This case study will discuss a client with complex needs. The study will take a look at a single patient, experienced in the clinical profession, evaluating the influence on the standard of care, as well as on the good health and welfare of the client, of fundamental features of concern. The case study will enable caregivers to assess essential components of the case as well as observation and treatment of treatment decisions made and efforts used, and to evaluate areas of care in the description. This case will traverse the client’s need for a patient named Dolphin, an aged, shanty dwelling adult diagnosed with Type 2 diabetes. She was referred to a medical hospital after she was found living alone in a wanting environment while every member of their family had neglected her. This study evaluates the features of Dolphin’s care which connect to the control of her situation, the evaluation as well as the monitoring of her social, community-based, safekeeping and individual needs, as well as the forethought of her coming times need and maintenance needs. Remarks will happen on government base guidelines and strategies, and to experts working as a basic requirement of satisfying client needs in this case (Goodwin, Dixon, Anderson, & Wodchis 2014, p.54).
Diabetes is a long-term disease noted to influence conspicuously on the health, welfare as well as the success of people, families as well as the entire society. Millions of people in Australia are affected by diabetes. Diabetes has a substantial effect on the public health and the on the National Health Service and the community –based care resources. The Health Sector has issued a National Service substructure for the disease, which sets quality for control and identification of diabetes and summarizes professional procedures with the knowledge of the currently available proof on the condition (Goodwin, Dixon, Anderson, & Wodchis 2014, p.54).
Diabetes occurs in two types. They are Type 1 and Type 2. The two types of diabetes are marked by a tenacious high level of circulating glucose in the blood, resulted from the deficiency of insulin or a seriously impaired insulin response, or to an association of both components. Diabetes Type 1 occurs as a result of pro-insulin cells found in the pancreas, known as Beta Cells, found in the islets of Langerhans, refusing in insulin production, since the immune system in the body has damaged them. Type 2 diabetes is normally resulted by a lessened volume of insulin produced by the cells, as well as the opposition of insulin amount in the body, in which the response of the body’s metabolic reaction to insulin are not much sensitive. Type 2 diabetes is the current situation which Dolphin, the client in this case has been conditioned (Wodchis, Dixon, Anderson, & Goodwin, 2015, p.62).
Dolphin is a woman aged 74 years who has Type 2 diabetes and has experienced it for a decade. She gets treatment two times on insulin and happens on a daily basis. She lives in a home where she was confined by the medical group to assist her as she was neglected at an old age by her relatives. The group monitors her glycaemic management as well as examines her insulin assortments and her welfare as a whole. Dolphin has a BMI of 35 and has a hypertension background which is managed by the use of medicinal drugs. Monitoring of her blood pressure was on a weekly basis. Dolphin lives with other clients confined in a medical institution that assists elders who suffer from complex conditions as hers. Dolphin is an outgoing woman who establishes a friendship with people from different groups irrespective of the religion, race or background. She is proficient in controlling her insulin as well as calculating her blood sugar. Despite being proficient, she is not consistent on her prescribed course of medical treatment as well as her advised diet since it may impede her social activities (Ogloff, Talevski, Lemphers, and Wood, & Simmons, 2015, p.72).
Dolphin was spotted by a Samaritan who had noted her suffering and reported the issue to the medical department of the institution. She was unconscious at the time of her recovery since she was feeding on a poor diet and had no funds to buy her medicine. She was carried by ambulance by paramedics who felt the need of assisting her. She was diabetic hypoglycemia which is a condition resulted by an overdose of insulin or insufficient carbohydrate in an individual subscribed to insulin, or by the client involving in too much exercise leading to overuse of glucose or by a combination of both (Kinner, Degenhardt, Coffey, Sawyer, Hearps, & Patton, 2014, p.86).
Paramedics noted that Dolphin’s blood sugar was 1.4 mg/dl and controlled glucagon to countermand hypoglycemia. Dolphin came back to normal when her blood sugar became better and also provided with facial oxygen and her complete information about her status recorded. She was later taken to the referred medical facility for a full examination to analyze her diabetes where she remains accommodated to date. About emergency care propositions for the diabetic clients, the interests are to rescue the client’s life, ease their symptoms, avert diabetes complications that relate to a long period as well as their recent risk features, and to device protection which will lessen risk components for their health. The risk components are high blood pressure, obese, smoking in company with giving underway education as well as contribute to self-administering of their situation (Wilkes, Cioffi, Cummings, Warne, & Harrison, 2014, p.34).
According to Dolphin’s case, the medical team examined her condition since though the previous diagnosis was hypoglycemia as recommended by her self-reported history of lacking meals on the last day as well as engagement. The distinctive diagnosis was diabetic ketoacidosis, which may be occasioned by physical or biological pressure, incorporating adjustments in endocrine purpose or other conditions like a heart attack. Dolphin is pale which suggests that she has hypoglycemia in company with her hypertension as well as dilated pupils. When Dolphin got back to normal, she reacted well with the glucagon. As stated by the established diabetic procedures, she requires stability as well as receives a variety of examinations to affect any other condition or constituents leading to her state (Hassett, 2014, p.54).
The blood pressure, temperature, pulse rate as well as respiration rate were observed and recorded by use of telemetry, and an ECG took which dismissed the chances of heart attack. Dolphin’s blood underwent several blood tests. Due to what the observation, Dolphin was subscribed on a constant IV insulin infusion, titrated by use of a syringe driver against glucose which is titrated every hour, with an injection of glucose 5% operating in a distinct IV port. The fluid therapy, as well as fluid balance, was observed in a narrowly enclosed way. Diabetes is capable of destroying the kidney and causing impaired functioning of the urinary function, thus finding kidney function was an essential part to monitor (Karalliedde, & Gnudi, 2014, p.64).
When Dolphin’s condition came to stability, monitoring ON her health support as well as healthy living and cutting back on complications of her diabetes status developed as an essential component worth consideration, diabetes is a vital issue for public health as it is related to the obesity disease and as a condition, it connects with diverse health inferences. The issues incorporate macro-vascular complexity which includes atherosclerosis and heart disease, diabetic retinopathy as well as loss of vision resulting from vascular injury which incapacitates the blood vessel walls in the eyes bringing about micro-aneurysms and protein disclosure in the retina, vascular impairment as well as damage tissue, outlying neuropathy, outlying vascular disease as well as dysfunction relating to the stomach and the intestine, glomerulus dysfunction as well as kidney failure. The effect of diabetes on public health connects with the certainty that most individuals of the productive age bracket have diabetes, and the condition’s persistence and more incurable, with profound aggravations as well as different complexity, it displays a critical deprive of strength on the well-being and social care resources. Consequently, it is of vital importance that clients with diabetes are recognized in the earliest stage possible and advised and assisted in proper individual control, and given continuous care to retain good glycemic control (Vivienne, Tung, Liang, and Lee, & Yu, 2014, p.35).
Dolphin’s condition as an aged person is a public health issue since elders in the country have the highest number of diabetic cases in Australia. The older adults absorb the highest percentage of healthcare services. Nevertheless, it is essential to steer clear of stereotyping Dolphin as an aged individual, as well as making suppositions on her requirements and her health status. Despite the possibility that she is overweight and with high blood pressure, and has Type 2 diabetes, she is energetic and has a social life of great significance, and was ordinarily independent and concerned about herself. There is a need to give a thought of the social aid that Dolphin had, and to make sure that she is conscious of the services or assistance she is capable of approaching whenever there was a need. Still yet, various individuals of the medical staff seemed to proceed in a manner which suggested that they were categorizing Dolphin emanating from her age, weight, and health. The team discussed her case short of making comprehensible allusion to her as an individual. There is need to examine the medical professional specializations input in Dolphin’s case, as well as the standard of the mutual professional working that occurred as discussed (Abdelhafiz, & Sinclair, 2015, p.31).
As illustrated in the case, diabetes can exert influence on an individual and their body in complicated ways, and therefore needs a holistic approach to care which is characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of the disease. Care for diabetic clients requires based on evidence, involving a course of action agreed by both parties care, as recommended by the Diabetes National Service Framework. Dolphin requires all aspects analysis of her management as well as her social life, the models of care and the regular observing of her condition. The medical institute for clinics suggests a client-oriented approach to progressing patient enlightenment and control. The institute recommends different options for clients who need various forms of insulin control, like regular sub-coetaneous insulin. This medication was inappropriate for Dolphin since it was generally for clients with Diabetes Type 1(Abdelhafiz, & Sinclair, 2015, p.38).
Health development and enlightenment is an essential function of Dolphin’s care since it connects to the reality that her admission to the medical facility is because of the condition caused individually. It is critical to establish the reasons for Dolphin’s lifestyle as well as behaviors resulted in the lapse and the severe hypoglycemia. Perpetual care, health promotion, and enlightenment incorporated mutual professional cooperation as well as a combination of care into a complicated, description care schedule. The objective was to give Dolphin the understanding, assist and offer to guide that would enable her diabetes control as a mode of attaining a standard quality of health, preferably than looking at her diabetic condition as an issue that impedes her standard of life. It is also necessary to approach Dolphin in relations of assisting her to carry on with her usual collective activities. A systematic investigation into the study recognizes that adjusting lifestyle as well as giving better, productive health advice, aids to contribute to lessening percentages of diabetes complexities (Karalliedde, & Gnudi, 2014, p.83).
Nevertheless, the type of health teaching and assistance employed is essential, since various approaches have distinct levels of success. Some investigation evaluates the dissimilarity between health instruction that attempts to convince clients to gain acquiescence with authorities and functions outlined by health experts, approaches which commonly collective, and health instruction which focuses on clients. Plans focused on the client usually are more successful since they are tailored to suit the individual. Research display distinctly that diabetic clients need to familiarize with their condition thoroughly and assisted and allowed to make their social life and behavioral adjustments that will improve their health while allowing them to manage their situation. According to this case, diabetic specialists gained concern with Dolphin’s case, and a schedule for health instruction and assistance halted, with distinctive guidelines and a customized program for controlling her diabetic lifestyle. Diabetes institutes in Australia suggest a planned and a personalized education schedule for clients experiencing this condition (Wodchis et al., 2015, p.70).
Mutual professional and professional specializations in a practical approach are an essential factor of care for a diabetic client as in Dolphin’s case. Practical approach conveys that diabetic clients require smooth and continuous safekeeping, catering for their whole needs, with entry to all the necessary experts to aid in her care. Expert participation, incorporating diabetic nursing experts, is a characteristic of this case, as well as assisted with a focus on the client. This case recommends the importance of an experienced expert to take responsibility. In dolphin’s case, her expert nurse was unavailable for most of her admission. Unavailability of the lead nurse resulted in the absence of successful coordination of the complex number of incorporated experts (Wodchis et al., 2015, p.70).
In connection to mutual professional and professional specializations working, Dolphin was transferred to ophthalmic services to be observed and guaranteed that diabetic retinopathy or glaucoma did not exist. A dietician attended to Dolphin’s case to assist her in the control of her dietary consumption. Diabetic professionals attended to her case, and a detailed report sent to the diabetic caregiver at the institution’s surgery. Dolphin stayed at the facility’s medical ward for several days despite her condition quickly altering to stability. With this in consideration, her health did not experience any more complexity. In Dolphin’s case, mutual professional working was successful, since referrals made. Dolphin was attended by the dietician who educated her on the need of maintaining a healthy diet. She was advised on what to and not to eat and exercises she would engage in to keep her body health stable. The experts responsible for Dolphin’s case tried to judge on plans to discharge the underway safekeeping in the absence of the caregiver and failing to consider some features of her lifestyle condition as well as Dolphin’s partialities (Goodwin et al., 2014, p.75).
It is evident from Dolphin’s case that while her immediate medical requirements attended, the mutual professional working element on her underway safekeeping did not achieve its maximum. There are varieties of experts and assistant staffs who give healthcare to clients with complex needs. Due to the complexity, mutual expert’s education is a category of the programs in the healthcare education which needs incorporation. Joint experts working is required to assist with the services of a real client focused safekeeping as well as the highest standards of care. Nevertheless, reliable contact in this case and some literature involved quotes under way difficulties with mutual professional working in various contexts. A few of these deals with the expert’s borders and leadership which endures in healthcare expertise pursue meticulous safeguarding by all experts. Some studies display that the superior attitude, expert isolationism as well as specialist protectiveness may have a contrary influence on health experts as well on the service provision of quality care. There exists guidance offered by the Australian government, specifically from the Health sector which targets to upgrade the provision of services and the national service framework for the elderly in the community. The national service framework for the elderly recognizes the most necessary components of care and service delivery which needs upgrading. The national service framework requires that health and safekeeping services customized around the requirements of the elderly patients and their caregivers. Nonetheless, this type of needs focused care requires an integrated approach to the delivery of services, irrespective of expert and organization borders, offered by clinical authorities, supported by individual experts’ regulation as well as long-term education (Kinner et al., 2014, p.102).
According to Dolphin’s case, the principal responsibility of the caregiver in giving leadership and cooperation for her safekeeping lacked support. Some investigators argue that it may result due to medical dominance. Contemporary approaches to counterbalancing such entrenched in hierarchical thought are so much centered on primary education of healthcare experts, prevailing over historical expert borders. The research displays dissimilarities between the work-place based working, which never go beyond the traditional ranks and limits as well as collaborative expert practice, which establishes on the need to care, assist one another, as well as value each other’s profession. The health department supports techniques for an upgraded teamed up practice (Ogloff, et al., 2015, p.92).
Conclusion
The above case study on clients with complex needs has identified the case of Dolphin, an elderly woman with Type 2 diabetes who received a standard clinical treatment in satisfying her severe safekeeping needs and controlling her medical situation and its probable outcomes. Diabetes is a critical public health issue, and a variety of administrative direction and investigation notify care for clients with this condition. The public health matters enclose the severe rate of disease in a population and death identified with diabetes and the reality that better control and glycemic management can lessen these complexities. In this case, Dolphin’s case designated as medically necessary. Diabetes is a critical, long-term condition and needs a focused client evaluation, recognition of needs, and control. Every individual with the diabetic condition is required to abide by the present guidelines and perpetrate to successful mutual professional practice.
References
Abdelhafiz, A. H., & Sinclair, A. J. (2015) Diabetes in the elderly: 4th ed. Abingdon-on-Thames: Routledge Publishers.
Goodwin, N., Dixon, A., Anderson, G., & Wodchis, W. (2014) Providing integrated care for older people with complex needs: 3rd ed. London: King’s Fund Publishers.
Hassett, S. (2014) Service integration: 2nd ed. Abingdon-on-Thames: Routledge Publishers.
Karalliedde, J., & Gnudi, L. (2014) Diabetes mellitus, a complex and heterogeneous disease: Vol. 6. New York City: Guilford Publications.
Kinner, S. A., Degenhardt, L., Coffey, C., Sawyer, S., Hearps, S., & Patton, G. (2014) Complex health needs in the youth justice system: 4th ed. Abingdon-on-Thames: Routledge Publishers.
Ogloff, J. R., Talevski, D., Lemphers, A., Wood, M., & Simmons, M. (2015) Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services: 6th ed. New York City: Guilford Publications.
Vivienne Wu, S. F., Tung, H. H., Liang, S. Y., Lee, M. C., & Yu, N. C. (2014) Differences in the perceptions of self-care, health education barriers and educational needs between diabetes patients and nurses: 5th ed. Abingdon-on-Thames: Routledge Publishers.
Wilkes, L., Cioffi, J., Cummings, J., Warne, B., & Harrison, K. (2014) Clients with chronic conditions: 3rd ed. Abingdon-on-Thames: Routledge Publishers.
Wodchis, W., Dixon, A., Anderson, G., & Goodwin, N. (2015) Integrating care for older people with complex needs: 4th ed. Abingdon-on-Thames: Routledge Publishers.
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