Identifying and Meeting the Needs of an Individual Client

1996 words (8 pages) Nursing Assignment

11th May 2020 Nursing Assignment Reference this

Tags: memory lossdisabilitysocial isolation

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Identifying and meeting the needs of an individual client

Introduction

In this assignment I will observe 3 clients who suffer from memory loss, social isolation/emotional upset and physical disability. I will provide background information of each client, challenges the clients experience and competencies the clients demonstrated. I will also give a description of the current measures used to assess the client’s needs, provide suggestions and implementation plan to improve the client’s quality of life.

For the purpose of this assignment all clients’ names have been changed for confidentiality reasons.

Client 1 – Memory Loss

Client Profile

Name: Deirdre McMahon    Age: 65   Occupation: Dressmaker

Three years ago, Deirdre was involved in serious car accident and in result to the injuries from the accident she now suffers from memory loss. Not only did Deidre lose her memory that day but she also lost her husband and the father of her 3 children. From the information provided by Deirdre’s children she was very active woman who enjoyed spending time with her family. She would arrange Sunday dinners for the family and loved bringing the grandchildren for walks in the park. Deirdre worked as dressmaker before starting a family but enjoyed doing alterations and dressmaking from home which allowed her to work and care for her family. From observations Deirdre finds it difficult holding a long conversation and has trouble remembering people’s names. Deirdre also struggles when it comes to dressing herself as she forgets where her clothes are. Deirdre likes to participate in the activities held in the nursing home and really enjoys arts and crafts, but during the sing a long session she became very distressed due to the level of noise. Deirdre sometimes get lost when walking around the home and is often found in other clients rooms as she thinks it’s her room and gets upset when assisted to back to her own room.

Challenges Experienced

Deirdre’s main challenge is holding a long conversation as she intends to ramble off topic or gets upset when she cannot remember certain times of her life.  She also struggles with being in a noisy environment as she finds it hard to concentrate. Sometimes Deirdre forgets to wear her denture, she also struggle with dressing as she forgets where her clothes are or the order in which her clothes should be worn.

Competencies Demonstrated

Deirdre demonstrates competencies with doing tasks such as showering and eating and does so independently. She is also very mobile and does not require use of a mobility aid.

Current Measures

Deirdre needs assistance with dressing and oral hygiene. When Deirdre is walking around, supervision is necessary as she occasional wonders off.

Suggestions

Autonomy is having the sense of control and responsibility over one’s own actions, behavior and life” (Class notes, Care Support Learner Resource Pack)

I feel that Deirdre’s autonomy should be promoted by fitting Deirdre with a GPS wrist band with a tracker which will make it easier to locate her and an alarm which will beckon if she leaves the building this will allow Deirdre to be more independent while maintaining her safety. I also recommend labeling the contents of Deirdre’s wardrobes and drawers on the outside to make it easier for Deirdre to locate her clothes. Deirdre should be treated with kindness, respect and patience and when communicating use mixtures of open-ended questions and touch.

Personal Learning

While observing Deirdre I have learned that memory loss is something terrible and it could happen to anyone. I also have a clearer understanding of my clients every day needs and how i can help her with these needs. I’ve learned that people with memory loss often feel lost and it is important that they receive a lot of emotional support. I have also learned that patience and empathy is essential when caring for people with memory loss.

Client 2 – Physical Disability

Client Profile

Name: James “Jim” Butler   Age: 55 years   Occupation: Farmer

Jim is Dairy Farmer from Wexford, who was out herding in the cattle one afternoon when he had a stroke, which has affected his speech and also mobility on the left hand side of his body. From an interview conducted with the family, Jim was a very active man whose passion and life was farming. He inherited the farm after his father’s passing and worked put is life and sole into making it great. Jim also was a member of his local GAA club and volunteered to train the underage teams. He is also the number one fan of the Wexford Hurling team and travelled around the country supporting the team. But due to his illness Jim unfortunately had to quit all these things.

Challenges

Paralysis is a common outcome of stroke, often on one side of the body (hemiplegia). Paralysis may affect only the face, an arm or a leg, or it may affect one entire side of the body and face. A person who suffers a stroke in the left hemisphere of the brain will show right-sided paralysis, or paresis. Likewise, a person with a stroke in the right hemisphere will show deficits on the left side of the body”. https://www.christopherreeve.org/living-with-paralysis/health/causes-of-paralysis/stroke [Accessed: 15th April 2019]

Jim has paralysis on the left hand side of his body, which tells me he has damage to the right hand side of the brain. This causes problems for Jim as he struggles to perform everyday tasks such as dressing, grooming and taking part in activities.  Jim’s speech has also being affected and he finds it hard to communicate and socialise with other residents in the nursing home which has led him to isolating himself in his room and not participating in activities in the home.

Competencies Demonstrated

Jim demonstrates competence when performing tasks such as brushing his teeth and showering and although he is assisted when doing so it is important that he feels independent when carrying out these tasks. When it comes to feeding Jim has the ability to feed himself by using his right hand.

Current Measures

Jim needs help with dressing, washing and rehabilitation exercises. In result of the stroke Jim has developed dysphagia texture of his food as too be altered. “Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids, while others can’t swallow at all.” https://www.nhs.uk/conditions/swallowing-problems-dysphagia/ [Accessed: 16th April 2019] He has a session with a Physiotherapist twice a week and sees a Speech Therapist once a fortnight.

Suggestions

To help with Jim’s quality of life, if his exercise took place in a local gym of swimming pool as aqua classes may help with balance and muscle strength while also help him with meeting new people. I find not only this Jim need help with his physical disability but he also need encouragement and motivation mentally to fight his illness.

Personal Learning

After observing Jim it has helped me with my communication skills. Assisting Jim with his daily rehabilitation exercises has shown me how important exercise is in their daily lives as Jim had a sense of accomplishment after completing them, which also made me feel that i had accomplished something. I find the most important thing to do when working with someone with a physical disability is to motivate them as much as possible and give them hope to stay strong and fight the illness they have

Client 3 – Social isolation & Emotional Upset

Client Profile

Name: Liam Hennessy  Age: 72     Occupation: Bank Manager

Liam and his wife Mary have been residents in the home for a number of years and had rooms opposite each other. They couple enjoyed participating in social activities with in the home together and their children came in everyday to visit. Unfortunately Mary passed away 5 months ago and Liam is having a hard time dealing with the loss of his wife.

Challenges

Grief can affect you mentally, emotionally and physically and it can also affect your relationships with others.”

https://www.counselling-directory.org.uk/blog/2016/03/25/emotional-effects-of-bereavement [Accessed: 18th April, 2019]

Since Mary’s passing Liam no longer participates in activities, nor those he come to the dining room for meals. Liam has little mobility from the waist down and is in a wheelchair. The only time Liam leaves the room throughout the day is to go for a cigarette. Some days Liam does not get out of bed till the afternoon and often refuses meals or assistance with personal care. As result of Liam refusing meals he is not maintaining a balanced, nutritious diet and there are concerns for is weight.

Competencies Demonstrated

On days where Liam agrees to assistance with personal care he shows great competence by shaving and brushing his teeth. He has mobility in his upper body and likes to dress himself.

Current Measures

Liam has been offered bereavement counseling and support, in hope that it will help with his emotional upset and social isolation. When Liam is being brought to the smoking area, Healthcare Assistance tend to take him the long way round in hope that he gets to speak to people on the way.

Suggestions

I would suggest that the activities coordinator visits Liam in his room on a one to one and suggest a game of cards. In time, these gestures may lead to Liam gaining confidence to participate in activities outside of his bedroom.

Personal Learning

From observing Liam I have learned that bereavement is a personal journey that everyone must take and that everyone takes this journey in different ways. With that I have also learned how to express empathy and compassion with small gestures such as listening and spending an extra 5 minutes sitting with him.  I have learned from talking to Liam that he really cared and loved his wife dearly. I hope that with continued support and time that Liam wills a way back to his new type of normal.

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