Case study for a client with schizophrenia

Case adopt for a node with schizophreniaand has had three admissions to hospital the last cardinal five twelvemonths ago ,her name hala ,at the age of 35 year old ,she live with her brother but tend to be a bit overprotective ,not allowed to take much(prenominal) province in the stead or to go go forth alone .The clinical come across of the lymph glandIt accept the, signs symptoms for the client.Hala has moderately severe negative symptoms ,The negative symptoms of schizophrenia, defined as the absence or diminution of normal behaviors and functions , negative symptoms account for much of the long-term morbidity and poor functional outcome of patients with schizophrenia.. The signs and symptoms of schizophrenia be numerous and debilitating , these symptoms are the lack of in-chief(postnominal) abilities . Some of these include1)Alogia or poverty of speech, is the less(prenominal)ening of speech fluency and productivity, unfitness to subscribe to a conversation ,thought to reflect slowing or blocked thoughts, and frequently manifested as short, empty replies to questions.2) Affective flattening is the reduction in the range and military capability of emotional expression, including nervus facialis expression, voice tone, midpoint contact (person seems to stare, doesnt maintain eye contact in a normal process), and is not able to get wind body language nor use appropriate body language.3) Avolition is the reduction, difficulty, or inability to initiate and persist in goal-directed behavior it is often erroneous for apparent dis beguile. ) Inappropriate societal skills or lack of interest or ability to socialize with other people. (examples of avolition include no drawn-out enkindle in going out and meeting with friends, no longer fire in activities that the person used to show enthusiasm for, no longer interested in much of anything, sitting in the house for legion(predicate) hours a day doing nothing.) .4) Catatonia Apparent unawareness of the environment, near ingrained absence of motion and speech, aimless body movements and bizarre postures, lack of self-care.5) accessible isolation person spends around of the day alone or single with close family, and inability to bugger off friends or keep friends, or not caring to have friends.6) Low energy the person tends to sit almost and sleep much more than normal.The client is being worked upon with the following MDT head-shrinker the psychiatrist works with the client using needed medication, such as Prozac.Psychologist the psychologist works with the client using different approaches, in order to recognise her, and her behaviors, through talking, observingSocial worker the social worker works with the client in understanding difficulties that the client has, that guess her social smellfor example not going to work, the thing that affects her social relations and networks. physician and nursing the physician is a general doctor that follows up the clients medical checkup status. On the other hand, the nursing team is available in the sanctuary for the clients need to be supervised by a medical team, for if mortal would have a relapse, an action would be done, such as big injections.Finally, the MDT works together, by meetings and reports about each client.She is treated with medication and visits the out patient clinic at the hospital every three months to see her doctor. she good about raking her medication and keeping her outpatient appointments. discourse may includebehavioural therapy patients with schizophrenia improve their social skills and put structure in their lives. through social skills training, they may learn how to make requests, express feelings, and adjust their voices and facial expressions.The impact of the illness will have on the clients occupational carrying outThe impact of these symptoms on ADL, work, and liesure.Activities of everyday living require the ability to perplex and repeat purposful task pe rformance so that give-up the ghost habitual or routine and these tasks or activities include bathing, grooming, and dressing, washing hands before a meal, eating with resonable table manners, then cleaning up. Persons who have schizophrenia may find routin task performance interrupted by symptoms, side do of medication, and progression of schizophrenia. Auditory or visual hallucinations may interrupt attention, and tactual discomfort with texture of materials may limit occupational performance. Many ADL routines become challenging in the presence of motor problems produced by negative symptoms and the neurologic side effects of medications. Incoordination, tremores, rigidity, or slow movement may arbitrate with tasks like replacing caps on bottles, shaving, and using eating utensils. In the mental area, major barriers to ADL are pathy, avolition, or extreme withdrawal. Even persons who show interest in social interaction may not complete the self-maintenance tasks that would addition social acceptance. They are unable to engage themselves in tasks and may figure on others to involve them. fainally, self-management difficulties in schizophrenia influenece ADL performance to a extensive extent. Routines are abandoned when persons are unable to cope with environmental or internal stressors. Time management and self control become weak. work upOfen persons with schizophrenia have difficulty finding satisfactory housing or keeping a job because of psychological, and self-management performance difficulties. Also, negative symptoms such as withdrawal, avolition, substance abuse, neurological impairment, medication side effects, and coexisting medical conditions make work performance impossible for many.The modelframe of reference I used to pack the judicial decision and intervention with the clientFrame of reference MOHO model of benignant occupationI chose MOHO because it 1)Furnishes a elaborate framework of the occupational process of hala.2)Enables p recise measurement and recyclable description of hala occupational characteristics .3)Give specific and detailed guidelines and tools for evaluating hala ,a specific language for describing the difficulties or challenges encountered ,and a framework for setting treatment goals and selecting the most appropriate strategy to achieve the desired direct of kind .4)allows for a flexible approach to individualized therapy for hala and provides a comprehensive picture of the occupational functioning .5)provides a conceptualization of the process and stages of change that was useful for guiding the sequence of therapy (including deciding when hala is ready to move from one level of change to another).how I assess the clientI chose an act during the assessment ,I chose washes plastic platesI chose ACIS assessment (( assessment of communication and interaction skills)).The ACIS is a formal observational tool ,to measure an individuals performance in an occupational form within a social gr oup ,that allows occupational healer to study a clients strengths and weaknesses in interacting and communicating with others in the course of daily occupations.I chose ACIS assessment because ,it is most effectively used to generate a profile of strengths and weaknesses and qualitative details about my client ,this profile is the most important source of information for deciding what skills to target for change. ACIS is often reformatory for understanding why is my client having difficulty with some interaction skills .The Canadian Occupational Performance Measure (COPM)to detect change in a clients self-perception of occupational performance over time. Follow the links below for foster information about the COPM.intervention processAssess clients level of freak out to determine specific requirements for sanctuary.Skill training interventionsIdentify areas of skill shortage person is willing to work on.determine the goals for the client (shortlong terms goals) starting I will establish the goals together with halaI will determine the goals from the deficit in her function ,from observation during the activity ,from the assessment ,and the client can ask me about some ability that she want to drive off it .Long term goal to let her take much responsibility in the home ,allow her go out alone without any riskiness to her ,or her health or people .for example let her visit the hospital to see her doctor.Let her work for example secretary as she prepare in the past ,or work in an office as she worked at age 21.Let her feeling more confident in social situations , can be operationalised by identifying performance indicatorsShort term good-natured in activity,increased motivation,improved judgment, increased energy, ability to experiencepleasure and cognitive Function.factors that affect or important in assisting the client to reach the goalsimportant factorthe client good response to the medication ,the acceptance of his situation, less number and the ra nge of episodes, if she like the activity .her tolerance and endurance during the activity ,assessment and medication.Environment good interaction with his environment ,feel some degree of safety in the therapy environment and in his living environment .Factors that might affect the clients programClient forget take the medication, she didnt like the activity or it is not suitable for her ,there is no therapeutic relationship.,Family members may require agree as clients in their own right. They may also play a key role as an extension of the therapy team. Where nipperren are involved, a detailed assessment of child safety is required, generally by someone specifically trained in this area such as a child protection worker