This essay considers a scenario of a troubled 37 year old mother and looks at the support from health organisations and other support services which could be accessed in terms of the impact on the service user and her family.
This is a case where Community Care is appropriate and calls for a multi discipline team. How the team would be drawn together is discussed on the basis of the problems highlighted in the scenario and the professional help that might relate. It is of course something of an estimate as only a detailed assessment and continued evaluation can identify the need in detail.
Range of health needs and services that may be accessed impact. Rhoda has been referred to the Community Mental Health Team (CMHT) by her GP. There is nothing to indicate any acute problem and the CMHT approach is appropriate to provide the best solution in supporting Rhonda. However, the indications are that there is a wide range of problems and will require the work of the Multi-disciplinary team. .
The first stage of treatment is to carrying out an Assessment of Rhoda. This has already been started by Rhoda’s GP who will have already have carried out a preliminary assessment and referred her to the CMHT. An assessment involves evaluating the service users mental, physical cultural and spiritual needs as well as their personal needs. Failing to respond adequately, or even to recognise the patients’ needs, can result in those needs not being met and would be a failure of care (Howatson-Jones et al, 2012a)
In line with the NMC document record keeping it states that nurses need to record details of any assessments and reviews that are carried out and also make note of any evidence of the arrangements that have been made for future and on-going care. (Barrett et al 2012 p.14). The community Mental Health team will now carry out further assessment and decide ,along with Rhoda, what treatment or other therapies could help her back to Mental Health.
Howatson-Jones et al, (2012b) states that Patients need to be assessed at key points in their care journey and the importance of assessing patients at a number of different times - for example, when they first identify they have a need or when meeting the patient for the first time.
The assessment will likely be a Care Programme Approach (CPA). The care program approach was introduced in 1999 as a framework for the care of service users with mental health problems. The main points were the systematic assessment of individuals health and social care needs, the forming of a care plan, and the appointment of a key worker to monitor the care given (Sainsbury Center, 2005a). The CPA is used for a person’s whose care will likely require support from more than one professional or longer term care. This assessment will involve getting information on Rhoda’s needs this includes mental health/psychological needs, physical health her housing situation her social and family relationships and financial situation also will look at her dietary needs. (Sainsbury Center, 2005b)
We know that Rhoda has split up from her partner who was being abusive, has recently seen her GP where it was reported she was feeling low in mood, not have a job currently and from the sound of it does not have much if any money at all. She has 3 children and her mother but there is no mention of her a father. Her partner has left her in a lot of debt. She also presents as very tearful and speaks in a monosyllabic way. This could indicate depression but may be more complicated.
The nurse has been confronted by monosyllabic speech and through patient gentle prompting and allowing enough time will have to try to get beyond this. It is unlikely to indicate a reluctance to be with Community Health in this case but may indicate, embarrassment, low self-esteem or a fear of being judged. It might also be a lack of confidence from the conditioning of previous experience in speaking up. What we can...
Bibliography: Patient Assessment and care planning in nursing (Howatson-Jones, 2012)
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