Care Planning Case Study
CARE PLAN
Patient details: Jean is 86 year old female with heart problems, chronic back pain, Alzheimer’s, suicide attempts and continual thoughts of suicide and depression. Activities of daily living | Assessed needs | Support and care provided | Outcome of plan | Maintaining a safe environment | Jean has had three overdoses of painkillers and been going out and forgetting where she lives and is no longer able to live on her own. | To ensure Jean’s safety she has been referred for psychiatric evaluation and CPN and help look for a place of safety for her to live. | CPN makes regular visits to see Jean and assess her needs. Jean has a safe place to live in a care home where her medication can be monitored. Regular psychiatric appointments. | …show more content…
| Keep up to date with hospital referrals. | Assist Jean with her hospital referrals. | Eating and drinking | Weight loss due to forgetting to eat. | Monitor weight and referral to dietician, encourage eating meals. | Stabilise weight. | elimination | Forgets to use the toilet on occasions. | To monitor and prompt jean to use the toilet. | Jean is using the toilet more by herself. | Washing and dressing | Forgets to wash and dress. | To assist and encourage Jean to wash and dress. | Jean is now washing and dressing a lot more on her own. | Controlling temperature | Jean feels the cold. | Assist Jean to put on extra clothes when cold. | Jean now has thick cardigans and jumpers. | mobilisation | Can mobilise on her own without the use of any walking aids but has chronic back pain. | To maintain that Jean is not in any pain. | Regular pain relief | Working and playing | Retired from workLoves to dance. | Encourage Jean to join in activities with other residents. | Jean is teaching other residents and staff to dance. | Expressing sexuality | Jean has challenging behavioural problems. | Monitor behaviour with other residents and staff. | To monitor Jeans behaviour and document any change.
Patient details: Jean is 86 year old female with heart problems, chronic back pain, Alzheimer’s, suicide attempts and continual thoughts of suicide and depression. Activities of daily living | Assessed needs | Support and care provided | Outcome of plan | Maintaining a safe environment | Jean has had three overdoses of painkillers and been going out and forgetting where she lives and is no longer able to live on her own. | To ensure Jean’s safety she has been referred for psychiatric evaluation and CPN and help look for a place of safety for her to live. | CPN makes regular visits to see Jean and assess her needs. Jean has a safe place to live in a care home where her medication can be monitored. Regular psychiatric appointments. | …show more content…
| Keep up to date with hospital referrals. | Assist Jean with her hospital referrals. | Eating and drinking | Weight loss due to forgetting to eat. | Monitor weight and referral to dietician, encourage eating meals. | Stabilise weight. | elimination | Forgets to use the toilet on occasions. | To monitor and prompt jean to use the toilet. | Jean is using the toilet more by herself. | Washing and dressing | Forgets to wash and dress. | To assist and encourage Jean to wash and dress. | Jean is now washing and dressing a lot more on her own. | Controlling temperature | Jean feels the cold. | Assist Jean to put on extra clothes when cold. | Jean now has thick cardigans and jumpers. | mobilisation | Can mobilise on her own without the use of any walking aids but has chronic back pain. | To maintain that Jean is not in any pain. | Regular pain relief | Working and playing | Retired from workLoves to dance. | Encourage Jean to join in activities with other residents. | Jean is teaching other residents and staff to dance. | Expressing sexuality | Jean has challenging behavioural problems. | Monitor behaviour with other residents and staff. | To monitor Jeans behaviour and document any change.