Working With Clients With Disabilities: The Case of Andres Andres is a 68-year-old male originally from Honduras. He is married and the father of two grown children: a daughter who is married with one child and a son who is unmarried. Andres lives with his wife in a brownstone in an upper-class urban neighborhood, and they are financially stable. He relies on Medicare for his health insurance. Andres is a retired child psychiatrist who completed medical school in Honduras and committed his career to working with Latino children and families in a major metropolitan area. Andres’ wife is a clinical psychologist who still maintains an active practice. Andres has a good relationship with his children, seeing them at least once a week for dinner, and his granddaughter is the light of his life. Approximately 6 years ago, Andres was diagnosed with a rare brain tumor and Parkinson’s disease. Prior to his diagnosis, Andres was still on staff at a hospital, jogged daily, and had plans to travel with his wife. In a short time, Andres’ health deteriorated significantly. He now uses a cane and walker to ambulate. His speech is slow and soft. He requires assistance to get dressed and eat at times due to severe tremors and the loss of dexterity in his hands. Andres has fallen on multiple occasions and therefore cannot go out alone. He suffers from depression and anxiety and is currently on medication for these conditions. Andres spends a majority of time at home reading. He has lost contact with many of his friends and almost all of his professional colleagues. Andres presented for treatment at an outpatient mental health setting. His daughter suggested it because she was concerned about her father’s worsening depression. Andres came into treatment stating his family thought he needed to talk to someone. He complied, but was unsure if treatment was really necessary. Andres agreed to weekly sessions and was escorted to each session by an aide who helped him at home. While Andres had difficulty stating specific goals in the beginning, the focus of treatment became obvious to both of us early on, and we were able to agree to a treatment plan. Across multiple spheres of his life, Andres was struggling with accepting his illness and the resulting disabilities. In addition, he was extremely socially isolated despite the fact that he lived with his family and they were supportive of his medical needs. Finally, Andres’ role and identity had changed in his family and the world overall. In a mere 6 years, Andres had lost his independence. He went from being a man who jogged every day to a man who could not carry a glass of water from one room to the next in his own home. Andres was trying valiantly to hold on to his independence. While his wife and his children were willing to provide any assistance he needed, Andres hated the idea of asking for help. As a result, he did things that compromised his balance, and he had several bad falls. In addition, Andres’ w ...

1. Working With Clients With Disabilities: The Case of Andres
Andres is a 68-year-old male originally from Honduras. He is
married and the father of two grown children: a daughter who is
married with one child and a son who is unmarried. Andres lives
with his wife in a brownstone in an upper-class urban
neighborhood, and they are financially stable. He relies on
Medicare for his health insurance. Andres is a retired child
psychiatrist who completed medical school in Honduras and
committed his career to working with Latino children and
families in a major metropolitan area. Andres’ wife is a clinical
psychologist who still maintains an active practice. Andres has
a good relationship with his children, seeing them at least once
a week for dinner, and his granddaughter is the light of his life.
Approximately 6 years ago, Andres was diagnosed with a rare
brain tumor and Parkinson’s disease. Prior to his diagnosis,
Andres was still on staff at a hospital, jogged daily, and had
plans to travel with his wife. In a short time, Andres’ health
deteriorated significantly. He now uses a cane and walker to
ambulate. His speech is slow and soft. He requires assistance to
get dressed and eat at times due to severe tremors and the loss
of dexterity in his hands. Andres has fallen on multiple
occasions and therefore cannot go out alone. He suffers from
depression and anxiety and is currently on medication for these
conditions. Andres spends a majority of time at home reading.
He has lost contact with many of his friends and almost all of
his professional colleagues.
Andres presented for treatment at an outpatient mental health
setting. His daughter suggested it because she was concerned
about her father’s worsening depression. Andres came into
treatment stating his family thought he needed to talk to

2. someone. He complied, but was unsure if treatment was really
necessary. Andres agreed to weekly sessions and was escorted
to each session by an aide who helped him at home.
While Andres had difficulty stating specific goals in the
beginning, the focus of treatment became obvious to both of us
early on, and we were able to agree to a treatment plan. Across
multiple spheres of his life, Andres was struggling with
accepting his illness and the resulting disabilities. In addition,
he was extremely socially isolated despite the fact that he lived
with his family and they were supportive of his medical needs.
Finally, Andres’ role and identity had changed in his family and
the world overall.
In a mere 6 years, Andres had lost his independence. He went
from being a man who jogged every day to a man who could not
carry a glass of water from one room to the next in his own
home. Andres was trying valiantly to hold on to his
independence. While his wife and his children were willing to
provide any assistance he needed, Andres hated the idea of
asking for help. As a result, he did things that compromised his
balance, and he had several bad falls. In addition, Andres’ wife
had assumed responsibility for all of the family’s affairs (i.e.,
financial, household, etc.), which had been Andres’ job before
he got sick. Andres struggled as he saw his wife overwhelmed
by all that she now had to take on. At the same time, he did not
feel like he had the ability to reclaim any of what had been
“taken” from him. Together, Andres and I identified the things
he felt he was capable of doing independently and worked on
how he could go about reclaiming some of the independence he
had lost. We spoke about how he could communicate his needs,
both for help and independence, to his family. We explored his
resistance to asking for help. On many occasions Andres would
say, “I was the one my children came to for help; now they have
to help me. I can’t stand that.”

3. In addition to the struggles Andres faced in his everyday life, he
also had to cope with the reality of his illness. Andres was well
aware that his illness was degenerative, and with each change in
his condition, this became a stronger reality. Andres frequently
spoke of “a miracle cure.” He constantly researched new and
experimental treatments in hopes that something new would be
found. While I never attempted to strip Andres of his hope for a
cure, we spent a considerable amount of effort getting Andres to
accept his condition and work with what was possible now. For
example, Andres had always been resistant to physical therapy
(PT), but during our treatment, he began PT to work on
maintaining his current balance rather than trying to cure his
balance problems. Facing his illness meant facing his own
mortality, and Andres knew his fate as much as he wanted to
deny it. He often spoke of the things he would never experience,
like his granddaughter graduating from high school and
traveling through Europe with his wife.
Andres’ treatment lasted a little bit more than a year. He
demonstrated significant improvement in his ability to
communicate with his wife and children. Andres continued to
struggle with asking for help, repeatedly putting himself in
compromising situations and having several more falls. After
the fact, he was able to evaluate his actions and see how he
could have asked for limited assistance, but in the moment it
was very difficult for him to take the active step of asking for
help. Andres was also able to reconnect with an old friend who
he had avoided as a result of his physical disabilities and
feelings of inadequacy. We were forced to terminate when I left
my position to relocate out of state.
Discussion

4. Social and Emotional Intelligence
What ideas or phrases come to mind when you hear the term
intelligence
? Prior to the current emphasis on emotional and social
intelligence, individuals tended to associate intelligence with
one measurement: intelligence quotient or the IQ. While the IQ
focuses on intellectual abilities, emotional intelligence focuses
on an individual's awareness of his or her feelings and the
feelings of others, and social intelligence focuses on an
individual's interpersonal skills (Zastrow & Kirst-Ashman,
2016, pp. 506-509).
To prepare for this Discussion, read "Working With People
With Disabilities: The Case of Andres" on pages 28–31 in
Social Work Case Studies: Foundation Year
. Consider what you have learned about social and emotional
intelligence in this week's resources as well as what you learn
about the person and environment as it relates to young and
middle adulthood.
Post a Discussion that includes the following:
o
An explanation of how social and emotional intelligence are
related to cultural factors
o
An explanation about how you, as a social worker, might apply
the concepts of emotional and/or social intelligence to the case
of Andres

5. o
An explanation of how social workers, in general, might apply
social and emotional intelligence to social work practice.
(Include a specific example in the explanation.)
Be sure to support your posts with specific references to the
resources. If you are using additional articles, be sure to
provide full APA-formatted citations for your references.
References (use 2 or more)
Plummer, S. -B., Makris, S., & Brocksen, S. M. (Eds.). (2014).
Social work case studies: Foundation year.
Baltimore, MD: Laureate International Universities Publishing.
[Vital Source e-reader]. The Case of Andres.
Zastrow, C. H., & Kirst-Ashman, K. K. (2016).
Understanding human behavior and the social environment
(10th ed.)
.
Boston, MA: Cengage Learning.