Joe is a 28-year-old man of Chinese origin who has a mild learning disability and suffers from bipolar affective disorder. He lives independently in his own home and is known to the local community learning disability team.
Joe works in the kitchen of the family take-away shop, cleaning and washing up. An environmental health officer who visited the premises reported an argument between Joe and his brother about the amount of money his brother was paying him; Joe had become very agitated. You have recently been made aware that Joe is unhappy working for his family.
As his learning disability community nurse you want to organise a case conference to discuss how to support Joe.
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1. What are some of the causes of these difficulties?
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Correct answer:
- Would you like someone to come with you?
- Would you like someone to speak on your behalf?
- Are you happy for us to speak in English, or would you like someone to translate what we say?
- Do you use any sign language, and if so would you like someone to sign for you?
- Would you like a list of people who will be there?
- Would you like to add to the list of things to be said?
- This helps to support Joe in a person-centred manner and ensures that Joe feels fully involved and engaged in the case conference.
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2. What is the role of the CLDT nurse in the case conference?
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Correct answer:
- Re-introduce yourself and ensure everyone introduces themselves to Joe.
- Ensure Joe feels at ease.
- What we say here will be confidential. Explain.
- Do you have any problems? Record and address.
- How are your moods? Address difficulties taking medication.
- and discuss consequences.
- How is your job? Address remuneration problems, hours worked, duties, supervision needs and so on.
- Any domestic problems (daily tasks, bills, etc.)
- Would you like to take any training courses or further education? Describe how this can be arranged.
- What will happen next… (likely consequences of this meeting).
- Explain how long processes may take and tell Joe how often you will contact him, either in person or by telephone.
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3. What is the role of the CLDT nurse following a case conference?
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Correct answer:
- Need to write up a report of this meeting.
- Review and update your care plan.
- Review and update your risk assessment with risk management guidelines and a crisis contingency plan covering health and social needs.
- Plan for regular meetings with Joe to review and update the care plan.
