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Essay: Caregiver reflective case study (Colon cancer, counselling)

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Introduction

I am Exxx Oxxx

I am a professional caregiver presently engaged with xxx Ltd as a caregiver.

In the course of my engagements, I have had the privilege to assist people of various backgrounds with issues of various ranges.

One of my most engaging interactions was with a young lady who recently migrated to Canada.

For reasons of privacy, I will refer to the lady as Linda.

Linda walked through the front door of our office at about 2pm on September 5th, 2018.

By happen stance, I was on my way back from lunch and I was two steps behind her.

From my training I could sense she was troubled. Her carriage was that of someone in some form of distress.

There was the usual hello and off I went to my section.

About half an hour later I was asked into my supervisor’s office where I met the same lady.

Introductions were made and Linda was asked to narrate why she was in xxxx.

LINDA’S STORY-

Linda arrived Canada August 28th xxxx through the Pearson international airport, Toronto with her 10-year-old daughter.

Same day, they proceeded to Hamilton on the go airport shuttle to Hamilton.

After the usual formalities, she resumed school in Mohawk College as an international nursing student.

She also enrolled her daughter into a public elementary school.

2 weeks after resumption, she sought employment and secured a job as a part time chambermaid in Sheraton hotels, on King Street West.

From her narrative, she settled in quickly and apart from the usual homesickness and loneliness of being apart from her husband, she was happy with her new environment.

The major challenge she said she faced was the weather- it was icy and difficult to venture outdoors.

School was fun, though the teaching methods were different from what she had gotten used to back in her home country- Sierra-Leone. She quickly made some friends who assisted her to navigate her new world.

Her daughter was her only companion and it was also a challenge juggling motherhood, school and work. But all put together, she was a happy mother as her daughter- Simi, was also very happy with her new environment.

All of this came to an abrupt stop one cold Tuesday morning in December.

She said she woke up at 6am to prepare breakfast and lunch for Simi.

Suddenly she felt faint and before she knew it she had passed out.

The next time she came around, she was on a hospital bed with a drip on her hand.

She was informed her daughter called the paramedics a she was rushed to Hamilton General hospital.

Several tests down the line and it became clear that she was afflicted with colon cancer.

She says she has been in and out of the hospital for tests and palliative treatment and now she is facing a hospital bill of $58,000.

She is jobless and facing the possibility of being ejected, as she cannot continue to pay her rent and other bills.

Phase one – preliminary

In preparation to meeting the client (Linda), I informed the receptionist about her visit and instructed her to cancel all other appointments with me because I wouldn’t want be interrupted. I also told her to give me a call when the client arrives. I made sure that the agency environment was neat, safe (this will make the client feel safe, Explore personal difficulties and facilitate interpersonal growth).
I displayed some motivational pictures of cancer survivors on the wall in my office to encourage her feel safe, give her hope because first impression matters. Some of my achievements and awards were also displayed. From the day I was assigned to handle this case, this thoughts kept ringing in my head “Developing competences represents for defining the role of a good counsellor (SSW) or navigator for patients with cancer, which could become a specialized employee in oncology services with favourable results” because I have always wished to work at a Cancer centre.

As noted above in the introduction, The problem guidance and counselling to cancer patient is based not only on assessing the status of services, but also on research to enable identifies the models of good practice and consulting experts in oncology prior to the clients visit. I delved into the clients file to have a deeper knowledge of her needs. I went further to research for financial aids and sponsors for her. So much emphasis was also made on two needs of the clients and the health professionals that are involved in proudly specialized services because these were major needs.

After my research, I documented my outcome, which will help me in a better service. Sometimes, there is always the fear of what to expect from the client we are meeting. Questions will be going through my head like how do I withstand the pressure, control my situation, my strengths, limitations, values, personal traits, sensitivity, vulnerability, mood disorders, and I prepared enough to work with the client. Will I be able to withstand the pressure from the client? What will be the outcome of this? With all these in place, it should be able to help me work with clients effectively and my objectives and goals will be achieved.

PHASE 2: BEGINNING

In the course of this phase, I was so particular in helping the client, so I was keen and looking forward in meeting the client. I was very interested in developing trust with the client and also helping her with the mood disorder because from my research, people with cancer have mood swing.

I was in the office on this day and got a call from the receptionist that the client has arrived. Upon meeting with her, I made sure that the environment safe, clean, the temperature was okay, and all forms of distractions were put in check like cellphones, computers. Windows were closed to avoid noise coming from outside.

When she walked in, we exchanged pleasantries and offered her a chair, showed her where she could hang her jacket. I asked her if she wanted something .she responded by saying she wanted a cup of with milk but no sugar. She was served a cup a tea, I allowed to rest and settle and to avoid rushing things; I spent some minutes glancing through some documents. She looked around the office focusing mostly on the pictures of the cancers survivals, there was so much attention and I noticed a sign of relieve on her face. I asked her the reason for seeking service from the agency. She paused and tears rolled out of her eyes, I gave her serviette to wipe her face. At this point I showed her empathy, and made sure that she understood I could feel her pain. I told her to take her time; after a while, she felt better and started narrating the reason for coming as written in the introduction. She is an international student diagnosed of colon cancer with no health insurance. She has been asked to pay $28000 for surgery $36000 for chemotherapy. She kids to take cater for, bills and fees to pay and above all of these, Fear of death, emotional trauma for her and the family are also issues she has to deal with.

I leaned forward, maintained a good eye contact , kept an open posture to make her realize that I was in tune with her emotional reactions ( Empathy is the basic tool ). I know that client’s greatest outcome of counselling is managing and understanding their painful emotions. I told her that I understand her situation and how difficult it could be for cancer patients. I asked the effect of this on her family, she said family are anxious but have also been supportive too. I asked her how she feels now because I told I will do my best and she said,” I feel better and hopeful after seeing all these pictures of cancer survivals and talking with me too.

We ended the session by summarizing what we had conversed and confirmed by asking her if the information gathered from the story is true. Reason for this, to evaluate what I have written and be sure that data collected by me was not based on assumptions. She agreed, smiled and said she is pleased with the summary. We shook hands, said good-bye, and looked forward to meeting her again.

PHASE 3: ACTION.

In this action phase, the client (Linda) came and we went through the different options, evaluated on the best ways of how services can delivered with the information I gathered. We also went through the working contract that was written in phase 1. I leaned forward, asked her how she and her family felt when she got the news about the cancer. She said, “it was not easy handling the news but it was expected because all the signs and symptoms were there. She went by saying i said to the doctor that the almighty and Mother Mary will protect and then prayed with rosary because am a very religious woman and took the news like bath water.” According to her, she is happy that she is Canada where hospitals have good facilities unlike her country. She expressed that it has been difficult and challenging raising money for her treatment and other bills.

I asked if she has tried seeking from the government and other organizations, she responded by saying that is why she has come the agency because I do not know where to start. I asked her for permission to create a treatment/care plan for her and if I could disclose her if necessary. She had no objection, I used reframing skill in finding opportunities and answers from her and also asked the right questions because it leads or gives you an idea of the next question.

We wrote a treatment/care plan, which serves like an agreement between the client and the agency which details, what kind of work would be done. Its like a good map which guides you on the way to get to where you want to go. It can flow from the discussion that reframes an individual problem into the needs. Some of the organizations include juravinski cancer centre (social services department), oncologist, oncology nurses, doctors that can help or provide referrals to support services and financial resources. In addition to these, local organizations, communities, churches that help cancer patient facing financial and emotional stress were pencil down too. I arranged a meeting between her and Ruth (SSW) the social service department at the cancer centre. Handed the documentation and the appointment details to her, she looked pleased, wished her luck and she left.

PHASE 4: TERMINATION

On this day, Linda came to the agency and was at the reception waiting to be called into my office. There were signs of relieve on her face, seems happy and looks like her joy new no bound. Seeing her in that state of obdurate happiness gave me so much joy, I was a so please and excited. I asked her about for the outcome of her meeting with the SSW, she smiled and narrated what transpired in the meeting and the outcome. The social worker, oncologist, doctor and nurse advocated on her behalf, got a sponsor that will cover part her surgery bill, chemotherapy bills and the balance will be largely discounted. This balance will be put into a pay plan of $20 every month. I told her that we run an open door policy so she could drop by anytime or prior to appointment for better service because it was our last section together, and also that I will appreciate if I can be getting update from her as the treatment and care progresses. She agreed with me, thanked me, said she will always be grateful to God, the agency and myself and left.

SUMMARY

In the phase 4 which is the termination phase, there was need for improvement on myself in order for me to assist my client (Linda) on getting an agency to cover the balance payment considering the fact that she was not working, also making arrangement with food banks, organise volunteer drivers and visits to her. It is the termination stage phase and there was need to do more her to get to her goals. Its termination stage which means bringing something to an end. I did even ask when the surgery and chemotherapy will carried out, what caring plan was put in place from her meeting. I feel I have to work more on that and ask welcome feedback because it will help me in knowing my blind spots. Sometimes, you might feel you did a great until somebody gives you a feedback. Getting feedback helps you in knowing your true self.

References

Shebib, B.( 2014) . Choices; Interviewing and counselling skills for Canadians ( 5th ed.).Toronto, Ca: Pearson Canada Inc.

16.02.2019

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