Case 1
Social Worker Assessment

Scenario

After a series of falls, Mr. Davies's PCP has requested in-home services from a local home health agency. As part of an initial assessment, a social worker is called to meet with Mr. Davies. The purpose of this assessment is to identify Mr. Davies's physical, social, and psychological strengths and needs. As needs are identified, available services in the community will be arranged to help meet these needs.

Initial assessment

Mr. Davies is an elderly white male who resides in a 1-story house (slideshow) in a rural town outside the city of Ithaca. He is currently 78 years old and has resided in the same town for most of his life. He has a high-school education, and has worked throughout his life at a number of skilled labor jobs including masonry, lumberjacking, and blacksmithing. Mr. Davies speaks very proudly of his past working career and of his accomplishments. He occasionally drives to the grocery store, approximately 7 miles from their home, but not during the winter months. Mr. Davies was married for over 40 years; his wife died approximately 2 years ago. He often speaks about how he misses her and feels quite lonely without her companionship.

The client struggles with a number of chronic medical conditions including Type 2 diabetes, coronary artery disease, hypertension, arthritis, and others. He states that he smoked cigarettes for 30 years, but quit sometime in the early 1980s. In addition, he was hospitalized in the 1990s with intestinal surgery; recuperation included a three-month stay in a nursing home. Over the past several months, Mr. Davies has been experiencing repeated falls which he blames on his "clumsiness." His hobbies include woodworking, which has decreased significantly since his arthritis has gotten worse, and writing poetry which takes up much of some of his free time, but has difficulty holding writing instruments. Overall, Mr. Davies seems content and relatively outgoing. Although he wasn't intoxicated, I noticed numerous empty beer cans in the kitchen sink.

In regards to social support he lives alone, but his neighbor Mildred, a 73-year old female, visits him at least three times per week. She stops by to visit Mr. Davies a couple of times during the week to socialize and sometimes to have lunch. Occasionally, Mildred will drive Mr. Davies to the store to buy groceries and medications if he is unable or not interested in driving. He has a son, Jim, who works in construction and lives about 2 hours away from Mr. Davies; he is not married and has no children. Mr. Davies states that he sees his son every couple of weeks, but that he phones him at least twice a week.

Mr. Davies manages to take care of himself in regards to most ADLs and IADLs, although he does have FoodNet (Meals On Wheels) deliver him lunch each day. He describes how proud he is to be able