SOCW 6204 Week 2 Inpatient Psychosocial Assessment Example

She Knows What Recovery Takes: An Inpatient Psychosocial Assessment of a Seventy-Nine-Year-Old Former Home Health Aide After Hip Surgery, Recorded Through a Haitian Creole Interpreter, Moving From Her Own Account Outward to Home, Supports, Finances, Memory and Her Fear of a Facility

Student Name

Walden University

SOCW 6204: Medical Social Work I

Instructor Name

Month Day, Year

She Knows What Recovery Takes: An Inpatient Psychosocial Assessment of a Seventy-Nine-Year-Old Former Home Health Aide After Hip Surgery, Recorded Through a Haitian Creole Interpreter, Moving From Her Own Account Outward to Home, Supports, Finances, Memory and Her Fear of a Facility

Summary for the Team

Lives by herself up one flight of stairs, no elevator. Her daughter is the main support but works a rotating schedule. Patient expects to go straight home and is afraid of being sent to a nursing facility.

Identifying Information and Source

Mrs. Rosette Augustin, invented for this course, is a widowed woman of 79 born in Haiti, here since the early 1990s. A fall in her apartment broke her right hip, which was repaired in surgery the day she arrived. This assessment was completed on hospital day two through a professional telephone interpreter in Haitian Creole, with her daughter present for part of the interview at Mrs. Augustin's request. A trained interpreter was used even with her daughter in the room, since the review by Karliner et al. (2007) found trained interpreters tied to better care than relatives or untrained staff pressed into the role. Psychosocial assessment of this kind is among the core activities of hospital social work described by Judd and Sheffield (2010).

Her Own Account

Mrs. Augustin worked for 22 years as a home health aide before retiring. Through the interpreter she said, "I know what it takes to get better. I helped many people walk again." She understands that she broke her hip and that the surgeon "fixed it with metal." She expects to be walking within a week and to go home. The surgeon's expected course, recorded in the chart, is weight bearing as tolerated with a walker, physical therapy daily and a likely need for several weeks of rehabilitation before she can manage stairs safely. Her understanding and the medical plan agree on the surgery and differ on the timeline.

Home

Her apartment is on the second floor of a three-story building, reached by 14 steps with one handrail. The bathroom has a tub without grab bars. She fell at about 2:00 a.m. heading for the bathroom and lay where she fell until her cousin, who lives on the first floor, heard her calling at 6:00. She does not have a medical alert device. The apartment is rent-stabilized, and she has lived there for 19 years.

Supports

Her daughter, 51, lives twenty minutes off, dispatches buses for the city on a schedule that rotates, and has two teenagers at home. Her son lives in Florida and sends money each month. Her cousin, also in her seventies, lives in the building and checks on her most days. She attends a Haitian Baptist church and says members brought food when she had the flu last winter.

Finances

Mrs. Augustin receives Social Security and a small pension. She has Medicare and Medicaid. She says she has enough for rent and food but worries about the cost of help at home. Her daughter manages her bills.

Memory and Cognition

Her daughter reports that over the past six months her mother has forgotten appointments twice and once left a pot on the stove. Mrs. Augustin dismissed this: "Everyone forgets." She was oriented and conversed clearly during the interview. A formal cognitive screen was deferred until after the effects of anesthesia and pain medication have cleared, and the concern was noted for the team.

Her Fear

Asked about her worries, Mrs. Augustin said that she has seen inside many nursing homes in her work and does not want to "end up like the people I cared for there." She said she would rather "take my chances at home." Her fear is grounded in her own experience and is central to how she will hear any recommendation about rehabilitation.

Assessment Summary

Mrs. Augustin has strengths that matter for recovery: long experience of rehabilitation from the caregiver's side, a cousin in the building, a daughter who is engaged, a church community and Medicaid coverage that may support home care. The risks are also clear. She lives alone up a flight of stairs, fell at night without a way to call for help, may have early memory changes and has a daughter whose work schedule limits what she can provide. The gap between her expected timeline and the medical plan, and her fear of facilities, will shape the discharge conversation. Health care practice standards ask social workers to weigh a patient's goals alongside safety (National Association of Social Workers, 2016); the next steps are a caregiver assessment with her daughter and a discussion with the therapy team about what Mrs. Augustin will need before she can manage the stairs.

The caregiver assessment is scheduled for tomorrow, when her daughter is off work.

References

Judd, R. G., & Sheffield, S. (2010). Hospital social work: Contemporary roles and professional activities. Social Work in Health Care, 49(9), 856-871. https://doi.org/10.1080/00981389.2010.499825

Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Services Research, 42(2), 727-754. https://doi.org/10.1111/j.1475-6773.2006.00629.x

National Association of Social Workers. (2016). NASW standards for social work practice in health care settings. https://www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines