Case Studies by https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on VIVA en-us 2021-01-21 08:52:29 UTC 2021-01-21 11:47:32 UTC hello@padlet.com Scenario One – LoisLois is 14 years old. She lives with her Mum, step dad and two siblings. Her siblings are aged 4 and 6 years old. Lois has a good relationship with her Mum and step dad. She visits her Dad every other weekend and enjoys spending time with him and his partner. Lois enjoys spending time with her siblings but also feels pushed out sometimes due to their age and the attention they receive. Lois has a good group of friends at school and is becoming more independent.Lois has a diagnosis of cystic fibrosis. As a result she has to take medication daily and should do physiotherapy on a daily basis. Lois has a port in situ and requires hospital admissions regularly for administration of intravenous antibiotics. When admitted to hospital Lois requires a cubicle and is not allowed to mix with other patients, especially other patient's with a diagnosis of cystic fibrosis. During hospital admissions Lois’s family struggle to stay with her due to work commitments and needing to care for her younger siblings.On a recent admission to the ward Lois is very quiet and withdrawn. She refuses to complete her physiotherapy and will not engage with the ward school teacher. You overhear Lois telling her Mum she is fine and does not need her to visit. When you speak to Lois she tells you that her friends will not be visiting this admission. nicolabowker_50 https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109108890 2021-01-21 08:54:18 UTC https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109108890 nicolabowker_50 https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109531800 2021-01-21 11:04:23 UTC https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109531800 Lois's own illness and medical needs. nicolabowker_50 https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109550597 Possible mental issues?
Guilt of having a chronic illness.
Affect on her family.
Annoyed and why me?
Not feeling normal?
Can exacerbate her physical illness.
Siblings might think she gets more attention. Sibling rivalry.
Why do we have to do things because of them!!
Different relationships with parents.
Adolescent brain.
independent patient? decision making?
Hyper vigilance for illness.

Lois's mum?
Stressed, different children have different needs, because of ages.
Guilt of having a poorly child.
Separation of previous relationship and 'new' family.
Juggling different roles.
Financial implication.
mum want Lois to be well.
Hyper vigilance for illness.
Lois's dad
Guilt
Only seeing at weekends
quality of the relationship? Barrier to communication
Covid - only 1 parent able to visit.
Does she want to burden her dad but saying how she is feeling?
Relationship between mum and dad?
Hyper vigilance for illness.
Step dad?
Depends on relationship?
similar issues as her mum.

Siblings
Do they need to be careful of illness around her?
Hyper vigilance for illness.]]> 2021-01-21 11:11:07 UTC https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109550597 Lois nicolabowker_50 https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109610326 How much time is she in school?
the affect on peer relationships.
academic work is she behind.
how does she maintain contact with her friends? 
Cannot do and be the same as her friends. 
support group.
Non compliant with medication and physio - taking control of the situation. creating a relief from the situation.
Cannot be bothered and want o forget it.
Friends don't want to do this.
Time!!!!
Adolescent brain wanting to sleep.

]]> 2021-01-21 11:33:10 UTC https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109610326 What can we do? nicolabowker_50 https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109628696 Talking therapy, discuss with Lois in an open conversation and see if you can pick up on whats happening for Lois.
Support groups, use social media to feel connected to people who have same condition. 

Play team and education team, specialist nurse. 

encourage mother and dad (all family) to face-time and phone Lois.

Acknowledge you cannot change her condition but you can impact on her day to day life, not just her CF. 

Make it about her as a person - see beyond her condition.  Normalising her.

Be careful about the language 'use the diabetic in bed x'

Make them feel less of a burden. 

Not Labeling them through their condition. ]]> 2021-01-21 11:40:09 UTC https://padlet.com/nicolabowker_50/ebqpdhmvp6sf90on/wish/1109628696