Aged Focus Case Study - Case Management Framework Assessment Answer

Internal Code: 1AHABI

Aged Focus Case Study Assessment Answer

Assignment Task: Specialist Homelessness and Domestic and Aboriginal Family Violence Services (SHS) Homelessness Strategy Division, Housing SA, Department for Communities and Social Inclusion July 2013. Aged Focus Case Study - A 55 year old woman was referred to your supported accommodation service by another SHS where she had been living since her release from prison. Intake The woman is accepted into one of your aged homelessness properties via a referral from an ex-custodial program as she is eligible for your service, has been assessed as having the highest priority, and agrees to engage in long-term support. Assessment You assist the woman to move into the property, and agree that you will initially visit her on a weekly basis, until she feels stable and settled. During your first discussion you discover her six-month incarceration significantly changed her life. Her teenage son became homeless, her elderly father (for whom she was a carer), needed to find alternate accommodation and she lost her home and all of her possessions. When she was released from prison, she had nothing. She is worried that her depression will re-surface and she will return to her alcohol addiction and, is concerned that her family may not accept her back into their lives. She is also worried about her health, as she was recently diagnosed with Hep C and says that she owes a lot of money to Centrelink and a finance loan company. She is particularly worried about her son, who also suffers depression and wants to be a good role model for him. Case planning You work with the woman to put together a case plan that reflects her goals and needs. You talk with her about engaging with supports quickly to help her feel stable and start to achieve her goals. You are able to engage a financial counselling service to help start reducing her debt and planning a realistic budget with her. Various other health and social supports are identified and appointments made for the first few weeks after moving into her new property. Implementation of case plan In the first few weeks, you have almost daily contact with the woman and talk her through how she is coping. You attend the local council with her to get information about local services and information such as rubbish collection days. You help her to work out a local bus route to get to the shops and do an initial shopping trip with her, using the budget the financial counsellor had prepared. The woman has an initial appointment with a local GP who will help her to manage her Hep C. The GP refers her to a local psychologist (via a mental health support plan) who talks her through a plan to reconnect with family and manage her depression. You support the psychologist’s work with her by connecting the woman and the psychologist to her son’s case manager. They collectively agree to set up a time for the woman and her son to meet and the first engagement goes well. A regular family contact plan is determined and you organise a case conference to connect all services involved and encourage a high level of communication and establish some set review periods. Monitoring Since being in stable accommodation, the woman has improved various aspects of her life. She is excited about the contact she is having with her son and is generally feeling more happy and confident. She participates regularly in a local social cooking class, which she enjoys. You talk with the woman about reducing your level of contact, with which she is happy. Evaluation, transition or exit You recognise the woman’s need for ongoing support, but feel that homelessness is no longer a key issue. You identify an agency that can provide some case management but whose focus is more about community engagement and parenting capacity than homelessness. You talk with the woman about engaging this service and she is open to the idea, although remains nervous about you closing your involvement. You talk with a case worker from the new agency who agrees to a meeting with you and the woman. The new worker is very warm and friendly and the woman feels an immediate connection. The new agency sets up some regular meetings and you make times to meet with the woman and review her feelings about the recent changes. Within four months, the woman is happy for you to close your agency involvement, although is pleased to hear she can re-connect should she need to in the future.

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