SWK211: Mdm Elaine Lim, 78 years old, lives alone in a four-room Housing and Development Board (HDB) flat: Reflective Practice and Cultural Competencies Case Study, SUSS, Singapore

Mdm Elaine Lim, 78 years old, lives alone in a four-room Housing and Development Board (HDB) flat. Her husband, Jerry, passed away two years ago. Mdm Lim has been recently diagnosed with Stage 3 cancer. There are options for treatment. However, Mdm Lim refuses treatment. For now, she is weak but still able to care for her daily needs. She prefers to remain at home and not stay in a hospital or residential care setting when she gets weaker and wants to die at home. She also wants to be at home with her son, David, 45 years old, who is intellectually challenged.

Mdm Lim used to work as a primary school teacher. She and her husband had lived frugally on their savings to care for their own needs and that of David. They did not want to trouble their other two children who are married and have to provide for their own families. Their two other children have been living abroad. Grace, 50 years old had settled in Hong Kong, and James, 48 years old, had settled in New Zealand.

Grace has returned to persuade Mdm Lim to go to a palliative care setting where she can be cared for well and be comfortable. She and her brother James have offered to cover the expenses of Mdm Lim’s care. Mdm Lim, however, has refused their help as she does not want to be a burden. She prefers instead to prepare for her death, saying she is not afraid of that eventuality. Mdm Lim has on her own, made her funeral arrangements with a Christian casket company. She has also prepared her Will and a Lasting Power of Attorney.

Grace and James have a hard time coming to terms with Mdm Lim’s decision. Their father, Jerry, passed away suddenly after a heart attack and because of the travel restrictions during COVID, both of them could not return for the funeral. They had experienced much regret and guilt over this. They hope to spend more time with Mdm Lim and care for her. They think that David should be placed in a care facility, but Mdm Lim will not hear of this.

Though Grace and James had settled abroad after their studies, they continued to stay in touch with their parents regularly and visited them at least yearly. Both their parents were fiercely independent and insisted that the children focus on their own families. Mdm Lim and her husband had seen how some of their peers who were dependent on their children were either ill-treated or abandoned by their children. Thus, Mdm Lim and her husband chose to rely on themselves and not be dependent on the children.

Grace is at a loss as to how to deal with the situation. She has approached your Senior Centre for assistance to persuade her mother to get treatment for her condition or at least stay in a palliative care setting. You are the social worker assigned to the case.

Question 1

Identify your personal values and beliefs on any THREE (3) of the following areas. Elaborate on how your personal experiences and attributes may have shaped these values and beliefs. Provide ONE (1) example in each of the THREE (3) areas to justify your points.

1. Parents’ responsibility toward their children
2. Children’s responsibility towards parents.
3. Respecting the wishes of the terminally ill.
4. Planning for one’s death.

Question 2

Discuss THREE (3) challenges you might face when carrying out your assessment and intervention roles in this case because of your personal values and beliefs. Illustrate how you would balance your personal and professional values.

Question 3

Explain Gibb’s Reflective Cycle (1988) and demonstrate how you might use this in your work with Mdm Lim and her family. Discuss ONE (1) challenge of using this reflective practice model in this case.