Examples of advocacy: a case manager s perspective

Transcription

1 CHCSS00069 Advocacy Skill Set Examples of advocacy: a case manager s perspective Introduction I have worked with people with disabilities and their families for over 10 years. I have been asked many times why I work in the industry. It certainly isn t for the money. But honestly I have to say it s because I enjoy helping people and ensuring that people were treated equally. As a child I was always looking out for my friends, even donating my toys to charities. As a teenager at school I organised a school charity event for drought effected farmers and organised a breast cancer fundraising event. I even volunteered with a Meals on Wheels service in my school holidays. My friends all thought I was crazy! I was lucky as I hadn t experienced disabilities first hand in my family, but had witnessed many events wherein people with disabilities were treated poorly and that drove me to want to work in the industry so I could be on their side and fight on their behalf. As a case manager I worked with people with disabilities, the frail aged, and their carers. Part of my role was to conduct a comprehensive assessment of their needs, prepare a care plan in consultation with the client and ultimately to assist the client to avoid inappropriate and/or premature institutionalisation. A big part of my role was advocating for my clients and also assisting my clients to develop advocacy skills. Then when I moved into a Management position I was supporting my staff with advocacy strategies. Over the years I have provided a lot of advocacy support and wanted to share some of those examples with you. Although the examples are based on real people, I have changed names and some personal details so they cannot be identified. The purpose of providing you with these examples is to give you some insight into different examples of advocacy. Version 1 Page 1 of 7

2 Danny Danny was 29 years old and was living in a boarding house. He had received an eviction notice as the boarding house was closing down and had nowhere else to live. Danny had a mild intellectual disability as well as anxiety. He was also an insulin dependent diabetic, and his diabetes was not stable. His mother was deceased and his father lived in a hostel. I met Danny initially at a shopping centre, this is where he chose as it was a place he was familiar with and felt safe there. He looked very nervous and scared he had his head down and was crying, shaking and kept saying that in 2 weeks he would have nowhere to live and didn t know what to do. My role as case manager ended up being quite intensive and complex over about 5 years I worked with him, but in terms of advocacy my role was quite clear. HOUSING! Danny advised that he had visited Department of Housing and they advised him that he was not eligible for Government Housing. This scared him as he did not have the income to pay for private rental. I had to do my research. As far as I was concerned, he DID meet the eligibility criteria. So I made an appointment to meet with a representative from Department of Housing, took Danny along to that appointment and made sure his rights were upheld. I also presented his situation in a clear and factual manner, and upon the completion of the interview they deemed that in fact they had made a mistake, and he was actually eligible for subsidised housing after all. Even though it was a great outcome, it was disappointing for me because if I hadn t been there to act on his behalf, and fight for his right to accommodation, what would have happened to him? Over the 5 years I worked for him, I advocated on many occasions, but this scenario stuck out the most with me, as I was carrying out this task instantly after meeting with him. Version 1 Page 2 of 7

3 William William was 90 years old and was still living in his own home, without assistance. That was until he had a fall and sustained a fracture. He was taken to hospital and his neighbour contacted me for help because the social workers and the doctors at the hospital were giving William no choice but to move into care. William did not want to move into a Nursing Home he wanted to return home, to his home. I conducted an assessment at the hospital and organised a case conference with all relevant stakeholders, and William. I gathered all the services together who I knew could support William to return home and we discussed a package of care that could sustain him. His neighbour also agreed to provide some information assistance too, and William supplemented the difference through private agencies. With a plan in place, the Doctors and social worker agreed to discharge him. William returned home. He was able to say good-bye and come to terms with the fact that he would eventually need more help and would need to move into care, but for now he was able to enjoy his time at home and come to some sort of closure. If I hadn t been there to speak on his behalf and fight for him to return home, he would have been forced straight into care. He would have had no closure and would have been unhappy. I believe it was a very good outcome as the William s rights, his right to live at home, were upheld. Version 1 Page 3 of 7

4 Iris Iris was 80 years old and lived alone in her own home. She had multiple health issues, including dementia and schizophrenia. She had no family. When I first came across Iris she had no services in place, and was not managing at home. Together with the mental health worker, and Iris, we came up with a package of care that she was happy with, to allow her to live more safely at home. This worked well for about 18 months, then she had an episode her cognitive functioning really deteriorated. She was more confused, wandering the streets and was unsafe. My role as an advocate in this case was to make an application for Guardianship. At this stage Iris did not have the capacity to decide if she should live at home or not I felt that she needed to move into full-time care, but wanted an appointed person to make that decision on her behalf. Applying for guardianship is a good example of advocacy it was about gathering information, making an application, gaining support from relevant health professionals and attending a hearing. At the hearing it was deemed that Iris was no longer able to make her own decisions, and that she was in fact unsafe living in the community. A guardian was appointed and together we found a facility that Iris could move to. Even though she was no longer living in her own home, we were able to find her a facility with extra facilities, that she could subsidise, and she was happy and healthy. I wonder what would have happened to Iris if I didn t meet her. How long would she have stayed at home? What would have happened if she continued to wander the streets at night in a confused and dehydrated state? Iris had no one to advocate on her behalf to ensure her safety. Version 1 Page 4 of 7

5 Jim Jim was 47 years old and had a severe brain injury. His communication was very poor, and he was confined to a wheelchair. He had an accident when he was around 18 years old. At that time, there weren t many options for support so he was consequently placed in a Nursing Home. A Nursing Home this is a facility that is generally for those aged over 65 years old, and he was placed here as a teenager. I cannot fathom how that must have been for him at the time. Anyway, he and his family had expressed that they wanted him out of the Nursing Home, and into the community. So that was my job. I had to do a lot of advocating in this situation. I had to liaise with the nursing home to have him discharged. With Department of Housing to get him a modified unit. Also with community services, who were close to capacity. I worked closely with those services together with the brain injury team, occupational therapist and his Guardian and together we were able to set up an accessible unit with a range of support services so that he could live independently in the community. This was a great sense of achievement for me recognising that Jim still had strengths and could still participate in society regardless of his disability. Version 1 Page 5 of 7

6 Personal experiences Let s not forget that we actually advocate for ourselves almost every day! A few examples of when I have needed to do this to ensure my own rights were upheld: Gas bill being charged a fee for late payment when in actual fact I hadn t paid the bill late, I paid it on the due date. It took me two weeks to have this fee reversed and credited back to my account. Clothing I purchased a faulty dress and had no luck with the shop in terms of trying to have the situation resolved. I had to speak to the Department of Fair Trading. The way I saw it, I didn t receive the quality service I paid for. The outcome: Department of Fair Trading spoke to the shop and the shop agreed to reimburse me for the cost of having the dress mended. Day care there was some issues at my daughter s day care in terms of the level of care. Now I knew my 3 year old could not speak up so it was my job to do that. Again, I was paying for a service, and I did not feel that the service was at a high quality. I had to advocate on my daughter s behalf in order to ensure her safety. Ticket I love my football and had bought tickets to a certain home game. This game was then changed to a bigger arena. My complaint was that I bought my ticket for the original ground it was front row. I didn t want to use my ticket at a larger stadium, stuck at the back of the arena. So I contacted the local paper. They conducted an interview with me and next you know I m on the front page of the local paper. So my voice, my story, my issue was then seen by many people. And surprisingly other people then wrote in to say that they were experiencing the same issue. Making this public then gained attention. Remember, advocacy doesn t always have to be big it can simply be making a phone call on someone s behalf, making a referral for them with their consent. Don t underestimate the power of speaking up. So that is a little about my experiences with advocacy. I hope these case studies gave you some insight into how advocacy may work. Version 1 Page 6 of 7

7 Other resources There are two movies that you can watch that really represent what advocacy is all about. I would highly recommend you watch these if you get a chance. Erin Brockovich Devil s Dust Version 1 Page 7 of 7