Management of a Long Term Condition

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This essay focuses on a patient encountered in clinical practice with the chronic long term condition multiple sclerosis (MS). The National Service Framework for Long Term Conditions (2005) defines a long term condition (LTC) as one which is incurable but manageable with therapeutic interventions. The patient’s name has been changed, and Trust identifiers’ removed to adhere to confidentiality as outlined in the Nursing and Midwifery Council’s Code of Professional Conduct 2008 (NMC 2010).

The second component to be explored will be collaborative working between the members of the healthcare team (Appendix 1). This will be done in conjunction with exploring the management approach

The patient, referred to as Mrs. J, is 57 and was diagnosed with MS in her late twenties. She lives in a bungalow with her husband. Mrs. J worked as a sports teacher up to five years ago. She advised her retirement was not disease related but she would find it difficult to return to teaching due to her MS. At home, Mrs. J requires the assistance of two carers in the morning to assist with getting out of bed and dealing with activities of daily living (ADL). In the evening her husband assists in this capacity.

On a number of occasions prior to the current hospital admission, 3 weeks ago, Mr. J has returned home to discover his wife had fallen. On some of these occasions she has been unable to get up and remained on the floor to await his return home. Mrs. J has also developed a sore in her natal cleft a few days earlier. The additional reasons for her admission to a neurological rehabilitation unit include reduced mobility, inability to intermittently self catheterize (ISC), truncal ataxia, dystonia, passing dark urine and lethargy.

Mrs. J is in the acute phase of her disease trajectory (Corbin & Strauss, 1992). The trajectory model considers the management approach of disease yet maintains focus on the patient’s ability to regain control of their ongoing...
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