Social Work in Healthcare – Case Study Analysis

Question 1

Using only ONE (1) of the three health conditions in case examples below, answer all the questions.

• Amir, 7 years old, recently received a diagnosis of epilepsy after experiencing multiple seizure episodes at home and school. He attends a mainstream primary school and lives with his parents and a 10-month-old sibling in an HDB flat. Both parents are currently working full-time.
• Mdm Lakshmi, 45 years old, employed on a renewable contract role as an administrative assistant, recently received a diagnosis of Stage 3 cervical cancer following routine health screening. She is married with three school-aged children (7, 10, 12 years old) and resides in a 4-room HDB flat. Husband works as a PHV driver. He is unable to work long hours due to health conditions.
• Mr Ong, 78 years old, recently received a diagnosis of early-stage Alzheimer’s disease following specialist assessment. He lives alone in a 2-room rental flat. He has a 55-year-old daughter (widowed) who lives separately. She is not working and is the primary caregiver to her two grandchildren (3 and 5 years old).

(a) Through literature search, describe and illustrate the incidence of the condition that you have chosen and the trajectory of the disease in your local context. (10 marks)

(b) Using the Biopsychosocial-Spiritual (BPS-S) model, appraise the impact of the health condition on the individual and his/her family. (20 marks)

Question 2

Mdm Salmah, aged 79, comes from a traditional Malay Muslim background that values family unity, filial responsibility, modesty, and spiritual acceptance. She was recently admitted to the hospital after experiencing recurrent shortness of breath, dizziness, and reduced appetite.

Following clinical assessment and investigations, the medical team diagnosed her with Stage IV chronic kidney disease (CKD), with significantly reduced renal function. They have recommended initiating dialysis as part of a long-term management plan to stabilise her condition and potentially extend her life expectancy.

During a recent care round, however, Mdm Salmah stated clearly that she does not want to undergo dialysis, expressing that she has “lived a full life” and prefers to focus on comfort, prayer, and time at home rather than participate in what she perceives to be burdensome medical procedures.

She specifically requests that the healthcare team not inform her adult children about the full extent of her diagnosis and prognosis, stating: “I do not want them to worry or sacrifice their own lives because of me. Let me carry this quietly. This is my choice.”

Her eldest son, who has been attending appointments with her, becomes increasingly distressed as he notices her physical decline. He insists that the healthcare team fully disclose her medical condition and treatment options, arguing: “As her child, I am responsible for her. You must tell me. We need to know the truth so we can plan and protect her.”

There is no documented Advance Care Planning, Advance Medical Directive, Lasting Power of Attorney, or written record of prior preferences. However, Mdm Salmah communicates clearly, demonstrates consistent reasoning, and appears able to understand information related to her illness and its consequences.

(a) Using relevant Bioethical Principles and/or the SASW Social Work Code of Ethics, identify and discuss two ethical dilemmas that you may face in working with Mdm Salmah and her family. (10 marks)

(b) Apply Reamer’s Ethical Decision-Making Framework to propose a reasoned, defensible course of action that balances patient’s autonomy, cultural sensitivity, therapeutic alliance and the best possible care outcomes. (20 marks)

Question 3

Read the case study and answer all the questions.

Mr Tan Boon Huat, 58, a taxi driver, recently survived a mild myocardial infarction (heart attack) and was diagnosed with coronary artery disease (CAD). Although he was medically stabilised, he continues to experience fatigue, occasional chest tightness, and reduced exercise tolerance, especially on long driving shifts. He has been advised to make significant changes to his lifestyle, medication adherence, and follow-up care, including cardiac rehabilitation and regular monitoring.

Mr Tan has a 10-year history of hypertension and high cholesterol, with inconsistent medication adherence due to long work hours, irregular meals, and the pressure of being the family’s sole income earner. He tends to downplay the seriousness of his condition, expressing worry about taking time off work, and often says he “cannot afford to rest” because the family needs his income.

His wife, Mdm Lim, 52, works part-time as a school canteen assistant and earns a modest income. Their two children, aged 13 and 15, are both in secondary school. The younger child (13) has mild Intellectual Disability and requires more guidance with schoolwork, daily routines, and managing tasks independently, which places additional caregiving demands on the family.

The family lives in a 3-room HDB flat with limited extended family support. Since the heart attack, the household has been experiencing increased emotional tension, as family members struggle to adjust to new caregiving responsibilities, fears about relapse, and worries over financial stability.

(a) Using components of Rolland’s Family Systems Illness Framework, analyse patient’s possible responses and needs AND family’s possible responses and needs in relation to the illness. (20 marks)

(b) Using Bronfenbrenner’s Ecological Systems Perspective, develop a holistic multi-level social work intervention plan that integrates relevant healthcare and community resources. Your answer should propose suitable interventions across three (3) different ecological levels. (15 marks)

Want Help Structuring Your Answers!!

Professional Nursing Experts

All Subjects Covered

Professional Guidance

Help with Social Work in HealthCare

Experts Answer on Above Case Study on Social Work in Healthcare

Epilepsy (Amir, 7 years old) – Incidence and disease trajectory

Epilepsy is mostly identified among children and it is a kind of childhood neurological condition, evident within Singaporean children with an estimation of 5 to 10 per 1000 children. The diagnosis is performed before the age limit of 10, and there is significant variation in trajectory because some children achieve good control with medication while others experience chronic epilepsy. In respect to Amir, the early diagnosis is considered as positive provided the medication is consistently applied, while the risk is break through seizures, normal schooling and social integration.

BPS-S impact

Biological – recurrent seizures would result into fatigue and medication side effects while the psychological impact is fear and embarrassment. The social impact would be in terms of parents balancing work along with caregiving for Amir. Spiritual impact is in terms of cultural interpretation of illness and family may seek coping through beliefs.
Mdm Salmah
The two ethical dilemmas are autonomy versus family rights, as there is a conflict of patient autonomy versus family involvement in the given case of Mdm salmah where her son demands full information but she refuses the disclosure to children. The second ethical dilemma is in terms of autonomy versus beneficence as dialysis was performed despite life prolonging benefit, and the healthcare team is required to maintain a balance in respecting her choice, and acting in her best medical interest.

Reamer’s ethical decision making requires identifying issues which include confidentiality, autonomy and family distress, followed by review of guidelines such as respecting autonomy and maintaining confidentiality. The next step is consultation with a multi disciplinary team, followed by exploration of options such as encouraging voluntary disclosure, family meeting, and providing support to the son without affecting the confidentiality. The next step is decision making which can be to respect the refusal of dialysis, maintain confidentiality, and finally document the record of the patient.

Mr Tan (CAD)

Rolland’s family systems illness framework

Mr Tan was faced with chronic illness (heart attack), and financial pressure leads to denial. The situation requires Lifestyle change and emotional support.
The responsive family would be the adjustments by children and wife while it may lead to financial anxiety because of sole breadwinner risk. It needs emotional support and proper financial planning to deal with the situation.

Ecological systems intervention plan

The Microsystem that includes individual and family needs health education, family counselling to reduce tension. At mesosystem, it is a community/ health Care link which requires enrollment in cardiac rehabilitation programs, and School support for children. At macrosystem level, support is needed in the form of financial aid, flexible work arrangements, and community support services.

Want a Full Worked Out Answer with References?

The responses above are given in brief and if you need detailed explanation on the application of relevant models to the case study, visit our nursing homework help page to get guidance and support from professional nursing experts.

Submit Your Request Here

Check Samples of Nursing Assignment Written by Experts