Research Proposal on "Factors That Affect Social Workers Perceptions About End Stage Dementia Patients"

Research Proposal 13 pages (4679 words) Sources: 13

[EXCERPT] . . . .

Social Workers' Perceptions revised

Social Workers Perception About End-Stage Dementia

Social Workers and Gerontological Patients

Therapeutic Nihilism

Impacts of Dementia

Role of Hospice Social Workers

Interaction between the Social Worker & Dementia Patients

Limitations in Earlier Studies

Research Question No.1

Research Question No.

Research Question No.

Research Question No.

Research Question No.

The healthcare sector is facing scarcity of medical professionals and healthcare workers globally. Alongside other fields of health care, the field of social work is also facing asimilar problem. Researchers have proved that there is visible reduction in the number of social workers interested in treating elderly patients (gerontological field of social work). The ratio of healthcare workers dealing with elderly patients having cognitive impairment is even lower. A similar case is observed with patients suffering from dementia. However, the number of social workers who are interested in treating such patients is limited. With an increasing number in patients of dementia, a doubt arises if there will be an equal number of social workers available for treating these patients in the future. If we follow an assumption that there will not be sufficient social workers pursuing for treatment of elderly dementia patients, it is clear that they will be forced to interface with gerontological patients with cognitive impairment; whether they are recruited in a similar setting or have prior required experience or not. Hence, a need for suitable research arises which would be related to identify the factors making these social workers reluctant in treating patients with end-stage dementia. Furthermore, this research will also identify the means to motivate them.

Since there is limited literature available related to end-stage dementia and the special needs of the patients suffering from it; there is limited awareness found in general public specifically in social work segment. End-stage dementia patients lose the ability of communication performing only daily functions of life. They can live up to 20 years suffering from this impairment, without showing any signs of improvement. Due to these factors, many social workers are forced to question the effectiveness of their efforts with reference to improvement in the quality patients' life. Since they are no substantial and clear answers available; many of these social workers find it difficult to continue their practice in this field.

Due to the rising number of patients suffering from cognitive impairment is rising; there is a need for substantial number of social workers who are trained in treating patients with end-stage dementia (Pearce, 2007). Considering the current trend of interest shown by social workers, a need arises to evaluate the following factors:

Why the social workers are reluctant to practice in this field?

What are the causative agents?

What are the barriers perceived by them?

What can be done to improve this situation?

The given research proposal outlines the problem as identified along with the purpose of this research. The main intent of this research is to discover the reasons behind the reluctance of social workers' practice in this field and also present possible solutions for this problem. Along with the identified reasons and solutions to this problem, this research is intended to provide a perspective of the whole population of social workers dealing with end-stage dementia instead of presenting a view of social workers working in a certain environment (such as hospice settings only instead of all the social workers). Furthermore, the limitations of earlier researches related to this area have been considered and necessary measures have been taken to overcome these limitations in order to reach an effective conclusion.

Literature Review

Social Workers and Gerontological Patients

Where there is scarcity of suitable talent in various other disciplines, the field of social work is no different. Researches have shown that the current population of social workers is showing less interest in dealing with older adults (Acker, 2011). Now it is established that social workers are showing less interest in treating such patients. The ratio is even lower for patients suffering from cognitive impairment (Helen & Padilla, 2012). A similar scenario is seen with patients having dementia. Due to an increasing number in patients suffering from dementia, there is still a concern if we will have sufficient number of social workers to treat such patients in the near future. Considering this fact, if a desired number of social workers for end-stage dementia patients is not available then the few number of social workers will be forced to treat such patients; whether they have the required training or not. Hence, there is a need for suitable research which would identify the reasons of reluctance in social workers to treat end-stage dementia patients and the suitable means to motivate these social workers.

Therapeutic Nihilism

Therapeutic nihilism is a belief that no remedial measures will have a tendency of improve the health conditions of the patients with cognitive impairment (Sanders & Swails, 2011). Apparently, most of the social workers have therapeutic nihilism which decreases their willingness to treat such patients and also decreases their motivation level. This general belief greatly affects the interest and intent of social workers. Due to this effect, the recruitment and training of the social workers in this particular field not only becomes difficult but also hampers the quality of their work. The professionals in dementia care are seen as more prone to therapeutic nihilism. When the end stages of dementia begin; the social worker suffers from a greater degree of therapeutic nihilism and the feeling of uselessness gains a major ground. This is so because during this period, the cognitive impairment of the patient is at its peak and the communication between the social worker and the patient is highly ineffective. Furthermore, the patient usually shows no or very little improvement. Although the general standards of social work and the relevant code of conduct makes it mandatory for the social workers to treat all the patients with equality irrespective of their physical and mental condition. The rationale behind these standards is the belief that every patient has a tendency of getting positive results by the therapeutic interventions adopted to benefit the patient and make his/her current state better. However, these standards have become difficult to follow as most of the traditional practices of social work require a mutual communication between the patient and the social worker. Due to this mutual and effective communication, the client gets involved during the intervention and the process of receiving feedback becomes easier. Where the patient appears to be suffering from cognitive impairment specially end-stage dementia, communication with such patients becomes very difficult for the social workers since the patient is unable to communicate and perform regular functions of life. Hence, the social work professionals become highly demotivated and end up questioning the effectiveness of their services in dealing with such patients. Such feeling as the lack of value, meaning and purpose makes them lose their interest in this particular discipline for further practice (Sanders & Swails, 2009).

Impacts of Dementia

Dementia has been characterized as one of the major mental illnesses which usually appears after the age of 65 but may also appear before that. The visible impact of this illness is mental loss hampering the memory of its bearer. Even though, impairment of memory is the most evident symbol of this illness, the other physical and mental health losses are not limited to it. Inability to communicate and enjoy the quality of life along with effectively dealing with other people which includes the caregivers, also present as a major difficulty caused by dementia. Dealing with the patients of dementia is exceptionally challenging because the quality of life of the patient is highly affected due to various side effects of this illness (Enck, 2010). The most evident outcomes are excessive weight loss, difficulty in communication due to fewer verbalizations, difficulty in intake of proper diet, requiring assistance with almost all the major activities of life, difficulty in mobilization, or even sit without assistance, various other infections such as urinary infections (Corr, Corr, & Ramsey, 2004). All these situations become highly challenging for the social care workers when they become unable to perform assessment of the current status of patient's health (both physical and psychological). As a result of this failure, the social workers also face difficulty in devising suitable treatments accordingly. The state of dementia can be highly complicated where the patient's situation can get worse and it may prolong up to 20 years (Alzheimer's Association, 2005). In the meanwhile, various changes (both positive and negative) are seen in the health status of a patient accordingly. Hence, evaluation and determination of the current status of patient can be highly challenging for the concerned social worker especially at the terminal state of the disease.

It is important to note that the patients of dementia along with other physical problems also suffer from a high degree of demotivation and emotional distress. As a result, the degree of cooperation between the patient and the social worker also decreases to a considerable extent. This lack of cooperation further worsens the situation… READ MORE

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