Delivery in day(s): 5
COUN5004 Psychosocial Development Process Assignments
Bob’s earlier family made him hypertensive. The medication has made him to have a high self- critical in his sexual life. He doesn’t want to take medication as he fears it would make him impotent and affect his relationship with his wife. In dementia cases, a person struggles to maintain his or her identity(Barnes, et al, 2013). Bob is also struggling to maintain his identity by being over confident in engaging in his hobbies, traditional roles, and occupation. This is also as a result of the caring environment provided by his wife. People with dementia may lose confidence in completing their tasks. For a person with dementia, he or she tends to withdraw from public activities which affect the identity, independence, relationships, social work roles and self- esteem(Kamaruzaman and Riaz, 2013). Margaret is supporting Bob to enhance his identity, self- esteem, and independence through social activities and interaction. She also wants Bob to exercise more and take the antihypertensive so that his health can be well.
The appropriate tool for assessment and its key elements
Bob is becoming forgetful and also caused an accident when he recalled some matters while driving.In this case, a Montreal Cognitive Assessment test shall be used(Lam, et al, 2013). The test is used to detect cognitive impairment. It contains thirty questions which take around twelve minutes to complete. The score of the test range from zero to thirty. The scoring is usually as follows: visuospatial and executive functioning is 5 points, animal naming is 3 points, attention is 6 points, language is 3 points, abstraction is 2 points, delayed recall is 5 points and orientation 6 points. The test helps determine if a person has an abnormal cognitive function. For the people with Mild Cognitive Impairment, it can predict dementia(Hsieh, et al, 2015).
Dementia people should be supported in their careers, health, and social care. The care should be person-centered by responding to their actual needs. Care can include knowing the person, offering meaningful activities in a flexible manner that is continuous. In the case of Bob, Margaret is trying to provide all these(Brooker and Latham, 2015).
They should also be provided with needs that are of their own skills, preferences, and abilities(Johnson, Ling and McBee, 2015). These help them in communication, attention, and recalling of memories. The social and friendly environment helps them feel socially accepted. Engaging Bob by visiting friends makes him express himself and feel socially accepted.
Another priority care is the provision of information to empower dementia persons and the caregivers.
Its awareness helps people appreciate and care for their loved ones without any embarrassment. Margaret is aware of Bob’s situation and is not discouraged but determined towards improving his health (Prince, et al, 2016).
Equity, rights and access issues
People with multiple needs should be recognized and be supported to acquire their needs from different systems(Johnson, Ling and McBee, 2015).
A person’s choice and control should be accessible. Their needs should be developed and the information provided. They should also be encouraged to go for appointment to discuss on their memory which will help them greatly.
The services and support should be maintained to cater to a person's needs. This can be achieved through increasing knowledge and reducing the stigma associated with dementia.
Equity and inclusiveness should be practiced and the community encouraged in coming up with supportive environment for dementia people.
Healthcare should emphasize on screening and diagnosis to diverse populations and not merely assume just because the patient has not requested for it(Barnes, et al, 2013).
Case study 2
Biophysical and psychosocial processes
Death of loved once especially to the elderly is a devastating experience to their life. This makes many experience a decline in health and passes away shortly after their spouse. Many end up resulting in stress cardiomyopathy. Hence proper physical and emotional care is needed. The social activities for the case of Dolly have been withdrawn and she is experiencing social isolation. She doesn’t want to meet friends anymore or invite anybody. Since she returned to her home from her daughter’s house, she lost confidence in the completion of task like cooking which she enjoyed while there. Her husband's death was also causing grief to her and affected her social life. Physically, it resulted in sleeplessness and loss of appetite and consequently depression (Sobal, Bisogni and Jastran, 2014). Dolly despised a cup of tea and vegemite as an unbalanced diet but had now become her usual meal. She had also lost independence and interest in her own care.
Assessment tool and key elements
Early dementia detection requires primary care which requires the detection of symptoms other than memory loss complains. In this case, Early Dementia Questionnaire (EDQ) can be used and then compared with the Mini-Mental State Examination (MMSE) assessment tool(Lam, et al, 2013). Inclusion criteria include a score of five or less in the Geriatric Depression Scale (GDS) with the presence of a reliable caregiver(Hsieh, et al, 2015). A face-to-face interview is also done using the EDQ with the caregiver and the patient to bring out any symptoms of dementia. For the cases where a caregiver is not present a telephone interview is used. Dolly's family noticed some changes in her behavior such as being forgetful of the family evens and having trouble to remember some of the family members.
Priorities of care
Feeding and diet monitoring plan. For dementia cases, there is a need for help in feeding. Changes in appetite or health should be monitored. Most aged people do not also take enough water hence the caregiver should remind and encourage them to increase water intake (Brooker and Latham, 2015).
Impaired memory cueing. Anxiety, memory loss, depression, and confusion are devastating effects to the patient and the whole family. Reminding them gently and in a discrete way maintains their dignity and independence. A patient’s approach prevents the patient from being disheartened or frustrated(Barnes, et al, 2013).
Monitor vital signs and medication. When it comes to seniors, the swallowing of pills is difficult. With the help of a pharmacist, some can be dissolved in liquids or crushed to ease swallowing. Pulse, temperatures, and respiration can also be measured to keep track of their condition.
Equity, rights and assess issues
Aged care and education training should be accessible. Their training should be included in the curriculum to ensure their special needs are communicated and met(Johnson, Ling and McBee, 2015).
Representatives should advocate for the evaluation of the systems and ensure their needs are identified, appropriate and meaningful information is provided in single or mainstream services.
Data on characteristics of the users of service care of the aged should be made available publicly checked to ensure planning and practice.
Case study 3
Biophysical and psychosocial processes
Janie is facing various biophysical and psychosocial processes. She has developed fear which has dominated her psychology. This has resulted to lack of confidence to herself after the frequent falls with the last fall spraining her shoulder which led to subsequent pain and suffering. Her risk of falling again has also made her not carry out her duties or interact with the outside environment(Pfortmueller, Lindner and Exadaktylos, 2014).She has also developed a mental conditioning that the next fall will cause a greater harm. Physically her injured arm cannot function hence she forgoes her appointment. Her considerations draw attention to those practices which inform the personal importance and social responses to being in pain. The sensation of pain is entirely subjective, explained, configured, perceived and communicated it affects a person's relationship to others and themselves. It is shaped by cultural beliefs, social practices, prevailing medical practices, and their beliefs(Stubbs, et al, 2014).
Assessment tool and key elements
In the case, Janie has encountered many falls for the last twelve months. To assess the causes of the fall, a multifactorial falls risk assessment should be carried out. The assessment examination is carried out by a health professional with the required skills. The multifactorial has the following key elements where assessment is carried out; a detailed identification of falls history, followed by assessment of balance, gait and muscle weakness, bone disease risk, assessment regarding perceived functional ability and fear relating to falling, visual impairment, cognitive impairment and neurological examination, ability to contain urine, risk factors at home and a cardiovascular examination followed by review on medication(Phelan, et al, 2015).
Priorities of care
One can ensure she is safe and able to manage on themselves in their home. They can also be helped with any assistance they need if they aren't capable of themselves.
Exercise and walking programs; By the fact that Janie has a care it means that she spends most of her time driving whenever she is out of her home. This has increased stress on her feet leading to arthritis. Strong leg muscles prevent falling. Daily walking exercise also reduces swelling, increases blood circulation and helps in maintaining the density of the bone(Voukelatos, et al, 2015)
Assistance in medical appointments; Caregivers should get the patient ready for appointments either by car or taxi and help in giving the doctor the necessary information on medication, medical history, and symptoms.
Physiotherapy; It is needed to help in gaining strength after an injury or surgery and also strengthen muscles for balance. The caregiver can evaluate proper body ways and the need for a walker, cane or other devices which can help reduce the risk of injury or fall again(Okubo, Schoene and Lord, 2016).
Equity, rights and assess issues
Prosthetic devices have been developed to help improve postural balance in the elderly. Vibrotactile device fit around the waist and give information regarding body tilt through vibration. Also, there is a tongue- placed device which helps in providing information on the head's position.
Professionals coming up with fall prevention programs should ensure the programs are flexible to fit the different needs and preferences of the people involved. It should also add value to them socially(Pfortmueller, Lindner and Exadaktylos, 2014).
Programs of fall prevention should ensurerelevant information is available in different languages. Barriers like fear of falling, low self- efficacy should be addressed and activity change encouraged to the participant(Vieira, Palmer and Chaves, 2016).
The professional involved in the assessment should consider discussing changes a participant is willing to make in preventing falls.
1. Barnes, D.E., Santos-Modesitt, W., Poelke, G., Kramer, A.F., Castro, C., Middleton, L.E. and Yaffe, K., 2013. The Mental Activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults. JAMA internal medicine, 173(9), pp.797-804.
2. Brooker, D. and Latham, I., 2015. Person-centred dementia care: Making services better with the VIPS framework. Jessica Kingsley Publishers.
3. Craig, K.D., 2014, June. 11 Putting the social back in the biopsychosocial model of pain. In Psychology Serving Humanity: Proceedings of the 30th International Congress of Psychology: Volume 2: Western Psychology (Vol. 2, p. 127). Psychology Press.
4. Croog, S.H., 2013. Recovery and rehabilitation of heart patients: psychosocial aspects. In Cardiovascular Disorders and Behavior (pp. 309-348). Psychology Press.
5. Hsieh, S., McGrory, S., Leslie, F., Dawson, K., Ahmed, S., Butler, C.R., Rowe, J.B., Mioshi, E. and Hodges, J.R., 2015. The Mini-Addenbrooke's Cognitive Examination: a new assessment tool for dementia. Dementia and geriatric cognitive disorders, 39(1-2), pp.1-11.
6. Johnson, H.L., Ling, C.G. and McBee, E.C., 2015. Multi-disciplinary care for the elderly in disasters: an integrative review. Prehospital and disaster medicine, 30(1), pp.72-79.
7. Kamaruzaman, M.F. and Riaz, R.P.M., 2013, April.Conceptual framework study on dynamic visual reminiscent therapy in Alzheimer psychosocial treatment. In Business Engineering and Industrial Applications Colloquium (BEIAC), 2013 IEEE(pp. 189-191). IEEE.
8. Lam, B., Middleton, L.E., Masellis, M., Stuss, D.T., Harry, R.D., Kiss, A. and Black, S.E., 2013. Criterion and convergent validity of the Montreal cognitive assessment with screening and standardized neuropsychological testing. Journal of the American Geriatrics Society, 61(12), pp.2181-2185.
9. Okubo, Y., Schoene, D. and Lord, S.R., 2016. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med, pp.bjsports-2015.
10. Phelan, E.A., Mahoney, J.E., Voit, J.C. and Stevens, J.A., 2015. Assessment and management of fall risk in primary care settings. Medical Clinics, 99(2), pp.281-293.
11. Pfortmueller, C.A., Lindner, G. and Exadaktylos, A.K., 2014. Reducing fall risk in the elderly:risk management factors and fall prevention, a systematic review. Minerva Med, 105(4), pp.275-81.
12. Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M. and Karagiannidou, M., 2016. World Alzheimer report 2016: improving healthcare for people living with dementia: coverage, quality and costs now and in the future.
13. Sobal, J., Bisogni, C.A. and Jastran, M., 2014. Food choice is multifaceted, contextual, dynamic, multilevel, integrated, and diverse. Mind, Brain, and Education, 8(1), pp.6-12.
14. Stubbs, B., Binnekade, T., Eggermont, L., Sepehry, A.A., Patchay, S. and Schofield, P., 2014. Pain and the risk for falls in community-dwelling older adults: systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 95(1), pp.175-187.
15. Vieira, E.R., Palmer, R.C. and Chaves, P.H., 2016. Prevention of falls in older people living in the community. bmj, 353, p.i1419.
16. Voukelatos, A., Merom, D., Sherrington, C., Rissel, C., Cumming, R.G. and Lord, S.R., 2015. The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial. Age and ageing, 44(3), pp.377-383.