Advance Care directives

› Advance care directives • An advance care directive allows a client to make determinations about his or her healthcare in advance of incapacitation.

Whether an advanced care directive exists is particularly important to determine for clients who are receiving medical care or hospice care, are elderly or disabled, or are living in long-term care facilities. If there is an advanced care directive in place, a copy should be obtained and reviewed. If one is not in place, completion of an advanced care directive can be noted as a possible treatment goal

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› Past history of treatment/interventions • Record review, collateral report, and client self-report can all be used to gather information about the client’s past history

of treatments for his or her presenting concerns. The social worker should determine what treatments have been tried and when treatments took place, as well as the effectiveness of treatments. The social worker should assess not only treatments and interventions that have been prescribed by a professional, but also assess any efforts that the client has made on his or her own to resolve the concern and any social supports that have been utilized to resolve the issue. Most clients will utilize their own informal social supports (i.e., friends and family members) to resolve concerns before turning to professional interventions. Those clients with strong spiritual practices may utilize the support of a clergyperson or other spiritual guide before seeking the help of a mental health professional. Some clients may also utilize cultural practices or folk medicine. All of these treatments should be assessed and viewed as valid and potentially effective treatments

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