# data[].attributes.headline
Psychotic symptoms: Auditory hallucination: Hearing voices of an elderly female telling her that she is worthless and does not have a bright future ahead 

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Psychotic symptoms: Auditory hallucination: Hearing voices of an elderly female telling her that she is worthless and does not have a bright future ahead 

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Self-management coping strategies: Ignoring auditory hallucinations through the use of doing other things/distraction, example: play piano, do arts.

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Lack of health literacy

Ineffective coping mechanism

Non-compliance to medications

Risk for self injury or recurrent suicidal attempt

Disturbed thought process and sensory

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Ensure adequate intake to promote normal body function  - provide small packets of snacks, prepare patient’s favourite food, Dietician referral

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Educate on the effective coping mechanism

Empower patient to be responsible for her own health

Reinforce and redirect patient to reality

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Suicidal ideation, as she feels hopeless about the future and worries that she will be a great burden to her family.

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Suicidal ideation, as she feels hopeless about the future and worries that she will be a great burden to her family.

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Express hope to the patient with realistic comments about the patient’s strengths through Family conference and reassurance from family.

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Referral to case manager and community resources to ensure patient is compliant to medications and treatments

Encourage open communication to explore issues and worries

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Lack of emotional support and communication from family

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Lack of emotional support and communication from family

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CGT- Educate family on importance of family support, by providing family counselling services.

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Lack of confident in taking care of patient at home

Ineffective communication with patient involving high expressed emotion and nagging

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Lack of communication

Lack of knowledge of community resources

Lack of education in managing patient during stress event

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Plan for problem faced by main caregiver 

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Plan for problem faced by main caregiver 

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assess caregiver’s knowledge

Educate post discharge care plan accordingly based on patient’s need

Counseling

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Educate the family on the ways of communication between patient and the family.

Educate the family on the coping mechanism in the event of stress

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Action for problems for the main caregiver 

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Action for problems for the main caregiver 

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Ensure the caregiver has the appropriate training/education before caring for the client.

Provide hand’s on training on caregiver education

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Refer to counseling session for the family and patients

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Declined functional status: neglect good hygiene, poor sleep hygiene due to insomnia

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Declined functional status: neglect good hygiene, poor sleep hygiene due to insomnia

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OT/PT Referral, Home AIC Programs. OT REFERRAL: To help or regain patients’ ability to perform ADLs and recommend ways to improve environment to suit the functional needs of patient. Home based community programs, help enhance patients functional status

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Caregiver stress due to physically aggressive and verbally assaultive client, constant suicide attempts 

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Caregiver stress due to physically aggressive and verbally assaultive client, constant suicide attempts 

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Provide family psychoeducation by sharing on crisis management. Emergency hotlines, mobile crisis team. Samaritans of Singapore, a 24 hour hotline.

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Caregiver stress: inability to manage their daughter at home.

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Caregiver stress: inability to manage their daughter at home.

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Provide family with community based services. Community Mental Health Programs. Psycho social rehabilitation.

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Thank you all for your submissions.
Here is an example of identified problems and the plan of care: | Problem Identification | Plan | Action

| For client      |
| Problem Identification |
·       Maladaptive coping - suicidal tendencies & Poor
hygiene
·       Altered thought process (Hallucination & Delusion)
·       Loss of appetite
·       Does not engage in social activities
·       Altered sleeping pattern
| Plan for the problems identified above |
·       Refer to psychiatrist to evaluate schizophrenic and depressive status
·       Psychoeducation
·       Refer to community resources for continuous psychiatric
rehab,  psychoeducation
·       Refer to counsellor
| Action for the plan stated above |
·       Counselling
·       Need for titration of anti-depressive medications
·       Need for titration of Anti-psychotic medications
·       Refer to Job club
·       Refer to day care centres

| For family   |
| Problem Identification |
·       Mother is overly involved
·       Parents having high expectations of Tracey
| Plan for the problems identified above |
·       Refer to counsellor / MSW for marital counselling,
parenting skills
| Action for the plan stated above |
·       Counselling

| For main caregiver | Not applicable

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Please see response in Column 1 (last entry)

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Please see response in Column 1 (last entry)

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Please see response in Column 1 (last entry)

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Please see response in Column 1 (last entry)

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Please see response in Column 1 (last entry)

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Please see response in Column 1 (last entry)