From a 
For nearly two years I saw a man in his 60’s for individual therapy, winding down to seeing him monthly.  He had initially had some homicidal ideation toward a rejecting lover, feelings of depression, acute loneliness, etc.  I last saw him in May and he was much more positive, dating a little, no further risky ideation, still lonely, but coming along.  He was also overweight and diabetic.  This man never missed an appointment, would arrive early, etc.  After the last appointment I have heard nothing more from him.  I have left messages on his home and cell phone on two occasions. 

I am wondering whatever happened to him, and have general concern, though not for risk of harming himself or others.  I jus t cared about the guy and am wondering what happened, particularly if he got sick or even died.   I am assuming that that is NOT sufficient justification to call his emergency contact which he provided on his intake form.  I am assuming that when a client vanishes, we do our typical outreach for no shows and leave it at that.  Is there any case for trying to find out what happened to him?

Submitted by a hospice social workers:  "I am working with an elderly gentleman who is the son and POA for a 93 year old woman suffering from end stage Dementia.  He has admitted to me that he “she has gifted $2,000 to a granddaughter one year ago and the granddaughter has not paid her back” – it is difficult to imagine that the patient may have been competent to make such a gift herself even one year ago.  In addition, he admits to using her investment funds to pay for his airfare back from Florida to take care of the patient after she needed to leave a local assisted living facility, to pay himself for being a caregiver for her (apparently thousands of dollars) and to pay himself for her room and board.  I educated him about the Deficit Reduction Act, cautioned him about being honest when filling out the nursing home application, and advised him to meet with an attorney as soon as possible to get legal advice to address her long term planning needs.  He did meet with the attorney, but apparently failed to fully disclose what he had told me.  He has called me to ask that I pick up his application for a local nursing home because he has filled it out and wants to move forward with her long term care placement.  I have already consulted with the patient’s physician and the Office of Aging caseworker regarding these concerning details.

This patient appears to have possibly have about $40,000 of investment funds left and will begin in a nursing home by being private pay, but will quickly need to apply for Medical Assistance funding.  How do I handle this dilemma  ethically and legally so that I am also not held liable if a facility accepts her and then has no payment source?"

 

A student reports this situation: 
The hospital social worker (my supervisor) was consulted on a case with a family without permanent housing.The patient was a three year old boy who was hospitalized with asthma. His mother and two siblings, a nine and four year old, were living with the boy in a shelter. At the time,  the family had no health insurance, but were working on getting ACCESS. So the little boy had to use a friend’s nebulizerfor his asthma. 

When the social worker was brought in, she reviewed the case and said: "There is nothing I can do, because they have nohealth insurance." She told the nurses, "He will have to keep sharing hisfriend’s nebulizer." She also didn’t do anything to help the family with theirliving situation. Basically, it seems she did nothing to help the family bettertheir situation.

Since the social worker didn’t provide any assistance with the case, the nurses didtheir best to help the family out. The one nurse used the hospital’s emergencyfund, which is used to help patients pay for medical services or medications,to get a nebulizer for the patient.  I was astounded and actually ashamed of my supervisor's behavior, but I did nothing.  What should I have done?  I felt like I was in a real dilemma of whether to report her behavior and/or go around her and try to help the family.

You are a social worker who works in a family service agency.  You have been working with a family (father, mother, two kids) for over a year.  Much of your work has been to empower the mother and have recommended she consider attending  Al-Anon to learn more about dealing with her husband's drinking behavior. You have also been attending a local Al-Anon group for quite a while and have established a support network through that group for yourself. Lo and behold when you attend the weekly group who walks in but your client!  Yes, you suggested Al-Anon to her, but you never expected her to show up in YOUR group! You feel uncomfortable sharing like you usually do.  What do you do?