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David - Homelessness. By John Palmer, Rachel Clark, Luke Fuller, Heidi Beattie, Michelle Grant, Lynnette Bush, Lucy Webber. Psychological Reduced motivation Mental Health Problems e.g. perhaps Schizophrenia Depression Loss of roles and habits Trauma Amnesia

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david homelessness

David - Homelessness

By John Palmer, Rachel Clark, Luke Fuller, Heidi Beattie, Michelle Grant, Lynnette Bush, Lucy Webber

slide2
Psychological

Reduced motivation

Mental Health Problems e.g. perhaps Schizophrenia

Depression

Loss of roles and habits

Trauma

Amnesia

Decreased self-esteem and confidence

Alcohol and Drug abuse

Physical and verbal abuse

Physical and Social

Malnutrition

Depleted water, if at all

Living on the streets

Poor self care

Diabetes

Cold/Hypothermia

Finances

Lack of sleep

Poor feet care

Lack of access to Health Care

Skin Problems

Toxic confusionals state

Low social role

Discrimination

Withdrawal symptoms

Dental problems

Stereotyping

slide3
Communication and Rapport

Empathise

Build of rapport in order to have trust

Comfortable environment with no distractions

Reflective listening

Observation of body language

Holding and disarming communication

Problem free talk

Look for transference

Appointments attended on time by MDT

Leaving information for him to take away

Gain Medical history from socials services etc asking David’s permission

Self Reporting

First hand information

Gain insight into emotions and feelings of David

David may lie

Has deluded ideas and beliefs affecting what he might say

Unaware or lack of insight to his condition

Amnesia

Psychotic symptoms, telling him not to talk to people

Perhaps write a personal log, due to feeling uncomfortable talking

slide4
Goals

Short term – Immediate health requirements; treatment of any immediate pathology/injury. A change of clothes and personal hygiene issues. Nutritional evaluation and address deficit. Immediate shelter for safety and welfare.

Medium term – 6-12 weeks detoxification. Access to group therapy and general counselling and support.

Long term – Sheltered housing scheme. Re integration of David into society, raising self esteem and confidence to establish himself as a member of society.

MDT/Services

OT

CPN/Mental Health Nurses

Dietician

Social Services

Podiatrists

Advocate

Care coordinator

Dentist

Social Security

Homeless Charities i.e. Big Issue

Rehabilitation Day Services

Non- Statutory and Statutory Drug and alcohol Services

Client centred care and overlapping of roles

All working to meet the same goals

future challenges
Future Challenges
  • Isolation
  • Stigmatisation
  • Hospitalisation
  • Discrimination
  • Reduce socialisation
  • Further homelessness
  • Compliance with medication and services
  • Adjusting to societal norms
  • Violence
  • Poor physical health
  • Contact with old associates
  • Try and keep contact with the services and reassess at different times
  • Encourage David to occupy his time to provide alternatives to drugs
  • CBT
  • Demonstrate mastery to increase confidence and sense of purpose
  • Anxiety management