Slide 1: Introduction
Client's Name: Carla Washburn
Demographics- 74-years-old black woman
Widowed 20 years ago.
Recently, she lost her grandson, whom she raised- in the line of duty during a US military
operation.
Fell off a ladder- which resulted in significant pain- but refuses to see a doctor.
The referent- Carla's sister, is concerned because her sister no longer wants to talk to her.
Carla Washburn is a 74-year-old black widowed woman who recently lost her 25-year-
old grandson during US military operations. Ms. Washburn has been undergoing much grief. She
fell off a ladder, leading to severe pain following an injury, and refused to see a doctor following
that. She has also stopped responding to her sister's calls, so she referred her for social services.
This plan prioritizes collaborating with Ms. Washburn to identify the prevailing and intersecting
issues and implement an effective strategy to address these issues. The report will also entail a
detailed evaluation, integrating sustainable and ongoing changes and a termination plan after
attaining the goals. The primary objectives are to control diabetes, obtain social support, and
access government resources.
Slide 2: Assessment- Micro-level Issues
Ms. Washburn has complicated grief- leading to a strained relationship with her sister.
She fell off a ladder, leading to serious injury and pain, and made walking difficult.
She also had unmanaged healthcare issues- diabetes, which was complicated following
the fall.
Ms. Washburn is also depressed about the previous events and has stopped talking to
others.
Reducing cognitive and executive functioning- does not remember how she fell.
Bereavement is significantly common in the older adult population, mainly due to much life
experience, relationships, and associated losses (Buur et al., 2024). However, some may not have
the appropriate support and resources to address these issues, leading to prolonged grief. This is
characterized by some of the symptoms observed in Ms. Washburn, including anxiety and
depression (Buur et al., 2024). The client also has unmanaged diabetes, which is often shared in
older individuals living alone.
Fall risks for older adults is significantly higher compared to other populations, so are the
detrimental outcomes. More than ¼ of the older adults, especially those living in the community
and alone experience falls. Some of these falls results in serious implications such as hip
fractures (Jin, 2024). Other impacts includes decreased quality of life and psychological issues
due to pain and inability to function normally.
Slide 3: Assessment- Mezzo-level Issues
Ms. Washburn lives alone in Plainville, a small town in the Northwest.
She lives in an aging community- younger populations are moving to the cities.
, Lack of social support- lost her husband and then son and daughter-in-law in a car
accident.
She also lost touch with her friends because she was more engaged in her grandson’s life
and had little time to socialize.
She has isolated connections with neighbors and is not involved in any organizations.
This creates a lack of access to valuable community resources.
Ms. Washburn lives alone in a small community with younger people moving to the city.
The housing stocks or structures are also old, which poses a significant risk for the older
population. However, the primary concern at this level is loneliness and isolation, which
significantly affects Ms. Washburn's mental health outcomes. These issues are attributed to
cognitive decline and physical outcomes such as heart disease and depression, among other
mental health outcomes (National Institute on Aging, 2019; Teo et al., 2023). Being isolated also
means she cannot access community resources, mainly because she is not engaged in support
groups assisting the older adults in the community.
Slide 4: Assessment: Macro-level Issues
Small pension and social security due to long-time informal unemployment.
The US Army focused all the family outreach services on Roland's widow, disregarding
the grandmother.
High cost of the required medication- she expressed concerns that her stretched budget;
hence cannot afford medications.
Living in a rural setting means limited access to healthcare facilities.
According to Samuel et al. (2021), approximately a third of the elderly population is
struggling to make ends meet, especially the majority who do not have a reliable source of
income. With the high medication prices, governmental support is inadequate to sustain all the
required needs. This is a critical issue for Ms. Washburn, especially because she has not had
formal employment for long. This led to minimal savings. Social security support is also
inadequate to cover all bases, especially because medications are so high. These aspects have
contributed to the adverse mental health issues and the client's inability to adhere to the
recommended diabetes treatment and management.
Slide 5: Intervention for Micro-Level issues
The primary goal at the individual level is to get diabetes under control
Integrate cognitive behavioral therapy (CBT) to address complicated grief and
depression- 45 minutes to an hour session, once every week for 6 months.
Integrate exercise therapy to improve physical fitness and prevent falls.
This will include 30-45 minutes of either- balance and strength training programs
focusing on muscle strength.
Client's Name: Carla Washburn
Demographics- 74-years-old black woman
Widowed 20 years ago.
Recently, she lost her grandson, whom she raised- in the line of duty during a US military
operation.
Fell off a ladder- which resulted in significant pain- but refuses to see a doctor.
The referent- Carla's sister, is concerned because her sister no longer wants to talk to her.
Carla Washburn is a 74-year-old black widowed woman who recently lost her 25-year-
old grandson during US military operations. Ms. Washburn has been undergoing much grief. She
fell off a ladder, leading to severe pain following an injury, and refused to see a doctor following
that. She has also stopped responding to her sister's calls, so she referred her for social services.
This plan prioritizes collaborating with Ms. Washburn to identify the prevailing and intersecting
issues and implement an effective strategy to address these issues. The report will also entail a
detailed evaluation, integrating sustainable and ongoing changes and a termination plan after
attaining the goals. The primary objectives are to control diabetes, obtain social support, and
access government resources.
Slide 2: Assessment- Micro-level Issues
Ms. Washburn has complicated grief- leading to a strained relationship with her sister.
She fell off a ladder, leading to serious injury and pain, and made walking difficult.
She also had unmanaged healthcare issues- diabetes, which was complicated following
the fall.
Ms. Washburn is also depressed about the previous events and has stopped talking to
others.
Reducing cognitive and executive functioning- does not remember how she fell.
Bereavement is significantly common in the older adult population, mainly due to much life
experience, relationships, and associated losses (Buur et al., 2024). However, some may not have
the appropriate support and resources to address these issues, leading to prolonged grief. This is
characterized by some of the symptoms observed in Ms. Washburn, including anxiety and
depression (Buur et al., 2024). The client also has unmanaged diabetes, which is often shared in
older individuals living alone.
Fall risks for older adults is significantly higher compared to other populations, so are the
detrimental outcomes. More than ¼ of the older adults, especially those living in the community
and alone experience falls. Some of these falls results in serious implications such as hip
fractures (Jin, 2024). Other impacts includes decreased quality of life and psychological issues
due to pain and inability to function normally.
Slide 3: Assessment- Mezzo-level Issues
Ms. Washburn lives alone in Plainville, a small town in the Northwest.
She lives in an aging community- younger populations are moving to the cities.
, Lack of social support- lost her husband and then son and daughter-in-law in a car
accident.
She also lost touch with her friends because she was more engaged in her grandson’s life
and had little time to socialize.
She has isolated connections with neighbors and is not involved in any organizations.
This creates a lack of access to valuable community resources.
Ms. Washburn lives alone in a small community with younger people moving to the city.
The housing stocks or structures are also old, which poses a significant risk for the older
population. However, the primary concern at this level is loneliness and isolation, which
significantly affects Ms. Washburn's mental health outcomes. These issues are attributed to
cognitive decline and physical outcomes such as heart disease and depression, among other
mental health outcomes (National Institute on Aging, 2019; Teo et al., 2023). Being isolated also
means she cannot access community resources, mainly because she is not engaged in support
groups assisting the older adults in the community.
Slide 4: Assessment: Macro-level Issues
Small pension and social security due to long-time informal unemployment.
The US Army focused all the family outreach services on Roland's widow, disregarding
the grandmother.
High cost of the required medication- she expressed concerns that her stretched budget;
hence cannot afford medications.
Living in a rural setting means limited access to healthcare facilities.
According to Samuel et al. (2021), approximately a third of the elderly population is
struggling to make ends meet, especially the majority who do not have a reliable source of
income. With the high medication prices, governmental support is inadequate to sustain all the
required needs. This is a critical issue for Ms. Washburn, especially because she has not had
formal employment for long. This led to minimal savings. Social security support is also
inadequate to cover all bases, especially because medications are so high. These aspects have
contributed to the adverse mental health issues and the client's inability to adhere to the
recommended diabetes treatment and management.
Slide 5: Intervention for Micro-Level issues
The primary goal at the individual level is to get diabetes under control
Integrate cognitive behavioral therapy (CBT) to address complicated grief and
depression- 45 minutes to an hour session, once every week for 6 months.
Integrate exercise therapy to improve physical fitness and prevent falls.
This will include 30-45 minutes of either- balance and strength training programs
focusing on muscle strength.
