Reference no: EM133846445

Question

Stanley is 57 years old and has motor neurone disease (MND). Stanley uses a wheelchair and has limited mobility and speech. A case manager has prepared an individualised support plan for him. You are meeting with Stanley to introduce yourself and confirm the broad details of the plan.

The meeting is taking place in his home. Stanley lives with his wife, Mavis. Prior to visiting Stanley you take the time to read the plan that was prepared by Stanley's case manager. When you arrive, Mavis opens the door and guides you to where Stanley is waiting for you in the living room. Mavis does most of the talking, and discusses Stanley's MND in quite a lot of detail. Stanley seems withdrawn and says very little.

You spend some time introducing yourself, sharing some of your professional background and listening to Mavis speak, and trying to ask Stanley some questions about himself too. You try and establish rapport with Stanley and Mavis.

Stanley and Mavis's home is quite busy and cluttered, and sometimes when Stanley wants to reach an item or complete a task, he is unable to get very close to the bench or table and has to lean out of his wheelchair. You suggest that an aid could be useful to help him reach across to objects.

You ask Stanley if he would like to review the draft support plan that was prepared with his case manager. Stanley agrees and, together with Mavis, you and Stanley review the plan. You ensure that you have brought two copies of the plan so that Stanley and Mavis each have a copy. The draft plan includes the goals that Stanley developed with his case manager, but the support activities have not been confirmed. Many of the activities focus on supporting Stanley to maintain as much independence as possible and to remain living at home with Mavis.

You allow Mavis and Stanley plenty of time to review the draft plan. Before moving on to prioritising support activities, you ask Stanley if there is anything else he would like included in his plan. Stanley has a complaint about how some of the support workers don't give him enough time to do things himself and tend to 'hurry him along'. He seems angry about this, and you note it down so that you can let your supervisor know later. Stanley also says he wants to attend the local self-advocacy organisation but has not caught public transport for over twenty years. Stanley has some cognitive difficulties associated with his MND, but he is very methodical and loves using maps and illustrations to help him with some of his activities of daily living.

After extensive discussion, it is agreed that the goals of Stanley's individual support plan should be for:

Stanley to continue to be supported to live at home and be assisted to maintain his independence (with a strength-based approached)

Stanley to attend the weekly self-advocacy group.

Together, you work on prioritising the support activities that will assist Stanley to meet these goals. As Stanley has been receiving services from your organisation for some time, a number of services are already in place and just require monitoring. Stanley is accessing daily personal care to help him to get up in the morning and assist him to shower, groom and dress, and then again at night to help him get to bed. Mavis helps Stanley with all his meals and other daily tasks.

Stanley's new goal is to attend his local self-advocacy group. Together you talk about the location of the group and Stanley's transport needs. Stanley is keen to catch the train to the group, as he says he never gets to do anything or go anywhere independently anymore. Stanley also says if he learns to catch the train that maybe he will be able to go other places independently too.

1. Given what you know about him, give an example of how a strengths-based approach could be used to support Stanley in one of his future goals of catching public transport.

2. How does the support worker encourage Stanley to take an active role in his own support needs?

3. Why is so much work put into the planning phase of Stanley's support, rather than just allowing the workers to get on with meeting his needs of showering and other everyday activities?

4. What monitoring and review processes might take place in future, in relation to Stanley's plan?

5. If Stanley seems to show signs of depression in the future, is this a problem that the support worker should be able to manage alone? Who else might be able to assist Stanley with depression?

6. Stanley will need to learn some new skills in order to catch public transport to his self-advocacy group, such as buying a ticket. Outline how each of the following skill development processes would be used to teach and maintain this skill:

task analysis
shaping
reinforcement

7. If Stanley was to start using an aid to help him with reaching objects, what should you check or be aware of before assembling this equipment?

8. What are three things can you do to create a clean and comfortable environment for Stanley, with the support of Mavis?

9. Identify three risks that could occur while following the individualised support plan. For each example, explain briefly how you might manage each of these risks.