• Gracie Jones

Gracie Jones is an 83-year-old African American woman who lives with her
husband in a senior housing complex in the central city. Her husband requires extensive
care following a stroke that has paralyzed him totally on the right side. He is able to
communicate quite well, although, at times, he cannot remember the names of common
objects and becomes very frustrated. He tends to take this frustration out on his wife in
the form of verbal abuse. He requires assistance with toileting, feeding, and transferring
from his wheelchair to the bed. Mrs. Jones is very healthy and has remained strong;
therefore, helping her husband has not been a problem for her. She does heavy physical
work around the house and remains extremely active for a woman her age. Two
afternoons a week, she also cares for three of her grandchildren. She enjoys the company
of the children, and they help to keep Mr. Jones entertained. Mr. Jones is a retired
factory worker with a small pension. Mrs. Jones was a homemaker. The couple has
adequate insurance coverage and has always had sufficient income to provide for the
necessities of life. However, rising medical bills and prescription drug costs have been
cutting into their savings.

Mrs. Jones has begun to worry constantly about what will happen to her husband
if she dies, despite the fact his health is much more precarious than hers. She does not
explore skilled nursing facilities or assisted-living arrangements and resists when her
adult children offer to do so. Mrs. Jones has had several heated arguments with her adult
children about what is best for their father. Mrs. Jones believes it is her duty to care for
him “till death do us part.” She has also been known to say, “We take care of our own.”
Mrs. Jones broods about how he will never cooperate with anyone but her and how he will probably die from neglect if she did not care for him. For the first time in her life,
she has developed headache that do not respond to over-the-counter remedies.

Despite constant attention from her grandchildren, Mrs. Jones says she feels
lonely. Caring for her husband has isolated her from friends and extended family
members and restricts how often she can leave the apartment to visit with others in the
neighborhood. She always feels tired. She tries to nap when her husband is sleeping
during the day, but she has difficulty falling asleep and staying asleep.

Assignment:

Imagine you are a medical social worker, assigned to follow up on patients from the
hospital’s Stroke Clinic/After Care program. Use appropriate social work assessment,
intervention and evaluation processes to assist the Jones family. Also within your paper,
please address the following issues:

• Discuss the concept of generalist practice related to this case study.
  • What theoretical frameworks in human development could be used when
    assessing the client system in this case study?
• How do Social Work values and ethics guide your practice with the Jones family?
• What social policy considerations should be addressed?

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