Case Study of a female resident at Rookwood
Antecedent and brief history - Rookwood - Female - 60 yrs
This female service user has been a resident at Rookwood MH services for 4 years. Diagnosis: A long history of mental health problems diagnosed in 1973 as being schizophrenic, presented with fixed delusional ideations of grandiose nature in that she was related to royalty, believing that she was pregnant, ideas where fixed and immovable.
The lady also presents with both auditory and visual hallucinations that can vary in severity and be quite distressing to her. She has had numerous admissions to psychiatric institutions such as Scalebor Park hospital and Lynfield Mount hospital.
Assessment and person centred planning
Reason for admission to Rookwood was to provide a more supportive environment in which this lady's needs could be met with encouragement given to promote independence and choice. Risks associated with individual care planning: wandering as a result of delusional ideation, can become lost and disorientated. Reluctant to accept medication as a result of delusional ideation- that it will harm her baby. Deterioration of self care skills and hygiene. Potential of exploitation/vulnerability. Encouraging participation in activities and interests.
Progress and outcomes to date
Since admission to Rookwood there has been a full Multi-Disciplinary Team working arrangements in place with partnership in formulating a Care Programme Approach Plan. This plan is reviewed on a six monthly basis, although it is reviewed at times of concerns/crisis. The main aim is to effectively manage her care within the community without the need for hospitalisation, and to encourage participation in community resources that are available. This lady settled well into the home and the main aims have been achieved with participation in activities both in the home and local resources, such as the art group. The main risk factors have been managed effectively by staff. Her mental health needs have remained stable and manageable until recently.
Concerns have been raised by staff with regards to increasing episodes of cognitive impairment. A Mini Mental State Exam scored this lady as having a moderate degree of cognitive impairment. This lady is now scheduled for furtherneuro-psychological testing and re-assessment.
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