You are to write a 3,000 word (+/- 10% excluding reference list) a care study. This can be based on the scenario provided or you may select a patient(s) of interest from your practice experience and relevant to your field of practice. The essay will draw upon relevant theoretical concepts supporting decision making in the assessment planning and interventions to meet the patient’s / client’s needs. A systematic approach in assessment and care delivery must be evident with reference to national and /or professional guidelines to support shared decisions.

Schizophrenia

Service user: Simon Evans, 32 has a diagnosis of schizophrenia

Present Situation: He still has some of the negative symptoms and still suffers from auditory hallucinations. He still lives in his mother’s home although he has little to do with his father. He has one brother who left home several years ago and now works as a teacher. His mother finds Simon’s symptoms and behaviour very difficult to cope with at times and has benefitted from family therapy and remains very supportive.
He often neglects his physical health and will stay up at night, chain smoking, will eat and drink erratically and neglect his personal hygiene unless constantly prompted by his mother.

History:
Simon was diagnosed with schizophrenia aged 20 following a deterioration of his mental health. Simon has a history of symptoms which include auditory hallucinations, disorders of perception, thoughts and affect.
His initial illness was followed by some deterioration in personal functioning which included memory and concentration problems, unusual behaviour and ideas, disturbed communication and affect, and social withdrawal, apathy and reduced interest in daily activities. This was then followed by an acute episode with hallucinations, delusions, and behavioural disturbances, which included agitation and distress.

Personal and social history:
He left school at 16 with no qualifications and has had several jobs in supermarkets e.g stacking shelves but found it difficult to hold down a job for long. He has not worked since his diagnosis.
He rarely goes out although when he goes out because of his bizarre dress he has been tormented by some local youngsters

Medication: He is now on Clozapine which he tolerates well but has gained weight

Assessment

After hospital admission for a further psychotic episode under the mental health act (2007) Following treatment and on discharge his assessment is:
Weight 16st 2lbs
BMI 30.5
ECG clear
Clozapine 500mgs per day
Urine Ketones detected
Blood test NAD
Family intervention to continue
Consider offering arts therapies, particularly to help negative symptoms of schizophrenia.
Has started CBT, in the inpatient setting which is to continue following discharge

His mother is still extremely worried about Simon’s behaviour but continues to be supportive and wants to be involved at every step of the care given.

Discuss how Simon’s on-going health needs will be met.