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Applying the model of living, discuss the care needs of a client in relation to their activities of daily living
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A project is a response to a brief devised by the assessor. A project is usually carried out over an extended period of time. Projects may involve research, require investigation of a topic, issue or problem or may involve process such as a design task, a performance or practical activity or production of an artefact or event”.

Instructions:

For your project please chose either option (1) or (2) depending on your current circumstance. Where possible learners are encouraged to choose Option (1), however, if you are unable to attend placement and/or have little or no experiences working with directly clients/service users, please chose Option (2).

1. Complete the project on a service user /client you have cared for during your current or previous work placement or family member relative you have cared for in the home, whereby you have been involved in assisting them with their care.

Or,

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

In your project, you must demonstrate your ability to research the topic independently. Please ensure to use relevant research and sources of information and provide a bibliography as per Harvard Style. 

For final presentation of your work please ensure: 

• Accuracy of information supplied. 
• Quality of Presentation 
• Grammatical correctness and proper spelling
• Written in the correct context as instructed. 
• Professional vocational language is used. 
• Referencing as per Harvard style. 

Case Study

James Brown a 75-year-old male and was admitted into the nursing home in January 2020. Previous to this Mr. Brown was in St. Vincent’s hospital following a stroke where he spent six months. Following the stroke Mr Brown now uses a rollator. He requires the assistances of one with his personal care needs. He is partially paralysed on the left side of his body, and sometimes his speech is a little slurred, he can become frustrated when he cannot communicate his needs. 

Mr Browns wife and son visit every few days. Prior to his retirement Mr. Brown worked in Dublin Dockyards and had a keen interest in swimming, hill walking and crossword puzzles. On occasions Mr.Brown can appear depressed and needs to be motivated, he has a history of type two diabetes and is 
on diabetic diet.

Guidelines: Please follow the below structure for your project

INTRODUCTION:
• In this section provide an overview of the nursing process and model of living
• Outline aims and objectives. 

CLIENT PROFILE:
• Client's name.
• Age.
• Health history/current problems.

MODEL OF LIVING:
• Lifespan - identify the correct lifespan for your client.
• Dependence/independence outlined.
• Factors affecting activities of living. In this section address factors affecting your client's quality of life/dependency level under the following headings:

a) Physical
b) Psychological 
c) Socio-cultural
d) Environmental
e) Economic 

ACTIVITES OF LIVING:

• In relation to your client, assess individual needs under each activity of living, identifying actual and potential problems.
• What factors are affecting health recovery.
• For each actual and potential problem, discuss the planning, implementation and evaluation of care interventions.

ANSWER

Introduction 

The nursing process is a methodical strategy healthcare professionals use to deliver complete and personalised patient care. It includes analysing, planning, executing, and evaluating the patient's requirements for the best possible health outcomes (Jeremy et al., 2023). This case study will use the nursing method for James Brown, a 75-year-old male in a nursing facility since January 2020.

The model of living focuses on determining how numerous circumstances influence a person's capacity to perform activities of daily living (ADLs) and sustain overall well-being (NCBI, n.d.). The goal is to properly handle Mr Brown's care requirements while considering his medical history and present issues. 

Aims and Objectives 

The following are the aims and objectives of this case study: 
1. To evaluate and analyse Mr Brown's health, medical history, and care needs. 
2. To use the model of living to explore the elements driving Mr Brown's everyday activities. 
3. To detect actual and prospective issues with Mr Brown's ADLs and health rehabilitation. 
4. To identify and execute appropriate care solutions to address these issues. 
5. To assess the results of the care interventions and their efficacy in enhancing Mr Brown's quality of life. 

Client profile 

Client's Name: James Brown

Age:75 years old

Health History/Present Issues:  Mr Brown's medical history includes a crucial occurrence in which he had a stroke and was hospitalised for six months at St. Vincent's. He has partial paralysis on the left side of his body due to the stroke, and his speech is often slurred. Mr Brown feels frustrated as a result of the communication challenges. He now relies on a rollator for mobility and requires assistance with his personal care needs. 

Mr Brown has a history of type 2 diabetes, which involves adhering to a diabetic diet in addition to the post-stroke issues. His medical ailments and physical restrictions impact his general freedom and ability to participate in activities he used to love, such as swimming, hill walking, and crossword puzzles.

Despite frequent visits from his wife and kids, Mr Brown sometimes seems depressed and unmotivated. The emotional and psychological impact of his health conditions and reduced ability to engage in his previous interests may contribute to his feelings of depression. 

Model of living

Lifespan: James Brown is 75 years old and belongs to the older adult stage. Older persons have distinct obstacles relating to physical and cognitive changes, social connections, and retaining independence (Abdi et al, .2020). Understanding the needs and characteristics of this stage is critical for establishing individualised care interventions to promote Mr Brown's well-being. 

Dependence/Independence

James Brown's present health situation, notably the consequences of the stroke, has made him largely reliant on others for personal care requirements. He uses a rollator for movement, and his left-side paralysis limits his ability to execute some things independently. However, he maintains considerable freedom, particularly in decision-making and self-expression. The objective of care should be to optimise Mr Brown's independence in ADLs while assisting when needed. 

Factors Influencing Daily Activities

a) Physical Elements:  The stroke's aftermath profoundly influences James Brown's physical well-being. His partial paralysis and movement constraints make it difficult for him to participate in activities he formerly liked, such as swimming and hill walking. His capacity to communicate effectively suffers due to the stroke's consequences on his speech. Furthermore, his type 2 diabetes necessitates adherence to a strict diet (Care, 2019), which affects his dietary choices and meal planning. Care interventions should focus on physical rehabilitation, speech therapy, and managing his diabetes effectively to enhance his overall physical well-being. 

b) Psychological Aspects: Since the stroke, the psychological elements of James Brown's life have been significantly impacted. The loss of his physical ability and communication challenges may cause him to feel depressed and dissatisfied. Mr Brown's previous interests in swimming, hill walking, and crossword puzzles provided him with contentment and joy. His incapacity to participate in these activities may exacerbate his emotional difficulties. Addressing his psychological well-being via therapy, social involvement, and activities that enhance his interests and cognitive talents is critical. 

c) Socio-cultural Aspects: Mr Brown's social interactions are influenced by his life in the nursing home and visits from his wife and son. However, his health condition and mobility concerns may have limited his prospects for social interaction. Maintaining meaningful ties with family and friends is critical for his emotional well-being and sense of belonging. Addressing his socio-cultural requirements entails promoting frequent visits from loved ones and enabling relationships with other nursing home patients and employees. 

d) Environmental Aspects: The nursing home environment is significant in Mr Brown's daily life. It should be adapted to accommodate his mobility requirements, ensuring he can move freely with the rollator. In addition, the living area should be designed to encourage safety and accessibility. Moreover, creating an environment stimulating his interests, such as puzzles and reminiscing, can enhance his overall well-being and cognitive functioning. 

e) Economic Aspects: Mr Brown's financial position may limit his access to some resources and services. As a nursing home resident, he relies on its amenities and services, which are influenced by his financial means. The nursing home's fees and financial capacity may impact access to recreational activities, specialist medical treatment, and treatment. As a result, it is critical that his care plan considers any financial limits and optimises the available resources. 

Activities of living 

Activity 1: Maintaining a Safe Environment

Assessment of Individual Needs: Because of James Brown's partial paralysis and movement restrictions resulting from the stroke, maintaining a safe environment is vital. He uses a rollator to go about, which creates concerns such as tripping hazards and difficulty traversing narrow spaces. Communication difficulties may also impair his capacity to summon assistance in an emergency, jeopardising his safety. 

Actual and Potential Problems: 
•    Actual Problem: Risk of falls and accidents owing to impaired mobility and balance. 
•    Potential Problem: Communication limitations impede access to aid during an emergency. 

Factors Affecting Health Recovery: 
The physical limitations of the stroke significantly impact James Brown's health recovery. Any more injuries or setbacks from falls or accidents might jeopardise his general well-being and independence. His displeasure with communication difficulties may lead to stress and mental anguish, influencing his rehabilitation process. 

Care Planning: To reduce the risk of falls, the care team should do a thorough safety evaluation of James Brown's living environment. This evaluation would identify possible dangers and recommend required changes, such as reducing tripping hazards and adding railings. Furthermore, keeping his rollator within reach and in excellent working condition is critical for preserving mobility and safety. 

Implementation: The care staff and physical therapists should help James Brown securely traverse his living surroundings and become acquainted with them to avoid possible risks. Additionally, placing communication tools, such as a call bell system (Kwame and Petrucka, 2021), within easy reach might assist him in seeking help. 
Evaluation: The efficacy of care interventions may be assessed by tracking the number of falls and incidents over a specific period. Furthermore, input from James Brown and his family on their feeling of safety and trust in his living environment might give valuable insights into the efficacy of the applied safety measures.

Activity 2: Maintaining Personal Hygiene

Assessment of Individual Needs: Because of his partial paralysis, James Brown requires help with personal care requirements, such as washing, clothing, and grooming. These duties may be complex for him to do on his own, affecting his self-esteem and emotional well-being. 

Actual and Potential Problems: 
•    Actual Problem: Difficulty maintaining personal Hygiene independently. 
•    Potential Problem: Decreased self-esteem and motivation due to needing assistance with personal care. 

Factors Affecting Health Recovery: 
James Brown's physical limitations may impede his ability to engage in personal hygiene activities without assistance. This loss of independence may lead to despair and frustration, reducing his drive to actively engage in treatment and rehabilitation. 

Care Planning: To assist James Brown's hygiene requirements, the care team should create a customised care plan. This plan may involve allocating dedicated staff to assist with bathing and grooming, ensuring dignity and respect are maintained throughout the process. 

Implementation: Trained caregivers should approach personal care tasks with sensitivity and empathy (Potter et. al., 2021), encouraging James Brown's active participation as much as possible. Maintaining a personal hygiene regimen may also give structure and consistency, improving his mental well-being. 

Evaluation: Monitoring James Brown's attitude towards personal care duties and any changes in his self-esteem or motivation may help determine the effectiveness of the care treatments. Feedback from him and his carers may aid in determining the efficacy of the care plan and identifying areas for improvement.

Activity 3: Nutrition and Meal Preparation

Assessment of Individual Needs: James Brown's history of type 2 diabetes necessitates a diabetic diet. His movement constraints may impair his capacity to prepare meals independently, necessitating the consideration of meal preparation help. 

Actual and Potential Problems: 
•    Actual Problem: Difficulty cooking meals independently owing to movement restrictions. 
•    Potential Problem: Poor diabetes diet adherence, resulting in uncontrolled blood sugar levels (Care, 2019). 

Factors Affecting Health Recovery: 
Adherence to a diabetic diet is critical for adequately treating James Brown's diabetes and supporting overall health recovery. If he fails to make balanced meals on his own, it may result in erratic eating habits and fluctuating blood sugar levels, thus harming his health. 

Care Planning: The care team should work with a nutritionist to create a customised food plan that suits James Brown's nutritional needs. Carers or meal delivery services that cater to dietary preferences might help with meal preparation. 

Implementation: Carers should ensure that James Brown gets balanced meals per his diabetes diet. Regular blood sugar testing may assist in measuring the success of the meal plan and discovering any required alterations. 

Evaluation: Monitoring James Brown's blood sugar levels over time will allow us to assess the efficacy of the care strategies. Consistent blood sugar management and favourable feedback from him about the meal plan suggest that the adopted measures were successful. 

Activity 4: Mobility and Exercise

Assessment of Individual Needs: Because of his partial paralysis, James Brown must use a rollator to get about. Regular exercise is critical to maintaining his physical function and preventing further deterioration. 

Actual and Potential Problems: 
•    Actual Problem: Limited mobility and difficulties participating in regular exercise independently. 
•    Potential Problem: Muscle atrophy and diminished functional ability due to inactivity. 

Factors Affecting Health Recovery: 
Regular physical activity may help James Brown's health recovery by improving muscular strength, coordination, and general physical function. However, his physical limitations may make it difficult to maintain an active lifestyle. 

Care Planning: The care team should work with physical therapists to create a customised exercise programme considering James Brown's mobility restrictions. The programme may include light exercises and stretches that may be done with the assistance of carers. 

Implementation: Carers should support James Brown in his recommended exercise regimen, ensuring good technique and safety. Incorporating activities like his prior hobbies, such as water-based workouts or walks, might further boost his drive and involvement. 

Evaluation: Monitoring James Brown's physical improvement over time will allow us to assess the efficacy of the care treatments. Assessments of muscular strength, flexibility, and total functional ability may aid in determining the effectiveness of an exercise programme. Feedback from James Brown on his experience and satisfaction with the activities might also be helpful. 

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Activity 5: Communication and Emotional Well-being

Assessment of Individual Needs: James Brown's communication difficulties, such as slurred speech, may irritate and influence his emotional well-being. He must receive adequate communication and emotional support for his mental health. 

Actual and Potential Problems: 
•    Actual Problem: Frustration and difficulty expressing needs due to communication difficulties. 
•    Potential Problems: Isolation and mental discomfort. 

Factors Affecting Health Recovery: 
By lowering stress and improving general well-being, effective communication and emotional support are critical in James Brown's health rehabilitation. Isolation and mental anguish might reduce his desire to participate in treatment and rehabilitation. 

Care Planning: The care team should ensure James Brown can access communication aids such as picture cards or boards. Carers may build a supportive atmosphere by encouraging active listening and patience. 

Implementation: Carers should communicate well with James Brown, allowing him plenty of opportunities to voice his needs. Despite his slurred speech, active listening and nonverbal signals might help us comprehend him. Encouraging social connections with other residents and allowing family members to visit may help lessen feelings of isolation and loneliness. 

Evaluation: Regular communication evaluations may assess the success of the care treatments, noting any gains in James Brown's capacity to communicate himself and his general emotional well-being. Feedback from him and his family on the level of communication and emotional support may give important insights into the care plan's efficacy. 

Activity 6: Meaningful Activities and Recreation

Assessment of Individual Needs: James Brown's interests in swimming, hill walking, and crossword puzzles indicate a need for meaningful activities and recreation that align with his previous hobbies.

Actual and Potential Problems: 
•    Actual Problem: Limited swimming and hill walking access due to mobility issues. 
•    Potential Problem: Reduced engagement in activities that previously brought joy and fulfilment. 

Factors Affecting Health Recovery: 
Participating in meaningful activities and hobbies can positively impact James Brown's health recovery by promoting mental stimulation, emotional well-being, and a sense of purpose. However, his movement constraints may make it difficult for him to pursue his past activities. 

Care Planning: The care team should investigate other activities compatible with James Brown's interests and physical ability—for example, water aerobics or seated crossword puzzles. 

Implementation: Carers and activity coordinators should make alternate activities available to James Brown. They should also promote family visits during which he may reminisce and share recollections of his previous hobbies. 

Evaluation: James Brown's degree of involvement and pleasure with the alternative activities may be used to measure the success of the care treatments. Observing his emotional reactions during these activities and gathering input from him and his family may aid in determining the effectiveness of the care plan. 

Activity 7: Social Interaction and Connection

Assessment of Individual Needs: James Brown's wife and son's frequent visits demonstrate the value of social engagement and preserving relationships with loved ones. 

Actual and Potential Problems: 
•    Actual Problem: Limited social connections with peers owing to mobility issues and communication difficulties. 
•    Potential problem: Feelings of loneliness and isolation. 

Factors Affecting Health Recovery: 
Social engagement and connection are essential in James Brown's health rehabilitation because they provide emotional support and a sense of belonging. Loneliness and isolation might severely influence his well-being and drive to engage in his recovery process fully (Archibald et. al.,, 2020). 

Care Planning: The care staff should organise group activities and events to foster social contact with other residents. Facilitating visits from family and friends helps establish emotional relationships and lessen feelings of loneliness. 

Implementation: Carers should actively include James Brown in group activities and foster peer connections. They should also encourage family visits and frequent contact between James Brown and his loved ones. 

Evaluation: The success of the care treatments may be assessed by analysing James Brown's degree of social engagement and emotional well-being. Observing his interactions with classmates and family members and receiving input from him and his family regarding the quality of social ties may give insights into the care plan's performance. 

Activity 8: Cognitive Stimulation and Mental Health

Assessment of Individual Needs: James Brown's history of enjoying crossword puzzles indicates a need for cognitive stimulation to support his mental health.

Actual and Potential Problems:
•    Actual Problem: Fewer chances for cognitive stimulation and mental involvement. 
•    Possible Issue: Decreased cognitive performance and mental well-being. 

Factors Affecting Health Recovery: 
Cognitive stimulation and mental engagement are critical for James Brown's health rehabilitation by boosting brain health and minimising cognitive decline. On the other hand, his restricted access to crossword puzzles and engaging activities may impact his cognitive well-being. 

Care Planning: The care team should provide access to cognitive stimulation through puzzles, reminiscing activities, and engaging discussions. Implementing cognitive rehabilitation techniques can also support his mental health. 

Implementation: Carers should include cognitive stimulation activities like puzzle sessions and memory games into James Brown's daily routine. They should encourage reminiscing about his past experiences and incorporate stimulating discussions into his interactions. 

Evaluation: The success of the care treatments may be assessed by looking at any improvements in James Brown's cognitive function and mental well-being. Monitoring his level of participation during cognitive stimulation activities and getting comments from him and his family may assist in determining the effectiveness of the care plan.

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Conclusion & Reflection

Critique of the Model of Living and Nursing Process

The model of living offers a valuable framework for comprehending the complex interaction of elements that impact an individual's capacity to participate in activities of daily living (ADLs) and overall well-being.

The model of living successfully emphasised the varied spectrum of physical, psychological, socio-cultural, environmental, and economic aspects that influenced James Brown's health and rehabilitation process. By thoroughly examining these characteristics, the nursing team established individualised care strategies that addressed James Brown's particular requirements and problems. 

The holistic perspective of the model of living, which understands that many interrelated elements impact an individual's well-being, is one of its strengths. This strategy guaranteed that James Brown's care treatments included not just his physical health but also his emotional, social, and cognitive well-being.

Considering socio-cultural and environmental aspects, the care staff established an atmosphere encouraging meaningful connections and involvement, enhancing James Brown's quality of life in the nursing home setting (Spillman Liu. and McGilliard, 2016). 

However, one potential limitation of the model of living is its complexity, which may make it challenging to prioritise and efficiently handle all concerns. Healthcare practitioners need to balance conflicting priorities and effectively distribute resources. Despite this obstacle, the living model is essential for planning comprehensive care and fostering person-centred care. 

The nursing process, which included assessment, planning, execution, and evaluation, was critical in James Brown's care journey. The nursing team gained vital insights into his health history, present challenges, and specific requirements through a comprehensive evaluation.

This data served as the basis for creating a tailored care plan to increase his freedom, boost health recovery, and address the highlighted issues. To create a unified and supportive approach, healthcare professionals, carers, and family members worked together to implement care interventions. 

The nursing team followed James Brown's development, evaluated the efficacy of the techniques, and made required modifications by regularly reviewing care interventions. This iterative procedure allowed for continual development while ensuring the treatment plan remained relevant to his changing demands and health. 

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Reflection on Care Interventions Provided to James Brown

James Brown's care interventions were designed to improve his general well-being, independence, and health recovery. The nursing team addressed his challenges, considering his physical, psychological, socio-cultural, environmental, and economic context.

One critical intervention focused on maintaining a safe environment for James Brown. The danger of falls and accidents was reduced by completing a complete safety evaluation and making the appropriate changes. The use of communication aids and the promotion of active listening solved his communication issues, boosting successful engagement and lowering frustration. 

Personal care assistance and support with meal preparation ensured that James Brown's hygiene needs were met and his diabetic diet was adhered to. Physical and cognitive rehabilitation activities were also included in his daily routine, which improved his mobility, muscular strength, and cognitive function.

The care team scheduled social events and enabled family visits to address James Brown's emotional well-being, lowering feelings of loneliness and isolation. Cognitive stimulation offered by puzzles and reminiscence activities improved his mental health and gave him a feeling of purpose and satisfaction.

The care interventions were evaluated through regular assessments and feedback from James Brown and his family. The tactics' effectiveness was evident in increased physical function, mental well-being, and participation in meaningful activities.

The adaptability of the care plan allowed for changes as required, ensuring that James Brown got customised and personalised care throughout his stay at the nursing home. 

Reflection on Knowledge Gained and Personal Recommendations

Some significant insights were found while analysing James Brown's case and applying the model of life and the nursing process. Understanding the significance of a holistic approach to care, which considers numerous elements impacting an individual's well-being, was enlightening. Recognising the importance of socio-cultural and environmental aspects in moulding an individual's experience in a care setting highlighted the need for tailored and culturally sensitive care. 

Furthermore, the case study emphasised the need for clear communication and emotional support in boosting a patient's overall health and rehabilitation. It is critical to nurture well-being and improve quality of life by providing chances for meaningful social connections and participating in activities that match the individual's interests and preferences. 

Enhancing multidisciplinary cooperation among healthcare professionals, carers, and family members is one of my suggestions for future care initiatives. This partnership guarantees that a patient's requirements are addressed in a coherent and integrated manner, promoting health and recovery.

Furthermore, continuing education and training for healthcare providers in person-centred care (Kwame and Petrucka, 2021) and communication skills may enhance care delivery to people like James Brown with communication issues. Giving carers the information and skills they need to offer empathic care may influence patients' emotional well-being and satisfaction with their care experience. 

The treatment given to James Brown demonstrated the need for a comprehensive and person-centred approach. The care team addressed his specific requirements fully by evaluating the living model and applying the nursing process, supporting his well-being and independence.

As a result of this case study, healthcare providers may continue to improve their care practices, resulting in improved results for patients with complicated care needs. Continuous learning and development may increase the quality of care offered to persons in long-term care settings. 

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References

Abdi, S. et al. (2020) Understanding the care and support needs of older people: A scoping review and categorisation using the WHO International Classification of functioning, Disability and Health Framework (ICF) - BMC geriatrics, BioMed Central. Available at: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1189-9 (Accessed: 30 July 2023). 
Activities of daily living - statpearls - NCBI bookshelf. (No date). Available at: https://www.ncbi.nlm.nih.gov/books/NBK470404/ (Accessed: 30 July 2023). 
Archibald, M., Lawless, M., Ambagtsheer, R.C. and Kitson, A., 2020. Older adults’ understandings and perspectives on frailty in community and residential aged care: an interpretive description. BMJ open, 10(3), p.e035339.
Care, D., 2019. Standards of medical care in diabetes 2019. Diabetes Care, 42(Suppl 1), pp.S124-38.
Jeremy et al. (2023) The nursing process: A comprehensive guide, Nurseslabs. Available at: https://nurseslabs.com/nursing-process/ (Accessed: 30 July 2023). 
Kwame, A. and Petrucka, P.M., 2021. A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC nursing, 20(1), pp.1-10.
Potter, P.A., Perry, A.G., Stockert, P.A. and Hall, A., 2021. Fundamentals of nursing-e-book. Elsevier health sciences.
Spillman, B.C., Liu, K. and McGilliard, C., 2016. Trends in residential long term care: Use of nursing homes and assisted living and characteristics of facilities and residents.

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