Case Study of a Care Plan for a Patient suffering multiple health problems

Case Study of a Care Plan for a Patient suffering multiple health problems In this assignment it will define and discuss a nursing intervention for a client with a long enduring mental health illness. A systematic approach will be used the nursing process and the role of the mental health nurse will be clearly identified in providing care for the client. The nursing process consists of four stages, the assessment, planning, implementing and evaluation. This problem solving approach will be adopted to structure, organise, and present the nursing intervention. A fully detailed client’s profile will be given. The â€Å"mental health assessment and plan† process will also be addressed. The client will be involved in the whole process as far as possible in order to empower him / her, a plan that is person centred and interventions that are evidence based will be displayed in the assignment. In this profile a pseudonym (James) will be used in accordance with the Nursing and Midwifery Council, (NMC, 2002) to maintain confidentiality. The need of the Multi – Displinary Team (MDT) for collaboration will be discussed in order to safe guard the patient to share skills and knowledge and to improve the quality of care. James is a 65 year old man with a diagnosis of severely depression and excessive alcohol intake. He was detained under section 3 of the mental health act (1983) at a low secure unit. James was admitted into the unit 12 months ago his index offence being physical assault and attempted suicide through an overdose with his prescribed medication for his depression and insomnia. He shares the house with four other men in the unit. James is potentially active and usually manages his day to day living activities as well as attending day care sessions without much prompting. However, he had recently become very reluctant to attend to his personal hygiene. This became worse when James started going for days without washing or bathing himself. His room was never cleaned hence having a bad odour because of his leg ulcer a nd he refuses the Tissue Viability Nurse (TV) to change the dressings regularly. Care Programme Approach (1991) which aims to improve the co-ordination of services and collaboration between the various agencies, carers and service user. The introduction of the CPA in (1991) was to provide shape, coherence to what had often been haphazard, uncoordinated attempts to provide support in the care for people with severe mental illnesses (DOH1991). CPA is a statutory framework within which bio-psycho-social needs assessments is carried out (Norman and Ryrie 2004). This odour was because James would not change allowing the TV nurse to dress his leg ulcer for days. At his previous review meeting, issues around his hygiene had been viewed as hazardous to his health and also the health of staff since there were times when they would have to go into his room now and again. If James had no day care sessions to attend to he would sit and watch television. James also had a fairly huge appetite, he was observed to be frequently asking for more food at meal times. The other factor that proved he had a huge appetite was that he always asked for tea and biscuits several times between meals. This could be seen as poor eating patterns as Henderson (2001) implied that frequent binging is a factor behind poor eating patterns. Concerns about his weight gain had recently been discussed in his review meeting. James had of late become very withdrawn, wanting to be alone all the time. In an interview with him, he expressed how he felt useless and not having any faith in himself.