CASE STUDY: Ms. Sarah Williams, a 65-year-old woman, presents with

CASE STUDY: Ms. Sarah Williams, a 65-year-old woman, presents with a history of mesothelioma, leading to chronic respiratory compromise. Sarah resides at home alone, in the Adelaide suburb of Marion, South Australia. Sarah’s partner of 30 years, Jane, died 6 months ago. Jane provided some care for Sarah and managed all the household financial business. Since Jane’s death, Sarah has found it increasingly difficult to maintain her ADL’s, particularly showering, housework, gardening, cooking, and shopping. Over the past 12 months Sarah has also found her weight has increased significantly (15kg weight gain) and at her last visit, the GP indicated that there were indications in her blood examinations that her HBA1C was elevated. Sarah also experiences breathlessness, particularly on exertion, requiring occasional supplementary oxygen therapy. Her medications include a combination of bronchodilators, corticosteroids, and analgesics to alleviate respiratory symptoms and manage the pain associated with mesothelioma. Sarah uses a walking frame around the house and an electric scooter to drive to the local shops for food and other shopping. She has expressed reluctance to attend any appointments at the GP or other healthcare practitioners as she finds getting in and out of a taxi difficult, and now that Jane is not with her, she has no one to accompany her if she needs assistance, for example to use public toilet facilities. Sarah also reports feeling very sad about the recent changes in her life and prefers to stay at home and not visit any of her friends as it is ‘just too hard’. The GP has recommended that Sarah apply for funding for a Home Support package however Sarah is not sure she will be able to do it; she has no landline, mobile phone, or home internet. Sarah’s financial situation: she receives an Australian Aged Care Pension, owns her home but has minimal savings in the bank. Sarah has stated the following person-centred care needs: • Wants to remain living at home. • Would like support to assist her with ADL’s but the person must be a female. • Would like someone to go with her to appointments and to do some of the bigger shopping. • Explore options she can use – other than a taxi, so she can go out. Sarah has heard of Access cabs but is not sure how to organise one or if she is able to have her transport subsidised. • Is aware her sadness/grief is impacting her significantly and would like to see if there are any services that she can access to be able to work through some of her feelings. TASK: Using the case study of Sarah Williams address the following assessment tasks. In this scenario you are the RN in Sara’s local GP Practice. Question 1: Discuss how the concept of ‘social isolation’ may be a barrier to Sarah accessing appropriate person-centred care, and how this can potentially lead to hospitalisation. Comprehensive, insightful rationales when discussing of concept of social isolation as a barrier to the case study person. Comprehensive range of examples and evidence to support the discussion. Makes comprehensive and insightful links to how the barrier can lead to hospitalisation. Maintains patient centred focus all of the time. Question 2: Identify two [2] local and one [1] national service that Sarah will need to access to address the above identified barrier of ‘social isolation’. In your answer, provide a rationale to why the specific services will support her and how they will be person-centred and support self-management. Local Service 1 and 2 – to address the identified barrier of ‘social isolation’. 1) Provide a rationale for why the specific services will support her and 2) How they will meet her person-centred needs for self-management. Local Service 1 and 2 – is an appropriate choice and the discussion demonstrates a comprehensive accurate understanding of need for the service and provides comprehensive rationales to support the case person specific needs related to social isolation. Provides comprehensive rationales of how the service will specifically meet the case study client’s needs. Supports discussion with a comprehensive range of evidenced based resources. Discussion is insightful and indicates the case study has been evaluated from multiple viewpoints National; Service 1 National Service to address the identified barrier of ‘social isolation’. 1) Provide a rationale for why the specific services will support her and 2) How they will meet her person-centred needs for self-management. National Service – is an appropriate choice and the discussion demonstrates a comprehensive accurate understanding of need for the service and provides comprehensive rationales to support the case person specific needs related to social isolation. Provides comprehensive rationales of how the service will specifically meet the case study client’s needs. Supports discussion with a comprehensive range of evidenced based resources. Discussion is insightful and indicates the case study has been evaluated from multiple viewpoints Question 3: Using the principles of the 2017 NSFCC (Part 2, Objective 2.1) as your foundation, discuss the role of the Registered Nurse and how integration of this framework will improve Sarah’s capacity to self-manage, including examples. You will need to incorporate the relevant, current NMBA Registered Nurse Standards for Practice (sub-standards) and link to the Fundamentals of care (FOC)to support your rationale. Comprehensive concise and links made to all relevant aspects of the NSFCC (2017). – Demonstrates an outstanding understanding of the NSFCC (2017) in relation to the role of the Registered Nurse for this specific case person. Provides an outstanding discussion on the integration of the framework to this Provides a comprehensive insightful range of examples of how integrating the NSFFCC (2017) will improve the case person’s capacity to self-manage. Provides comprehensive to the NMBA and specific sub- standards demonstrate understanding of the integrated role of the Registered Nurse. Provides comprehensive links to the Fundamentals of Care (FOC) Examples and rationales provided are flawlessly supported by appropriate and current evidence. Question 4: Sarah has self-identified person-centred care needs. Choose one [1] of these and discuss one current local or national health promotion initiative that could support Sarah to retain her independence and avoid hospitalisation. Has chosen a specific and relevant self- identified person- centred care need of the case study person. Provides comprehensive insightful discussion relating the chosen care need to the case study person’s health literacy. Provides comprehensive insightful examples of how the person’s specific care need and health literacy are integrated. Demonstrates comprehensive insightful understanding and provides several clear specific examples of how reduce/avoid hospitalisation. Demonstrates a comprehensive understanding of the role of the registered nurse in health literacy. Provides current and relevant references to support all rationales and discussion.

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