Peer Responds

Your substantive responses of approximately 100-200 words

Peer 1

Depression is the Dilemma I have chosen
for week 4 discussion. Depression is one of the most undiagnosed and
undertreated mental health problems of Elders.
Depression can be due to major life change, loss of a partner/spouse,
retirement or major physical illness (McInnis-Dittrich, 2005). Depression in older adults may be difficult to
recognize because they may show different symptoms than younger people. For
some older adults with depression, sadness is not their main symptom. They may
have other, less obvious symptoms of depression, or they may not be willing to
talk about their feelings. This makes it very difficult for doctors to
recognize that their patient has depression Sometimes depression in elders
present as fatigue, insomnia, loss of appetite or irritability. These symptoms may be overlooked as
depression and attributed to numerous other physical conditions (National
Institute on Aging).

In order to correctly diagnose depression our task as future
clinicians will be to assess and evaluate the entire picture. I believe that means also engaging family and
healthcare workers if client is receiving services to identify life changes and
sometimes medication changes that may affect patient?s mood. As this relates to
Hispanic elders, I believe our task is the same. There will come a time when resources may be
limited because of legal status but this is our opportunity as Social Workers
to shine and identify resources.


McInnis-Dittrich, K. (2005). Social work with older
adults: A biopsychosocial approach to assessment in intervention. (4th
edition). California: Pearson.

Lesly James

Peer 2

When I was interning with hospice I
came across many complex dilemmas, but there was a patient and his family that
really stuck with me. This man came into our care from GOP (general out-patient
care) where it had been found just weeks earlier that he had stomach cancer.
The family was not only coping with the news of the cancer, but also the idea
that their husband, father, grandfather, and brother would no longer be with
them in a few weeks. During the psychosocial assessment that must be done for
admittance the family let on that this was all a shock to them, he had just had
some stomach pain, they thought he had a little bug and needed antibiotics,
they had no idea he was dying and did not know how to mentally or spiritually
cope with this news. The complex dilemma in this case was not only dealing with
the terminal illness, but also navigating through hospice and the terminal

As the social work intern I had to
determine the best intervention and potential resolution so during my next meeting
with my internship coordinator we discussed this case and my ideas. I thought
it would be best to have the chaplain and myself make more frequent visits as
the family seemed high risk because of how fast everything was progressing.
While nothing any of us said or did was guaranteed to resolve the problems,
there were things we could do to assist the family through this crisis and make
it to where all they had to do was grief. I sat with the wife and daughter while
assisting with the funeral and service arrangements, also being sure that they
were able to have the proper military burial that the patient deserved. I also
discussed with the family the different options that were available in their
area for grief counseling as they had no time to grief the cancer before having
to grieve the idea of immediate death which could potentially cause delayed
grief (Doughty et al., 2013). I made a list of counselors for the wife, daughter,
and grandchildren, providing at least six counselors. As for the intervention I
did life review with the patient promoting the idea of meaning in and
throughout his life. The reason we do life review is because reviewing someone?s
life can assist the patient with coming to terms with the idea of death in the
near future (Kleijn et al., 2018). In the first few days the family was not
open to all of the care and the idea of planning a funeral, but instead of
making one visit a week I had it approved to make three visits a week. One week
into our care the patient went on CC and passed roughly six days later.


Doughty Horn, E. A., Crews, J. A., & Harrawood, L. K.
(2013). Grief and Loss Education: Recommendations for Curricular Inclusion.
Counselor Education & Supervision, 52(1), 70?80.

Kleijn, G., Lissenberg-Witte, B. I., Bohlmeijer, E. T.,
Steunenberg, B., Knipscheer- Kuijpers, K., Willemsen, V., Verdonck-de Leeuw,
I. M. (2018). The efficacy of Life Review Therapy combined with Memory
Specificity Training (LRT-MST) targeting cancer patients in palliative care: A
randomized controlled trial. PLoS ONE, 13(5), 1?13.…

by Lauren Reynolds

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