Health and social care is a very patient-centred care, where people receive treatment and care based on the individual. Due to this, in each case the individual will have a care assessment plan made, which will analyse the patients needs as well as have a detailed plan of action from a variety of professionals involved. This assessment will identify the needs of a fifteen year old boy and a fifty four year old woman, in different circumstances. As well as determine different support strategies, backed by theorists, as possible solutions to help improve their lives.
Case study B follows the story of Alex who is a fifteen-year-old boy. At the age of six Alex experienced an Adverse Childhood Experience (ACE) in the form of the sudden death of his father. Following the death of his father, the individuals mother also had to return to work in the local shop to support the family, which reinforced the rupture of losing his father. Once his mother remarried and went on to have another 2 children, the individual became very aggressive. It appeared Alex’s mother had moved on from the death, but Alex couldn’t. The individual had been expelled from school several times for challenging behaviour and had also been caught breaking into cars and shoplifting. His mother felt she could no longer care for him as she was frightened of him and the stepfather could not control him either. At aged twelve, he suffered another Adverse Childhood Experience as he was put into foster care as it would give his family respite and would give Alex the support he needed. During Alex’s time in care he spent a few weekends at home with his family, however his mother didn’t feel these were working in her best interest as she feared when he turned sixteen, he would ruin their family.
According to Maslow, in the Theory of Human Motivation (1943), there is a Hierarchy of Needs, that all behaviour and needs can be categorised into . This hierarchy can be visualised in a triangle with 5 levels; Self-actualisation, Esteem, Belongingness, Safety, and physiological. According to Maslow’s theory, the ACE of his fathers death and mother returning to work would breach belongingness. Due to the loss of a significant family member, a figure of unconditional love, the sense of being abandoned by his mother, and grieving, indicates that the child’s emotional needs are not being met. Once Alex’s mother remarried and had a further 2 children, Alex may have felt feelings of resentment for his mother and her new family. This merged in the form of aggression as it appears to Alex that she is replacing his late father. This could jeopardise the hierarchy of esteem as it is compromising the respect between himself and his mother. As a result of the aggression Alex had outbursts in the form of shoplifting and breaking into cars, as well as being expelled from school on multiple occasions. It is clear that this behaviour will have an impact on the highest level of the hierarchy of self-actualisation as the actions are morally wrong . Finally, due to his mother being unable to cope with Alex, he was placed into foster care which has an impact on safety. Alex was removed from his family home, a familiar environment, and moved to a foreign place which creates further complications with attachment, confidence and building relationships. In relation to Maslow’s theory it is evident Alex’s needs were not being met as 4 out of 5 of the levels of hierarchy were not achieved.
Following the death of a loved one, it is only natural to have a time of mourning or grief to help cope with the loss. In John Bowlby’s Theory of Attachment (1973), he discovered that the bonds of attachment formed between a child and parent have 4 characteristics are; proximity maintenance, safe heaven, secure base and separation distress. It is a natural response for the children to express behaviours sourced from anxiety, sadness and increased aggression when the child suffers a separation. This was also applied to death, where Bowlby identified 4 stages of grief; shock and numbness, yearning and searching, despair and disorganisation and finally reorganisation and recovery. As Alex was young when he experienced the permanent separation from his father, he would suffer from emotional damage. This is evident as later in life as Alex is making his way through the stages, stuck between numbness and searching, his mother described him as aggressive which is clear by breaking into cars and shop lifting. The death of his father still, at the age of fifteen, has a big impact in relation to building new relationships as Alex has made no effort to form relationships with his step father and two sisters.
A support strategy used often when dealing with grief is a form of therapy called Cognitive Behavioural Therapy (CBT). Cognitive Behavioural Therapy is a way to manage thoughts and feelings by changing the brains natural prewired patterns through talk therapy. The therapy works by changing current overwhelming problems into various smaller problems to tackle. CBT is typically used to treat mental health issues. Even though grieving is not a mental health issue, which Bowlby’s theory explains, the emotions related to grief could manifest into mental health issues. During a Cognitive Behavioural Therapy session, a therapist will break the problem down into separate issues such as feelings, thoughts, smells and actions. As Cognitive Behavioural Therapy is about replacing negative patterns, the therapist will help decide helpful, realistic ways to change the patterns that can be used in other situations. In relation to Alex, Cognitive Behavioural Therapy would break down the feelings and thoughts around his fathers death, including the feelings for his new step dad and sisters and pave for new patterns in order to allow him to return to the famIly and come to terms with a future without his father.Cognitive behavioural Therapy , in comparison with other therapies can work incredibly faster as it doesn’t go back to the very start, it deals with the most recent issues. Another benefit of Cognitive Behavioural Therapy is the strategies that have been implemented into once situation can be transferable to help with other problems the individual may face. However, as Alex is so young, this therapy requires a lot of self-help, out with therapy sessions which take a lot of time and determination. It also requires individuals to address the immediate raw emotions which can cause anxiety and discomfort, especially for someone as young as Alex.
Case study D is based on a fifty four year old woman called Margaret who has a husband and two children. As a result of her children being grown ups they have both moved out and rarely come back to visit, which has left the individual feeling isolated. Margaret originally grew up in a council estate in Dundee, mainly looked after by her eldest sister as their parents both had to work to support the family. When when the individual was young she trained as a seamstress and moved from Dundee to London. Once qualified she moved back to Scotland, Glasgow. This resulted in being completely separated from all of her family. However, Margaret met her husband in Glasgow and raised her two children in the suburbs. At the time of the birth of her first child which was complicated, Margaret’s husband was also in hospital with Tuberculosis for eighteen months. As a result of this Margaret was left to raise her son until the age of 14 months old. After the birth of her second son, it was identified that the individual was suffering from postnatal depression, and prescribed antidepressants. Margaret’s husband didn’t agree with prescription drugs at the time so prompted her not to take them, which she complied with. Margaret’s husband has always dictated what she should do, such as, to be a stay at home mother.
Care plans are designed to take the views of the individual and surround professionals in order to create a plan that meets all the needs of the individual, which will also include details of any equipment or adaptations in plan from the relevant services. Following the Age U.K. Care plan, there are 5 general areas where individuals needs must be met; social, physical, emotional, cognitive and cultural. It appears both Margaret’s physical and cultural needs are being met, however it does not seem to be the same for the social, emotional and cognitive needs. Although the individual now attends many group activities where she is able to make friends and socialise, she feels as though she is isolated and misses out on socialising with family. As when Margaret was younger she stopped contact with the family when she moved back to Scotland, the only family she has now is the one she created for herself. Once the children moved out, Margaret was left home alone with her husband but desires the company of her children, who rarely visit her. Margaret’s emotional needs are also not being met, as she is experiencing negative emotions, to the extend she wants to attend the doctors. However her husband has discouraged her and persuaded her not to go. Finally, the individuals cognitive needs are also not going met as she lives with a dictating husband, who makes all of her decisions