The family was asked if extra tests could be carried out on Mrs Patel to see if the new unexplained signs could be checked out, to put the families mind at ease.
Mrs Patel voiced her concerns of having to spend time at the hospital, as she feared hospitalisation and requested that the majority of tests be done within the home; these concerns were voiced through the father and son interpreting her needs. Her personal details were written on an assessment sheet along with her blood pressure and pulse rate, taken when Mrs Patel was admitted and these were to be sent to Mrs Patel’s General Practitioner (GP) and Social Services.
Mr Patel junior was asked if there would be somebody at home to interpret for Mr & Mrs Patel when somebody calls, he informed nursing staff that there was always him or his wife, who also speaks fluent English, at home.
Social services
The social services sent an appointment letters out addressed to Mrs Patel written in her own language, even though Mrs Patel does not understand English she must still be treated as an equal. Mrs Patel or a family member was to phone the number at the bottom of the letter to contact a member of staff who spoke different languages.
The appointment was confirmed on an appropriate date and time, given by Mrs Patel. Over the phone Mrs Patel was asked if she could supply a urine sample for the nurse who would be accompanying, also asking Mrs Patel for her consent to take a blood sample.
The social services arrived promptly accompanied by a neurologist and the district nurse. Mrs Patel was asked if they could take a blood sample. Her daughter – in – law was present and translated the request to her mother who agreed. The district nurse took blood from Mrs Patel, and then requested the urine sample, this is done to rule out or identify any other medical problems. The district nurse explained that they would be taken to the local infirmary and her family GP would receive the results via letter in one week, the daughter translated this to Mrs Patel who acknowledged by nodding. Mrs Patel also had her blood pressure and pulse rate taken and recorded; these were taken to compare with the ones already documented on her hospital admittance, to see if there had been any changes.
The neurologist explained to Mrs Patel that he would like do some testing for mental response such as: memory, problem solving, and counting, again this was translated to Mrs Patel who agreed verbally. The tests were carried out in Mrs Patel’s dining room, the results were noted down on an assessment sheet. The neurologist asked Mrs Patel if she would attend the hospital for a day visit only, for a Medical Resonance Imaging scan (MRI), visual examination of the brain can reveal structural abnormalities associated with dementia, Hoyle 2005. By doing this they would find concrete evidence of Mrs Patel’s condition.
Social service’s explained that they could contact an occupational therapist (OT) who would assess Mrs Patel in her home to see if she needed any alterations for example: stair lifts, shower seat, bath seats - Muslims only bath after intercourse or when the woman has finished her menstrual cycle, Muslims usually shower as they think that bathing in their own dirt is un-hygienic. Sharma 2006.
They explained to Mrs Patel that their aim was to enable her to still be independent in her own home also that when she had received her results from the doctors that she could ring them again, if necessary, to reassess her needs.
Leaflets were left for Mrs Patel and her husband to read through, they contained information about the services and help that the social services provide also benefits that they could claim.
Mrs Patel received and attended an appointment for an MRI scan, accompanied by her husband and son, the results were sent to her family’s GP. Mrs Patel’s family GP rang her at home explaining in her native tongue, as he too was a Muslim, that he had received her results back from the hospital and would like to visit her at home, at a time that was suitable for her.
When the GP arrived he was greeted by Mr Patel and shown into the lounge. The doctor explained that he had the results and they were not too good. He carried on explaining that all the tests that had been taken had come back with abnormalities. He broke the news that Mrs Patel had Alzheimer’s disease, a physical disease that affected the brain – a form of dementia. Age is the greatest factor for dementia along with a combination of genetics, environmental diet and general health. He reassured them both that they had caught it early enough, so that any treatment or help would be adhered to, to Mrs Patel’s wishes and dignities while she was still stable enough to request them. He asked if they had any questions. Mrs Patel asked what she was to expect from the illness, if it was curable and what he could do to help her. He explained that there was no cure for Alzheimer’s but there was a drug that would slow down the progress. Her symptoms from the disease would consist of: confusion, forgetfulness, mood swings and she may become withdrawn. Alzheimer’s Society 2003.
He informed Mr & Mrs Patel that he knew of good organisations that specialised in her condition and if they wanted he would send away for some information, he also advised them to ring the social services back and tell them of the changes in circumstances that have occurred, for them to reassess their situation and get them some family and home help. The GP wrote out a prescription for Exelon, as stated above this drug could slow down the progress of dementia, and advised her to take the drug morning and night, if she experienced any adverse side affects apart from the ones specified, to contact him immediately. Mr & Mr Patel thanked him and saw him out.
The Social Services again visited Mrs Patel, this time she was accompanied by her husband, son and Daughter –in – law. The social services explained that it was their duty to assess and obtain the most appropriate care needs of the individual, in this case being Mrs Patel; to live as independently as possible in her later years, this was translated to Mrs Patel by her son.
The social services work closely with other organisations, which helps speed the waiting time of the care to be received.
They informed Mrs Patel, that through lengthy discussions, with her family GP, they had arranged for a community psychiatric nurse (CPN) to visit, they provide treatment, care and support for people with dementia. They were in the process of arranging counselling for Mrs Patel, this would involve regular sessions for Mrs Patel to speak openly about her feelings, as family and friends can sometimes get tied up in their own feelings making it hard to talk to them, and they asked Mrs Patel if she thought this would be appropriate, Mrs Patel nodded.
The Social Services explained that there were many services available, which would assist with Mrs Patel living an independent life at home:
Equipment adoptions (OT) – for equipment specified on pg five
Home Care – women to assist with Mrs Patel person care and well being.
Respite Care / Day Care – somewhere for Mrs Patel to go and become acquainted with others who are suffering the same illness also for the family to have a break.
The last thing to discuss was the cost of care that Mrs Patel required; this was dependant on the level of care and benefits received to how much of a discount they would receive. All of this was translated to Mrs Patel again by her son.
Once matters had come to a conclusion a care plan was put into place to review on a six-monthly basis Mrs Patel’s progression of illness, then the whole procedure would start again.
References
RCN (2005) Example of a Transcultural Nursing Assessment. [online]. Available from:
SMW (2003) Regarding: women in Islam [online] available from
Gina Marie Awoko Higginbottom (2006) 'Pressure of life': Australia. Blackwell Publishing, Inc.
Hoyle Brian PhD (2005). Encyclopaedia of Neurological Disorders, The Gale Practice Inc, Gale, Detroit.
Sharma S Sanya (2006) communities of India, Drexel University, Philadelphia.
Alzheimer’s Society (2003) What is Alzheimer’s. Information sheet, London.
Bibliography
Alzheimer’s Society (2003) What is Alzheimer’s. Information sheet, London.
Gina marieAwoko Higginbottom (2006) 'Pressure of life': Australia. Blackwell Publishing, Inc.
Hoyle Brian PhD (2005). Encyclopaedia of Neurological Disorders, The Gale Practice Inc, Gale, Detroit.
RCN (2005) Example of a Transcultural Nursing Assessment. [Online]. Available from:
Sharma S Sanya (2006) communities of India, Drexel University, Philadelphia.
SMW (2003) Regarding: women in Islam. [Online] available from:
