Analysis of Case Study
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Analysis of Case study
Introduction
This case study is about an older woman named Louise whose husband passed away and she has now no one to take care of her. She only has two children, a daughter who is married with a child and a son who is in a homosexual relationship, living in overseas. Both the grown-up children are busy in their lives, she does not have good terms with her son in law and son. She is forced to live in a single bedroom because of the financial crisis. Her daughter moved to another city and Louise cannot meet her grandson anymore. Considering this situation, below is the analysis made on her situation that will also help in solving the problems she is facing.
Part A
Kinds of Losses present in the Case study
Almost everyone experiences some kind of losses in their lives because of the ups and downs life is famous for. People have good times at one point and they have bad times at another point which often makes the survival a challenge for them. The case presented under study about Louise is very sad as Louise is in the old age of her life. She is already suffering physical and mental deterioration of capabilities she had in her youth and the situation got worse for her as she recently experienced the death of her spouse. Having an age where a person is not very active and becomes dependent on others for the additional care and needs, death of the partner is something unbearable (Kaur, Kaur & Thapar 2015). Tony’s departure left her shocked on her current situation. Before Tony’s death, she was responsible for the house maintenance and used to perform all day to day tasks with full motivation. She used to do that because she knew that Tony will take care of her emotional needs and will be there with her in the late years of life. But, his sudden death broke her down and she faced the interpersonal (from both sides) as well as tangible loss (visible loss) with the death of her husband. Additionally, she used to take care of her 4-year-old grandson named Max two afternoons per week. But now her grandson is also going with his mother to New York as his father got promoted. Grandmother and grandson share a very special bond in the world but the separation of her daughter and grandson added more pain to the interpersonal loss.
The second kind of loss is Louise’s poor financial situation, this second can also be named as the secondary loss as it linked with Tony's death. She is in the age where she cannot afford from a job and her spouse who used to earn also died. After Tony’s death, she moved to single bedroom unit because she couldn’t maintain the loan repayments of the house. Financial loss intensifies her miserable situation as she now feels like a burden in the society who cannot even help oneself to live peacefully. The financial stability is absent in her life where she needs the most. This loss limits her to overcome her other problems.
To make her feel more terrible, her grown-up children left her side in the old age. Her daughter Sally is going to New York and she offered Louise to visit her home in New York. But the problem here is, Louise does not view the visits to be suitable as she is in no good terms with her son in law. She does not have any contact with her son Barney for ten years. This is a symbolic loss as the relation of children with her is in declining terms and she cannot do anything to save the bond. She cannot stand the breaking of this parent-child bond and is left helpless by the children.
Socio-Cultural and Familial Factors influencing Louise's Experience
There are many socio-cultural and familial factors that are adversely influencing Louise's experience. The familial factors that she is experiencing are the burden of single-parent responsibilities, loneliness due to spouse's death and the complicated bond she has with her son due to his homosexuality. These factors are deepening her pain and are not helping her to focus on her life at this stage. Apart from these familial factors, she is also suffering from many socio-cultural factors which are, the custom that parents do not live with daughters after her marriage. Even if her daughter Sally insists, she is culturally bound not to take this decision of living with her. The other socio-cultural factor that comes as a restriction for her is that, no matter how much she wants to be with her son Barney now, she cannot do that so. The reason for not opting for this decision is that in her culture, the dead are respected and so are his wishes. Therefore, she is respecting the wishes of her dead husband and is not contacting her son. She is also facing social isolation from society as one of the factors that are leading to her depression in this unstable state. There is no person of contact around her in times of need. She also does not have any social group that may help her to feel better in grief and pain she is facing. The factor of social negligence and no social support are very strong towards her as she is widow and old too but is receiving no moral support from the society (Min et al.,2018).
Louise’s Support Network
Louise has a very weak social network as there is currently no one who could take care of her physical, emotional, informational and appraisal needs (Isherwood, King & Luszcz, 2017). Her husband suddenly died depriving her of the huge support he was for her. She cannot share any feelings and emotions with her daughter as Sally is moving to another city. She has no contact with Barney for ten years now. She is living alone and the lack of social support is affecting her health. It is shown in the studies that the absence of social support reduces the life expectancy as the person becomes depressed and his body forms many diseases. A social network is very important as the company of friends, family, reach out to the person in times of crisis and improves the quality of life for that person. They provide a shield against the adverse life events that the person is experiencing.
Impact of these Factors on Louise’s Grieving Process
As Louise has a very weak social support and no support from the family either so these factors will affect negatively on her. All of these factors which are mentioned in detail above have adverse effects on the grieving process of Louise. In fact, they accelerate her grief and stress which she is having, from all the kinds of losses she experienced recently. She does not have anyone who could listen to her concerns, there is nobody who could take care of her or assist her in the tasks which she is performing alone. This is why she will take more time to recover from the grief because there is nobody to counsel her and to become her support in this time of deprivation from her family members. The effect of all these factors might have reduced if she had a strong social network and social support provided by the community (Recksiedler et al.,2018).
Part B
Approach to Grief Counselling
Looking at the situation Louise is currently going through, it is very hard to recommend any one particular approach because she is the state of grief. She is undergoing a bereavement process and it will take a lot of time to make her recover from the losses she suffered (Rodgers & DuBois, 2018). This is because she also lacks a strong social network and there is no family and social support around her to make it at least bearable for her. Given this case, it can be said that coping therapy varies from one person to another person. Some people will prefer to share their feeling and emotions related to the pain they are experiencing from the loss they had while others will remain silent and will do some tasks to distract themselves. Every person has a different level of tolerance towards the certain level of grief they had been through. Some individuals might take the loss as a positive sign of motivation and inspiration while others might end up getting depressed and isolating themselves from the rest of the world.
There are mainly five stages of grief which Louise will experience before getting stable in her behavior. The first stage is denial. It will be very hard to accept anything this point when her husband is no more and her daughter moved to another city instead of staying by her side to assist her in emotional needs. The second stage which will hit her will be the anger. She will become irritated when everything being told to her and will resist the advice given to her like moving on. She is not ready yet to forget everything that happened suddenly in her life. After that, the phase of bargaining will come followed by the depression phase which is normal to expect from her after all that she went through. The last stage of grief will be the phase of acceptance where she will accept the reality and will try to adapt to the negative changes life offered to her.
In this situation, it is very critical to give grief counseling to Louise otherwise she might take more time than what is required to recover from her grief. Grief counseling will accelerate the natural healing process and will save her mental and physical health from deterioration. Grief counseling has its importance in helping the individuals who suffered severe grief in their lives from different kinds of losses. The needs of a beavered person are very vulnerable and should be paid detailed attention so that they do not face further depression and disturbance in their lives.
The most suitable approach here for grief counseling to Louise is the person-centered approach (Spence & Smale, 2015). In this approach, the client is dealt with the ways in which that individual perceive themselves by the realization made by their counselor. This approach centers around that particular individual who is need of insurance that he can do that particular decision n his own without taking anyone's help or support. Continuous efforts are made to help him regain the confidence he lost because of the trauma he experienced (Sippel et al.,2015). This approach involves detailed listening to the problems and concerns the client has and then thinking with the client about the possible solutions. Coaching is done and ideas are shared and after that, feedback is assessed.
The reason for opting for this approach is that, despite all the unfortunate happenings in her life, Louise is a very strong woman who knows how to take care of her grief and will try to fight back. Like in the case study, in the start was mentioned that Louise used to take care of her house tasks and she had maintained her house well and was responsible for day to days' tasks that used half of her energy. She did it many times and there is a great possibly hat she does it once again.
In the counseling sessions, the counselor will first listen carefully to the thoughts and feelings Louise has related to her relationship with her son Barney. It is more important to know what she thinks that it was to know what her deceased husband thought about their son. She will be asked to revisit the loss experiences she recently came through to analyze logically what those experiences gave her to learn about life. Louise will be guided neutrally without pressurizing her to take a certain decision. The decision will be completely left on her to contact Barney or not to contact him. Depending on the intensity of her state, the counselor will recommend her the possibilities that are available for her. If she is in very critical condition and could no longer take care of herself then she will be assisted to make a contact with her estranged son. There should be at least one attempt made to reach out to Barney so that it should be known what he is feeling about his mother, whether he misses her or not and is ready to change or not. Barney should be informed about the recent loss the whole family suffered. If approaching him to leave her more devastated, then it will be made sure not to contact him again in future for the same reasons. The decision that should be made here is that one chance should be given to Barney to take care of his mother otherwise he will lose his second mother. She is trapped in two contracting situations not knowing where to go and this stress is affecting her mind and overall health adversely. She is carrying the burden of the guilt that she still misses her son and wants him to come back and apologize to her but she cannot go against the promise she made with her deceased husband. Louise needs to be told that she is not doing anything wrong if she chooses to approach Barney as she is also a mother and the bonding of mother and son cannot be broken on mere promises. So, she should focus on her son and definitely she would not let go of his late husband's command but focusing on present rather than past. The motive of the person-centered approach should be to gain her confidence in the decisions she makes without regretting her choices (Spence & Smale, 2015).
Part C
Ethical Issues in this Case
The case is very challenging as it may raise many concerns for the counselor. The counselor, in this case, is not in a position to defend himself on either possibility taken by Louise related to her son Barney. If the counselor decides to make Louise's mind to contact Barney, then people including Louise will perceive that the counselor has no regards to the ethics and shows no respect to the promises made by the deceased people. On the contrary, if Louise is supported on the decision to not approach Barney due to his sexuality then again ethical problems will arise in this case too. People including Louise will interpret that the counselor dislikes same-sex relationships and thinks that homosexual people are a threat to this society. The counselor will be made to question his beliefs because of the alternatives he will suggest for Louise to follow. It is a very ethically vulnerable and contextual case which cannot be fitted in all the aspects of society. Not everyone thinks the same in society and this is why there are many types of people including both conservative and liberal.
If I were to support Louise, then I would have said to her that there is nothing she can do about her son's sexuality and that his sexuality should be perceived as a danger to her family's norms and values. Homosexual people are humans too and they have the same rights as others in society. As a widow, she should know how much social acceptance means to the person who is involved in a divergent relationship which is viewed oddly by the whole society. As a widow, she should know how much respect is important for every person and sentiments of the homosexual couples should also be not hurt by society.
Louise is torn between two undesirable possibilities which are risky as well but she needs to take a rational decision that will benefit her in the long run. Facing a contracting situation, it will be hard for her to understand anything that is being told to her this is why efforts should be made by the counselor to minimize any adverse effects that these ethical issues on both ends might have on the counselor’s relationship with Louise. I will use cognitive therapy to help Louise understand the ethical issues associated with both the types of decisions without taking me wrong. I will make her see all the aspects her decision might bring for her and her son and will tell her that this is what a rational person should suggest her without the fear of being judged. The bigger picture of every picture is important and sometimes selfish attitude is required to survive in the society. Accepting the sexuality of her son will not do her any harm, in fact, her son will be grateful to her throughout his life for understanding him.
Conclusion
Louise is a brave woman who knows how to tackle the grief and depressing situations in her life without the help from family and society. But bonds are important and mother-son bond shares a special connection with each other. Person-centered therapy is needed to help Louise to let of the past and choose to live in the present. She should also make an attempt to resolve her constrained relationship with her son and that will not hurt her husband’s sentiments.
References
Isherwood, L. M., King, D. S., & Luszcz, M. A. (2017). Widowhood in the fourth age: support exchange, relationships and social participation. Ageing & Society, 37(1), 188-212.
Kaur, N., Kaur, J., & Thapar, K. (2015). Perceived self care deficit and social support system among elderly. Nurs Midwifery Res J, 11(3), 112-19.
Min, J., Li, Y., Xu, L., & Chi, I. (2018). Psychological vulnerability of widowhood: financial strain, social engagement and worry about having no care-giver as mediators and moderators. Ageing & Society, 38(11), 2356-2375.
Recksiedler, C., Loter, K., Klaas, H. S., Hollstein, B., & Perrig-Chiello, P. (2018). Social dimensions of personal growth following widowhood: a three-wave study. Gerontology, 64(4), 344-360.
Rodgers, R. F., & DuBois, R. H. (2018). Grief Reactions: A Sociocultural Approach. In Clinical Handbook of Bereavement and Grief Reactions (pp. 1-18). Humana Press, Cham.
Sippel, L. M., Pietrzak, R. H., Charney, D. S., Mayes, L. C., & Southwick, S. M. (2015). How does social support enhance resilience in the trauma-exposed individual?. Ecology and Society, 20(4).
Spence, S., & Smale, U. (2015). Group work with bereaved people: developing person-centered practice. Person-Centered & Experiential Psychotherapies, 14(1), 3-17.
