Miriana Case Study: Social Work Assessment and Intervention Strategies

This document presents a comprehensive case analysis of Miriana, a 65-year-old woman facing various challenges including loneliness, anxiety, and potential risks to her safety. The analysis employs a social work assessment framework, including data collection, analysis, and decision-making stages. The assessment utilizes a multidimensional framework to understand Miriana's physical, psychological, spiritual, structural, social, and cultural dimensions. The case explores Miriana's strengths, stressors, and weak connections, using tools like ecomaps and genograms. The analysis identifies immediate and long-term concerns, such as loneliness, the risk of harm, social isolation, and potential economic crisis. Intervention strategies are developed using the SMART approach, focusing on facilitating independent living, addressing her immediate issues, and planning for long-term concerns, including addressing her relationship with her daughter-in-law, Jenny. The document highlights the importance of professional and personal values, social work ethics, and potential ethical dilemmas related to Miriana's care, emphasizing the importance of client self-determination and the role of family support. The paper concludes by emphasizing the need for ongoing evaluation and the setting of a timeframe for achieving the established goals.

Running Head: Case Scenario 2: Miriana
Case Scenario 2:
Miriana
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Case Scenario 2: Miriana 1
Miriana Case Analysis
Social work assessment framework can be defined as a continuous process of
individual's engagement and the aim of this framework is to perceive the individual
according to their social context and determining the tasks needs to be accomplished to
perpetuate, promote and bring the changes in the individual's life (Milner, Myers, &
O'Byrne, 2015). There are five stages of assessment of a client situation:
 Preparation that includes planning and engagement
 Data collection
 Analysis and interpretation of data
 Making judgements: regarding safety, necessity, the standard of care, capacity to
cope up with the change, risk or seriousness of the situation, etc.
 Decision making: what are the tasks, when, how and by whom it can be done and
the progress will be measured (Maidment & Egan, 2016).
In order to initiate the assessment and engaging with the client Miriana, I will show
my interest and warmth by shaking hands and initiating informal conversation, to remove
her fear, anxiety and feel her welcomed. Then I will clarify my role to her and discussed
confidentiality, the purpose of the assessment and disclosure of the information if
necessary for her wellbeing (AASW Code of Ethics, 2010). I will take her consent about
the assessment then I will also try to build rapport and relationship of trust by an
empathic understanding of her situation (Maidment & Egan, 2016).

Case Scenario 2: Miriana 2
According to Maidment & Egan, (2016), middle stage of the assessment is to
identify her strength and self-efficacy by allowing her to talk, empathic listening,
affirming, questioning and summarizing the brief overview that has been discussed
during her assessment (stage of data collection and analysis). An ecomap and genogram
have been drawn and used as assessment tool to identify the strength, weak connections,
and stressors of her present situation. She is living in her own house with her son Peter,
who is very caring to her and can be considered as her strength. She is getting support
from the hospital, social worker and specialist /geriatrician. She is having a number of
stressors compared to strength. Peter's wife Jenny may be a stressor for her as she wants
to send her in aged care. Other than that, $10,000 has been lost from her account, that is
also becoming a stressor. She doesn't want to leave her home so residential care service
might be another stressor for her as well. Relationship with colleagues, friends, relatives,
religious institution and the previous work has been identified as weak connections with
Miriana. I will use my questioning skills to explore her stressors and weak connections
present in her nature and behaviour.
To organise the data I will use the “Multidimensional framework” for the
assessment of Miriana. It is an approach to understand and reflect a person's situation in
the context of both the inner and outer-world (Harms, 2010).
The data has been presented below:
Multidimensional framework

Case Scenario 2: Miriana 3
Physical
dimensions
Psychologica
l dimensions
Spiritual
dimensions
Structural
dimensions
Social
dimensions
Cultural
dimensions
age: 65 y Intellectual
capacity:
average
spiritual
practices:
need
exploration
Financial
circumstance
s: left the job
two years
ago now
depends on
her son. Need
exploration
about any
deposit in the
bank account
Quality of
relational
network with
family:
A very good
relationship
between
Miriana and
her son.
Relationship
with
daughter-in-
law needs to
explore
Ethnicity:
Eastern
European
background
Gender:
female
language
capacity:
Good English
speaking(ass
ume)
legal
circumstance
s: no such
history
social
networks:
needs
exploration
culturally
held beliefs
and
practices:
needs

Case Scenario 2: Miriana 4
exploration
General
presentation
and
appearance:
anxious
looking
(assume)
Self-esteem:
healthy self-
esteem. very
determined in
her opinion
to stay in her
house.
socio-
economic
status:
middle class,
migrant
occupation:
Used to do a
job in a local
shop but left
the job after
her husband's
funeral.
cultural
changes and
their impact
on well-
being: needs
exploration
General
physical
health:
average
(assume)
Sense of
motivation:
not
motivated.
Education:
needs
exploration
cultural
sources of
stress:
needs
exploration
History of
drug and
alcohol use:
No
mental health
status:
Disoriented,
unaware
about
surroundings.
Suffering

Case Scenario 2: Miriana 5
from
loneliness
and anxiety.
sources of
physical
stress: No
sources of
psychologica
l stress:
Daughter-in-
law Jenny,
residential
care service,
loses a big
amount of
money from
a bank
account,
death of her
husband.
coping
strategies and
resources:
own house
psychologica
l coping
strategies and

Case Scenario 2: Miriana 6
and
supportive
son
resources:
Caring son.
Gaps and further exploration,
Though, most of the information is adequately obtained about Miriana from the
above-mentioned framework but still a lot of information is required to plan appropriate
intervention. The things we need to explore have been discussed below:
The immediate issues for Miriana have been identified are loneliness,
anxiousness, and risk of harm. The causes of loneliness might be due to the death of her
husband and inadequate time from other family members. Though her son Peter is happy
to stay with her but her daughter in law Jenny wants to send her back to the nursing
home. So I wanted to explore the relationship of Miriana with Jenny. In relation to this, I
also wanted to know how long Peter and Jenny are married for, to sort out is there any
other cause of loneliness. Another reason could be reduce working hours due to
unemployment as well as reduce housework due to her husband's death. In addition, the
causes of anxiousness may be feeling pressured into moving out of the home. Loss of
money from her bank account could be another reason for the stress that I need to further
explore. As an impact of her disease, she is unaware of her surroundings, for
instance, she forget to off the stove and lock herself out of the house. So there are
different types of harms that can occur if she is alone in the house.

Case Scenario 2: Miriana 7
The long term concerns of this case may be Social isolation and economic
crisis. I need to explore about her social networking, relationship with friends, relatives or
previous work colleagues and any religious belief. If no connections identified then there
is a chance of social isolation. Though she lives in her own house she doesn't have any
income source at present. So she has to be depend on her son for daily expenses. I need to
further explore her husband's occupation and any deposited money from her husband or
from her previous income. If no, then in the long run there is a chance of an economic
crisis. I also need to explore the occupation of Peter and Jenny to identify the income
source at present.
After gathering all the information I will summarize it and receive feedback from her to
ensure the accuracy of the information (Sheafor & Horejsi, 2012). At the end stage, we
can make the decision on the basis of the above information obtained that is- facilitate her
independence living.
Intervention strategies and plan: Appropriate intervention plan is required in
which the client and professional both can work together to modify the distress caused by
a problem situation (Cardona-Cardona, Montano-Moreno, & Campos-Vidal. 2017).
I will use the SMART (Specific, Manageable, Achievable, Realistic, Timely)
approach Suggested by Teater, 2014, p. 193 to set up an intervention plan.
Miriana is determined to stay in her own house so in that situation, we can discuss
with her about the available social and community support and support from Alzheimer
society with one of a specific goal to facilitate her independent living (Alzheimer Society
of Canada, 2018). She can ask for help or take help when it offers such as during meal

Case Scenario 2: Miriana 8
preparation, transportation, and housekeeping. We can discuss the options with her even
though she doesn't want anyone to help her in daily activities. we can talk with bank
manager to give her bank at home services. After exploring the relationship with Jenny if
she agreed to cooperate or if we clarify to her still it is possible for Miriana to live
independently then Jenny could also help her when she requires.
We can talk with Peter to help her when necessary such as if they are going
outside leave a set of keys to the trusted neighbour, arrange her dresser drawer to find
easy what to wear, use the type of electrical appliances that will shut off their own. If she
is going outside herself she can use a notebook to keep the emergency contact numbers
and a home map to show her where it is (Alzheimer Society of Canada, 2018). How she
is going with that we can measure it through every weekly visit, talk with her and with
her family members.
Once the goal has been set then I would work to bring the change of her internal
belief. I would explain to her the benefits of asking for help. Other than that, Peter and
Jenny could be her biggest strength if they are intended to support her. In that case, the
intervention strategy will be ensuring that Miriana is taking help when it necessary.
Ensuring that all the electrical appliances are safe and automatically shut off after a fixed
time.
Professional values and beliefs:
Before assessing Miriana I clarified my role, took consent and prioritise her
interest for the assessment. During the assessment I maintain privacy, confidentiality and
valuing her self-determination. I encouraged to make her own decision and made her

Case Scenario 2: Miriana 9
aware of the rights and responsibilities. Provided her honest and accurate information
about our organisation and information about the recording. She can access the recording
if she wants. This is my responsibility to respect her culture and belief as she is from a
different cultural background. Besides this, I made the effort to know her social
connections and religious beliefs to make the appropriate decision (AASW, Code of
Ethics, 2010).
Personal values and beliefs:
When assessing Miriana apart from professional values my personal values would
also resist me to make any assumptions on her cultural, spiritual, educational or family
backgrounds. It also prohibited me to believe only on the provided information without
any exploration. She is from different country, race, ethnicity, and culture, I would need
to assure I would not discriminate when assessing her.
Social work ethics and values:
According to the AASW Code of Ethics, 2010 as a social worker I would respect her self
determination and autonomy. I would try to expand choice and potential when providing
services to her. To keep in mind about my professional integrity I would behave with her
with dignity and responsibility.
Ethical dilemma:
The ethical dilemma is a circumstance when two or more values are in conflict (AASW,
2010). When making a decision about Miriana the ethical dilemma may arise; allow her
to stay in her house or place her to residential care.

Case Scenario 2: Miriana 10
In conclusion it should be noted that Miriana should be encouraged about her strength
and progress when measuring the improvement. To achieve the goal we (client and
professional) have to be prepared for any constraints or obstacles. The work will end
once the goal has achieved or any problem alleviated or diminished. We have to set a
time frame to achieve the goal. At the end of the work as a professional, I have to
evaluate the result according to the intervention plan. The paper was planned and
prepared on the basis of case study given about Miriana who was resisting to go nursing
care and wanted to stay at home.

Case Scenario 2: Miriana 11
References
Alzheimer Society of canada. (2018). Living alone. Retrieved from
https://alzheimer.ca/en/Home/Living-with-dementia/Staying-connected/Living-
alone
Cardona-Cardona, J., Montano-Moreno, J., & Campos-Vidal, J. (2017). Definition of
Intervention Contexts in Social Casework Practice: Predictor Variables. British
Journal of Social Work, 47(2), 343-357.
Code of Ethics. (2010). Australian Association of Social Workers (AASW). Retrieved
from https://www.aasw.asn.au/practitioner-resources/code-of-ethics
Harms, L. (2010). Understanding human development: A multidimensional Approach
(2nd ed.). Australia: Oxford University Press
Maidment, J. & Egan, R. (Eds.). (2016). Practice Skills in Social Work and Welfare:
More than just common sense (3rd Ed.). Crows Nest: Allen and Unwin
Milner, J., Myers, S., O'Byrne, P. (2015). Assessment in Social Work. Macmillan
International Higher Education Press.
Shaefor, B.W., & Horesji, C.J., (2012). Techniques and guidelines for social work
practice. (9th Ed). Boston: Allyn & Bacon
Teater, B. (2014). An Introduction To Applying Social Work Theories And Methods.
McGraw-Hill Education (UK).