However if you are seen as enjoying playing the sick role, people might label you as a malingerer. “A malingerer is someone who shirks their duties by pretending to be ill” (Block 1 who cares, p-67), this also has its problems as you start to feel isolated, depressed and loss of self-esteem from hiding daily activities from people. Therefore, before you even contemplate on seeing a doctor you will have already taken on the sick role. The NHS is split into two, Primary and Secondary health services they both look after people who suffer from long-term illnesses i. . diabetes, asthma and coronary heart disease. It is estimated that there are around 15 million people in England that have a long-term illness (DH 2006). ‘Your local doctors’ surgery or GP practice provides a wide range of family health services’ (NHS Choices, 2007). I myself will often refer to a study of a man named Anwar Malik that I have been studying, who himself has used most of the health services. Anwar Malik is a 54 year old green grocer and lives with his wife Hansa and their youngest son Iqbal.
Anwar originally was born in Pakistan and came to live in the UK when he was a young man. Anwar’s first language is Punjabi and Urdu, but can speak English as Hansar and Anwar speak it in their shop. Anwar had been feeling unwell for a while, lethargic, tired and generally thirsty. Anwar’s wife noticed that he had become less active and frequenting the toilet more often. Hansa his wife became concerned for her husband’s health and advised him to visit his doctor. Anwar’s G. P referred him to hospital for further tests where it was discovered he in fact was diagnosed with diabetes.
Primary care services are normally the first point of contact if you have a health related issue, an appointment with your GP (general practitioner), dentist, nurse or optometrist. It is estimated that around 90% use this service and most can be accessed in the doctor’s surgery, although Anwar could have gone to his local walk in center or even telephoned NHS direct. If your illness requires further tests your G. P will refer you to a secondary health care provider, this is what happened to Anwar Malik. Secondary care is defined as a service provided by medical specialists who generally do not have first contact with patients.
Secondary care is usually delivered in hospitals and patients have usually been referred to secondary care by their primary care provider (usually their GP) (Dr Foster 2001). What can people expect to find in a hospital setting? Consultants, nurses, health care assistants and domestics are just a few to name. There are different departments that split the hospital, intensive care; different medical wards i. e. Neurology, surgical, and also not forgetting the Accident and Emergency department. Communication between primary and secondary care breaks down quite easily, especially if you are receiving long term care.
If you are being seen as an outpatient for long periods, the GP will need to be informed of their treatment and progress, as this could have an impact on the GP’s own treatment for the patient. Social care supports people for whatever reason that is unable to function without support or supervision in their own homes. Some families struggle to fund this kind of service as it is not always free and requires service users to use their own money in order to obtain the service. Home care workers work to a care plan which determines what they do for each service user.
However there needs to be clear boundaries between the home care worker and the service user in being friendly and being a friend, otherwise this could lead to considerable emotional demands on the home care worker. There are a combination of factors why some are reluctant to use this service, as it requires ‘strangers’ going into the service users own home and carrying out personal care. Service users can also get very frustrated with home care as there are frequent changes in staff and some are even poorly trained.
The service can be unreliable due to staff sickness or not receiving a call due to adverse conditions, leaving the service user stranded. However there are a majority of service users that enjoy home care as it is delivered in the comfort of their own homes, takes pressure off families and can even postpone or stop the need to go in hospital or care homes. Everybody’s illness differs from person to person so it is always important to take into account individuals sensitivities and circumstances, like Anwar were his taken into account?
It is not just the individual with the illness that needs to be thought about, the family is often affected to. As we are aware Anwar originated from Pakistan and maybe he did not fully understanding English properly, also Hansa cannot read English very well and this proved difficult when trying to plan and follow meals for Anwar from a leaflet given to her by the nurse. The menu showed typical ‘English’ food; had anyone taken into account that Asians eat western food and their eating patterns differ from our own culture, this can lead to cultural barriers.
Should the hospital have translated the diet sheet into the appropriate language that Anwar and Hansa are familiar with? What about communication and visual aids? Should the hospital have provided a translator, so that both Anwar and Hansa fully understand the effects of diabetes? The hospital also could have shown Anwar and Hansa photos of a gangrenous foot or even an amputee, this could have made Anwar think twice about his own health (this could be me). Two per cent of the UK suffers with diabetes, South Asian residents of the UK are 4 times likely to be affected by diabetes than the rest of the population (Block 1, who cares p-85).
What about financial worries? Having to follow a healthy eating plan can cause financial burden on the whole family. “Families struggle to eat healthily amid rising food bills and shrinking budgets” (Guardian 2012), could this be another obstacle in the way of Anwar’s treatment. Can they afford to change the whole family’s diet, or have they enough money for extra food just for Anwar? Should the hospital be taking this into account for the sake of people’s health? However it is also important to think about a person’s psychological needs, do they understand what is being asked of them, are they fully aware of the condition that they have.
Living with a chronic illness is a demanding job and can often lead to bouts of depression; many people are so overwhelmed by complications that may arise with their health and may experience a number of other emotions apart from depression, anger is also common as to why this is happening to them, mood swings, frustration and fear of the unknown. If such emotions do arise it is important for the health care professionals to support them and encourage them to communicate their concerns straight away, otherwise this can have a long term effect on how they and their families manage their illness, thus helping to improve a erson’s health for the see able future. Over the last century health care has been totally transformed by biomedical science to understand what causes illness and diseases, and to find a cure. However biomedical science is not enough to encourage people to administer their own care. To provide effective health care involves educating, informing, engaging and supporting people and their families, so that they can manage their own treatment. This means you would have to look at things from the service user perspective, asking them how they feel and helping them make sense of their illness.
Any treatment that has to be given must take into account peoples cultural, social circumstances and lifestyles. Word Count-1420 Good practice 1) Liz appears to be ensuring Clarice gets the level of support she wants, to do the things she wants, in the way she wants. Liz doesn’t appear to impose an agenda of her own or one defined by Somebody Cares. I think this is supporting Clarice s rights to appropriate services. 2) When Clarice is in conversation with Liz, not only does Liz listen but lets her lead the conversation.
Liz puts no time pressure on Clarice and lets her do what she can for herself and only helps when asked by Clarice. Liz is supporting Clarice in maximising her potential to being independent. 3) Clarice opens the door to Liz; they then have a little chat before any tasks are done. Not at any point does Liz talk about another client and lets Clarice lead the way to the bathroom. I think Liz is maximising Clarice’s potential by letting her be as independent as possible and by not divulging confidential information onto Clarice about another client. Bad practice ) Marjorie does not engage Iris in two-way conversation at any point. She talks over her all the time. Consequently, Iris has no chance to give voice to her views or wishes. She doesn’t get a chance to make her point even in her own room. This is not supporting Iris to have a voice or be heard. 2) Iris’s room is treated like a public place, where Marjorie comes and goes as she pleases. Iris is given no dignity in her own room shouting “do you want the lavvie? ” Marjorie moans about another person to Iris, leaving Iris wondering “does she speak about me to other people”.
I think Marjorie has no concept of people’s rights to privacy and confidentiality. 3) Iris is capable of having a bath; she probably would find it a pleasure but unfortunately Marjorie runs it for her. This is not taking into account Iris’s capabilities’ or wishes and definitely not maximising Iris’s potential to run it herself. Word count-346 My tutor’s feedback has helped me to develop my writing, thinking skills and to actually believe in myself. The only negative I had was no reference list, but I did send one (maybe didn’t receive it).
The most difficult task I’ve found while doing TMA02 was not to ramble on and miss the point. References The Open University (second edition2010), block 1 who cares, Malta, Gutenberg Press Limited (p-67) & (p-85) Parson, T, (1951) the Social System, Glencoe IL, the Free Press. Department of Health (DH) (2006) Our Health Our Care, our Say: A New Direction for Community Services, Norwich, The Stationary Office; also available online at www. dh. gov. uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4127453 (Accessed 26 February 2008).
NHS Choices (2007) About NHS Services: NHS GPs/Doctors [online], www. nhs. uk/AboutNHSservices/doctors/pages/DoctorsSummary. aspx (Accessed 17 December 2007 www. guardian. co. uk/society/2012/nov/18/families-rising-food-prices-budgets (Accessed 10 November 2012). www. uwic. ac. uk/shss/dom/newweb/Sick_role/Introduction. htm (Accessed 10 November 2012). www. drfosterhealth. co. uk/medical-dictionary/terminology/secondary-care. aspx (Accessed 12 November 2012). www. medicalprotection. org/uk/booklets/common-problems-hospital/communication-between-specialties (Accessed 17 November 2012).
