Reference no: EM133523015

Case: This scenario covers the end-of-life situations for two clients in a hospice care facility in San Diego California. As a hospice social worker, we are tasked with assessing clients, working to ensure quality end-of-life care and working with family and friends during the grief process. On a certain day in the hospice unit there were two clients who were nearing the end of their lives but had not passed yet.

The first client (Mr. H) is male, Latinx, elderly, in a vegetative state and had an estimated survival time of hours to days. The client was divorced and then remarried. Both marriages produced children and both families were present at the bedside of the client.

The second client (Mrs. P.) is female, Hmong, late-adulthood aged, at the end of their life due to terminal cancer and is actively passing away. She has two children who are both present at her bedside.

In Mr. H's room the two families were engaging in a conversation about how his service would be conducted, where it would take place, and how the ashes following cremation would be separated between the families. There was a significant disagreement between the parties about all aspects of Mr. H's death plan. Mr. H's first wife had a written plan that Mr. H prepared over 30 years ago. Mr. H's second wife insisted this plan was null and void as he had expressed different ideas to her and their children. The conversation become very heated, the family members became upset and they start yelling at one another over the top of Mr. H. and at a volume level that all could hear in the facility.

The social worker on the unit rushed to intervene in Mr. H's room. While the social worker was engaging the family members of Mr. H, they noticed that Mrs. P's children were carrying her down the hall towards to doors that led to the facility garden. Security was split between Mr. H's room and trying to stop Mrs. P's children from leaving with her. The social worker was also split between trying to mediate Mr. H's family and trying to understand what Mrs. P's children were trying to accomplish.

There were many things that transpired over the next several minutes. The most important are as follows: 1. Mrs. P was taken to the facility garden where she passed away in a green space, with her children by her side. The facility security monitored the doors and asked that everyone stay inside the building until Mrs. P had passed. She was monitored and declared dead by a Nurse Practitioner. The facility allowed the family to remain in the garden while they engaged in their traditional right of passage for their mother. 2. Mr. H's family members were separated into separate rooms, the young children were removed and sent to a different area. The social worker engaged one part of the family while the attending physician engaged the other part of the family. Ultimately, there was an agreement that the family would leave the negotiation to the elder females and that negotiation would be done with the assistance of the social worker at a different location in the facility.

Notes about this scenario: In the Hmong culture when someone is passing away, they must be surrounded by peace. In the facility there was yelling that put "discord" into the environment. Mrs. P's children expressed that if she had passed in that environment her soul would not cross over. Mr. H's family has strong cultural beliefs about the afterlife and how a family member should be handled. The split between the two families was creating a situation where they believed his soul would never be at rest.

Question 1. In Western society professionals often adhere to the Kubler-Ross framework of grief and loss. how do the ideas proposed in the Kubler-Ross framework apply to the clients in the provided scenario? How do they conflict? Identify an alternative lens or framework of grief and loss, specifically one that is a nonwestern framework. Provide a critical analysis of this framework and provide areas of social work practice where it could or should be used.

Question 2. Bring all of your work together and propose a new or altered framework for death & dying or grief & loss. Please be clear about why you have included aspects of the framework and how your altered framework could better assist clients experiencing these situations.