Principles of Care – Depression

He is married with 2 children and works as a supervisor at a local call centre. He is buying his own home and runs a car. He has been worrying a lot, feels under pressure and has been increasingly depressed in the last 3 months. His sleep and appetite are poor and he has fleeting ideas of killing himself. Case Study Mr Jones walked home alone and bewildered after his consultation with his G.P, he was sure to be labelled as a nutter by his colleagues at work once they knew that he had to been referred to the Mental Health Services. The thoughts crowded his head as he turned the box of Prozac over and over in his hands. He opened the box and retrieved the leaflet from inside reading the first part:

What your medication is prescribed for. Prozac (Generic Name: fluoxetine) affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms. Prozac is used to treat major depressive disorder, bulimia nervosa (an eating disorder) obsessive compulsive disorder, and panic disorder. Drugs (2006) Mr Jones’s G.P had explained to him about Sever depression, also called major depression which can dramatically impair a person’s ability to function in social situations as well as at work. People with major depression often have feelings of despair, hopelessness, and worthlessness, as well as thoughts of committing suicide. NHS Direct (2007)

Mr Jones entered his empty home and retired to his bedroom. Forty-five minutes later Mrs Jones entered her home after taking the twins, Sasha and Josh both five years old, to school. She called her husbands name but had no reply, on entering her bed room she discovered Mr Jones on the bed with an empty bottle of whiskey and an empty packet of Prozac. Mrs Jones phoned 999 to report that her husband had taken an overdose and she needed medical attention immediately. On arrival at the hospital Mr Jones was rushed to have his stomach pumped, they had taken details from Mrs Jones on what medication her husband had taken.

After Mr Jones had come round and had time to take in his surroundings he was joined by a doctor, who explained to Mr Jones that he would like him to voluntarily admit himself to hospital. He also explained to Mr Jones that the help he needed would be best given within the hospital in order for him to be assessed and receive psychotherapist. Mr Jones asked what would happen if he refused. The consequences of refusing would not be taken lightly; Mr Jones could be therefore admitted without consent under the auspices of the Mental Health Act compulsorily. The decision must be made by three professionals (two doctors and a social worker) who would all have to agree that they were taking the best interests of the patient who is ill.

Dr Stefan Cembrowicz and Dr Dorcas Kingham (2002) He also told him that the length of time that he would stop in hospital would probably be minimal and as soon as they had found a successful treatment for Mr Jones, to help bring him out of his depressed state then he could be treated from home. Furthermore they preferred to treat people from home because it was a more natural surrounding to the patient assisting then to be more relaxed and keeping them in a social environment. National service framework (1999) Mr Jones agreed to admit himself to hospital as he saw no other way out. Hospital Treatment

Once admitted to the wards Mr Jones was briefed by a consultant on the treatment that was going to commence within the next couple of days; 1. To check that there is no physical illnesses present that maybe contributing to his depression. This will include blood pressure and pulse, listening to the heart and lungs and examinations of your abdomen, nervous system, eyes, reflexes and blood count. A urine sample will be needed; this will be tested to see if there are any traces of glucose, protein or blood. 2. A review on Mr Jones medical history to see if he has ever experienced depression before. Detail of family history in case there has been history of psychiatric disorders.

3. He will be assigned a ‘key worker’ who will either be a nurse or a social worker. They will program a timetable of daily activities these will include group and one to one therapies, relaxation classes, occupational therapies. Drug treatment is likely, as Mr Jones can be monitored closely on the ward. A care plan was made for Mr Jones; a care plan will involve all of Mr Jones vital statistics such as pulse, blood pressure and weight.

Mr Jones will be weighed a lot throughout his recovery period because a lot of people with depression loose weight through loss of appetite. A gain in weight after admission is a sure sign of progress. The care plan was discussed with Mr Jones because it involves him it is his care plan which gives him the opportunity to ask any questions. The care plan will return home with Mr Jones when he is ready so that professionals that continue to assist Mr Jones in his recovery can document his progress.

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