Responsibility to Linda Is to

¶ … responsibility to Linda is to provide her with the information she needs to make her own decisions. As her case worker, I cannot tell her what to do, but I can use this opportunity to build her internal motivation to make the right lifestyle changes. As such, I need to ensure that I provide her with a compelling argument that draws links between her behaviors and her current health problems.

The approach I want to take is supportive and information -- she has already been told what to do and is not motivated to follow those instructions, so my role here is to address her sense of motivation and perhaps help her to implement structure in her life that will allow her to follow the path set out by the physician. While Linda is aware that she has diabetes, she has refused all treatment.

I do not want to focus on her past refusals for treatment, but rather to focus on helping her understand how she can solve the problems that she currently faces. I will explain to her that her lack of treatment has led to high blood sugar levels and the pain that she is currently experiencing. I will also explain that such pains are going to become more common and more intense if she continues to refuse treatment.

The pain has motivated her to seek help from me now, so hopefully the pain will continue to serve as a motivator for Linda to begin treatment. One of the biggest challenges that Linda will face is that if she begins treatment, her pain will subside. This could reduce her motivation and she may slide back to her old behaviors. To address this, I will need to make sure that she is comfortable coming back to me if the pain comes back.

I want her to know that I am always available to help, because I believe that there is a high risk that Linda will stop her treatment once she starts to feel better. Linda may not be able to draw the connection clearly between preventative medicine and a lack of symptoms. While I can see that there is a direct connection between the smoking and the intensity of the symptoms, implementing a holistic solution that involves changing a number of lifestyle practices is unlikely at this point in time.

I want to start Linda on medication for her diabetes and while I will remind her that her smoking is unhealthy, I will address that issue more fully at a later point in time. Linda has not approached me for help with her smoking, so she is unlikely to be motivated to deal with that addition at present. Linda's bipolar diagnosis presents an additional challenge.

I expect that this could cause her motivation level to fluctuate and may prevent her from staying on her diabetes medication, if I can get her to start that medication. My approach to this would be to provide her with the information and support that she needs. I will take the approach of making incremental gains with Linda, since the likelihood of setbacks is high given her state.

I would also let Linda know that if she is sufficiently motivated to take medication for her diabetes, I would be willing to work with her to set up a system that would encourage her to take her medication regularly. She lives alone, so will not have anybody to watch over her -- but if we.