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Motor neuron disease (MND) is a degenerative neurological disease also known as amyotrophic lateral sclerosis, is a rapidly progressive neurological condition which targets the central nervous system (Vesey, 2017). The people with MND will die within 2-3 years of developing symptom (NlCE, 2013). There are about 5000 people with MND in the UK and about 1100 people are being diagnosed with the condition each year, however 25% can survive to 5-10 year after developing syndrome (Elliott et al. 2020).
Here the essay is going to present the case study of Alice Smith, who had been diagnosed with Motor Neuron Disease [MND] four years ago. She lives with two children who are autistic and her husband. I work as her carer in the community. Under NMC Code (2018), nurses need to maintain proper confidentiality of patient’s personal and professional data in terms of eliminating the chances of any type unauthorised access [NMC, 2018]. Under this code I am presenting the lady in the case study as Alice which is not her real name in terms of maintaining the confidentiality of the personal information of this lady. This essay will demonstrate how much Alice and her autistic children are vulnerable to the risk of abuse and harm. Here the essay will present a care plan in terms of promoting the holistic development of Alice and her children thereby improving their quality of living. Moreover, the essay will discuss how dignity, autonomy and rights of Alice and her children can be protected throughout the care process.
A vulnerable person one who is exposed to being bodily or psychologically harmed and may lack the capacity to defend themselves (Wendler,2017). People may become vulnerable at some point in life depending on lifetime situations. Here in the case study, Alice, who suffers from the Motor Neuron Disease [MND] is highly vulnerable to physical, emotional and psychological distress throughout her lifespan. As mentioned by Åkerlund (2017), not only adults but also children who suffer from severe mental disorders such as autism and dementia are highly vulnerable to abuse, harm and negligence. In this context, Alice’s children need proper observation and guidance that are important in terms of improving their interpersonal skill, cognitive skill and decision-making ability (Garcia-Quiroga and Agoglia, 2020). Being a care provider of Alice and her children, I emphasize on developing holistic care framework which will not only improve overall mental, emotional and physical wellbeing of Alice, but also promote the good thoughts, positive decision-making and strong analysing as well as reasoning skill in her children.
Resilience can be referred as the ability of people to adapt to any critical situation in life (Ungar and Theron, 2020). Resilience protects people from any kind of mental illness such as anxiety, depression and loneliness. Alice suffers from a life-threatening disease (MND) and has the liability to raise a young family. Therefore, Alice is vulnerable to the risk of different psychological distresses such as depression, anxiety, frustration and loneliness. In additional to this, as the two children of Alice are autistic it poses severe mental stress on her which can enhance her vulnerability toward deterioration of her mental health. In this context, a systematic care process needs to be implemented in case of Alice to enhance her resilience. Care providers must consider the factors that can enhance the resilience of Alice and her children such as social support, emotional, psychological and physical support, holistic development, community engagement and professional support (Anka et al. 2017).
As mentioned by Patel et al. (2018.), biological factors influence the growth and development of the human being. Any error in gene coding can cause severe mental and physical health issues in people. While treating Alice, I use to check her pre-medical history, to determine whether any family members of Alice had MND or other chronic neuronal disease. While setting effective care plan for vulnerable adults like Alice care providers need to determine hormonal function, genes, heredity, physiology and functioning of the internal body system. As mentioned by Khan et al. (2019) while taking care of vulnerable adults, care providers need to evaluate that whether there is a genetic cause or hormonal disbalance or dysfunction of internal organ function which contribute to the poor mental and physical health of vulnerable adults. While delivering care to Alice, care providers would determine if she has any family history of MND to determine whether the disease is hereditary in case of her. This is because, evaluating genetic history of Alice, I can make effective changes in the care plan for Alice that can promote her holistic development (Bryois et al. 2018).
While it comes to provide best quality care to vulnerable patients, care providers need to consider the environmental factors such as learning and reinforcement family support, society environment, parental care, positive family environment and positive culture. As mentioned by Shanahan (2018), in most of the cases of vulnerable adults they experience lack of a supportive and positive environment that pose an adverse impact on their mental and physical health. In case of Alice, care providers need to analyse whether she has any history of unsupportive and conservative family or social environment that pose potential barriers in developing positive and healthy thoughts, good problem-solving skill and strong self-dependence in her. As mentioned by Bryois et al. (2018), family environment plays as important roles in promoting the psychological development in people. Evidence suggests that in case of people who suffer from the life threating mental illness such as MND, unsupportive behaviour of family members can cause deterioration the mental health. Therefore, being a care provider, it is important for me to consider the family environment of Alice while evaluating her holistic needs.
Here 1 have applied Erick Erickson’ psychosocial theory (1958), in which Erickson had represented eight stages of human life ((Syed and Mclean, 2017). In case of Alice 1 have chosen the seventh stage. In case of Alice, I have chosen the sixth and seventh stage. The sixth stage, intimacy versus isolation is highly useful in which I emphasize on determining the bonding of Alice with her husband, children and parents, which will assist me to understand her psychology (Maree, 2020). On the other hand, through applying this stage, I can stress on providing her proper emotional support by working in partnership with her husband in terms of protecting her from loneliness and depression. On the other hand, through applying the seventh stage generativity versus stagnation, I reinforce positive thoughts, decision making in Alice in terms of motivating her to maintaining proper time management in guiding and supporting her children to improve their physical and emotional wellbeing (Syed and McLean, 2017).
While it comes to take care of vulnerable people, holistic care is highly recommended that promotes health and wellbeing of patients in manifold ways such as improves their interpersonal skill, improves their professional and personal skill, develops strong cognitive skill and improves their physical, mental and emotional wellbeing (Drake, 2019). NICE (2019) sets the guidelines under the Care Act 2014 which recommends the use of holistic and person-centred care approach to treating vulnerable adults [NICE,2019].
Under NMC (2018), while it comes to provide the holistic care to vulnerable children and adults, community care providers need to ensure that they should follow the NMC codes such as preserving safety, prioritising people and ensuring bias less and discrimination free care. While taking care of the needs of Alice and her children I always work under the limit of my competence and professional knowledge in terms of providing safe care to them. I also ensure that while setting proper care plan for Alice and her children, their preferences, choice, decision and interest are considered (O’Toole et al. 2016).
Being a community care provider, I always adhere to duties to the NMC (2015) codes and conducts to provide safe and high-quality care to Alice and her children. Under NMC (2015) code “prioritising people” I emphasise on providing a person-centred care to Alice in which her physical, psychological, emotional and social needs are met. NMC (2015), suggests that care providers must maintain high level of confidentiality of patient’s personal and professional data to protect their rights to confidentiality [NMC, 2015]. As stated by Aluaş et al. (2019), throughout the care delivery process care providers must respect patient’s autonomy, rights, confidentiality to ensure the safe and high-quality care delivery to the patients also assure that throughout the care I listen to the needs, preferences and issues of these children, which will assist me to make effective modification in the care plan thereby meeting all their needs and developing their interpersonal, cognitive and reasoning skill.
PHE (2019) has mentioned that, through taking a holistic approach in developing effective care setting for vulnerable people, NHS staffs can promote not only the physical and emotional wellbeing of people but also can improve the connection between their body and mind that assist them to live a healthy and quality life. As Alice suffers from MND, she needs a holistic care approach in which I emphasize on promoting her good physical health, positive thoughts, healthy approaches and creative decisions. According to Buka et al. (2016), in case of mentally ill people, a holistic care plan needs to be conducted that will consider all kinds of patients’ needs such as psychological, social, physical and emotional needs. Throughout the care process I assure that the physical, emotional and psychological heath issues that Alice and her children face due to their health condition can be determined accordingly. As mentioned by Glasper (2018), through conducting thorough analysis different kinds of health needs of patients, care providers can set effective care strategies to improve their overall health through promoting, emotional, physical, psychological and spiritual wellbeing. While providing holistic care to Alice I refer her to a psychotherapist for undertaking a conducted cognitive behavioural therapy [CBT]. As stated by Wilby (2019), psychotherapy can make a positive transformation of behaviour, thoughts and cognition of mentally ill patients. On the other hand, I also refer her to some special therapies for Alice’s children such as Applied behaviour analysis (APA), special skill development, speech therapy and sensory integrating therapy (SIT). These therapies are intended to develop communication skill, reasoning skill, analysing skill, interactive skill and decision-making skill in the children.
In case of the Alice’s children, I have chosen the fourth stage, industry versus inferiority, through which I work in partnership with school teachers and educators to ensure that the children are provided with supportive positive and creative environment and also make sure that they are protected from any kind of harm and abuse.
NICE (2019) developed the codes of conducts and professional standard that health and social care professionals need to follow as well as implement while taking care of vulnerable people. In this context, health and social care professionals must ensure that the autonomy, preference and decision of Alice will be respected throughout the care process. Care providers must ensure that they have considered individual rights, dignity and choice for treatment of Alice while setting an effective care plan for her. Under the Safeguarding Vulnerable Group Act (2014), care providers must ensure that Alice would be provided with a safe and protective environment in which she is free from any kind of harm, neglect and abuse. In addition to that, care providers need to ensure that they have taken informed consent from Alice and her husband before implementing any care plan. Under the Care Act 2014, care providers must understand their professional boundaries under which they always maintain their accountability and professional integrity while providing care to Alice (Anka et al. 2017). Additionally, care providers will always work under the level of their competencies in terms of maintaining the safety and protection of Alice throughout the care process.
From the overall discussion, it can be stated that MND is a neurological health condition that poses adverse impact on the physical, mental, emotional and behavioural status of patients. People who suffer from this illness are highly vulnerable to risk of premature death and morbidity. For providing proper care to vulnerable people, health and social care professionals need to consider many factors such socio-economic, cultural, environmental and biological factors that allow them to make relevant care plan according to the current health needs of patients. Care providers need to take a holistic care approach for providing safe and compassionate care to vulnerable adults. Moreover, care providers also ensure that they maintain patients’ safety and respect their dignity and right throughout the care process.
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