Identifying and Meeting the Needs of the Individual Client

1458 words (6 pages) Nursing Case Study

22nd Jun 2020 Nursing Case Study Reference this

Tags: memory lossdisabilitysocial isolation

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Identifying and meeting the needs of the individual client

Annie Mc Donald

Client One Social isolation

Client Profile

Mary is an 85 year old female. Mary is currently in the nursing home now for 6 months. Mary had to stay in care when she came dependant on 24-hour care. Mary lived in the country with her husband on a small farm, Mary was a house wife and her husband passed away 2 years ago . Most of her children are moved away and living far away leaving only one living nearby who works full time. Mary has a Diabetes and does have frequent urination (from urinary tract infections or kidney problems) Marys has arthritis and her mobility is slow and she uses a walking aid to help her move around although can only go for short periods of times and if walking for long lengths must use a wheelchair.

Challenges

Mary is finding it hard to socialize and is quite withdrawal from others in the nursing home. Mary finds it hard to take part in group activities as there is a lot of people in the room she doesn’t know and because she grew up in the country, she liked the quietness and seems to become quite irritated by a lot of noise. Mary is used to her privacy and is trying to come to terms with her new settings and seems emotionally distressed from been away from her home and her daughter. Bringing Mary to the toilet can become stressful for her and she seems uncomfortable with having to be helped and sometimes gets angry and hits out.

Competencies

Mary is very bright lady she is into crosswords and reading magazines and she likes to look well. She watches the news. She likes a cup of tea and this seems to get her to the table when there’s a group sitting down. She can get out of bed but needs help dressing.

Current measures

At the moment Mary likes to stay in the lounge area that is a more quite part of the sitting room area with double doors leading in with can be closed for more privacy. Mary prefers one to one discussion rather than group activities.

Realistic Suggestions

Events coordinators go to her room and play cards one to one and gain her trust. Introduce Mary to another patient with similar interests. Encourage her to join in and always ask. Talk to the family to see why she might be upset with group settings. Do things as a group that she likes and has interest in so Mary might be more likely to join in and get to know more patients.

Learning Outcome

I feel like this has helped me a lot as it gives me a better understanding on how difficult it might be for a patience to change their whole environment and adapt to a new way of living and new people, it also help me with new ways I could help any more patients feel more comfortable and secure in their new environment.

Client 2

Memory Loss

John is a 76 year old male. He came into care in the dementia unit 3 weeks ago. John was a lorry driver. John used to play the according and he likes music. John was still driving but was forgetting where the lights while driving at night and forgetting to put the handbrake on in car and leaving stoves on and not turning off lights, he was living with his wife who also has dementia she was also admitted to the female ward that specialises in dementia. John mobility is good and he is able to dress and bring himself and go to the toilet and wash himself but needs help to remind him to do these things. John is living with his elderly wife who was finding it hard to look after him as her mobility is slow. John was fine the first week but is getting increasingly aggravated by been in the care setting and wants to go home.

Challenges

John seemed ok the first week in the care home but at the week past he became upset and aggravated when he realised, he would not be going home. John becomes uneasy past 6pm and is always hanging around the doors to see if he can get out. He is starting to get angry and aggressive with other patience and with the staff. He tends to get confused and angry when we try to get john to explain what is upsetting him.

Current Measures

John likes to play board games, he loves draughts. when john is still upset after explaining where he is we bring out the board as a way to distract him from his upset and to give him something he enjoys to do.

Realistic Measures

According to https://www.unforgettable.org Patience with dementia that want to go might not know where home is or could be talking about home they lived in 50 years. It is important to tell the truth and to talk to john and ask why he feels the way he does. Talking to John’s family to see if there is anything that we could do that might be missing from his routine at home to make him feel more at home. Taking john for walks and not getting angry by his aggressive behaviour. Identify the cause of his upset by taking a log a log of the timings of this behaviour. What is going on at the time, what was happening beforehand what happened afterwards. Rule out pain or infection if there is an underlining health problem like urine infection this could cause a delirium, leading John to be more confused and upset. Talk to john about his memories of home as talking might show a lot more empathy on what john may be going through.

Learning Outcome

I have learned a lot about john and his condition dementia. I have gained a better understanding and empathy and realise that the reason he was frustrated and angry was part of dementia and to understand ways that I can help john feel better and calmer by talking and helping him talk about how he feels and doing tasks that help john take his mind of the confusion and anger. As Care workers we should focus on the person rather than the behaviour we need to understand the reasons behind the behaviour and then we can support the person.

It is widely accepted that responsive behaviour is an attempt by the person to communicate an unmet need ,wellbeing will only be attained when we meet the needs of those living with dementia, we must meet their psychological needs as well as their physical needs if we want to improve their well being (Kitwood 1997,Stokes 2001)

Physical disability

Client 3

Katrina is 81 years of age; Katrina is 2 years in the care home. She lived in the country and her husband who sadly passed away 5 years ago with only her daughter to visit. Mary was always a very independent woman and liked to make her OWN DECISIONS AND LOVED HER INDEPENDENCE. Now she has very limited mobility in her legs and needs a wheelchair to move from one area to another, Katrina has COPD needs oxygen and 4 nebulisers a day. Mary likes jig saws and loves to play cards.

Challenges

Challenges Katrina faces are her physical abilities of being fully independent. Katrina needs assisted with all of her physical ADL’S. Such as maintain a safe environment, mobilising, toileting, personal cleaning and dressing. Mary sometimes gets frustrated on a day to day basis. She hates the fact she needs so much help and sometimes will attempt to walk and is a huge falls risk because of this she has a chair alarm. This adds to her frustration when it goes off .

Current Measures

All staff are aware of Katrina’s life story and understand her frustration at her lack of mobility. She is seen regularly by the Physio and Staff encourage her to mobilize for short distances. Katrina gets a sense of achievement when she goes even a short distance without the wheelchair, it is important that staff realize this and maintain her abilities as much as possible. In all aspects of her care it is important that I as a care worker do all I can to enable Katrina to maintain her abilities by giving her the help she needs whilst encouraging her to do what she can herself be it washing her face if I give her a face cloth ,brushing her hair or buttoning her blouse or cardigan . I must not rush but go at her pace and help her maintain as much independence as possible.

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