How might Alice respond if June, Polly, and Jenna state conflicting wishes related to patient care, finances, living arrangements, and types of services utilized? Are there risks for Alice if she finds she must advocate for June in the face of Pollyís and Jennaís opposition?

Question

Alice Singletary, a novice social worker with Magnolia Hospice in Alexandria, Louisiana, met June Plunket, who had terminal cancer, and her daughter, Polly, for an admission interview. June was in quite a bit of pain and trying to cope with dying. Polly blamed Dr. Dubuis and herself for her mother’s approaching death, and was also angry with her brother, who had distanced himself from the family. June and Polly lived in a chaotic and overcrowded household with Polly’s daughter, Jenna, and Jenna’s two young children. While assessing June’s situation, Alice identified a multitude of family problems which had to be balanced with the mission of the hospice. In this situation, Alice was not sure where to begin.

Answer 1

Alice will have to identify who is the primary client. She will have to balance her interventions to maximize services to each of the individuals. There is a risk that the family will join together to confront Alice if she appears to be stepping between June and the rest of the family or if they feel Alice is leaving them out of the decisions. Because there are other social workers at Magnolia Hospice, it may be appropriate to utilize the advanced skills of the MSW social worker to address the ongoing mental health issues of Polly and Jenna, in consultation with the professionals currently responsible for their mental healthcare.
Resolving the need for money for medication for June would provide immediate comfort for June and remove some of Pollyís stress.