Social Work in Health Care

ISSN: 0098-1389 (Print) 1541-034X (Online) Journal homepage: http://www.tandfonline.com/loi/wshc20

EDITORIAL Grace Fields To cite this article: Grace Fields (1978) EDITORIAL, Social Work in Health Care, 4:1, 5-6, DOI: 10.1300/J010v04n01_01 To link to this article: http://dx.doi.org/10.1300/J010v04n01_01

Published online: 12 Dec 2008.

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EDITORIAL

T H E ANATOMY OF DISCHARGE PLANNING

The care ofhuman life and happiness, andnot their destruction, is thefirst and only legitimate object ofgood government.

-Thomas Jefferson

People caught in a medical cure system that has not been able to effect the total cures they need are defined by Utilization Review mechanisms as discharge problems. People are not discharge problems. They have dischargeproblems. The plight of beingunable, to leave a hospital on one's own when physical treatment there is a t best demoralizinn. and a t worst, disastrous. I t is difficult to envision a time when the intervention of a social worker is more needed than when an individual is unable to exit from an institution he would like not to have enteredin the first place. A family's inability or unwillingness to absorb its incapacitated member is also a statement of limitation, if not actual trouble. Are family members so burdened already that they are also a t risk? Have interpersonal relationships deteriorated? Are interlocked human needs conflictual? Who can better assess and work with a family's resources and limitations than a social worker? The collective incapacity of many persons to transit smoothly back to Social WorkinHealthCam.Vol. 4Ill.FsU 1978 Dl978 byl'he HeworthPress. AUrightsreswal.

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SOCIAL WORK IN HEALTH CARE

accustomed life styles after illness and hospitalization is a societal stress. This is the product of our mobile, competitive culture. Advertisements do not sell us on meeting common human needs. They convinceus that we can continue to work and play and buy and make love. The universality of aging and disability has not been reckoned with. And who understands the cost of defending against stark reality better than social workers? That is how we got into discharge planning. Individuals, families, and society need us a t this point, because we know the complexity of grappling with the problems. Three articles in this issue deal with this work. We believe they reflect our growing, though sometimesuncertain, pride in owning thisrkponsibility and our increasing concensus about its human and professionally tactical significance. To the extent that we help patients leave the hospital, because "the doctor wants the bed" or "UR is pushing us," we act as demeaned instruments of a system we neither understand nor can hope to impact. To the extent that we look behind those "presentingrequests" and identify the sources of pressures, assessing their nature, strength, and legitimacy, we will be able, trustworthy helpers to patients and families, and responsiblecolleagues to phy sicians and administrators. To view discharge planning as low status, is to miss its significance. How we plan for those who need care reflects our societal as well as our social work value system. What is important? Who decides what is overpriced and why? How we identify needs, expose care deficits, propose alternatives, and mobilize human monitoring systems, will shape our human valiuesystemabout thequality oflife. Accountability is reciprocal between managers and managed, b e tween provider and consumer, between regulators and regulated, and between taxpayers sometimes turned patients and healing institutions sometimes turned expedient. Hearings in the courts of common sense and public opinion are still possible through the press, political process, and other methods of public enlightenment. Discharge planning is where medical care interfaces with quality of life concerns. I t is where human care needs clash or mesh with our technical cure capability. I t is where institutions must validate their mission and raison d'etre. I t is where the action is, and we belong there. Let us hold that territory with courage. compassion, resourcefulness, and pride. Grace Fields

The anatomy of discharge planning.

Social Work in Health Care ISSN: 0098-1389 (Print) 1541-034X (Online) Journal homepage: http://www.tandfonline.com/loi/wshc20 EDITORIAL Grace Fields...
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