Health & Social Care

For this assignment I have been asked to explore the care needs of an individual in a care setting, explain methods of assessment and choose one that will suit the individual in that particular care setting. I will describe my role in his/her care and how am going to provide the best possible care informed by the care value base.

I have chosen a nursing home as my care setting. I have based my assignment on my own case study whereby I will be considering an individuals physical, intellectual, emotional and social need (PIES).

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In order to work effectively and provide the best care for my client, am going to work to the following guidelines:

I will be observing the methods of assessment based on the client’s needs and see that facilities can be used to meet his needs. I will identify the factors that can influence care delivery and continuously monitor the effectiveness of the care given.

Mr G is a 68 year old, clinically overweight Muslim man, who lives with his wife M. He has been living in England for 45 years, he is originally from Pakistan. The couple had been married for 32 years and have only one daughter-Anne who lives abroad with her husband and child.

For the last three years of his retirement, Mr G has been suffering from chronic arthritis. This has mainly affected his fingers causing him great distress in day to day activities. He has had to rely heavily on his wife for simple things such as brushing teeth, hair, and bathing.

Five months ago, Mr G was hospitalised with symptoms of chronic fatigue, difficulty in starting and then stopping urination. Initially, Mr G thought it was merely old age but after extensive medical examinations, it was revealed that Mr G had a tumour in his prostate. Further tests showed the tumour to be malignant, i.e. cancerous. Mr G was duly diagnosed with Prostate cancer. This diagnosis has left him feeling rather hopeless with considerable psychological and emotional trauma, especially after being told there was no preventive or reversible cause of action. He was assured that there were modern drugs that could control it very adequately; therefore the outlook for the future was not desperate.

Mr G also seems to be having difficulty with his eye sight, experiencing pain and blurring of his vision. A visit to the GP revealed that he was suffering from acute glaucoma. Unfortunately, during one of Mr G’s regular walks he experienced severe tight pains that began across the upper part of the front of his chest and spread to his jaw and down his left arm. This pain lasted for only a few minutes, however it seems to recur whenever he goes for his walks. His GP arranged for him to have checks in the local hospital. During those checks it was discovered he had fatty deposits in the walls of the arteries, which harden, making the arteries rigid. The deposits had enlarged into plaques which lead to the narrowing of his arteries.

In a recent trip to see their daughter-Anne- Mr and Mrs G were involved in what proved to be a fatal accident; Mrs G sadly lost her life. Mr G severed his right leg badly and had to have it amputated, causing him to be inevitably less mobile.

Let it also be noted that Mrs G, had been the ‘foundation’ of Mr G, in the sense that she had cared for him since they got married (physically and emotionally.) She also contributed financially to the up keep of the house. This incapacitation meant Mr G was therefore admitted to a nursing care home, where there would be carers to care for him.

Before the accident Mr. G was very much involved with his local debate club and also kept up with the daily affairs in the newspapers with the help of his wife. As a result of the death of his wife, Mr G had lost his confidence and seems to suffer from a low self-esteem. This has led to him not being able to form intimate/trusting relationship, and has rather made him more lonely and miserable.

Mr G is also suffering from depression and he has also lost interest in his surrounding and has turned to food for consolation. He is clearly suffering from some form of isolation, mostly due to his only daughter Anne, living so far away and not visiting for unknown reasons.

Assessment

The client is made aware that any decision on care/treatment that would be provided for him will solely be his decision. The role of the assessor is to merely give all the best possible scenarios or care available to the client. This basic form of care is outlined in the National Health Service and Community Act 1990, which gives people the right to have their needs assessed.

Taking into account the financial restraints on services that can be made available to the client, one has to be careful as not to compromise the care values of the client. Take for instance the case of Mr G, who is unable to afford an electronic wheelchair. It is all too easy to simply ignore his needs for an individual service care plan and simply provide him a with a ‘general’ care plan. It is imperative that a suitable alternative is sought to compensate for this financial drawback.

Money is clearly one factor which can and does affect the development of care plans for individuals but should NOT affect the implementation of care values. However immorality of care workers can mean that a well to do client can perhaps offer some financial reward to secure constant and better care. Better care in the sense that they will monopolise facilities and resources.

The facilities and resources are themselves other factors that can influence the delivery of care. Environmental factors such as the availability of facilities in the ‘home’ and the local community will have a direct effect on the quality of care. To an extent The Registered Homes Act 1984 ensures that the two essential factors influencing the delivery of individual service plans-environment and resources-are adequate.

For instance, in this nursing home, there is a 24 hour transportation service available to the clientele in the home. There are more than enough nurses, carers and a doctor on call during the night (In case of any emergency). Apart from the carers who are well trained, there is also a visiting doctor who comes to the home once every week to visit the clients. There is also a therapist and a social worker who helps and advises the clients when needed. The ambience of the place we live greatly influences our emotions. Spacious, attractive and comfortable homes, will feel much better than an unattractive, crowded or poorly equipped home. There is no ideal as to how a home/room is furnished or facilitated. For example a wheelchair user such as Mr G will find high sinks difficult to use, a hinged door difficult to manoeuvre and will need a sliding door. Whereas a client with a bad spine will find it difficult to bend down to a low sink and sliding doors may not be quite suitable for someone with memory impairment. Rooms may need to be adjusted to meet the needs of specific individuals thus fostering diversity.

As a result of Mr G’s disability-right leg having been amputated-he would be provided with a choice of wheelchairs. Cheaper alternatives such as a walking frame or walking stick will be of no use to him. A motorised wheelchair will be the recommended choice due to his arthritic fingers.

Due to his mobility being restricted, he is going to need help with his bathing and general movements. He will therefore be provided with moving and lifting equipment such as a hoist, a lifting handle, a transfer board, a table and a bath lift.

Mr G’s heart condition would have to be monitored, in order to prevent it from getting any worse. This would be done through frequent exercise and a proper healthy balanced diet. (i.e. less fat and low cholesterol food).

He also needs a regular visit to the optician because of his bad eye sight, and would be assisted in his reading by a carer. This would ensure that he keeps up to date with current affairs. As a result of less interaction with other people, Mr G lost his self-confidence, in order for him to regain his self- confidence; he must attend social gatherings such as, discos, parties, bingo, etc. These types of gatherings will allow him to meet and interact with people in a group and also on a one to one basis. Along with this he will have regular sessions with the in-house therapist.

In not restricting the activities Mr G can undertake, but rather making sure that all services are accessible by him we would be adhering to the Disability Discrimination Act 1995. This act is designed to prevent discrimination against people with disabilities. It ensures that disabled people are not treated less favourably than non-disabled people.

My Role

As a care assistant provided by the private Health and social care firm “Angie’s Care for the infirm (ACI), I would be assisting Mr G with day to day social care and meeting his daily comforts. I will make sure that all the recommendations agreed to by Mr G, his specialist doctors; GP and therapist in the care plan are adhered to.

The care plan for Mr G is outlined in the care plan sheet as shown.

As a care assistant at the home, Mr G is one of my main clients and I work on a shift basis with other care assistants to ensure that the care plan for Mr G is adhered to.

Skills and qualities of care assistance are to be able to work with people from different backgrounds in terms of different age group, culture religion and gender.

The plan ensures that some form of regularity is maintained with Mr G’s routine, no matter who the care worker is. This in turn will make the monitoring and evaluating of Mr G’s wellbeing very efficient.

A typical day for me starts with me arriving at the care home at about seven in the morning. The first hour will be spent reviewing the previous night/days notes on Mr G to see if there are any special points of notice. At about eight, I will run a bath for Mr G and rouse him out of bed. I will help him with bathing, shaving and brushing his teeth. I will let him do as much as he can for himself to promote independence and maintain mobility.

At about nine thirty, Mr G will be taking into the dinner room where he will breakfast with other clients. He enjoys this very much because he likes company at meal times. Mr G’s diet is quite specific, due to his narrowing arteries and him being slightly over weight. He has been advised not to eat food cooked in fat, not to eat sugar but if he feels the urge for something sweet to try eating a few grapes, raisins or dates. His diet needs to include reasonable amounts of wholemeal bread (two to four slices a day), potatoes, fruits and vegetables.

Mr G is on a lot of medications and it is all too easy to forget when to take some of them. He needs to take medications for his narrowed arteries, his prostate cancer, his arthritic fingers and his glaucoma. Some of these medications might react with each other therefore it is very important that the doctor’s instructions on how and when to take them are followed carefully.

At some point during the day Mr G, will be taken to see the therapist. There will also be arrangement for social invents such as binge so he will be able to join in with other client in the home to help him improve his social abilities. He will need to speak to his only daughter at least twice a week.

Some encouragement has been made for Mr G to be taking regular naps because of his chronic fatigue. In view of his anxious mental state being related to his prostate cancer, it will perhaps be necessary for Mr G to attend a meeting specifically for Prostate cancer suffers.

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