Question

When you assess and respond to the needs of at least 3 different people and their carers or family members in the context of your job role and use strengths-based solutions to respond to both routine and unpredictable problems related to care relationships, you are to keep a journal. There are 3 journal templates in the following pages that you can use to record the relevant information while you are working with these three people.

JOURNAL 1 Client Name:    Client A Situation:

Please describe your response below:

The strategies you use to work in a positive manner with the family.

The family patterns and structures and how they impact each person T

he types of lifecycle transitions and the positive and negative impacts these create

The impact of the caring role on family member(s)

The pathways the family take to enter the service and the implications for all stakeholders

The attitudes, stereotypes and false beliefs that family members and other stakeholders have about the person and the service

The carer support services and resources used by each person and their support team

How carer and family members supported the person

What changes occurred in the care relationship and how you respond to those changes

How you promote the carer rights, health and wellbeing during your work with each client.

Answer 1

Situation: Mr. Vincent is a 75 year old man, admitted to the hospital after being found lying unconsious on the floor of his bed room. His son assumes that he may have been on the floor overnight. On admission, Mr. Vincent was diagnosed with a right sided stroke, with moderate weakness of left arm and leg. Mr Vincent stays with his son and family after his wife died.Mr. Vincent needed much encouragement to accept cleaning and shopping assistance once a week after the most recent admission; however, he does not agree to increase service provision. From the conversation with his family,it is understood that Mr.Vincent and his son had a long standing conflict that's not yet resolved. His son verbalized understanding about the effect of stroke on his physical and cognitive functioning, but they do not agree on a discharge destination. Mr. Vincent too lacks insight into his care needs and verbalizes that he will be fine once he gets back home.

Mr. Vincent has a history of Alzheimer’s disease; type II Insulin dependent diabetes mellitus, hypertension and osteoarthritis He has had two recent admissions to hospital for a urinary tract infection and a fall due to low blood sugar levels. He is currently requiring one to two people to assist him to mobilize in & out of bed and one person to assist with post-toilet hygiene. He can walk slowly for short distances with a four-wheel frame under supervision. He also require assistance in feeding and medication intake. Mr. Vincent is discharged home and his son has appointed a maid to look after his health needs, as he didn't prefered for a residential care. Mr. Vincent is reluctuant to take support from outsiders and prefers privacy. His son has a busy schedule at work. His daughter in law is a primi mother with a 6 month old baby.Nurse visits the home for health care assistance and education for long term support.

The strategies you use to work in a positive manner with the family.

• Establishing a therapeutic relationship to promote trust and verbalization of concerns
• Treating the client with respect and dignity
• Identifying the limitaions family is facing to meet his care needs
• Listening patiently and clarification of doubts
• Planning of practicable solutions to improve Mr.Vincent's health status with the involvement of family and the client
• Fostering two way communication
• Planning for periodic evaluation for outcomes of health care goals.

The family patterns and structures and how they impact each person

• Mr.Vincent is a widower
• Mr.Vincent has unresolved dispute with his son.
• He likes privacy and relectuant to take help,but now he is helpless and dependant for daily living activities.
• Informal care for older people is provided mainly by their partners and adult children. Changes in family structure,like having fewer children and starting families later, marital disruption, loss of spouse,complex family relationships or greater geographical separation of families, may affect the availability of care.

The types of lifecycle transitions and the positive and negative impacts these create

• Mr.Vincent was an Independent person reluctant to ask for or receive help. Chronic illnessess and weakness had transformed him to a totally dependant person that can negatively affect his self esteem and confidence. This may even lead to psychological issues.
• Life transitions which are unanticipated may force to leave behind the familiar and forces one to adjust to new ways of living.
• After these stages the person may slowly begin to accept the changes,acknowledge the need of  letting go the past and accept the present situation,increases self-esteem,and develops an optimistic view of the future. This is the positive prediction of life cycle transmission that may not be same in every case.

The impact of the caring role on family member(s)

• Mr.Vincents son and family finds it difficult to cope with his care needs and balance their social and professional life.
• Finacial burden due to frequent hospitalizations unless insured.
• Other posible impacts on family members are lack of time for socialisation,stress and psychological issues

The pathways the family take to enter the service and the implications for all stakeholders

• Acceptance of the need for long term support and the decision to make use of community based residential care services will be the best choice for Mr. Vincents condition.
• This could be achieved with proper counselling and education.
• Collaborative approach of the major stake holders like primary care givers,therapists,health care agencies could support the patient to maintain an active life style within the limitations.

The attitudes, stereotypes and false beliefs that family members and other stakeholders have about the person and the service

• An elderly with chronic illness may not have good life expectancy
• Old age people as they are matured individuals dose'nt need any love and psychological support
• Older people with acute or chronic illness are high users of informal and formal health care services .

The carer support services and resources used by each person and their support team

• A full time health care aid support was made available to support the client in his daily health care needs
• Carer's have the right to their own life, and to nurture own mental and physical health.
• Taking support from a local carer service forums.

How carer and family members supported the person

• Carer assissted Mr.Vincent in establishing his health care needs and goals
• Education and counselling about the current health status and strategies to be followed to remain active
• Family members could find time after the job hours and week ends to spend together
• Hiring of a personal support aider to asist in daily activities

What changes occurred in the care relationship and how you respond to those changes

• With regular home visits and communication Patient will develop a trustworthy relationship with the nurse
• It will help him to verbalise his concers without hesitation
• The nurse should maintain therapeutic relationship without being personal and supporting the client with education,necessary referral services and education on self care measures.
• Nurse could also train and educate the primary care giver about proper techniques and procedures.

How you promote the carer rights, health and wellbeing during your work with each client?

• Identifying the rights of the carer
• Providing time for self by effective communication with family members and finding alternatives during your break time.
• Identifying the main issues that a carer face in the support of an elderly family member or one who have a disability and support implementation measures within the context of different family patterns and access to resources
• Identifying the impacts of care measures on individuals and their families and implementing strategies to support their rights.