Block 1 : Case Studies

CASE STUDY : ANN & ANGUS Ann, Bob (Husband) and Zoe (Daughter) live with Angus Ann has cared for Angus (her Father) since her mother died. Angus suffers from Parkinson's Disease Feels as though caring is a 'woman's job' so had no choice Doesn't see herself as a carer - she is a mother, wife and daughter Ann helps Angus up and down stairs, toilet, wash, dress She also cooks, cleans and helps Angus medically - she puts cream on his piles By Parker & Lawton's (1995) criteria Ann fits the identity of a carer; -performs personal services (washing, toileting), -physical labour, -administers medicine, -keeps Angus company Ann could be entitled to practical and financial support yet she need to accept her identity as a carer - she doesn't see herself as one Also difficult for Angus to accept that he is unable to care for himself and requires a carer - wants to retain identity as head of family and homeowner Ann finds caring;Rewarding - Knows Angus appreciates help; fulfilling promise she made to her motherIsolating - Doesn't have time to relax, gave up her job so no longer working with a group of people on a daily basis, lost friendships led to a sense of lonelinessStressful - Always busy looking after Angus as well as spending time with family and looking after the houseHard work - Ann has to help Angus around the house - up and down stairs and in and out of bedTime consuming - She has to help Angus day and night, no time for anything elseBarriers to asking for help;Lack of knowledge - doesn't know where to look, what should they expect to receive, social care help less knownPride - fear of being seen as failure; asking for help means cannot copeResistance - Angus told her he didn't want a stranger looking after himReluctance - Opening family home up to someone they don't knowPessimism - fear that only option for help is a homeUncertainty - costs involved

Anwar Malik54 years old Started to feel unwell; tired and less able to be active also more frequent trips to toilet His wife was concerned ... Anwar was very reluctant to visit GP insistent that there was nothing wrong He visited the Optician - found worrying degeneration of eyesight - Anwar was told to visit his GP asap Hard for Anwar to accept that he was ill- accepting illness takes time- he has to come to terms with claiming sick role-psychological adjustment and changes to daily life and routines Anwar went to the GP - asked questions about eyesight, tiredness, thirst also has physical examination Had to visit the nurse - urine sample found that he had high glucose levels = possible diabetes Further blood tests revealed Anwar has Type 2 Diabetes = chronic condition / regular self medication / exercise / specialist diet Given kit for self-monitoring blood glucose levels and taught how to use it Given leaflets about diabetesTold that he had to test his glucose levels regularly and take tablets for it and exactly the same time each dayTold about important of diet and exerciseAnwar couldn't understand some of the help and advice given to him. His wife, who does the cooking, couldn't understand the new diet plan Anwar was givenAnwar was confused about what glucose and insulin wereCouldn't fit exercise and diet changes into daily routine = didn't fit in with their cultureTreatment programme made more culturally sensitive and compatible with lifestyle Given pictorial guidelines about diet Contact with South Asian diabetes support group - able to better understand condition and treatment in first language / share experiences with others Struggling with treatment programme? - Depression                 - Guilty (failure sticking to treatment programme)                            - Letting down Nurse Richards (missing Diabetes Clinic) Failure at 'job' of diabetes patient   Taken to hospital by Ambulance - emergency admittance Gangrenous toe - bruised after hitting it, Anwar didn't think anything of it Ward Nurse examined it and made notes Diabetics doctor examined it and confirmed that it was gangrenous and was also spreading Surgeon came and explained Anwar would need immediate amputation Anaesthetist came and asked Anwar to consent Anwar felt alone and helpless after Hansa went home Anwar became a 'hospital patient' = more extreme version of sick role --- handed over to medical regime / completely removed from normal duties Shedding identity - acquiring passive identity      

Parkinson's Disease 1 in 500 people affected in the UK Unknown cause Three common symptoms Tremor / uncontrollable shaking Muscular stiffness Slow movement Diabetes First became treatable in the 1920s - before that it was a fatal disease Scientists discovered that insulin was important in managing storage and release of energy They found that you could take insulin to stay alive, but also needed to keep blood sugar levels steady Cause complication with kidneys, eyes and feet Type 1 Body's immune system attacks and kills insulin producing cells Increased blood sugar levels Can cause serious damage to all organs Type 2 Do not produce enough insulin Not potentially fatal in short term Shortage of insulin leads to imbalance of blood sugar

Bethnal Green1950s - The Family Life of Older People by Peter Townsend1992 - The New East End: Kinship, Race and Conflict by Geoff Dench, Kate Gavron and Michael Young1950sMajor factors in ill, elderly lives = relatives Reciprocity"Two way traffic is essential feature of the family" - backed up by Forbat, 2005No relatives = tend to live the worstWithout family care, care demand would be huge1990sFamilies have dispersed - no longer live together or within close proximity ; changes in wealth, economy, housing policy and jobsCaring is less of shared responsibilityDifferent type of contact - no less caring

Ann & Angus

Anwar Malik

Parkinson's Disease and Diabetes

Bethnal Green 1950s