Case Study Health and Society

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Case Study NU1505
For the purpose of this assignment I am going to do a case study on an individual patient/client which focuses on the nursing health model used in care, the socially and/or culturally specific components of care. I will also look at Health promotion and patient education and Inter/Multidisciplinary team approach to care provision. For the purpose of the assignment and to ensure I adhere to NMC Code of Conduct (2004) I must guard against breaches of confidentiality by protecting information from improper disclosure at all times. I will therefore change all the names of people and places in the assignment where relevant in line with these guidelines. The individual patient I choose is Mrs A, Mrs A is an 87 year old lady who is retired and currently at home with her husband. Mrs A’s nationality is white/Irish; she was born in Ireland and moved to England around 60 years ago. Mrs A has four children and before retiring enjoyed the lifestyle she led with an occupation in hotel work and a social life which included singing and dancing. Earlier in the year Mrs A suffered a stroke which resulted in a number of health problems. Mrs A’s speech was affected by the stroke and now she often gets her words mixed up when communicating and finds it difficult to find the right words to express herself . Often she uses yes instead of no and vice versa. Her mobility has also deteriorated resulting now in using a walking frame and wheel chair for distances. Mrs A’s medical history includes having a total hip replacement, Spondylosis, Cognitive impairment, pseudo bulbar palsy, cerebral atrophy and a speech and language impairment. Previously Mrs A has no known history of Mental illness yet as a result of age is becoming increasingly more forgetful and experiencing memory problems both short and long term. Mrs A was admitted to the service (my placement area) after being referred by a speech and language therapists. Mrs A has been attending these therapies for about 8 months however the speech and language therapist expressed that limited improvements have been made due to memory. The speech and language therapist thought Mrs A would benefit from a full assessment of memory in a group setting. The placement area I was on where Mrs A attended was a memory clinic which was dedicated to facility treat patients with memory problems. Memory services/clinics were established with a key number of things in mind, they aim to assess patients with memory problems, establish a diagnosis, treat if necessary and provide support to themselves and their carers. The service is provided as day care within a hospital environment. The day unit was on the ground floor of a hospital, it was one large room with a comfy seating area, a dining area, a small kitchen facility and toilets. For the staff it had small offices branching off the sides, a clinic room and a meeting room. The service was run by a Doctor, a CMHN (Community mental health nurse) an Occupational therapist, a physiotherapist, two senior general nurses and two support workers. When Mrs A was admitted to the memory clinic an assessment had to be carried out. Most nursing assessments are guided by nursing models. Newton (1991) describes a nursing model as a mental picture of nursing. There are many models of nursing to choose from and apply to practice. On the memory service a specific model wasn’t used yet a person centred approach and a CPA assessment worked as tools for guiding, directing and organizing care. A CPA is a process by which needs are identified and care plans are provided. One popular nursing model is The Roper, Logan and Tierney (1980/1996) model of nursing; this is a British model which uses as its framework 12 activities of living. Walsh (1991) suggests that the Roper, Logan and Tierney model is to simplistic, while others suggest that simplicity is one of its strengths (Luker 1986) I think the model is a good framework for assessment yet is more suited and...
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