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Case Study: Multiple Sclerosis

Info: 1849 words (7 pages) Nursing Case Study
Published: 12th Feb 2020

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Tagged: multiple sclerosis

Kaitlyn Elliot

Values and Principles

Case Study

Bob is 65 and has had multiple sclerosis for 15 years. He has a wheelchair and drives a specially adapted car. He lives with his wife, Jean, in a cottage in the country and they have always been involved in several community and church activates. Jean is Bob’s main carer and although Bob is quite independent, Jean tends to do everything for him. Last month Jean had a slight stroke which left her with a right sided weakness and some speech difficulties that she finds frustrating. She cannot walk without a walking frame and still needs help with most personal care tasks. While Jean’s been in hospital Bob has been supported by daily visits from home carers, however he is missing his outings as Jean’s not been there to help him. Jean will be discharged from hospital next week and is worried about how they will manage.

Suri is the hospital social worker and is going to meet jean later today to plan her discharge from hospital next week and her future care.

  • Describe at least one individual using car services and explain at least two needs of this individual.

Jean used to be an independent woman but after she had her stroke she has become more vulnerable and can’t do all the daily tasks that she used to do like looking after Bob. Jeans basic essential physical needs are not being met completely. The stroke has caused her right-hand side of the body to become weaker and she also struggles to walk unsupported. Jean may have to be referred to a physiotherapist who would assess her abilities and draw up a treatment plan that will help Jean improve her muscle strength and help her to walk without the frame. An occupational therapist might also have to be introduced to assess her ability to carry out everyday tasks and may have to adapt her home to suit Jean’s ability. Jean might struggle to keep a balanced diet up as she might find it hard to swallow some foods and may not be able to get access to pureed or easy to swallow food. The stroke could also be causing Jean to be extremely tired. She also might struggle to clean and dress herself and let her good hygiene go down.

Cognitive needs refer to the things that helps us to develop and maintain an active mind. Jean’s stroke has cause her to have speech problems and will find it hard to communicate. She could be referred to a speech and language therapist who could do some exercises to improve the control over Jeans speech muscles. They could introduce her to some letter charts and using gestures and writing to communicate with others. Jeans memory will deteriorate as the stroke will have affected her brain. A care worker could introduce a diary or even just routines and involve her in the planning of this to help her out with daily tasks when she is discharged from hospital. Jean may also end up with dementia and if she does you could show her some family pictures or even find out what activities she used to do and encourage her to try some of them again or take her to some of her favourite places her and Bob used to go to. Without cognitive spurring, mental abilities will not develop or will deteriorate. Most of these functions will return after time and rehabilitation, but she will notice they do not return to what they used to be.

  • Explain how two methods of assessment are used to identify needs of individuals.

Needs are essential things in our life’s that we cannot live without. Needs can often be confused with wants. One way of assessing an individual’s needs is using the SPECCS model. This is your social, physical, emotional, cognitive and cultural. All individuals have these types of needs. Social needs ae the need to have conversations and experience a variety of social relationships and how we interact with others. However, people who use care services may not be able to make these needs by their self’s. if they don’t get any help they might not achieve a sense of acceptance and belonging and this may cause isolation and low self – esteem. Physical needs refer to fresh air, food, water, warmth, shelter, hygiene, sleep and exercise. These are the basic physical needs that we need in our lives to promote wellbeing. Emotional needs are our feelings. We all experience different emotions including happiness, excitement, sadness and anxiety. Emotional needs include the need for love, security and confidence. If we have these needs, we can express our feelings and people can also recognise them. Cognitive needs refer to our thought processes and how we make sense of the world. Cognitive abilities include the use of memory, thinking, understanding, communicating and making choices and decisions. Without these our mental abilities, will deteriorate. Care workers can play an important part in meeting an individual’s cognitive needs by just even talking to them and giving opinions. The last one is cultural needs. This refers to values, beliefs language, gender, sexuality, clothing worn, and food eaten. It is important for the care worker to find out about the care users cultural needs and not make any assumptions about their culture.

Another way of assessing an individual’s needs is using Maslow’s Hierarchy of Needs. This theory is split into 5 sections. The stages in this theory are Biological and physiological needs, safety needs, belongings and love needs, esteem needs and self-actualisation.  Maslow believes that all humans are motivated towards achieving their full potential. He stated, “People are motivated to achieve certain needs and that some needs take precedence over others. Our most basic need is for physical survival, and this will be the first thing that motivates our behaviour. Frustrated and unmet needs can lead to dysfunctional behaviour.

  • Describe three features of positive care practice. At least one of these ways must include reference to values and principles.

There are six principles to the National Care Standards, dignity, privacy, choice, safety, realising, potential and equality and diversity. Carers should value the service users and respect their space and own way of life. The service user also has the right to stop other people from seeing or knowing about their personal information. Choices help staff understand what range of options can be put in place for the user. Carers should be encouraging and help care service users to make the most of their life and achieving as much as they can with the resources available to them. In a positive care practice empowerment, should be used. All carers should help the service users to make their own choices and have some sort of control over their own lives. The carers could provide them with opportunities, information and support to help them do this. The SSSC have a code of practice to help gain a positive care practice. The code is set out in two parts. The first part if for the employers of social service workers. Employer must make sure the social service workers are suitable for the job and help them understand their responsibilities and roles they will have. They also must have written policies in place to protect those who use the services and the carers. The employer must also promote the use of the code of practice to the social service workers. The second part is for the social service worker. They must protect and promote the rights and interests of the service users and treat them all as an individual. The worker must create trust and build confidence with the service users to allow them and you to be open and honest with each other. Promote the service users independence and help them understand their rights. The Nursing and Midwifery Council (NMC) have created a code of conduct to create a positive care practice. The nurse or midwife should be kind and respectful and putting the care and the safety of the patients first. They should also listen and take any notes that may concern them and also respect their right to their dignity, privacy and choice and will share any information about the patient’s treatment or health in a way that they should be able to understand. They should always be paying attention to the patient’s wellbeing as well as their treatment and care.

  • Describe how one care service creates a positive care environment.
  • Give at least one example to explain how they meet the needs of individuals.

Speirs Care Home, Beith creates a positive care environment by allowing the care service users to socialise in their lounge areas and provide spacious gardens for the users to relax in beautiful surroundings. They provide regular music entertainment for the users to allow them to have some sort of social life. They have a positive atmosphere in the care home and allow the community to be involved in their fair. They allow different types of care such as palliative care, respite care and convalescent care. The home also provide any transport the users need for going out and doctor appointments or even going out on day trips. They encourage the relatives to visit regularly to allow the users with alzheimer’s to familiarise their memory and hopefully try and help them not forget.

  • Describe one way in which legislation helps promote a positive care environment.

Care workers must comply with the legislation when they are carrying out work in a care environment to create a positive care environment. The legislation becomes a policy in the work place so, if the care workers fail to do this it could jeopardise their carer as legal action will be taken. The legislation is in place for the health and safety and their right to confidentiality as a care service user. Is also promotes health and wellbeing and equality of opportunity to promote a positive care practice.








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Multiple Sclerosis (MS) is a neurological disease that affects the brain and spinal cord. This occurs because of damage to the outer layer of nerve called the myelin sheath. An autoimmune response occurs, and the body attacks part of the nerve called the myelin sheath.

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