Context of the case study
Ms. Edith Fitzpatrick is a 54-year-old woman who identifies as white Scottish and has a diagnosis of Parkinson’s disease. From exploring the social work database, you can see Edith has previously worked with an allocated community occupational therapist (OT). On the system, there is also an old assessment completed by a social worker, which describes Edith as wanting to maintain her independence and reluctant to engage with support. The outcome of this assessment was that Edith did not meet the threshold for support and the case was closed. However, there is a new referral, this recent referral has been made to the social work team by Edith’s GP. This referral mentions an allocated Parkinson’s nurse. The GP has requested a community care assessment highlighting that in recent months Edith’s condition had progressed, stating she is now struggling to undertake tasks that she could previously manage. She enjoyed cooking and baking in particular. She has not taken the risk for several years, as she is worried that she might drop hot items. She finds it sad but says that she has got used to it.
Edith has a son Jack (38). There are a number of pictures of Jack around the living room, and she talks fondly of him. She says that he does visit when he can, but he has a young family, works long hours, and is sometimes away from home, so she understands why he’s not there more often.
She describes a day when she could get out. Mornings are better for her if she’s had a decent night’s sleep she would get up around 10 am go out for her morning papers at the local shop and chat with the shopkeeper or neighbour if she met them, come back and watch some TV. Lunch would be a sandwich or soup heated in the microwave, and in the afternoon she would go out for coffee with one of her friends. If not she would do a video call. She is now struggling to undertake these tasks that she could previously manage. Edith stresses that the main thing for her is her independence.” I want to be as independent as I can for as long as I can. It’s the way I was brought up”. Therefore the proposal is to get the best option of Self-Directed support for Edith and help her to maintain her independence
Support System
Edith mentions two women of her own age, Mary and Jackie, whom she used to work with and are part of the circle of friends that she goes out with sometimes like going for coffee. She knows a few people locally and knows that they will help if needed. She has a small circle of friends, who will collect her from the house for outings and do small errands for her. Some of these friends she has known for years since before the onset of Parkinson’s and they have stuck with her through difficult times. Edith points to the spare bedroom and explains that her son has recently moved in and he also helps out. She explains that he sometimes gets her cups of tea or makes some food.
There has been adaptation in the home for Edith’s safety by the OT, with a wet room, handrails, and also has a hospital bed. Edith says that she is happy where she is living, is content with the adaptations that have been made to the flat, and feels safe. If need be, she can go to neighbours or use the pendant alarm. Edith says that she is happy where she is living, is content with the adaptations that have been made to the flat, and feels safe.
Loss: Such loss of identity can result in increased levels of anxiety, low-self esteem, depression, and loss of self-confidence, social anxiety, isolation, chronic loneliness all of which threaten our ability to connect with other people. When we lose our identity likely to seek our sense of worth from others it suddenly becomes very important how others see us.
INTERVENTION
Task-centered approaches are also used for problems that have been clearly defined by the clients and are resolved through actions. For example, when a client acknowledges that he or she is having a problem, the problem can be easily and immediately resolved by finding out the possible course of action that can be used. Task centered approaches and crisis intervention methods appear to merge well
I notice the carpets are ill-fitted and have become all bunched up resulting in her wheelchair getting stuck as she navigates around the house. She said that she needs support now with someone pushing her chair home. Edith explained that on the way home she would sometimes take a break at the bus stop or at a bench until she felt able to continue pushing her chair home. She mentioned that an electric wheelchair would help her stay independent.
Summary of needs and risks
Electric wheelchair: She said that she needs support now with someone pushing her chair home. Edith explained that on the way home she would sometimes take a break at the bus stop or at a bench until she felt able to continue pushing her chair home. She mentioned that an electric wheelchair would help her stay independent.
Replace neck pendant: You notice that she is not wearing her community alarm pendant around her neck, which would enable her to call for help if she fell. Edith reports that she has lost it, however, would really like another one as she has stumbled and it has been a bit frightening.
Home improvement: The carpet and door need fixing. Hoist probably New hospital bed:
Person-centered theory. People’s values and putting people at the center of caretaking into account people’s preferences and choices, For example, treating people with respect, kindness, warmth, and dignity. Instead of seeing a person as being flawed and needing to be fixed, the person-centered theory suggests that everyone has a capacity and desire for change and personal growth.
It means people feel able to speak about what is important to them and the workforce listens and develops an understanding of what matters to people. It means working in a system in which people and staff feel in control, valued, motivated, and supported.
The person, and their family where appropriate, becomes an equal partner in the planning of their care and support, ensuring it meets their needs, goals, and outcomes.
Legal Mandates
Adult Support and Protection (Scotland) Act 2007.
They have the power to visit and interview people, arrange medical examinations, examine records, and issue protection orders. They must also consider if there is any need for advocacy and other services, such as help with medication or support services. Sarah meets this threshold therefore Safeguarding Sarah involves reducing or preventing the risk of significant harm from neglect or abuse, while also supporting her to maintain control of their own life.
Self-Directed Support Act
Self-directed Support (SDS) Self Directed Support is a way of providing social care support that empowers individuals to have informed choices about how support is provided to them with a focus on working together to achieve individual outcomes.
represents a significant shift in the way social care services are to be provided in Scotland. Consequently, part of the provisions within the Act is an informed choice where the service user is supported to express themselves and indicate what they want from their support and how they want it to be arranged, this will allow the authority to deliver its assessment in accordance with the legal principles of collaboration and informed decision-making.
Self-directed support cannot be implemented directly without an active local third sector and thus would be very expensive to involve the third sector. At the same time, practitioners have also raised concerns that self-directed support can result in poor working conditions for the directly employed staff.
You try to talk through the four options with her, but she seems to be quite tired by this point and she said “I don’t think I would want all the fuss of arranging things myself. That sounds like too much work. I’m happy that you sort it all out. You seem to know what you are doing. If I can get some extra help that would be great, but I’m really not sure what else I need just now”.
Co- Production
As it underlines the importance of working together to develop assessments and assistance programs. People are often experts in their own lives, and we must engage with them to analyse both solutions and risks and agree on what will work best for them.
Four Options of SDS
- A Direct Payment to the individual
- An arrangement where the supported person chooses their own support, but someone else arranges that support and manages the budget (sometimes via an Individual Service Fund)
- The LA manages support and budget on behalf of the supported person
- A mix of these
However, evidence suggests that the traditional care culture has been difficult to shift and that little has changed with regard to the type of services people are receiving. It has been found that option 3, direct delivery of services by the LA, remains the dominant SDS provision. The principles of SDS clearly state that staff should support decision-making through co-production rather than make decisions on behalf of individuals.
COMMUNICATION
Body language, respect, volume, and clarity. Adapt your communication style to your audience. Different styles of communication are appropriate in different. Edith reports she is having a good day with regard to her mobility and her speech. She explains she is better in the morning, but as she gets tired throughout the day her mobility and speech tend to slow
Communication involves understanding what the patient is saying and studying their body language. Effective communication involves active listening to give the patient the confidence of listening to their complaints.
Ethical Issues
Confidentiality.
Edith should be informed on what her information is being used for and who has access to it, and they should give consent for it to be used in this way. (only talked to Edith about what she has given me consent on).
Communication For love ones
Though providing safety and social stimulation for your loved ones is good, however, you need the opportunity for you to step away and pursue your own interests. This is never easy, but you must remember that your frame of mind is important in communication. make sure your voice is heard, too.
Caregiving is stressful. Be sure to discuss your needs, feelings, and fears with family, a trusted friend, or a mental health counselor. Ask questions about the disease and take advantage of the information provided by medical professionals.
