I think the MSW's philosophy is to empower the family to take some initiative. I can't tell you how many times I have sent a MSW to assist with a Medicaid application, only to find the one thing the family has to do themselves, like gather a bank statement, is just not done. I can understand the frustration, and I think the MSW's really have to distance themselves, b/c some people will leech on, and expect the MSW to do everything for them.
I do find that our MSW is a list person, and it aggravates me to no end, b/c I could have handed them a list myself. BUT, I will still refer in some cases, just so I can document I saw a problem and initiated the proper channels.
I had one LOL who changed her story constantly. I was roped in at first, thinking her dtr was unreasonable, until she completely embarrassed me when she told the doctor she could not give her own insulin inj's. This after she c/o her dtr interfering too much in her life, after I had the commission for the blind come and do an eval to get her the equipment needed for self-inj, and got the doc to change her regimen to evening only lantus. She also c/o dizziness constantly, yet did not take her meclazine, which ironically, when she was hospitalized (and talking it all the time) she never had dizziness (Duh!!) She wouldn't allow a pre-pour or her pills would "go stale" She fell at home constantly, yet was supposedly eligible for Medicaid but refused to apply.
In hindsight, I am quite certain the reason she didn't want Medicaid was b/c she had some money stashed that she didn't want her dtr to know about, and if she applied, she knew she'd be turned down. This is the only plausible reason I can think of, either that, or she likes to have attention and be needy.
But, after so much head-bashing, I sent the MSW who gave her a list and agreed the pt was able to make up her own mind, and we would have to d/c her, and she would have to find someone to pay to privately give her insulin inj, since she "fired" her dtr. Suddenly, she is able to give herself the injections again.
So, when all you do is see those cases all day, I can see where they have to remain aloof. I have seen new grad SW's come in gangbusters, and burn out over time too.
You are really lucky Karen. What kind of populations are you working with? Rural, city, etc..?