Unfolding Case Study Explained for Students (Easy Guide)
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Original Question
Unfolding Case Study for Youth with Special Healthcare Needs Health History Caleb Walker is the middle child of Lisa and Ken Walker. He was born with Trisomy 21. He has an older brother and a younger sister. He has had a repair for a VSD. His diet initially was primarily tube feedings of formula through a mickey button due to his history of aspiration on oral foods and liquids. All daily medicines were given through his button. As he has grown, he has worked with various therapies and has mastered chewing and swallowing and is independent of his needs for mealtime. He still needs assistance and supervision with taking medicines but is able to take his meds orally. He has been sick often in the fall and winter months with hospitalizations from pneumonia. At this time, he is ambulatory but still needing various therapies. He knows a few sign words and is verbal with a limited but growing vocabulary. He has visual defects and wears glasses. His father works and his mom is a stay at home mom. His grandmother also lives with them in a small ranch house. The family income is limited and the family often receives food assistance from their local church and food pantry. Part One Caleb is at your clinic for a checkup. He is 12 and attends a life skills class in his local middle school. He rides a special needs bus to and from school and receives therapies at school. Caleb appears happy and smiles often. He loves to help his mom with household chores. His mother has brought him in for his visit today. She seems anxious and after talking with mom, mom verbalizes she has been trying to care for her ailing parent as well as keep up with Caleb’s therapies/doctor visits and family life of the other children. Caleb appears worried when he sees his mom cry. How would you as the nurse assess Caleb and his family for needs and desires? What are the transition concerns for Caleb and his family at this time and how would you discuss these concerns with Caleb’s mom? Describe the value of assessing the family’s perspective on Caleb’s health transition. What resources are available at the local, state and federal level for Caleb and his family? What resources are available at Caleb’s school? Describe how you can collaborate to coordinate his care. Detail how you would put a transition plan in place and monitor Caleb’s progress. Part Two Caleb is 17 and has come to your clinic for his routine check. He is full grown but short in stature and appears happy. His vocabulary has improved and Caleb is more verbal this visit. Caleb is still in public school and can remain a student and attend until he is 22. Mom has brought his younger sister with him today. Caleb appears close in his relationship with his sibling. Mom reports grandmother has passed away. Caleb’s father is still working and carries the family’s insurance. Mom expresses concern with legal paperwork for Caleb’s transitions and asks for assistance. Reflect on social aspects of Caleb’s life that you note as important. What are your concerns regarding Caleb’s upcoming birthday? What issues are important to address with Caleb’s mom at this time with his plan for transitions of care? How you can assess Caleb for his wishes for life transitions as an adult as well as his readiness with skills. What specific steps can you put in place to connect Caleb’s mom with needed resources in the community or local organizations? How would you evaluate if the family needs are being met? Part Three Caleb is 21 and was brought in today by his mother and sister. Caleb will be finishing high school this next school year. He still lives at home with his mom, dad and younger sibling. He is extremely verbal at the visit and wants to tell you about his part time job he has after school cleaning tables at a local restaurant. His younger sister is graduating this year and attending college out of state. His mom expresses concern over changes that are happening both now with the family dynamic as well as in the long term future when her and her husband’s health deteriorates. She would like to plan ahead for where and how Caleb will live when they pass away. The siblings do have a good relationship with Caleb, but mom does not expect the siblings to care for Caleb long term. Describe where Caleb is at in his transitions with his family. Explain how graduating from school will impact Caleb and his family. What resources are available to help Caleb as he finishes school and continues his transitioning to an adult lifestyle or adult-centered care? How would you evaluate if the resources are effective? What state and federal policies are in place currently to help Caleb and his family? Reflect on the long term outlook for Caleb and his family.
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