Guidelines:

Write a comprehensive discussion on a chosen client with a specific illness / disability within a care setting. Your assignment will be assessed on the following:

•    Comprehensive description of client’s needs    
•    Accurate identification of assistance required    
•    Clear recommendations on an effective course of action to better meet client’s needs
•    Evidence of reflection as a result of knowledge gained    

Instructions:

For this Assignment you can:

1.    Choose one of the case study profiles below to complete this assignment and follow the guidelines provided to complete same. The below case studies are a brief overview of the client and you are free to interpret and expand upon the client history, background if you wish.

Case Study One

Mary Jones is a 75-year-old female, currently residing in Lakeview Nursing Home. Mary was admitted to the nursing home four years ago, following a left sided Cerebral Vascular Accident (stroke). Mary has a supportive family, two daughters and a number of grandchildren, who frequently visit her on a weekly basis.

Mary requires assistances with her activities of daily living, mainly personal hygiene, dressing, maintaining safe environment, mobility and elimination needs. The Barthel index shows Mary is of medium dependency.

Structure /Headings for your assignments:

INTRODUCTION: In this section introduce your client (not real name) and the care setting (where applicable). Provide an overview of the specific care topic i.e. your clients condition you are going to discuss, supporting same with research, illustrating understanding of illness /disability.

CLIENTS NEEDS:  In this section discuss the following in relation to your client.

•    Physical needs
•    Emotional needs
•    Social needs
•    Rehabilitation and Recreational Needs
•    Intellectual needs
•    Spiritual needs

LEVEL OF ASSISTANCE REQUIRED: In this section discuss the following interventions in relation to your client and show understanding of interventions / assistances they would require under the below headings.

•    Practical skills of Daily living
•    Communication needs
•    Mechanical aids --- if appropriate.

ROLE OF HEALTHCARE ASSISTANT: In this section outline your role in promoting the following for your client:

•    Clients’ privacy and dignity
•    Independence/autonomy
•    Self-esteem
•    Clients’ safety
•    Confidentiality
 
EVALUATION: In this section you are required to reflect on the knowledge gained, in relation to the care of the client with this illness/disability. Based on external readings you have sourced, provide recommendations that could be implemented to improve quality of care for a client with this illness/disability.

Introduction

Mary Jones, a 75-year-old female, currently resides in Lakeview Nursing Home, having been admitted four years ago following a left-sided Cerebral Vascular Accident (CVA), commonly referred to as a stroke. Managing the multifaceted needs of stroke survivors like Mrs. Jones necessitates a comprehensive care approach that extends beyond mere medical treatment.

According to seminal studies in geriatric care, specialized interventions tailored to the unique challenges faced by stroke survivors significantly enhance their quality of life and overall well-being.

This essay aims to elucidate the complexities inherent in delivering holistic care to Mary, thereby highlighting the indispensable role of individualized care in optimizing outcomes for patients with similar medical histories.

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Client’s needs

Addressing the multifaceted needs of Mary Jones, a 75-year-old stroke survivor, demands a nuanced understanding of her physical, emotional, social, rehabilitative, intellectual, and spiritual requirements.

On the physical front, Mrs. Jones faces mobility challenges that necessitate assistance in personal hygiene, dressing, and maintaining a secure environment. Her medium dependency, as indicated by the Barthel index, underscores the need for partial assistance with activities of daily living (ADLs) (Lui and Nguyen, 2018).

Emotionally, Mrs. Jones grapples with the psychological ramifications of her physical limitations. The emotional support afforded by her familial visits serves as an invaluable coping mechanism. Research corroborates that family involvement in the emotional well-being of nursing home residents significantly augments their overall quality of life (Irisawa and Mmizushima, 2022).

In terms of social needs, Mrs. Jones benefits from regular interactions within the Lakeview Nursing Home community, as well as her weekly family visits. Social engagement, as documented in gerontological literature, plays a vital role in preserving the mental health of elderly individuals, particularly those with debilitating conditions (Geng et al., 2019).

Rehabilitation and recreational needs for Mrs. Jones involve a regimen of physical therapy aimed at mitigating the adverse effects of her stroke. Moreover, recreational activities tailored to her capabilities, such as light exercise or arts and crafts, contribute to her holistic well-being (Ning et al., 2022).

Intellectual stimulation for Mrs. Jones is primarily achieved through activities like reading and puzzle-solving. These endeavors not only offer cognitive benefits but also provide a valuable sense of accomplishment, thereby enriching her daily life (Yu et al., 2021).

Lastly, spiritual needs must not be overlooked. Mrs. Jones may find solace in her personal belief system, which can serve as an essential coping strategy. Various studies have indicated that spirituality often plays a crucial role in how elderly individuals cope with chronic illnesses (Xiao-hong et al., 2020).

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Level Of Assistance Required

To address the myriad challenges that Mary Jones faces in her daily life, especially in light of her medical history involving a Cerebral Vascular Accident, specific levels of assistance are imperative. With regard to practical skills of daily living, Mrs. Jones requires assistance in maintaining personal hygiene, dressing, and sustaining a safe environment.

Given her medium level of dependency as per the Barthel index, intermittent yet skilled help is crucial to ensure her dignity and physical well-being. This necessity goes beyond mere task completion, extending into the realm of enabling her to engage meaningfully with her environment (van der Veen et al., 2019).

Communication presents another area where specialized intervention is warranted. Post-stroke patients often confront a range of communication difficulties, from mild to severe, that may involve speech, language, or cognitive deficits.

Adapted communication techniques, potentially involving augmentative and alternative communication devices, serve as beneficial tools in facilitating meaningful interactions for Mrs. Jones. These methods, as corroborated by existing research, significantly improve the patient's social engagement and emotional health (Mutai et al., 2018).

Mechanical aids can also play an instrumental role in optimizing Mrs. Jones' quality of life. Walking aids tailored to her specific mobility challenges, along with specialized bathroom facilities, can greatly enhance her independence.

These mechanical aids not only alleviate the physical burden but also confer a psychological benefit by promoting autonomy and reducing dependency (Lui and Nguyen, 2018).

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Role Of Healthcare Assistant

In the continuum of healthcare provision for Mary Jones, the role of a healthcare assistant is multidimensional and pivotal. First and foremost, safeguarding the client's privacy and dignity is non-negotiable.

This involves treating Mrs. Jones with the utmost respect and ensuring that her personal care activities, such as bathing and dressing, are conducted in a manner that upholds her dignity. The objective extends beyond mere protocol adherence; it is a cornerstone in establishing a therapeutic relationship (Lui and Nguyen, 2018).

Promoting independence and autonomy for Mrs. Jones is another cardinal aspect. Where feasible, the healthcare assistant encourages her to partake in self-management of daily activities, thereby fostering a sense of control.

This aligns with the principles of person-centered care, which evidence suggests significantly contributes to improved patient outcomes (Irisawa and Mizushima, 2022).

Equally important is the bolstering of self-esteem. Emotional support and validation from healthcare staff can serve as powerful antidotes to the feelings of helplessness that often accompany chronic illnesses. Positive affirmations and genuine interactions help in reinforcing Mrs. Jones' sense of self-worth.

In terms of client safety, the healthcare assistant bears the responsibility of vigilantly monitoring and maintaining an environment that minimizes risks, thereby precluding any potential harm to Mrs. Jones.

Lastly, the tenet of confidentiality is sacrosanct (Geng et al., 2019). Adhering to strict ethical guidelines ensures that all personal and medical information pertaining to Mrs. Jones is handled with the highest level of discretion.

In sum, the healthcare assistant serves as a linchpin in the coordinated effort to provide comprehensive and dignified care to Mrs. Jones.

Evaluation

The exploration of Mary Jones' case offers invaluable insights into the intricate web of needs and interventions required for comprehensive care of stroke survivors. Drawing upon a plethora of external readings and research findings, it becomes abundantly clear that a multi-disciplinary approach is vital for optimizing patient outcomes.

Studies in geriatric care strongly advocate for an integrative strategy that addresses not just the physical, but also the emotional, social, and intellectual dimensions of well-being.

As for recommendations to enhance the quality of care for stroke survivors like Mrs. Jones, several avenues present themselves. Firstly, ongoing staff training in specialized communication techniques for stroke patients can significantly improve patient engagement and emotional well-being.

Secondly, recent research supports the integration of technology, such as tele-rehabilitation and assistive devices, as complementary treatment modalities that can potentially accelerate functional recovery and enhance quality of life.

Lastly, implementing a regular review mechanism, involving healthcare providers and family members, can help in the timely identification of emerging needs and adjustment of care plans accordingly.

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References

Geng, G., He, W., Ding, L., Klug, D. and Xiao, Y., 2019. Impact of transitional care for discharged elderly stroke patients in China: an application of the Integrated Behavioral Model. Topics in Stroke Rehabilitation, 26(8), pp.621-629.
Irisawa, H. and Mizushima, T., 2022. Assessment of changes in muscle mass, strength, and quality and activities of daily living in elderly stroke patients. International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung. Revue Internationale De Recherches De Readaptation, 45(2), p.161.
Lui, S.K. and Nguyen, M.H., 2018. Elderly stroke rehabilitation: overcoming the complications and its associated challenges. Current gerontology and geriatrics research, 2018.
Mutai, H., Furukawa, T., Wakabayashi, A., Suzuki, A. and Hanihara, T., 2018. Functional outcomes of inpatient rehabilitation in very elderly patients with stroke: differences across three age groups. Topics in sTroke rehabiliTaTion, 25(4), pp.269-275.
Ning, M., Chen, F., Wu, H., Zheng, H., Zheng, C. and Li, S., 2022. Effect of early rehabilitation and nursing intervention on the rehabilitation prognosis of elderly stroke hemiplegia patients in the department of neurology. Applied Bionics and Biomechanics, 2022.
van der Veen, D.J., Döpp, C.M., Siemonsma, P.C., Nijhuis-van der Sanden, M.W., de Swart, B.J. and Steultjens, E.M., 2019. Factors influencing the implementation of home-based stroke rehabilitation: professionals’ perspective. PLoS One, 14(7), p.e0220226.
Xiao-hong, H., Ping, W., Zu-qin, R., Xiang-li, Z., Wen-yun, M. and Min, L., 2020. Research on Stroke Rehabilitation Nursing Mode with Senior Nurses as Bond. Medical Research, 2(1), pp.15-20.
Yu, M., Wang, L., Wang, H. and Wu, H., 2021. The effect of early systematic rehabilitation nursing on the quality of life and limb function in elderly patients with stroke sequelae. American Journal of Translational Research, 13(8), p.9639.