CMCT01_Case_Studies 2015

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CASE STUDY 2 – TOM

CDC is a way of delivering services that allows consumers to have greater control over their own lives by allowing them to make choices about the types of care and services they access and the delivery of those services, including who will deliver the services and when. Under a CDC approach, consumers are encouraged to identify goals, which could include independence, wellness and re-ablement. The consumer on a CDC package decides the level of involvement they wish to have in managing their package, which could range from involvement in all aspects of the package, including co-ordination of care and services, to a less active role in decision- making and management of the package. The key principles of Consumer Directed Care are; Consumer choice and control; Consumer rights; respectful and balanced partnerships; participation, wellness and transparency (including financial). Please consider the CDC philosophy and requirements/guidelines when reading and responding to this case study. Tom is a 78 year old alcoholic who lives in a ground floor unit close to the beach. He has had 8 admissions to hospital in the last 6 months, usually as a result of falls whilst he is intoxicated or because he has been found semi- conscious by the police. Tom has a diagnosis of gout and hypertension. He often has injuries from his falls and has some chronic ulcers on his legs. Tom’s toenails are overgrown and causing him some pain. He has been referred to your service by the local ACAT team and discharge planner from the local hospital for a Consumer Directed Care Level 2 with a view to Consumer Directed Care Level 4 package in the future. When you visit Tom you find the front door is unlocked and there is a younger man living in one of the bedrooms. There is no telephone connected, no food in the fridge and only some cans of food in the pantry. The house is relatively clean but there is no electricity connected and very little furniture or household appliances. ►► Tom later reveals that he usually shoplifts his tinned food and tells you the best places to undertake this activity. He has been in gaol for petty crimes and not paying fines. Tom has not been incarcerated for many years yet he very vivid memories of this time that causes him great anxiety and distress. ►► Tom has refused further residential respite as it “felt too much like gaol” last time he was there. ►► Tom confides in you that his flat mate pays no rent and has taken the main bedroom but he is OK with this as the second room is warmer in winter and if someone breaks in then the flatmate can protect him. ►► Tom later confides in you that the flatmate has also borrowed money from him and not paid him back. ►► Tom usually leaves the unit by 11.00AM so that he can go to the early opener. ►► Tom has never voluntarily visited a local doctor and has only been examined by a medical practitioner during his recent hospital admissions. Instructions: 1. Please answer each of the questions overleaf utilising the CDC philosophy 2. Please complete this activity with reference to the resource materials provided. Please document and report your findings back to the group. Questions: 1. What guidelines from each of the CMSA National Standards of Practice for Case Management would you utilise in this case? 2. How does your proposed case management provide evidence of: A. Facilitating the personal development of Tom? (i.e. his individual, diverse and special needs, including his aspirations, choices, expectations, motivations, preferences and values) B. Advocating for Tom’s rights? (including developing Tom’s strengths to advocate for himself) C. Addressing Tom’s needs? (i.e. purposeful case management) D. Promoting sustainable solutions for Tom? (i.e. balances Tom’s needs with the available resources and any of your possible limitations as a case manager) E. Effective communication? (i.e. with Tom and other Key Stakeholders) Additional information ►► Tom has tried MOW but due to the times of delivery and his dislike of strangers he doesn’t really want to use this service again.

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