A Critical Reflection on Case of Daniella and Family
The Concept of Safeguarding
Introduction
This assignment is based on the critical reflection of a case study provided to us by our tutor. The given case study revolves around the Slovakian migrant family in UK struggling with drug abuse, poverty and threats of lenders. The case study is based around a woman named Daniella having 3 children and a husband who has been taken to drugs. The woman now suffers poverty and is threatened by the drug dealers asking for their payment. Simultaneously, as they have failed to pay their rents, the family is also threatened by the landlord. The condition of the children indicates physical abuse and domestic violence as bruises are found on their faces. Likewise, Daniella is also found mentally disturbed and unware of her rights. Daniella repels from approaching any authority as she believes that her children will be taken from her. On the basis of this case study, it must be noted that the case study revolves around 4 distinct vulnerable groups. These groups include- Drug Abused Josef, Child Abused (Stefan, Anya and Martina), the Domestic Violence victim (Daniealla) and the case of elderly abuse (Julia).
All these groups required sufficient care and safeguarding but they are unaware of their state and rights. Now, in this critical reflection, I am going to discuss, how to convince Daniella to take the necessary actions and make her aware of her rights.
Discussion
Let us first start with the case of Josef, the 35 year old father of the family. He has been taken to drugs and family now makes no sense to him. Owing to the mental satisfaction known as Euphoria, a person who begins taking drugs gets addicted in no time. Cocaine especially, affect the mind of a person in the most addictive manner. The individual who has been taken to drugs tends to lose his or her intellect, confidence, and IQ. Constant drugging also makes a person depressed after sometimes, when he begins to realise that his social life and finances are depleting due to drugs (Fundamentals of Toxicology, 2016). Because of depression and drug addiction, the person is unable to focus on caring for others; he or she is always under the influence of drugs and completely lost, unable to focus on things properly; as a result, it has a negative impact on a person's life; he is always isolated, does not talk to anyone, takes drugs, and is unable to focus on daily activities (Eske, 2020).
Drugs and intoxication become the be all and end all of a person and family does not matter for him. The same is the case of Josef who is least bothered to take care of the family. Clearly, the bruise signs on the face of children and unkempt appearance of them indicates domestic violence and unavailability of care. Josef is spoiling the future of his children. These children are entitled to a safe environment as per the UK government and the Civil Child Protection Act, it is the responsibility of the caretaker to arrange for the child's protection and court remedies. The focus remains on the child's future and advising him on how to overcome the emotional and physical damage he has suffered as a result of the abuse. Physical abuse is one of the most heinous types of abuse, leaving the victim with life-long emotional suffering. When a victim is as young as Daniella's kids, their entire mental, physical, and social growth and development is severely hampered. Daniella is scared that her children will be separated from her, but as a guide, I would ensure her that nobody has the right to do that and also she can avail the facilities free of cost so she will not have to pay anything for any service. Rather, the children will received food and shelter away from the father where they will be safe and will also be given food and education as the government has tie ups with many such NGOs and agencies working for the wellbeing of children. Also, Daniella will be allowed to stay with her children only (Skivenes and Sørsdal, 2018).
Another thing which bothers Daniella is the matter of confidentiality. Daniella does not want to reveal her information to anyone. May be she fears of insult. To overcome this trouble I will let Daniella know that care and nursing in UK has to follow certain ethical codes. The caregivers have to abide by certain ethical codes while dealing with such sensitive case. Maintaining patient confidentiality is a need under both Human Rights and UK legislation in all instances. Eventually, the patient's data and sensitive information must be kept between the caretaker and the patient. However, the law of confidentiality may be broken in some circumstances. The care giver has the authority to break confidentiality if the patient is unable to reason and think normally or is mentally retarded. In this circumstance, the caregiver may address the situation with the patient's family member before contacting the appropriate authorities, such as the supervisor, senior doctors, and others. However, in this case, the victim (Daniella) is not mentally retarded but is fully mentally sound. She just lacks sufficient education, knowledge and information. Hence, her details will remain confidential (Kabir, 2017).
'Autonomy' and ‘beneficence’ are another ethical principles in nursing and caregiving. According to autonomy, the patient is free to choose his or her own course. In this manner, a nurse is unable to impose any therapy on the patient. However, if the patient is unable to make sound judgments owing to a lack of normal maturity or a bad mental condition, the nurse has the authority to breach autonomy. ‘Beneficence’ simply means welfare of the victim or patient. Eventually, the children of Daniella cannot be separated from her under ‘autonomy’ principle. She has to choose for her own path and if she does not want her children to be separated from her in name of ‘help’, ‘remedy’ or ‘treatment’ no one has the right to do so. Also, if the children as young as Daniella’s are separated for their caregiver, it will go against the principle of beneficence, as these children require motherly care.
Besides, another point which Daniella needs to know is the Care Act 2014, which was launched by the UK government six years back to protect the children from abuse and exploitation. The act lays six principles for child care. Daniella needs to know them all in detail. The first principle emphasises ‘accountability’ on part of the care giver. No individual or a body can provide care to Daniella and family until it has the safeguarding training certification. Eventually, they will be receiving services from a government trained persona or body only. Therefore, they need not to fear of any fraud. Secondly, ‘empowerment’ is the core aim of safeguarding a victim, eventually, even if I am advising Daniella, she must not feel as if I am forcing her or pressurising her, rather my responsibility is to provide her with sufficient knowledge so that she can take her own decisions. Therefore, instead of reporting to a known agency, I shall only encourage her to seek guidance from the ones I know. The next principle is ‘partnership’ which implies that the safeguarding agencies have tie-ups with different local authorities which can help in protecting Daniella and her family. So, I will first confirm with the food bank I am volunteering at if they have such facilities, if yes, then I will ensure Daniella to bring justice to her and the children (UK Government, 2014).
‘Prevention’ is yet another principle which states that if the signs of abuse are detected earlier, they must be resolved as soon as possible. In this case, the children have bruises and scratches on their face which intensifies the requirement of prevention. I will make Daniella aware of the fact that these marks are already reporting abuse and hence, people can judge by their own. Daniella needs to know that his children have great tendency of developing Phobias, anxiety, post-traumatic stress, sadness, isolation, and even suicidal thoughts due to such poor mental and physical condition. Another issue is the bodily injury. Such children require both safety and psychological treatment. In such a circumstance, the caregiver must employ strategic communication and counselling abilities which can be provided by an expert only (Norman et al., 2012). Then comes ‘proportionality’ principle which stipulates that as I have witnessed bruises on the children I must note this down and must report further so that I can pave way for the other principle which is ‘protection’.
These children need to receive proper care, education, food and shelter which their father is failing to provide them. Daniella needs to be educated about their rights and needs which I can do for her. It is not a matter of a single day, but effective communication strategies have to be used with her. It will surely take certain weeks or even a few months to get Daniella convinced and empowered fully. I would first need to establish a good rapport with her. I cannot just go to her and ask about her problems as it might trouble her. So I will first try to break the ice between us with general conversations. Becoming personalised within a few days will be a better approach. For example, there are ways for overcoming the client's anxieties and establishing rapport with Daniella, such as employing a kind tone and compassionate facial gestures when advising her. The message must be delivered in a language that she understands (as per his language and maturity and literacy level).
I shall thus, have to avoid using incomprehensible medical words and instead talk in the manner of caregiver. Furthermore, the message must be repeated frequently. To minimise boredom, I can also try to opt for giving the same message in a different way each time. For speedy comprehension and understanding, a communication approach that engages the victim’s multiple senses as well as her emotions must be used. Another, trouble is that Daniella cannot speak English, nor she can comprehend it. Therefore, like Daniella uses a translator, I too will have to identify the language she speaks and will need a translator to communicate with her.
Coming back to the root cause of Daniella’s condition-her husband Josef’s drug addiction. Once the children have been given care and protection, it does not mean that they do not need their father at all. The aim of safeguarding is not to separate the victim from the family, but to help and safeguard the family as a whole. Josef is now addicted and needs medical treatment. Even if he tries hard to leave smoking cocaine he simply cannot as the drugs once enter a human body they have a psychological effect on them which makes them addicted. Also, certain physical symptoms are observed when the victim does not acquire drugs after a long term use. For example, suppose if Josef takes drugs daily and one day he does not find the same, he might suffer palpitation, restlessness, strokes and severe anger. He might perspire hard and find it difficult to breathe. These conditions also make a person addicted. Therefore, even Josef is not a villain in the picture but those who are supplying drugs to him have to be arrested immediately. It is possible only when Daniella co-operates with the police and other local authorities.
Thus, I would also inform Daniella that since Josef has a long record of cocaine use, according to the case study, he is a victim and not a villain. Whether cocaine or another intoxicating drug, drug addiction leads to a variety of physical and mental problems. The effects of alcohol and drugs on the brain and nervous system are known to be slowed (Goodman & Packard, 2016). When the brain activities slow down, the consumer's cognitive and thinking abilities deteriorate (for the time being). Euphoria is a common side effect of this illness (a sense of being happy and tension free). A person becomes addicted to the drugs as a result of this pleasure (Bearn & O'Brien, 2015). Furthermore, when the individual's mental processes slow down, he is forced to behave and think in ways he would never do otherwise. Delusions, hallucinations, and a loss of contact with reality can occur as a result of such a lack of logic and reasoning.
Long term drug consumption can also result in mental illness. Unfortunately, there is a cyclic relationship between mental illness and drug use. To achieve Euphoria, a person uses intoxicating medications while he is unhappy or depressed. He becomes hooked to the sensation of Euphoria rather than the drugs when he experiences it. Drugs, on the other hand, cause mental disease, as already mentioned (Mohamed et al., 2020). As a result, the issue grows exponentially over time, trapping an individual in hallucinations. Thus, Josef also needs to be rescued. He needs proper medical treatment and counseling which can bring Daniella a far better Josef again who is loving and caring to her.
Another, vulnerable person found in this case study is the Grandmother Julia. Julia is a 60 years old woman who dependent upon Josef and Daniella. Owing to Josef’s drug addiction, even Julia suffers poverty. During the old age Julia needs care, love, mental peace and healthcare facilities. But on the contrary, her life is being disturbed due to the case of Josef. Rather, the carer amount Daniella receives for Julia, is also taken away by Josef. The same Care Act 2014 also covers the elderly abuse and states that abuse for elderly people have several dimensions. In case of Julia, she is suffering majorly from Financial and Psychological Abuse. The threats from the drug smugglers and the landlord come under psychological abuse as they destroy the mental peace of Julia. Financial abuse if what Josef is doing by taking away the carer money from Daniella. So Julia’s case also needs to be reported immediately. However, in this case as I am supposed to educate and advise Daniella, I can only let her know that Julia’s mental peace is being destroyed due to the clashes between Josef and her. This will make Julia’s health decline and it is also depriving Julia of the comforts and peace she deserves as a senior citizen. Health, dignity and peace are the only requirements of the elderly people which they have moral right to.
Daniella by neglecting the case of Josef is indeed depriving Julia of her rights. Thus, I would be using a caring tone with Daniella and will try to convince her to take the necessary actions. Another significant point in the case study is that Daniella goes to the food bank with her children only and we do not find mention of Julia the grandmother which further indicates that Julia is being neglected by Daniella as well which is not a good point at all. All such conditions together worsens the mental health of all the victims. Mental wellness is the foundation of human existence. The significance of mental health in one's life should not be overlooked. Scholars and philosophers have long contended that mental health encompasses not just a person's mental well-being but also their physical well-being. Mental health is consequently critical to a human being's healthy existence, and all other parts of his life, whether physical, social, or emotional, are all reliant on his mental health (Ohrnberger et al., 2017). Different societal variables, on the other hand, might have a detrimental impact on a person's mental health. Toxic individuals in one's environment, job stress, education stress, depression, drugs, alcohol, and a variety of other issues are among them. When a person's mental health is disrupted, his physical health suffers as well (Hellman, 2018). Stress, depression, drunkenness, and other mental illnesses lead to weariness, stomach problems, impaired memory, and other physical problems, along with social withdrawal. Similar is the case of Josef and Daniella who have been isolated from the world.
Safeguarding is an important process for both children and adults. Especially this is vital for people because at old age the individuals might get some diseases like dementia, learning disability, mental illness or drug abuse. Safeguarding Discuss how children and possible adults at risk in the case would be protected. This support and care are necessary for people who are facing some mental or physical issues. These age groups people need care because they themselves cannot report any report against abuse or sometimes children are unable to identify abuse. In these instances, people need proper guidance and their needs should be fulfilled, for these reasons safeguarding is really important. This process must be carried out by different health workers and in healthcare settings such as care homes, orphanages, and hospitals.
The Care Act Statutory guidance defines this process as “Protecting adult’s rights for living in safety, abuse-free environment. This care is all about people from different organizations working in a collaborative manner to prevent diseases and also reduce the risk of experiencing abuse or neglect at any place. This also ensures that the adults and children are well educated about well-being and also adults have some interpersonal relationships conflicts and be unclear about certain things, during this phase safeguarding is important. (Appleton et al., 2020). Safeguarding of children and adult works on 6 different principles which are empowerment, prevention, proportionality, protection, partnership, and accountability. Empowerment is a step that ensures that the health workers empower vulnerable people to make their own choice and decisions. Prevention is essential to stop a person from going into any danger for example it is important for children who are using drugs must be prevented from that. Protection of these people is done for protecting them from any harm and partnership is the most important process in the safeguarding process.
Partnership promotes multi-agency working which ensures that the health workers from different organizations come together and work in a collaborative manner for safeguarding older adults and children. Multiagency and interdisciplinary collaborative working is a process where both across and within sectors and teams work together to ensure that kids are adequately protected. Many researchers have also suggested when many stakeholders work collaboratively then children are most effectively protected. It is impossible that a single agency to respond to any kind of allegation and also the complex nature of the child, hence this type of work is essential. Child Hub is a multiagency platform that works for child protection and works on the regulation such as The Child Protection Act, Inter-Ministerial Committee for Children Rights, and Law 272/2004 on the protection and promotion of children’s rights (child hub,2022).
The agencies for collaboration are social workers, police, the National Society for Prevention of Cruelty to Children, the Local Safeguarding Children Board, Health Visitors, medical staff, child Psychologist, and many other agencies. The job of these agencies is to safeguard and promote children’s and adults’ welfare and if there is any kind of investigation then the police are involved. Later for curing any disease or mental illness different agencies work and help children and adults have their own opinion and views.
However, mental health is not limited to typical diseases such as stress, anxiety, depression, and others; there are a variety of personality disorders that can occur as a result of poor mental health. Certain disorders are so serious that they necessitate medical and clinical attention as well as mental health treatment (Godoy et al., 2018). Although, thankfully, the family does not yet face any personality disorder issues.
Conclusion
Finally, on the basis of above discussion, it may be concluded that Daniella suffers illiteracy and unawareness. The major cause of her unawareness includes language as the major barrier. Besides, since Daniella is not educated enough and lacks knowledge of English language, she finds it difficult to gain knowledge and exchange thoughts with the people around her. Josef, Daniella’s husband has been taken to drug consumption and now exploits the family physically and even financially. The children are deprived of their basic right of care, nutrition and education whereas the grandmother of the family namely Julia is another victim facing elderly abuse. A volunteer in the food bank, where Daniella comes with her children has the social and moral duty to educate and save Daniella and her family from the turmoil they are going through. Therefore, it has been decided by the author that rapport will be established with Daniella to create awareness in her and empower her. Also, it may be concluded that Josef must not be seen as the villain but as a victim as he himself is threatened by drug abuse. In case of Julia as well which is the case of elderly neglect, Daniella is equally blameable.
References
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