5N1370: Bríd Maloney is 62, she was diagnosed with Picks Disease at the age of 52. She is Married to Mike and has two children, a daughter and a son: Care Practice & Provision Assignment, CPE, Ireland

In this assessment, you are required to carry out research and investigate the topic of  Dementia using the case study below

Bríd Maloney is 62, she was diagnosed with Picks Disease at the age of 52. She is Married to Mike and has two children, a daughter and a son. Her daughter is 32 married with two small children and her son is 28 living at home. Bríd was a manager in jewelers, always dressed very well, and wore makeup. Bríd got her hair set weekly.

Bríds daughter Mary and husband Mike have been very involved with Bríds care; they have cared for her at home for the last 9 years. At the age of 59, Bríd moved into a nursing home as the family could no longer manage at home, and Bríd’s needs became more complex. Bríd was no longer able to feed herself her speech deteriorated and her mobility was very poor.

She has now become very poorly and after catching the flu over Christmas her body is beginning to shut down. Bríd is now spending more time in bed as when she is up her she flops over and falls asleep. She has little interest in the activities, however when there is country music playing she appears more alert. Her family are very good to her and visit very often. She does reach out for her grandchildren when they visit. Her family celebrate all major events in the nursing home for example christenings, birthdays and Christmas. Bríd is now fully dependent, she is no longer able to swallow soft food, and her fluids are thickened to grade 4 which is the maximum it’s almost like a pudding. There is now a cd player in her room and her husband has brought her favourite cds in to play.

The staff have continued to get Bríds hair done by the hairdresser and keep on top of her eyebrows to keep her self-identity. The husband loves to see her on a Thursday afternoon after getting her hair done and says he feels like its back in the old days when they were going to a dance.

Bríd, is beginning to appear in a lot of pain, she is now quenching her face a lot more and due to her being non-verbal it is very difficult for the nurses to tell how painful it is or where the pain is coming from. To enable Bríd to stay in the nursing home the palliative care nurse visits daily to ensure everything is going the way it should be. The activity staff are doing regular hand massages with Bríd, sitting in the room with her, and talking to her about her family photos. Bríd had always attended mass when she was well and her wishes have been discussed with her husband for example she wants the priest to do a blessing and she wants to be buried with her rosary beads. Although Brid is very poorly now the staff do what they can to keep up her image such as hair nails and putting a bit of lipstick on.

Bríds family have now been told to ignore the visiting times and to come and go when it suits them. Her family have been notified the changes that have been apparent and are made aware of the next stage that is coming which is death. They appear to be taking it in their stride, however it is very difficult for both staff and family as Bríd is very young. Her husband often tells staff about Brid when she was well and talks about the good times that they had as a family, the care staff support the family through this process by listening to their stories and offering refreshments to them.

Use relevant and up to date sources of information. Evaluate and interpret findings.

Draw conclusions and make recommendations.

A thorough discussion of the caring qualities necessary for working with client groups 

1. Introduce the client, care setting and research the client’s condition.
2. Discuss important caring qualities that would be necessary when working with Bríd such as:

• Active listening
• Body Language
• Eye Contact
• Respect
• Empathy
• Patience
• Confidentiality to include completion of client documentation as appropriate
• Reporting changes in a client’s condition to the relevant supervisor or other members of the healthcare team

A comprehensive examination of the skills involved to ensure total patient care

1. Discuss three components of Logan Roper & Tierney – Illustrate the activities of daily living that Bríd requires assistance with and to what extent the assistance is needed
2. Illustrate the importance of improving Brids quality of life by promoting:

• Independence / autonomy
• Privacy and dignity
• Positive Self Image

Accurate and appropriate suggestions made on how to care in the community for client groups including correct identification of a typical daily routine that aids physical, social, intellectual, emotional and spiritual wellbeing

1. Identify Bríds individual needs in this situation (physical, intellectual, language, emotional, social and spiritual). You should demonstrate your understanding of theories around ageing in your answe
2. Identify the support that the multi-disciplinary team can offer to Bríd and her family such as :

• Pain Management
• Management of physical symptoms
• Psychological and spiritual care
• Interpersonal Skills
• End of life Care
• Bereavement

Accurate evaluation and interpretation of findings and excellent conclusions and recommendations made

• Discuss the importance of care and support to be available to anyone affected by the end of life and death of an individual including family, friends, staff and other clients/service users.
• Suggest an appropriate recommendation that could ease Bríd and her family during this difficult time.
• Reflect on your learning from this case study and how you can apply sensitive actions to meet the needs outlined