Case study 1 Les Angela has been working with Les and Sylvia

Case study 1: Les Angela has been working with Les and Sylvia for several years; Les has advanced Alzheimer’s disease and has become increasingly violent towards Sylvia. Les has a hearing impairment and can only communicate by using sign language. He has also lost the ability to distinguish between night and day and spends most nights awake and walking around the house. Angela the care worker, has noticed that caring for Les is increasingly exhausting Sylvia, Les’ informal carer. A support plan is put in place for Les. Les is recommended to have regular visits to a day centre and respite care to give Sylvia a break from caring.Case study 2: JimJim was diagnosed with bipolar when he was at university. Jim is in his mid-fifties and has lived with his parents for his whole life. Jim’s parents have not had access to any support and they are increasingly worried about their ability to cope with Jim when he is at his most withdrawn and what will happen to him once they are no longer able to look after him. While they have tried to treat Jim as an adult, the reality is that he is the ‘child’ in the relationship. Jim doesn’t cook, clean or do his own laundry and his parents’ friends are also his friends. Jim and his parents decide for Jim to move into supported living accommodation. Where a support worker will be his key worker. A GP, social worker and advocate will also support Jim.A care plan decides what’s important to the individual and what they would like to change in their life. It’s also designed to meet the holistic needs of that individual and how the health and social care workers can come up with strategies to do so.Cycle of assessment and planning –There are ten stages to this cycle.1) Referral – a referral is made by a professional or the individual themselves asking for help and support.2) Holistic Assessment – assessment of needs and preferences is undertaken by a professional using the assessment tools working closely with the individual.3) Identifying current provision – the professional identifies what resources are required to meet the individual’s needs.4) Care planning – professional identifies what resources are required to meet the needs of the individual.5) Recording – professional documents who is involved in the care plan, including the individual, family and neighbours as well as other professionals.6) Communicating – professional ensures all those concerned receive a copy of the care plan and understands the roles as well as responsibilities.7) Implementation – date to be identified by professional in consultation with the individual for when services and support are going to be made available.8) Monitoring – professional discusses with the individual and relevant others about what’s working well and what needs changing.9) Reviewing – professional reviews the support with the individual and other professionals to identify new goals and to alter the care plan if something isn’t working.10) Evaluating – professional and individual decide a date to analyse and evaluate the success of the care plan. Assessment tools are resources which are used in the support planning process to help build up a holistic picture of an individual’s needs. Assessment tools include:- Questions – Observations: mobility and fitness- Physical assessment: blood pressure, breathing, blood tests, temperature, pulse rate, BMI- Records of accidents and incidents- Diary of individual (thoughts, feelings, mood)- Checklists- Forms- Medical history- Questions for the family- Speaking to the practitioners involved in the individual’s care already- Interviews- One page profile – Memory/cognitive test- Personal histories- Carer assessments – X-rays/ scans Two assessment tools which can be used to help identify what Les’ needs are:1) Questions – this can be used to help identify what Les’ needs are as the professionals will be able to find out more about him such as his likes/dislikes, interests, medication etc. By doing this means that a care plan will be put together which meets the holistic needs of Les and ensures that he receives everything that he needs to and hopefully reduce the chances of him complaining about his care or something not being right.2) X-rays and scans can be carried on Les to identify how badly the Alzheimer’s has affected his brain, as they’re different stages which means his needs will alter in time. The stages of Alzheimer’s include: • Preclinical Alzheimer’s disease.• Mild cognitive impairment due to Alzheimer’s disease.• Mild dementia due to Alzheimer’s disease.• Moderate dementia due to Alzheimer’s disease.• Severe dementia due to Alzheimer’s disease.By doing this means that a care plan will be put together which meets the holistic needs of Les and ensures that he receives everything that he needs to and hopefully reduce the chances of him complaining about his care or something not being right.Two assessment tools which can be used to help identify what Jim’s needs are:1) Diary of the individual (mood, thoughts, feelings) – this enables professionals to see how Jim is feelings and coping with his bipolar and could potentially help them come up with strategies to help him cope with his illness and will be able to come up with a care plan which will help Jim in the long run cope with his bipolar on his bad days as well as his good days.2) Observations – this enables professionals to see what Jim’s mobility and fitness is like and can decide if they need to get him extra support to help develop his fitness and mobility or not. This also enables them to see what Jim is capable of doing and what he’s not capable of doing which will help the professionals come up with a care plan which helps support him in completing things such as daily tasks of making a cup of tea or doing his own washing. Care plan: LesArea of need (PIES) Desired outcome Support/advice required Professionals involved Assessment tools usedLes is Paralysed recently came out of hospital and has just lost a family member. Physical to be able to carry out daily tasks, take his own medication and do as much of his own personal care as possible. Someone should be with Les at all times assisting him with daily tasks and personal care whilst also encouraging him to carry them on his own as much as possible. Somebody should also assist him whilst he takes his medication and explain to him how to do so to help him maintain his independence. Many professionals should be involved in this process such as: GP, occupational therapist, nurse, care workers and social workers. The assessment tools which should be used are: questions, observations, physical assessment, one page profile and medical history.Intellectual Stimulate his brain by reading books, doing jigsaws, playing games and participating in activities. Somebody should encourage and help Les with these activities as he might struggle. The professionals which should be involved are social workers and care workers. The assessment tools which should be used are: questions, observations, forms and a memory test.Emotional to be able to cope with his emotions by having counselling and keeping a diary about his thoughts, feelings and mood. Les should be given advice on how to cope with his emotions and feelings. He should be given coping strategies to overcome barriers. The professionals involved will be a counsellor, nurse, care workers and social workers. The assessment tools which should be used are: questions, observations, diary and one page profile.Social To speak with others, participate in activities with others and to always get involved. Les should be encouraged to socialise with others and participate in activities as he’s at risk of social isolation. The professionals involved should be an advocate, social worker, and interpreter and care workers. The assessment tools which should be used are: personal history, questions, one page profile and interviews.Spiritual Practice what he believes in? Les should be given support to practice what he believes in as he might be nervous about doing so. A social worker, interpreter, care workers and nurses should be involved in doing this. The assessment tools which should be used are: questions, forms and checklists.Care plan: JimJim has also lost a family member, recently has come out of hospital and has been diagnosed with arthritis. Area of need (PIES) Desired outcome Support/advice required Professionals involved Assessment tools usedPhysical to be able to carry out daily tasks, take his own medication and do as much of his own personal care as possible. Someone should assist Jim with caring out daily tasks to show him how to do them himself and encourage him to do so. Somebody should also assist him whilst he takes his medication and explain to him how to do so to help him maintain his independence. Many professionals should be involved in this process such as: GP, occupational therapist, nurse, care workers and social workers. The assessment tools which should be used are: questions, observations, physical assessment, one page profile and medical history.Intellectual Stimulate his brain by reading books, doing jigsaws, playing games and participating in activities. Or to go back to college to complete a qualification in something he likes. Somebody should encourage and help him with these activities as he might struggle. If he was to do go do a course at college he should be given support with completing this qualification as he might struggle with reading and writing. The professionals which should be involved are social workers and care workers. The assessment tools which should be used are: questions, observations, forms and a memory test.Emotional to be able to cope with his emotions by having counselling and keeping a diary about his thoughts, feelings and mood. Jim should be given advice on how to cope with his emotions and feelings. He should be given coping strategies to overcome barriers. The professionals involved will be a counsellor, nurse, care workers and social workers. The assessment tools which should be used are: questions, observations, diary and one page profile.Social To speak with others, participate in activities with others and to always get involved. Jim should be encouraged to socialise with others and participate in activities as he’s at risk of social isolation. The professionals involved should be an advocate, social worker and care workers.The assessment tools which should be used are: personal history, questions, one page profile and interviews.Spiritual Practice what he believes in? Jim should be given support to practice what he believes in as he might be nervous about doing so. A social worker, care workers and nurses should be involved in doing this. The assessment tools which should be used are: questions, forms and checklists.