MODULE TITLE: ACCESSING HEALTH AND SOCIAL CARE

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MODULE TITLE: ACCESSING HEALTH AND SOCIAL CARE

STUDENT ID : 0507702-1

This essay the author has selected a patient who was admitted to a care of the elderly ward with continuing health care needs. A brief biography will be outlined and the patient's needs or problems will be further explored. Within this profile the author will consider the major cultural, socio-economic factors that influence the health and health choices made by individuals. The author will identify and discuss the differences between Health education and Health Promotion and describe the relationship between the concepts of Health, Public health and Social care. The author will also explore the challenges inherent in meeting the needs of people of varying abilities and needs and consider the relevant legislation related to provision of care and identify why inequalities of provision may arise.

In the whole essay the chosen patient confidentiality and place they live will be maintained in accordance to one of the NMC Code of Professional Conduct (2004) which nurse must adhere to meaning that their real names will not be used will be given the pseudonym of Maggie.

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Maggie was an 89 year old Asian lady who for the previous five years has been known to be suffering from Alzheimer's type of dementia. She was admitted to hospital following a fall in her home which caused lacerations and multiple bruising to her face. When she was admitted Maggie was disoriented in time and place and unable to understand why she was in hospital. Maggie was able to give little information about her home and family; it was her nephew who gave a comprehensive history and account of her present circumstances because Maggie English was not her first language. Once admitted it became evident from the results of Urinalysis test the Maggie was also suffering from a Urinary Tract infection. During a previous admission Maggie's dementia had been thoroughly investigated with a CT scan of the brain. The conclusion of this was that Maggie was suffering from cerebral atrophy. Clear evidence of mass lesions could also be seen, that Maggie's dementia was classified as severe with formal mental test score of 0/10.

Maggie's mobility was restricted to the extent that a walking stick was required at all times, although Maggie mobilised sufficiently around her flat she only ever went out if escorted. Up until shortly before her admission Maggie had been self caring in her hygiene needs but due to the increased phases of confusion, at times had becomes too much for Maggie to cope with. Maggie's two main carers are her daughter and her nephew, her daughter lived in Thailand, but travelled to visit her mother once every year. Maggie's nephew lived locally and is responsible for the bulk of her

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care. Maggie lived in a first floor, council rented flat that have been her home for the previous thirty years. The stairs had posed a major problem for Maggie and had been the cause of many previous falls. Maggie loves her home and is adamant that despite her problems that she wish to return home upon her discharge. Both Maggie's daughter and nephew were concerned about Maggie's safety should she return home, both parties felt that she would benefit from residential care. Maggie's nephew who have a full time job was often unable to attend to her during the day and is increasingly finding that caring for the Auntie although loving her dearly is causing a strain on this own marital relationship. The decision of where to discharge Maggie to once well enough was a subject that both staff and relative agonised over in order to reach the most appropriate answer for. Denham (2004) defined the term continuing care as long term need for care and support due to either physical disability or illness. This care is provided in a multiplicity of settings hospitals, nursing homes, and residential care homes and in the community.
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Services to older people have changed dramatically in recent years. Legislation has had a profound effect by dictating how are care to older people should be delivered both in the hospital and the community. Community care has no single definition which causes some controversy, however the 1998 White paper, "Caring for people defined it as providing the services and support which people need to live as independently as possible in their own homes or in a homely settings in the community enabling people to achieve their full potential (DoH 1998). Community

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care draws on ...

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