Rehabilitation in Community Settings : Case Study

Internal Code: MAS3956

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Case Study:

Richard is a 31 year old man who sustained an Acquired Brain Injury 3 years ago from a farming accident. At the time Richard was a married man with 3 young children and living on his family farm which he worked with his older brother Anthony and their family. Richard’s home is a high set old Queenslander style home, situated 20 kilometers from Biolela in Central Queensland. Although all of the bedrooms and bathroom are on one level, there are 10 steps at the front and back of the home.

Richard left school after Year 10 as he didn’t like or do well at school. Prior to his injury Richard played Rugby league with the local team the “Super-Roos”, enjoyed spending time with his young children and was a happy-go- lucky kind of person who was always keen to help others. The injury which Richard sustained resulted in damage to his right parietal lobe, and the frontal lobe of his brain. Since his accident he has had a very short attention span, is often irritable and experiences very poor short term memory. Although Richard is able to walk with a walking stick due to weakness on the left side of his body, he fatigues very quickly. Both Richard’s immediate and extended family remain very supportive although he requires continuing daily support. Richard’s brother, Anthony has installed an airlift to their home to enable Richard to be able to help in the machinery shed which is situated beside the family home. Richard is unable to drive due to poorly managed epilepsy since the accident.

Questions:

Section A: Utilizing the ICF, critically analyze the presented case study to determine what the likely barriers and facilitators are for Richard and his family.

Section B: The following goals have been set for Richard by the domiciliary nurse who assists Richard to have a shower 3 days each week.
a. In 2 years, Richard will have completed a TAFE course in Farm Management
b. Richard will attend the “Super-Roos” end of season barbeque without a carer
c. By the end of September 2017, Richard will be able to shower himself without the assistance of the domiciliary nurse or his wife.
1. Using Gordon’s Functional Health Patterns, identify which section of Gordon’s Functional Health pattern EACH goal belongs to and briefly explain how it is relevant.
2. Discuss how these goals are realistic (achievable) or unrealistic goals.
3. Use the 3-step MAGPIE PLAN process described in the course materials (Section 4.6) to devise a detailed plan on how to achieve ONLY ONE (1) of these 3 goals and what interventions will be required.

Section C: The Domiciliary Nurse who has assumed case management of Richard and his family often clashes with Richard’s brother, Anthony over what is best for him as she has considerable experience from working in a Rehabilitation Centre in Melbourne. She has organized a number of activities way from the farm in the nearby town which has caused considerable conflict with Richard’s family. Discuss how paternalism from healthcare providers can impact on family relationships.

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