A. Take Home Assignment.

Module 7 – Care Planning/

Restorative Care/
Documentation/Working in the
Community Assignment

General Directions:

B. The assignment will count for 40% of your final mark in Module 7.

Name: _________________________________________________________

Due Date: ______________________________________________________

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CASE #1

Mrs. Gregg is a 55-year-old widow who has had an active career as a lawyer. She is an avid
reader. She is an independent woman who has had to adapt to many changes in her life. She
enjoys crafts and sings in the choir at her church. She has an adult son and daughter, and two
grandchildren who visit her frequently. She lives in her own home, a small bungalow in the
city.

You are assigned to give care and support to Mrs. Gregg, who had a stroke two weeks ago.
She is paralyzed on the left side and has difficulty speaking. She is able to hear well and can
understand when you speak to her. The long-term goals for her care include:

∙ regaining mobility
∙ regaining speech
∙ being as independent as possible
∙ preventing complicationssuch as contractures and pressure sores

You are required to assist her to participate fully in all activities of daily living, and assist to
meet her physical, safety, and psychosocial needs.

1. What information would you want to find out about Mrs. Gregg and her home before
beginning her care?

Medical History and Current Condition:

● Detailed information about the stroke, including the extent of paralysis and speech difficulties.
● Any other medical conditions or allergies she might have.
● Current medications and any treatments or therapies she is undergoing.

Cognitive and Emotional State:

 ● Her current cognitive abilities and any changes post-stroke.
● Her emotional and psychological state, including any signs of depression or anxiety.

2. List the types of information that you would expect to obtain from the care plan.

Medical Diagnosis and History:

● Details of her stroke and any other relevant medical conditions.

● Her overall medical history, including previous surgeries, chronic conditions, and allergies.

Current Medications and Treatments:

● List of medications she is currently taking, including dosages and schedules.

● Information on any ongoing treatments or therapies (e.g., physical therapy, speech therapy).

Cognitive Status:

● Information on her cognitive abilities and any changes since the stroke.
● Cognitive rehabilitation goals and progress notes.

3. In the following problem, explain briefly the feeling expressed by the client and the actions
for the Personal Support Worker to take (2 marks each).

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Situation 1

Mrs. Gregg continually uses her knife to eat with and is generally unable to choose the
correct utensil and unable to cut her meat. She has difficulty getting food to her mouth.
She resists help. One day she threw her plate acrossthe room.

Client’s Feelings

_Mrs. Gregg is likely feeling overwhelmed and frustrated due to her difficulty in
using utensils properly and feeding herself. Her resistance to help and the
incident of throwing her plate suggest that she is experiencing a strong sense of
helplessness and loss of independence, which can lead to anger and distress.
 PSW Actions (physical and emotional help)

Acknowledge Her Emotions:

● Approach Mrs. Gregg with empathy and understanding. Use calming and supportive language
like, "It seems like this is really frustrating for you, Mrs. Gregg. It's okay to feel that way."

Offer Gentle Assistance:

● Suggest adaptive utensils or tools that can help her eat more easily without taking over
completely. Explain that these aids are meant to help her maintain her independence and make
eating less challenging.

Situation 2

Mrs. Gregg has expressed a desire to read, but she is unable to understand the text in her
old books. She asks you to help her practice words. She says that she has trouble passing
the time and that she expects to return to work in several weeks.

Client’s Feelings

Mrs. Gregg is likely feeling discouraged and anxious about her inability to
understand the text in her books, something she once enjoyed and found
meaningful. She may also feel bored and restless due to the difficulty in passing
the time. Despite these challenges, she shows determination and optimism by
wanting to practice words and expressing a desire to return to work soon.

PSW Actions (physical and emotional help)

Acknowledge Her Concerns:

● Show empathy and understanding. Say something like, "I can see that this is frustrating for you,
and it's great that you want to work on improving your reading."

Facilitate Reading Practice:

● Dedicate time each day to help her practice reading. Start with simple words and gradually
introduce more complex texts as she improves. Consider using large print or audiobooks if
needed.
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Situation 3

One day when you approach Mrs. Gregg, she is crying and says she doesn’t want to get
up. She says, “None of this should have happened to me. What did I do to deserve this?”

Client’s Feelings

Mrs. Gregg is likely feeling profound sadness, frustration, and a sense of

injustice. She may be overwhelmed by her situation, questioning why this
happened to her and grappling with feelings of helplessness and despair.

PSW Actions (physical and emotional help)

Express Empathy and Compassion:

● Approach her gently and acknowledge her feelings. You might say, "I'm really sorry you're
feeling this way, Mrs. Gregg. It's completely okay to feel upset."

Listen and Provide Emotional Support:

● Sit with her and let her talk about her feelings without interruption. Sometimes, having
someone who listens can be very comforting.

Situation 4

Mrs. Gregg insists on getting up by herself and moving independently from her chair to
the bathroom. She uses a walker. Occasionally she falls. She is a private person and does
not want you to attend her in the bathroom.

Client’s Feelings

Mrs. Gregg likely feels a strong desire to remain independent and in control of
her own life. Her insistence on moving by herself and her need for privacy,
especially in the bathroom, show that she values her personal space and
autonomy. Despite occasional falls, she prefers to handle things on her own,
which reflects her determination to maintain her dignity and self-sufficiency.
 PSW Actions (physical and emotional help)

Enhance Safety:

● Make sure the bathroom is safe by adding features like grab bars and slip-resistant mats.
Suggest any changes that could help her move more securely and comfortably.

Offer Assistance Discreetly:

● Let her know you’re available if she needs help but respect her desire for privacy. For example,
say, "I'll be just outside if you need anything, but I’ll give you the privacy you prefer."

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4. Using all of the above information, describe how the following factors might affect Mrs.
Gregg’s relearning of speech and mobility. Use case study information to help answer
questions.

a. Age
Mrs. Gregg, at 55 years old, is relatively young for someone who has had a
stroke, which can impact her relearning of speech and mobility in both positive
and challenging ways:

Positive Factors:

1. Neuroplasticity:
○ Younger individuals generally have higher levels of neuroplasticity, meaning their brains
may be more adaptable and capable of reorganizing and recovering function after a
stroke. This can aid in her relearning of speech and mobility.
2. Physical Resilience:
○ Being relatively young, Mrs. Gregg may have better overall physical health and stamina,
which can support her recovery and rehabilitation efforts.

Challenges:

1. Expectations and Self-Perception:

○ At 55, Mrs. Gregg might have high expectations for a full recovery, potentially leading to
 frustration if progress is slower than anticipated. Her professional background and
desire to return to work soon may contribute to this pressure.
2. Age-Related Changes:
○ While age is not a major barrier at 55, some age-related factors such as changes in
muscle strength or coordination could still impact her physical recovery and
rehabilitation efforts.

b. Individual characteristics: personality

Mrs. Gregg's personality traits significantly influence her relearning of speech
and mobility

Positive Factors:

1. Determination and Independence:

○ Mrs. Gregg's strong desire to maintain independence and return to work shows her
determination and resilience. These traits are likely to drive her commitment to
rehabilitation and help her persist through challenges.
2. Proactive Attitude:
○ Her willingness to practice reading and improve her cognitive skills indicates a proactive
approach to her recovery. This attitude can be beneficial for both her speech and
mobility rehabilitation.

Challenges:

1. Resistance to Help:
○ Mrs. Gregg's resistance to accepting help, especially in personal activities like using the
bathroom, may impact her ability to receive necessary support and adapt to changes.
This resistance might also make it harder for her to engage in therapy if she perceives it
as intrusive.
2. Frustration and Self-Criticism:
○ Her frustration and feelings of injustice, as shown by her emotional reactions and
self-criticism, could affect her motivation and emotional well-being. Negative emotions
might hinder her progress if they lead to decreased engagement in rehabilitation
activities.

c. Environment
Mrs. Gregg’s environment plays a crucial role in her relearning of speech and mobility:

Positive Factors:

1. Home Comfort and Familiarity:

○ Living in her own home provides Mrs. Gregg with a familiar and comfortable
environment, which can positively impact her emotional well-being and motivation.
Familiar surroundings can help reduce stress and make it easier for her to engage in
rehabilitation activities.
2. Support from Family:
○ Regular visits from her adult children and grandchildren offer emotional support and
encouragement, which can be beneficial for her recovery. Family support can boost her
morale and provide motivation for her rehabilitation efforts.

Challenges:

1. Safety and Accessibility Issues:

○ Her current home setup may pose safety risks, such as the potential for falls when
moving with a walker. Ensuring that her home environment is adapted for her
needs—such as having grab bars, non-slip mats, and an accessible layout—will be
important to prevent accidents and facilitate mobility.
2. Privacy Concerns:
○ Mrs. Gregg’s preference for privacy, especially in personal spaces like the bathroom,
may limit the extent of assistance she is willing to accept. This could impact her ability to
fully benefit from support and adaptations aimed at improving her safety and mobility.

5. Describe five (5) ways in which the PSW can promote Mrs. Gregg’s self-esteem and
motivation during her daily routines.

Encourage Independence:

● Allow her to perform tasks on her own and make decisions about her routine.

Acknowledge Achievements:

● Praise her progress and celebrate milestones, no matter how small.

 Offer Positive Reinforcement:

● Use encouraging words and support her interests to keep her motivated.

Create a Supportive Environment:

● Ensure her home is safe and comfortable, and respect her privacy.

Foster Social Connections:

● Encourage interactions with family and friends, and listen empathetically to her concerns.

6. Define Restorative Care and what role it would play in helping with Mrs. Greg’s
rehabilitation. How could the PSW assist with this process?

Definition of Restorative Care

Restorative care focuses on helping individuals recover their highest level of function and
independence after an illness or injury. It aims to restore physical, mental, and emotional health
through targeted interventions and supportive practices to enhance overall quality of life.

Role in Mrs. Gregg’s Rehabilitation

For Mrs. Gregg, restorative care would be important in:

1. Restoring Mobility:
○ Assisting her in regaining the ability to move and walk independently through specific
exercises and physical therapy.
2. Improving Communication:
○ Helping her recover her speech and communication skills through speech therapy and
practice.
3. Encouraging Self-Reliance:
○ Supporting her efforts to take part in daily activities and make decisions, fostering a
sense of control and self-sufficiency.

PSW’s Role in the Restorative Care Process

 1. Support Exercise Routines:
○ Help Mrs. Gregg with her prescribed exercises and physical activities to ensure she
follows her therapy plan.
2. Encourage Daily Activities:
○ Motivate her to participate in daily tasks and make decisions, which helps her practice
and maintain her skills.
3. Track and Report Progress:
○ Observe and record her progress, and inform her healthcare team about any changes or
concerns.

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