Psychosocial evaluation and assessment:
Psychosocial assessment is the social worker’s summary judgement as to the problems to be solved. The social worker considers a variety of factors, which may include the physical/psychiatric illness and its impact, results derived from psychological tests, legal status, descriptions of the problem(s), existing assets and resources, the prognosis or prediction of outcome, and the plan designed to resolve the problem(s). Throughout the intervention process, the psychosocial assessment is a "work in progress" in that it is revised continually as new information is acquired, as circumstances and goals change, and as progress toward goals is made. The psychosocial assessment is related to dynamic forces including the patient’s health status, personal reactions to illness or injury, waxing or waning interpersonal, familial, or community problem-solving resources, and the patient’s and family’s capacity to manage these events.
Social workers acquire information to develop a plan for helping the patient and family. This information may include the patient’s and family's description of the problem, corroboration from other sources, psychosocial
| history, the patient’s cultural and sub cultural groups, the specific environment in which the patient lives, and various resources that might be used to help the patient.
|
|
The purpose of the psychosocial assessment is to help the health care team identify variables that either impede or facilitate health care progress. Overall, the goal of psychosocial assessment and subsequent social work intervention is to assist the patient in reaching the maximum benefit from health care resources.
Help with psychosocial functioning:
Psychosocial functioning describes a person’s ability to perform the tasks of daily life and to engage in mutual relationships with other people in ways that are gratifying to self and others and that meet the needs of the organized community in which the person lives. Acute or chronic illness may be accompanied by difficulties and strains that bring about a period of disequilibrium. The patient’s or family’s perceptions of the world and themselves may also change.
In these instances, social workers provide individual, family, marital and group counseling directed toward enhancing the patient’s or families cognitive, emotional, interpersonal, and/or social functioning. The goals of the social work intervention are to mediate the disruption that illness and treatment bring, and to help the patient and family mobilize their personal and interpersonal resources.
Help with adaptation to illness or treatment plan:
Illness disrupts normal body systems and require medical intervention may also disrupt social relationships and functioning. The patient’s ability to participate in social, religious, or cultural activities may be curtailed, the ability to earn a living or support a family may be diminished and family roles and friendships may be affected. Treatment regimens may impose new ways of thinking and acting, special equipment, or changes in living arrangements.
|
Social workers help patients and family members cope with these and other demands by addressing issues related to: the patient’s perception of the illness and its impact, previous experiences with this or other illnesses, necessary lifestyle changes, coping with restriction in lifestyle, and adjustments that will be needed by the family. |
The social worker provides counseling aimed at increasing the patient’s understanding of the illness and treatment and the impact on self and family, conducts intervention to help in adjusting to illness, disability and /or hospitalization, leads support and educational groups, and provides death and dying counseling to terminally ill patients and their families. The goal of this intervention is to assist the patient and family in reaching maximum physical, psychological, and social potential.
Support groups at UI Hospitals and Clinics
Help with post-hospital planning:
Discharge planning services are designed to assist patients and their families in developing and implementing timely and appropriate post-hospital care plans. Post-hospital care plans may include return to home with in-home services or equipment, placement in long term care facility, or other arrangements needed at time of discharge.
Discharge planning is an ongoing problem-solving process and may necessitate the development of several alternate plans before a final discharge plan can be implemented.
The social worker, based on the psychosocial assessment identifies the patient’s medical and psychosocial discharge planning needs, taking into account the patient’s illness and treatment needs, patient and family preferences, level of care, financial resources, services/facilities available, and any special circumstances. The social worker also provides counseling to the patient and family, to prepare them for discharge from the hospital and post-hospital care. Discharge planning is an interdisciplinary process, and the social worker can serve as case manager, to ensure that the patient makes a timely transfer and health adjustment from care within the hospital to alternative sources of care or to alternative sources of care or to self care when the need for services has passed.
Facilitating services:
Payment for medical care, pharmaceuticals, necessary living expenses, and other financial or material concerns can be an added source of stress to patients and families as they cope with the emotional impact of illness. Needs such as lodging and meals for family members, transportation to and from the hospital or payment for special equipment or services after discharge can produce anxiety. Only when patients and families are provided with adequate material and financial support to meet their basic needs, can they benefit fully from health care services.
The expertise of social workers regarding available resources, specific eligibility requirements and application procedures is central to the helping process. Social workers provide linkages between the patient/family and community resources and governmental programs to meet their needs, by providing information, assisting with referrals for categorical assistance and entitlement programs, connecting family with sources of emergency financial assistance, and assisting with applications for health care and medication coverage. Social workers also identify unmet needs and advocate for the development of services to meet those needs.
In collaboration with the Iowa Insurance Commissioner’s office, trained volunteers provide on-site information on understanding Medicare, organizing medical bills, filing Medicare claims, long-term care insurance policies, evaluating Medicare, supplemental plans, and recognizing Medicare fraud and abuse.
When material and financial stress is reduced, the patient and family can focus their energies on coping with the other demands of illness and treatment.
Helpful Links:
Protective services:
Intervention on behalf of individuals who may be in danger of harm from others or who are unable to take care of their own physical needs has historically been and important social work function. Social workers are committed to the welfare of those who may have been abused or neglected. Protective services are provided to suspected victims of child abuse, dependent adult abuse, spouse abuse, and other forms of family violence. Family violence includes physical abuse, sexual abuse, denial of critical care (neglect), emotional/psychological abuse, and financial exploitation.
Hospitals are in a primary position to identify, treat, and protect those who may be victims of abuse and neglect, and social workers serve a central role in this process.
The social worker identifies situations in which a person may be at risk, assists other hospital staff in evaluating and reporting situations to the Department of Human Services, cooperates in subsequent investigations, coordinates discharge plans, and facilitates alternative resources for the person at risk. During this process, the social worker remains therapeutic and helpful to the suspected abuser as well as the victim.
Social workers also provide training to mandatory reporters in the identification of abuse and reporting procedures and work to sensitize other staff and the general public to the characteristics and impact of family violence.
The goals of protective services are to identify situations in which a person may be at risk, help ameliorate the situation, minimize further risk, and find and facilitate alternative resources for the person at risk.
Links:
Suspected Child and Dependent Adult Abuse Policy (Internal Access Only)
Iowa Department of Human Services
Iowa Domestic Abuse Hotline, 1-800-284-7821
National Child Abuse Hotline, 1-800-4-A-CHILD
Clinical Social Workers at UI Hospitals and Clinics
|
|
