Problem: Kenny Strober
Kenny is an 84 year old widower who lives alone in a senior citizen housing complex. He suffers from Parkinson's disease and has poor vision. He is friendly and sociable, attends many activities, takes his meals in the complex's dining hall and loves to sit outside on the bench in front of the building with neighbors. His son pays his bills, but they are not close, and Kenny does not share any of his daily life or concerns with him during his monthly visits.
Kenny fell 7 months ago in his apartment, fracturing a hip. After several weeks in the hospital, he was discharged to a convalescent center, with the plan of returning to his apartment as soon as he was rehabilitated and able to walk again. Kenny worked hard with the physical therapist and returned home recently, using a cane for stability. He has a walker, too, "just in case." He was thrilled to be back and has returned to his friends and his daily activities. As part of his discharge planning, he was referred for case management services.
In assessing Kenny's condition, his apartment, and his needs, the case manager found several issues of concerns:
A. Kenny kept the blinds drawn "to keep it cool in here," because he did not like using any air conditioning, even thought it was July. She was concerned that the darkness would further limit his already poor vision.
B. Kenny had a very long telephone cord running through his apartment. He had one phone and moved it from place to place - bed to chair to couch to kitchen-leaving long loops of cord curling along the floor. His phone, he told her, was his "lifeline." It rang frequently as friends called socially to check on him.
C. Kenny seemed unsteady on his feet. While he could sometimes be convinced to use the cane outside of the house, he didn't think he needed any support in his apartment. Passageways were often narrow and cluttered with pieces of furniture and boxes of papers, and it was hard to get around.
The case manager felt that these problems constituted a real safety hazard for Kenny. She carefully discussed each item with him, suggesting more light, a cordless phone and getting help to rearrange his furniture and belongings. Kenny refused all of her suggestions.
Three months have passed. Kenny has fallen once. Although he was taken to the emergency room, his fall resulted only in a bruise and he was not hospitalized. The worker has discussed safety concerns with him repeatedly. When she asked for permission to discuss his problems with his son, Kenny refused adamantly. The blinds remain drawn; the telephone cord wraps around chair legs, under tables, and across hallways; and Kenny's unsteadiness is increasing, albeit slowly.
When responding to this case study please use the following steps for full credit:
i. Describe the Case and the Context;
ii. Define the Ethical Problem;
iii. Gathering Information;
iv. Determine Applicable Ethical Theories and Principles;
v. Determine Relevant Elements in the NASW Code of Ethics;
vi. Define your Personal Values and Biases;
vii. Consider the Values of the System/Agency;
viii. Define Options;
ix. Select an Option;
x. Plan for Implementation.