Social Work Ethics in Dementia and Homeless Patient Care
This paper examines the ethical responsibilities of a social worker dealing with a homeless patient diagnosed with dementia who was prematurely discharged from a medical facility without a continuity of care plan. Drawing on the NASW Code of Ethics and scholarly literature on dementia care, the paper identifies failures in addressing the patient's nutritional, hygienic, and medication needs. It distinguishes between acute and long-term care ethics, advocates for an integrative approach that honors the patient's dignity and the importance of human relationships, and proposes a social worker–led intervention to transition the patient into an appropriate assisted living or in-patient facility.
- Introduction: Homeless dementia patient discharged without care plan
- Ethical Principles in Acute Versus Long-Term Care: Contrasting ethical demands of acute vs. long-term care
- Assessing the Patient's Living Conditions: Shelter deficiencies and unmet patient needs identified
- Applying the NASW Code of Ethics: Dignity, relationships, and integrative ethics applied
- Proposed Intervention and Advocacy: Social worker as proxy support and placement advocate
- References: Cited sources in APA format
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What makes this paper effective
- Grounds every ethical claim in a named professional standard — the NASW Code of Ethics — giving the argument institutional authority rather than relying solely on personal judgment.
- Uses a concrete clinical scenario to illustrate abstract distinctions (acute vs. long-term care ethics), making the argument accessible and directly applicable to social work practice.
- Integrates direct quotation from the NASW Code alongside secondary literature, demonstrating multi-source synthesis appropriate for professional ethics writing.
Key academic technique demonstrated
The paper demonstrates applied ethics reasoning: it moves systematically from factual assessment (shelter conditions, patient deficits) to ethical framework (NASW principles, Wickersham's acute/long-term distinction) to concrete recommendation (proxy social support and placement advocacy). This structure — observe, frame, propose — is a hallmark of professional social work case analysis.
Structure breakdown
The paper opens with a brief situational introduction, then consolidates its argument under a single extended section ("Ethical Principles") that covers assessment, ethical frameworks, and intervention planning. The reference list follows standard APA format. At this length the paper functions as a focused professional memo or reflection paper, prioritizing clarity and actionable conclusions over exhaustive literature review.
Introduction
A patient suffering from several mental health issues, including dementia, has recently been discharged from a medical facility prematurely. The patient has been sent to a homeless shelter that offers no ambulatory or outpatient care, and no continuity of care program has been arranged by the patient's medical team. Because the patient is indigent, he has no recourse.
Ethical Principles in Acute Versus Long-Term Care
The primary concern for the social worker is the patient and ensuring that his current living situation is safe. In this case, conditions at the homeless shelter have been assessed and several problems identified — both regarding the safety of the shelter itself and the shelter's ability to meet the patient's needs. For several years, this patient has been unable to properly care for himself. He does not maintain adequate personal hygiene on his own and needs daily assistance in this regard. He does not eat properly and likewise needs help preparing meals. Recently, his motor skills have deteriorated, he has lost several more teeth, and he has experienced difficulties swallowing. All of this points to underlying issues that the medical care team has yet to fully address; the patient was discharged prematurely because the acute presenting factors had been resolved in critical care and emergency units.
This case illustrates what Wickersham (2007) identifies as the core differences between the ethics of acute versus long-term care. In acute care scenarios, meeting the patient's immediate needs is the primary goal. Long-term care, by contrast, requires engagement with multiple, distinct levels of ethical decision-making that extend well beyond crisis stabilization.
Assessing the Patient's Living Conditions
An assessment of the homeless shelter has revealed additional concerns regarding cleanliness and hygiene. Responsibility for bed sheets and towels falls on the guests themselves, and due to his dementia and other mental health and physical impairments, the patient has not been doing his laundry. He has no family members who check in on him regularly. He does have a few acquaintances who also frequent the shelter, and while those individuals care about the patient, they are not close enough to provide meaningful ongoing support. The patient requires regular medication and has not been taking it consistently. It is the social worker's assessment that the patient needs to be placed in a more suitable assisted living or inpatient setting where proper care and therapy can be provided.
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