or 44.281 million persons, were without any health insurance. The size of the uninsured population varies across states within the United States. Ethnic variation most advantages in the United States racial and ethnic minority group members tend to fare worse than the white majority. Age variation the elderly are most advantaged in terms of health insurance coverage. A mix model form also characterises the health services themselves, in the hospital, nursing home care agencies, outpatient clinics, and other organisational settings of such services are sometimes public tax supported, sometimes private nonprofit, and sometimes private for profit. Most Americans are very satisfied with the health care services they receive ( Zis Jacobs, and Shapiro, 1996), and professional health care providers, such as physicians, nurses, and allied health care professionals( social worker, physical therapists, occupational therapists, and speech therapists) are generally well traine, with high legal and professional practice standards.

Reference: Social Work in the Health Field A Care Perspective Second edition Lois A. Fort Cowles

Reflection Blog for Chapter 8 Even though the United States has some of the highest qualified doctors and some of the most advanced technology in the world, not all Americans has access to this high quality health care especially the poor, the elderly and the very young. The fact is the uninsured population is rising while health care cost are skyrocketing and we live in a country where basic health care is denied to those in need everyday. An elderly person should not have to decide between medication and food. The number one cause of bankruptcy in America is medical bills. Americans fear the cost of a universal health care system that is working well in other countries. This fear is unfounded though because they are already paying for it through waste, abuse and fraud in our for-profit hospitals. Only thing is, sick people are not the ones benefiting. (Cowles, L.A.F., 2003)In some cases, your medical treatment can be determined by a third party whose only interest is in keeping your health care cost low so that the money saved can be distributed to the CEO's of the corporation they work for. This may sound jaded, but it is a fact. The bright side is, there is a trend that is focusing on promotion and education for a healthy lifestyle and prevention of disease. This focus is on preventing rather that curing and should prove to be more cost effective, not to mention the emotional toll that a disease can have on an individual as well as their family. This is a positive step in the right direction. Unfortunately, the power goes in the direction of the money flow and the American Medical Association is much, much more powerful than all of the poor American put together. References Cowles, L. A. (2003). Social work in the health field: A care perspective. New York: Haworth Social Work Practice Press.

Reflection 8

Chapter 8 discusses the strengths and problems of the health care system featured in the United States. The health care system is made up of many attributes that are beneficial but also have flaws at times. Three of the biggest systems that make up the United State’s health care system are Medicare and Medicaid and private health insurance. Medicare is, “amounts to national health insurance for selected groups, elderly and disabled who are eligible for Social Security, as well as persons who are medially dependent upon expensive renal dialysis treatments for survival as a result of end-stage renal disease that is financed from employee payroll taxes” (Cowles, p.319). Medicaid is just the opposite and is mostly for children or adults who need the extra help. It is a government program which is financed by the state. Along with these a private health insurance is the insurance supplied by an employer to their worker. Although these three systems help out so many and are great programs, they do not “fit” together or cover every person with insurance. The costs of these programs vary. Every year it is mostly changed and depends on the type of insurance that is provided and how much it is put to use. Controlling health care costs is a big goal for the United States and is why a reform has been put to place. “Managed care has emerged in the United States as one method to control health care costs…” (Cowles, p.332). Managed care is a cluster of health service systems who try to control the costs throughout the health care system. In my opinion, the United States has good intentions on health care systems, but it seems like there is always more problems and confusing with ours than needed to be. I feel like new trends need to be added.

Resource:

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Digital Presentation

Reflection 7

In chapter 7 we learn the importance of social work in the hospice care. This type of care was created was a sense of responsibility to help relieve human suffering. "The objective of hospice care is to maximize the  quality of a patient's remaining life and to facilitate his or her 'safe passage'" (Cowles, p. 285). Although hospice is normally mistaken for taking the family's place of taken care, it is not. Hospice provides support and care for the patient and family, especially right before time of death. Hospice workers are to provide strength that recognizes the patient's sense of wholeness and, intactness, and also control. "Hospice care has a holistic perspective in that it directs attention to the needs of the whole person" (Cowles, p. 285). Hospice also includes recognizing the biological, psychological, and also social spheres of a person's life. This refers to relationships with other people through the community, family, society, and cultural influences. Social workers are used in hospice for these reasons. A social worker's prime focus throughout hospice health is the patient's care and their psychological needs. They are to provide comfort to the patient and family through this hard time and to make sure they engage in a "passing death". The social worker also helps the family through their grieving before and after the patient passes. Hospice is a good organization that provides care all over. It provides support and comfort that is needed throughout  a scary time. Social workers also play a huge role and make a difference day by day.

Weekly Blog Reflection Ch. 7

Social work in the hospice care setting can be practiced similarly to the settings of a hospital, home health care, or nursing home social worker thorough public, private, and nonprofit agencies that either employ or contract social workers to perform hospice duties. Therefore, hospice social workers can work within the settings of the other medical social workers, often crossing paths and receiving information for and about the patient. 

  Hospice care is referred in the text as, end of life care that requires social workers to participate in interdisciplinary teamwork as well as, to provide direct care for patients and their families. This care is met by a social worker performing several functions that address, focus, individualize,and meet the holistic needs of a patient's biological, psychological, and social aspects. In addition to meeting the patient's needs a social worker must also address and meet those same needs of the patient's family, so that they may be able to support, transition, and provide care for the dying family member both before and after death. 

   Like other medical social workers, hospice social workers often run into the same organizational, funding, and the overstepping of other professions boundaries, issues, and conflicts while trying to effectively practice and provide care for a patient. However, like in any other medical setting, a hospice social worker must advocate for themselves as well as, the clients right to practice and receive extraordinary end of life care and educate future social workers of these types of situations and steps to prevent and resolve them.

  I believe this chapter really opened my eyes to the possibility of practicing hospice social work and emphasized on the importance of assisting a patient understand their pain, rights, wishes, concerns, and transition into and about their dying process. Something that I found particularly interesting about the chapter on Hospice care, was that the text stated that physician often delays the referral for hospice care for a patient and that many patients die within a few weeks to only of month after receiving services. Clearly this is not enough time for a social worker, a patient, or their family members to perform or receive the due care that they deserve. This doesn't seem very ethical...

Reference:

 Cowles, L. A. F. (2003). Social work in the health field: A care perspective. Routledge.

Weekly reflection 7

Chapter seven discusses the role of a social worker in hospice care. Hospice is a program and a philosophy not just a particular place or setting. Most hospice care is provided in the home, however hospice agencies sometimes follow former home care patients into nursing homes to provide continuity of appropriate care. Some acute care hospitals provide hospice care service on the hospital site.  Client problems and social worker functions relating to hospice care depend on the type of organizational setting. “From the perspective of social worker functions, the problems of patients in hospice care may be classified as those associated with: admission to the hospice service, adjustment to the service or facility, adjustment to the diagnosis, prognosis, or care plan, the lack of information to make informed decisions and take control, the lack of needed supportive resources, such as supportive tools and equipment, support services, income supports, supportive environmental adaptations, and interpersonal supports, and barriers to discharge from the service or setting” (Fort Cowles, 2003, p. 293). I think that being a social worker in hospice care would be very hard. It is a hard job to get to know people and to watch them die even though it is part of life.

Reference:
Fort Cowles, L.A. (2003). Social Work in the Health Field: A Care Perspective. Binghamton, NY: The Hawthorn Press.

weekly reflection # 7

Weekly reflection # 7

Historically, hospice care is based on a moral necessity, value of concern about human suffering and the ethical sense of responsibility to help relieve that suffering (Cowles, 2003).   The hospice care maximizes the quality of a patient’s last days and to provide his or her “safe passage”.  Family care is not substituted by hospice care but rather facilitated and supported based on the patient’s needs. 

Hospice care has a holistic perspective and a biopsychosocial perspective.  The holistic perspective gives the direct attention to the needs of the whole person which involves interaction with the spiritual person of the patient and his or her physical needs.  The biopsychosocial perspective involves biological, psychological, and social spheres of our lives interacting and affecting one another.  Fish (1994) and Germain (1984) mention that terminally ill patients often encounter a variety of physical associated discomforts, such as pain, dyspnea, weakness, eating and sleeping problems, digestion and excretion problems, sensory impairment, paralysis, skin problems, or swallowing difficulty.  My father-in-law who suffers from Parkinson’s disease and is in a bed-ridden stage has the symptoms mentioned above.  Since he is a terminally ill person, his family decided to bring him home last month.  Even though he seems more comfortable staying home rather than at hospital, he is having associated physical discomforts.  Because he weighs only 70 lbs, he is so bony and so weak.  Even though he feels pain all the time because of his muscle rigidity and pressure sores, he cannot complain about his pain because it takes a lot of his energy to speak, and as a result, he feels so sad and cries very often.  Social workers and nurses understand his pain and suffering, so they give him pain relief medication four times a day.  They look after him using holistic and biopsychosocial perspectives.

Reference

Cowles, L. A. F. (Ed.). (2003). Social work in the health field: A care perspective. (2nd ed.) Binghamton, NY: The Haworth Press.

Fish, N. M. (1994). Social work practice in hospice care. Social work practice in health care settings, 403-419.

Germain, C. B. (1984). Social work practice in health care: An ecological perspective. New York: The Free Press.