SWK356 Tutor-Marked Assignment
Question 1 (30 Marks)
Using only ONE (1) of the three health conditions in case examples below, answer all the questions.
- Amir, 7 years old, recently received a diagnosis of epilepsy after experiencing multiple seizure episodes at home and school. He attends a mainstream primary school and lives with his parents and a 10-month-old sibling in an HDB flat. Both parents are currently working full-time.
- Mdm Lakshmi, 45 years old, employed on a renewable contract role as an administrative assistant, recently received a diagnosis of Stage 3 cervical cancer following routine health screening. She is married with three school-aged children (7, 10, 12 years old) and resides in a 4-room HDB flat. Husband works as a PHV driver. He is unable to work long hours due to health conditions.
- Mr Ong, 78 years old, recently received a diagnosis of early-stage Alzheimer’s disease following specialist assessment. He lives alone in a 2-room rental flat. He has a 55-year-old daughter (widowed) who lives separately. She is not working and is the primary caregiver to her two grandchildren (3 and 5 years old).
(a) Through literature search, describe and illustrate the incidence of the condition that you have chosen and the trajectory of the disease in your local context. (10 marks)
(b) Using the Biopsychosocial-Spiritual (BPS-S) model, appraise the impact of the health condition on the individual and his/her family. (20 marks)
Question 2 (30 Marks)
Mdm Salmah, aged 79, comes from a traditional Malay Muslim background that values family unity, filial responsibility, modesty, and spiritual acceptance. She was recently admitted to the hospital after experiencing recurrent shortness of breath, dizziness, and reduced appetite.
Following clinical assessment and investigations, the medical team diagnosed her with Stage IV chronic kidney disease (CKD), with significantly reduced renal function. They have recommended initiating dialysis as part of a long-term management plan to stabilise her condition and potentially extend her life expectancy.
During a recent care round, however, Mdm Salmah stated clearly that she does not want to undergo dialysis, expressing that she has “lived a full life” and prefers to focus on comfort, prayer, and time at home rather than participate in what she perceives to be burdensome medical procedures.
She specifically requests that the healthcare team not inform her adult children about the full extent of her diagnosis and prognosis, stating: “I do not want them to worry or sacrifice their own lives because of me. Let me carry this quietly. This is my choice.”
Her eldest son, who has been attending appointments with her, becomes increasingly distressed as he notices her physical decline. He insists that the healthcare team fully disclose her medical condition and treatment options, arguing: “As her child, I am responsible for her. You must tell me. We need to know the truth so we can plan and protect her.”
There is no documented Advance Care Planning, Advance Medical Directive, Lasting Power of Attorney, or written record of prior preferences. However, Mdm Salmah communicates clearly, demonstrates consistent reasoning, and appears able to understand information related to her illness and its consequences.
(a) Using relevant Bioethical Principles and/or the SASW Social Work Code of Ethics, identify and discuss two ethical dilemmas that you may face in working with Mdm Salmah and her family. (10 marks)
(b) Apply Reamer’s Ethical Decision-Making Framework to propose a reasoned, defensible course of action that balances patient’s autonomy, cultural sensitivity, therapeutic alliance and the best possible care outcomes. (20 marks)
Question 3 (35 Marks)
Read the case study and answer all the questions.
Mr Tan Boon Huat, 58, a taxi driver, recently survived a mild myocardial infarction (heart attack) and was diagnosed with coronary artery disease (CAD). Although he was medically stabilised, he continues to experience fatigue, occasional chest tightness, and reduced exercise tolerance, especially on long driving shifts. He has been advised to make significant changes to his lifestyle, medication adherence, and follow-up care, including cardiac rehabilitation and regular monitoring.
Mr Tan has a 10-year history of hypertension and high cholesterol, with inconsistent medication adherence due to long work hours, irregular meals, and the pressure of being the family’s sole income earner. He tends to downplay the seriousness of his condition, expressing worry about taking time off work, and often says he “cannot afford to rest” because the family needs his income.
His wife, Mdm Lim, 52, works part-time as a school canteen assistant and earns a modest income. Their two children, aged 13 and 15, are both in secondary school. The younger child (13) has mild Intellectual Disability and requires more guidance with schoolwork, daily routines, and managing tasks independently, which places additional caregiving demands on the family.
The family lives in a 3-room HDB flat with limited extended family support. Since the heart attack, the household has been experiencing increased emotional tension, as family members struggle to adjust to new caregiving responsibilities, fears about relapse, and worries over financial stability.
(a) Using components of Rolland’s Family Systems Illness Framework, analyse patient’s possible responses and needs AND family’s possible responses and needs in relation to the illness. (20 marks)
(b) Using Bronfenbrenner’s Ecological Systems Perspective, develop a holistic multi-level social work intervention plan that integrates relevant healthcare and community resources. Your answer should propose suitable interventions across three (3) different ecological levels. (15 marks)
5 marks are awarded for grammar, organisation and referencing in APA 7 style. (5 marks)