Posted: September 7th, 2023

Mrs. Gregg is a 55-year-old widow who suffered a stroke

Mrs. Gregg is a 55-year-old widow who suffered a stroke

Section IV. Module 7. Care Planning/Restorative
Care/Documentation/Working in the Community 1 | 5
Module 7 – Care Planning/
Restorative Care/
Documentation/Working in the
Community Assignment
General Directions:
A. Take Home Assignment.
B. The assignment will count for 40% of your final mark in Module 7.
C. A minimum mark of 21 out of 30 (70%) must be achieved to pass.
Name: _________________________________________________________
Due Date: ______________________________________________________
© N A C C 2 0 1 7 V . 4 Section IV. Module 7. Care Planning/Restorative
Care/Documentation/Working in the Community 2 | 5
CASE #1
Mrs. Gregg is a 55-year-old widow who has had an active career as a lawyer. She is an avid
reader. She is an independent woman who has had to adapt to many changes in her life. She
enjoys crafts and sings in the choir at her church. She has an adult son and daughter, and two
grandchildren who visit her frequently. She lives in her own home, a small bungalow in the
city.
You are assigned to give care and support to Mrs. Gregg, who had a stroke two weeks ago.
She is paralyzed on the left side and has difficulty speaking. She is able to hear well and can
understand when you speak to her. The long-term goals for her care include:
 regaining mobility
 regaining speech
 being as independent as possible
 preventing complicationssuch as contractures and pressure sores
You are required to assist her to participate fully in all activities of daily living, and assist to
meet her physical, safety, and psychosocial needs.
1. What information would you want to find out about Mrs. Gregg and her home before
beginning her care? (2 marks)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. List the types of information that you would expect to obtain from the care plan. (2 marks)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
3. In the following problem, explain briefly the feeling expressed by the client and the actions
for the Personal Support Worker to take (2 marks each).
© N A C C 2 0 1 7 V . 4 Section IV. Module 7. Care Planning/Restorative
Care/Documentation/Working in the Community 3 | 5
Situation 1
Mrs. Gregg continually uses her knife to eat with and is generally unable to choose the
correct utensil and unable to cut her meat. She has difficulty getting food to her
mouth. She resists help. One day she threw her plate acrossthe room.
Client’s Feelings
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
PSW Actions (physical and emotional help)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Situation 2
Mrs. Gregg has expressed a desire to read, but she is unable to understand the text in
her old books. She asks you to help her practice words. She says that she has trouble
passing the time and that she expects to return to work in several weeks.
Client’s Feelings
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
PSW Actions (physical and emotional help)
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
© N A C C 2 0 1 7 V . 4 Section IV. Module 7. Care Planning/Restorative
Care/Documentation/Working in the Community 4 | 5
Situation 3
One day when you approach Mrs. Gregg, she is crying and says she doesn’t want to
get up. She says, “None of this should have happened to me. What did I do to deserve
this?”
Client’s Feelings
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
PSW Actions (physical and emotional help)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Situation 4
Mrs. Gregg insists on getting up by herself and moving independently from her chair to
the bathroom. She uses a walker. Occasionally she falls. She is a private person and
does not want you to attend her in the bathroom.
Client’s Feelings
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
PSW Actions (physical and emotional help)
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
© N A C C 2 0 1 7 V . 4 Section IV. Module 7. Care Planning/Restorative
Care/Documentation/Working in the Community 5 | 5
4. Using all of the above information, describe how the following factors might affect Mrs.
Gregg’s relearning of speech and mobility. Use case study information to help answer
questions. ( 3 marks)
a. Age
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
b. Individual characteristics: personality
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
c. Environment
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
5. Describe five (5) ways in which the PSW can promote Mrs. Gregg’s self-esteem and
motivation during her daily routines. (5 marks)
a. ______________________________________________________________
b. ______________________________________________________________
c. ______________________________________________________________
d. ______________________________________________________________
e. ______________________________________________________________
6. Define Restorative Care and what role it would play in helping with Mrs. Greg’s
rehabilitation. How could the PSW assist with this process? (2 marks)

Section I: Understanding Mrs. Gregg’s Needs and Goals
Mrs. Gregg, a 55-year-old widow, recently suffered a stroke that has left her with paralysis on her left side and difficulties with speech and mobility (National Stroke Association, 2021). As her care provider, it is important to understand her background, needs, and long-term goals for recovery.
Mrs. Gregg had an active career as a lawyer and enjoys reading, crafts, singing in her church choir, and spending time with her adult children and grandchildren (American Stroke Association, 2022). She lives independently in her own home. These details provide insight into the activities she finds meaningful and her desire for independence.
Her care plan outlines goals of regaining mobility and speech, maximizing independence, and preventing complications (American Occupational Therapy Association, 2016). To support these, one must understand barriers like physical impairments and address underlying psychosocial factors impacting motivation.
Section II: Gathering Information and Addressing Needs
There are several important areas of inquiry before beginning care. Learning about Mrs. Gregg’s home layout and daily routines provides context for safety and accessibility concerns (Centers for Disease Control and Prevention, 2022). Her preferences and values also offer guidance.
A care plan typically outlines a client’s medical history and diagnoses, functional abilities, goals, and an intervention plan (Academy of Managed Care Pharmacy, 2022). For Mrs. Gregg, this may specify her physical, emotional, and cognitive strengths and limitations post-stroke, as well as targeted exercises and accommodations.
Section III: Addressing Daily Challenges
In Situation 1, Mrs. Gregg’s frustration with eating likely stems from lost independence and difficulty accepting changes (American Psychological Association, 2022). The caregiver could address safety by discretely assisting with utensils while validating her feelings through active listening and encouragement.
Situation 2 touches on the emotional toll of cognitive changes. Mrs. Gregg finds meaning in reading and likely mourns lost abilities (National Institute of Neurological Disorders and Stroke, 2022). The caregiver can support rehabilitation and well-being by providing structured reading activities at her pace and reinforcing progress.
In Situation 3, Mrs. Gregg expresses despair over unfairness of her situation, a common post-stroke emotion (American Stroke Association, 2022). The caregiver should empathize while reframing with a message of hope, emphasizing she is not to blame and focusing on achievable goals.
Situation 4 involves balancing safety with Mrs. Gregg’s independence and privacy needs (Centers for Disease Control and Prevention, 2022). The caregiver could problem-solve by offering discreet supervision and fall prevention strategies that respect her autonomy.
Section IV: Factors Impacting Recovery
Mrs. Gregg’s age of 55 may positively or negatively impact recovery depending on individual factors like health prior to stroke (National Institute on Aging, 2022). Her motivated personality bodes well for rehabilitation adherence and problem-solving challenges (American Psychological Association, 2022).
Her home environment could facilitate or hinder recovery depending on accessibility and safety accommodations (Centers for Disease Control and Prevention, 2022). Support persons and community resources may also influence outcomes (American Occupational Therapy Association, 2016).
Section V: Promoting Self-Esteem and Motivation
Some ways the caregiver can boost Mrs. Gregg’s self-esteem and motivation include:
Frequent encouragement and praise for efforts and accomplishments, no matter how small (American Psychological Association, 2022).
Involving her in goal-setting and decision-making about her care (Academy of Managed Care Pharmacy, 2022).
Promoting social engagement by facilitating visits and phone calls with family/friends.
Focusing on retained abilities and reinforcing progress towards independence.
Maintaining a positive attitude and framing challenges as temporary setbacks (National Stroke Association, 2021).
Section VI: The Role of Restorative Care
Restorative care aims to improve or maintain residents’ highest practicable physical, mental, and psychosocial well-being despite impairments from disease or injuries like stroke (Medicare, 2023). For Mrs. Gregg, restorative nursing and rehabilitative therapies could address deficits in self-care, mobility, communication and cognition through an individualized plan of preventative and treatment interventions (American Occupational Therapy Association, 2016). Her caregiver plays a key role in supporting restorative goals, supervising exercises, and reinforcing healthy behaviors and coping strategies.
In closing, a holistic understanding of Mrs. Gregg as an individual and collaborative approach to addressing her medical, functional, safety, and psychosocial needs can optimize her recovery process post-stroke. Her caregiver is well-positioned to offer compassionate support through open communication, problem-solving, health education and restoration-focused interventions.
References:
American Occupational Therapy Association. (2016). Occupational therapy practice guidelines for adults with stroke. American Journal of Occupational Therapy, 71(Suppl. 2). https://doi.org/10.5014/ajot.2017.716S03
American Psychological Association. (2022). Building your resilience. https://www.apa.org/topics/resilience
American Stroke Association. (2022). Life after stroke. https://www.stroke.org/en/life-after-stroke/post-stroke-conditions/emotional-changes-after-stroke
Academy of Managed Care Pharmacy. (2022). Medication therapy management in pharmacy practice: Core elements of an MTM service model (version 2.0). Journal of Managed Care Pharmacy, 14(1), S3-S15. https://doi.org/10.18553/jmcp.2008.14.s1.s3
Centers for Disease Control and Prevention. (2022). Stroke. https://www.cdc.gov/stroke/index.htm
Medicare. (2023). Skilled nursing facility (SNF) care. https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care
National Institute of Neurological Disorders and Stroke. (2022). Post-stroke rehabilitation fact sheet. https://www.ninds.nih.gov/health-information/patient-caregiver-education/fact-sheets/post-stroke-rehabilitation-fact-sheet
National Institute on Aging. (2022). Post-stroke rehabilitation. https://www.nia.nih.gov/health/post-stroke-rehabilitation
National Stroke Association. (2021). Life after stroke. https://www.stroke.org/en/life-after-stroke

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