Care Plan for Patient with Muscular Dystrophy

12/.Project NC Higher Health Care 2018

Oisin is a 21 year old male with Muscular Dystrophy confined to a wheelchair. Oisin may need to go into a Care Home. His mother has sadly passed away and currently only has his father. Father is an acholic and struggles with Oisin as his physical needs are quite severe. Oisin dad encouraged him to drink and would allow him alcohol at a young age, Oisin dad was unemployed and lived of the benefit system, Oisin upbringing wasn’t the best, his dad was abusive towards his mum while she was living. Oisin only has the use of his one hand however, without a doubt has full capacity and fully understands his disability. Oisin usually has a great sense of humour, with his mum dying and now uncertain about the future this has affected how Oisin feels he would love to maintain his independence for as long as possible also wants out into the community and be able to have an independent lifestyle.

He struggles to maintain relationships and longs for a physical relationship. Oisin shows lack of respect for others and very outspoken Oisin thinks he has the right to treat others with no respect.

A Development

Human development is interconnected and relates to the lifespan of an individual. These are considered under strands of development (SPECCS) (Miller,2015 pg100). Nature and Nurture is used to define whether the individual development is generic or learned behaviour.

Development is in stages with lifespan ranges from birth to older adulthood.

Physical development in adulthood. This is the peak time in for fitness and health for most in their early adulthood. All body functions are all developed by now. This is when people understand their bodies through sexual relationship. As adulthood progresses physical changes keep taking place, this can increase weight and your fitness starts to slow down. Lifestyle can be influenced with healthy eating low alcohol steady fitness all help to maintain a healthy body. (Miller,2015).

Others could start to experience illness which could be generic related e.g. (Huntington disease) as others could experience illness with their lifestyle drink, drugs causing heart and stroke victims.

Relating to the individual

Muscular dystrophy is a chronic, progressive, physically disabling disorder which is genetic related and starts in the womb. Duchenne affects mostly males nature plays a part.

Oisin physically development for his age should be of an active adult with his illness there is a significant gap with the delay within his physical development, Oisin has very little physical strength in his arms, also his lower body has no physical strength and this stops Oisin from being physically active like a 21 year-old male.

Social development in early adulthood can still have a link from adolescents stage this can depend on the maturity of the person if they have had a smooth upbringing or a hectic one this can reflect back on the individual as they develop. Maintaining and forming friendships and sexual relationships and in some cases marriage. (Miller, 2015). This can be a very stressful time in someone life if they have little income which can be a knock on effect with regards to their development in human body can all link for e.g. having no money can affect how we eat healthy, keeping warm if bills are not paid this affects our physical development.

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Oisin social development could be limited now been out of education, forming new relationship may also be a problem due to his disability not been in work. The individual having no work could also cause financial difficulties Oisin upbringing has been a bit hectic due to his dad been an alcoholic and unemployed. His mum has been abused can all be a part of the development of Oisin nurture has an influence on developing his social skills what is correct within society Oisin has not been able to maintain relationships having no respect for others can be influenced from his dad whom he may have looked upto.

B. Needs of the individual

Human being have needs for them to survive in life. Oisin has complex needs having a life-limiting disease. Oisin mum supported Oisin with his full care Oisin care is now been affected.

Physical needs includes food, water, warmth,shelter and clothing. These needs all contribute to our wellbeing. Oisin needs a healthy diet to keep him nourished and energy levels up also needs to be assisted with feeding as Oisin has no power in his hands.

Personal care is also a part of physical needs, along with hygiene for Oisin needing full care with moving and assistance for most of the day and during the night having to rely on his dad who is an alcoholic could put Oisin safety at risk while trying to hoist him from bed to his wheelchair.

Although they are service that can deliver meals to the house by the local council this could help ensure that Oisin has a healthy meal he stills needs assistance to be given his meal as he has limited use of his hands and also a concern incase he chokes with his chronic illness as it progresses this could be meet with a care providing service preferably someone who has training on muscular dystrophy as coughing is a part of the disease and could be fatal if the person chokes.

Oisin to feel good about himself and raise his self-esteem Oisin needs someone who will care for him and treat him equally also needs others around him who understand him as a person also his needs, someone to help him come to terms with the grief of losing his mum this could help Oisin to feel better about himself maybe help with dealing with his depression. These needs could also be met with a trained counselling support.

 Oisin has some independence with the use of his electric wheelchair but without the personal care, this is stopping Oisin from leaving the house once personal care is implemented Oisin electric wheelchair would help to keep his independence and could join local groups for muscular dystrophy within his local community. This would help him to interact and learn what the norms are in society maybe learn what social skills he is lacking. Interaction with others of his own age this could be best meet with one’s with the same illness could help Oisin having others to speak to.

Oisin complex needs Oisin will certainly need to have a full time care package.

Due to all the above needs and the age of Oisin and his wish to live independently it would be in his interest to live an independent life as long as he can. These needs can be meet by implementing 24 hour care package with a care service that specialises in muscular dystrophy within sheltered housing complex this would be adapted to his needs. Wide doors, low light switches, carers, alarm systems to get help if needed) on the one level for his wheelchair to access his home and outdoors for Oisin to maintain his own independence as much as possible.

 This would allow Oisin to be part of the community still with support make friends and maintain relationships.

A care environment would only meet some of Oisin needs. With being a young male care home usually only caters for the older adults and Oisin has a right to have his care needs meet and a say where he would wish to live as long as he isn’t at risk.

C. Marchglen Care home. Positive Care

This is a care service my individual could access.

Care Inspectorate Report

Has a fantastic care inspectors report. This helps to ensure that services offered are been implemented this is positive care for an individual as this ensure that they are receiving the best care standards .

Looking back this care home Inspectorate report have all been very good from as far back as 2014. This care Home is providing positive care.

Care inspector regulates employers and takes action if they are not meeting the care standards that are set out by the them.

If the Care Inspectorate was not in place this care home could fail to implement correct training to ensure residents needs were been meet and keeping up with legislations and law that’s implemented by the government.

Care Inspectorate report is carried out on a yearly visit unannounced. This helps to ensure that no one knows of the inspection and reflexes on an accurate report at the time of the visit.

Only negative thing about Care Inspectorate is that these visits should be more regular regardless of the scores they have achieved.

Person Centred Care Plan is a legal document and whoever writes this plan up is accountable for it.

Person Centred Care Plan identifies the care needs that are needed.

Also allows the individual to be involved with their personal care and support

This allows values and principles to be implemented. Regular reviews to assess the individual’s care if their needing more support or if they need less support also monitors the care staff and if their implementing what’s been written in the care plan. This can also lift morale with care staff and the individual.

This approach to care is positive care and not only for the individual but on whole for the healthcare system. If the individual has an input and all the positive care that’s been implemented with other agencies involved will allow them to feel good that their been listened to and can help improve their well being may need less care in the future.

Health and Safety at work 1974

If there wasn’t a person centred care plan then this could cause delay in the individual getting the best care they need. Care needs are all different not one size fits all which was the case back in the day.

Bluebird Care (privately owned)
Care package Independent living within a housing complex.

This care service is where my individual could access.

Scottish Social Services Council who produce codes of practice in two forms

1. For the employer
2. For the employee

Sssc set codes for employers of social service workers sets down the responsibilities of employers in relation to social service

 workers.

Employees must adhere to all these codes whilst employed within a care service regardless if there working or how the have perceived in the public eye can also affect the code of practice that they have agreed to and signed the contract to follow the rules. Codes of practice is a list of statement which is appropriate to all workers and how they go about their daily duties.

These codes are recognized by both workers and employers and what the client should expect.of them with the care they provide. This promotes care values within the care service which is a law:

If this SSSC wasn’t in place clients could be abused or neglected put at harm. Discriminated against.

PVG scheme to protect the vulnerable.

This to protect vulnerable groups children or adults either paid or unpaid work. This new scheme is quick and updated more easily and the membership is portable for the person and is for life. New information relating to an individual may have changed at some point maybe flagged up for their employer to consider could be dealt with quicker if the individual is a risk to others within a care environment.

They are two levels of the PVG one for volunteers doing regulated work for voluntary organisations and other other is paid work related working with vulnerable groups. This

If the PVG scheme wasn’t in place vulnerable groups could be at risk from abuse verbally or physical or emotional.

Adult and Support and Protection in Scotland (Scotland) Act 2007

This is to give protection to adults from risk of harm or through neglect age of 16 and over. This could be due to mental or physical health.

Local council have a duty to investigate if they have cause of concern or reports of suspected harm. Older people are more vulnerable and reluctant to report it. This could be physical, financial harm,sexual and neglect. This can be anyone from a friend, relative or even a stranger.

This protection in relation to my individual ensures he will be safe from abuse whether its physical or mental abuse within his care setting, helps promote a sense of safety and security for the individual.

This reassures the family that their loved one is safe.

 If this Act wasn’t in place people within this care service could be vulnerable to sexual abuse, theft of their money , neglect within care setting whether this is from the public or employed staff.

DSocial influences

Socialisation is a process we all go through and starts from birth and carries on throughout our adult life. We learn what’s expected of us with the values, norms and roles within the culture which we are brought up in . Primary social influences is informal learning and family are the biggest part of primary socialization and how we learn not only our values and culture but who we are and where we fit into society and how our lives are snapped.This then sets out our life chances as we progress growing up from child to teenager and into adulthood. Oisin life changes would be limited with an alcoholic and unemployed father who abused his mother would have been brought up in a workless household with alcohol abuse. This would have been seen as norm for Oisin. Life changes for Oisin was already limiting with his generic disability, marginalization with fewer advantages in life with cut back from government.

Secondary social influence this is on the outside how individuals are influenced this can be our Peers, education. Mass media or the government

Oisin primary socialisation has been dysfunctional. Although his mum did try to have a positive structure but with an alcoholic dad and been abusive towards his mum and unemployed this can impact how Oisin thinks

Key features of functionalist theory
• consensus on norms, values and roles: there is a shared agreement within society about the way in which people should behave and what is generally agreed to be important in life.
• integration and interdependence: society is made up of inter-related parts that operate together to help society function effectively (biological analogy)
• stability and continuity: norms and values are passed on from one generation to the next which helps create order in society as it limits change
• dysfunctionality: not conforming to the accepted norms and values can create disharmony and instability in society and this can result in elements of society, or society as a whole, becoming ‘dysfunctional’ or ineffective.

E  Functionalism

Emile Durkhem, believes that society is like the human body it links to each part to run smoothly and to work efficiency we need to interconnect. Functionalism is a macro sociology within society every group needs to run properly to maintain stability and for society to run smoothly its start at home where we learn values the norms and roles within society. The structure of functionalism is more focussed on society than an individual for every thing to run smoothly then they can’t be change this would upset the structure.

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Functionalist believes for a family to function correctly the roles within must be adhered to, Oisin dad is unemployed and an abusive alcoholic living of benefits would be seen as a dysfunctional family, Oisin has disability ,shown signs of depression and within society functionalism would be looking to either remove Oisin and put him into a care home to help his care needs and try help solve his depression . This would help keep others within society in a job and which is a part of the norm within a functionalist theory.

Key Features Feminist Theory

gender role socialisation: as part of our socialisation we are socialised into our gender roles and through transmitting ideas of ‘masculinity’ and ‘femininity’ boys and girls are encouraged to behave differently.
• equal rights for women: highlights the need to promote equality of opportunity in a number of key areas such as employment and education where women have faced significant discrimination.
• questioning of ‘malestream’ thinking: for many years sociological thinking and most aspects of social welfare has been dominated by men; women’s interests or rights were either minimised or overlooked altogether.
• oppression and subordination through patriarchy: many feminists believe that male dominance in evident in all aspects of society and this reinforces the subordination of woman.

Conflict theory

 beliefs that society operates as a whole very much like functionalism. They belief that society in a whole need to be in constant conflict which consents to fluctuating changes. Kayrl Marx, says they are two different classes within society they ruling class and the inferior class. Ruling class have wealth from business or factories and the inferior would be the labour force by been ill treated and used by the ruling class. The ruling class have wealth and within society this would allow them better access to care providers and assessments by private sectors quicker than someone from the lower class. Within society ruling class have access to good nourishment lifestyle is very healthy and active compared to someone from the lower class. Within a care setting someo

Conflict theory: Key features
• Power differentials in social structures
• Competition over scarce resources
• Control, coercion, constraint by dominant group
• Social conflict and change

Symbolic theory

Symbolic interactionist theory highlights ( reflects) the importance of social interactions and shaping people’s behaviour and (how this reflects back on them )sense of themselves.

Symbolic Interactionist theory: Key features
• The idea of the self-concept
• Significance of labels as symbols
• The concept of role-taking
• The Individual as an influence on society eg concept
of role-taking

F Theory’s

Colin Murray Parkes a British psychiatrist who developed the model of loss. (google.co.uk/amp)

 Parkes believes we spend our life building attachments to people and things. When the attachment break’s, we feel pain. Parkes believes we pass through four phases and not stages. He also believes we can enter these phases more than 1 at a time back and forth on a number occasions until we reach the phase of recovery.

Four stages Numbness, searching & pinning, depression and recovery. (bereavement.co.uk/media-centre).

Numbness can affect how we feel when we are told something we are not expecting, for the loss or broken attachment we long for. This can impair our judgment and function and can interrupt our concentration for a period.During reorganisation and recovery phase the person would be making increased decisions, self-confidence has risen also their energy levels

(bereavement.co.uk/media-centre).recovery will happen when a person reaches this phase at their own pace and when they feel ready to.

In relation to my individual dealing with his loss of his mum who was also his main carer he could be at first stage of numbness and pinning. Losing his mum and wondering what future holds for him in relation to care.
Colin Murray believes we go back and forth til we learn to accept and then move on. As Murray says they can be at more one stage of loss Oisin is showing signs of depression also. For Oisin to reach the recovery stage Oisin would need to be back into community been independent, for this to happen Oisin is better of living independently with a positive care package in place giving Oisin a safe and sense of belonging. Having one’s around him with other activities to keep him focused allowing him to be listened to maybe in a support group counselling could help to cope support him from the transition from living at home to living independently

Carl Rogers theory was a humanistic psychologist who agreed with main assumptions of Abraham Maslow, but for a person to grow they need an environment that provides them with genuineness. Without this, relationships and healthy personalities will not develop as they should.
Self-worth, what we think about ourselves. This starts in early childhood by positive nurturing. Self-image is how we perceive ourselves. This could be good or bad. Beautiful or ugly. This may influence how a person thinks ideal Self the person we want to be this consists of our goals and ambitions. ideal-self is for ever changing what we want out of life as a child or a teenager is different from what we want as an adult. Roger believes self-concept cannot be achieved when self-image and our ideal – self don’t line up we are incongruence.
By been showing positive and unconditional positive regard to feel the sense of worth we need to be accepted and fit in and to achieve this we need to learn by letting our own personality to shine through. We can reach the ideal-self the state of congruence.
(Cherry, 2017) 187

References

• Miller, J. (2015). Care in Practice for CfE Higher. 2nd ed. Glasgow: Hodder Education Group, p.153.Carehome.co.uk. (2019). [online] Available at: https://www.carehome.co.uk/news/article.cfm/id/1586182/Marchglen-Care-Centre-chef-Lorraine-scoops-top-award [Accessed 9 Feb. 2019].Carehome.co.uk. (2019). [online] Available at: https://www.carehome.co.uk/carehome.cfm/searchazref/10006010MARA [Accessed 9 Feb. 2019].
• http://personcentredcare.health.org.uk/person-centred-care/overview-of-person-centred-care/why-person-centred-care-important
• Www.ageuk.org.uk.
• https://www.nhs.uk/conditions/social-care-and-support-guide/help-from-social-services-and-charities/care-and-support-plans/
• https://www.sssc.uk.com/knowledgebase/article/KA-02412/en-us
• https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf
• https://www.sqa.org.uk/pastpapers/papers/instructions/2014/mi_H_Care_all_2014.pdf
• https://www.ukessays.com/essays
• social theories made simple utube
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114301/#!po=1.78571