Mr. Jacob Springfield is a predominantly right-handed, but ambidextrous, 72-year-old retired television repair technician who ran his own business for 32 years out of a converted garage behind his house in Halifax, Nova Scotia. He has been married for over 47 years to Mrs. May Springfield, who is 68 years old. Mr. Springfield and his wife have three adult children. The eldest daughter (aged 45) is a family physician who lives in the Yukon Territories. Their other daughter (aged 38) suffers from developmental disabilities and lives in a group home in Halifax. The Springfield’s middle child, a son (aged 43), lives in Ontario with his family (wife and 2 young children). He is a mechanical engineer.
Mr. Springfield completed Grade 9 and is self-taught in electronic repairs. Mrs. Springfield completed Grade 12 and one year of Business School. She was once her husband’s bookkeeper but now works in the home and acts as a volunteer for local community service agencies. Both Mr. and Mrs. Springfield are native speakers of English. They do not speak any other languages.
The Springfield’s live in a two-story clapboard frame house with three bedrooms. Their yard is not fenced. The house opens directly onto the sidewalk in the front. Mr. Springfield’s repair shop behind the house opens onto an alley that runs behind the houses on their street.
Mr. Springfield loves puttering in his repair shop and watching television. He has few other interests. They both drive the family car.
Medical Information
Mr. Springfield has a recent history of angina for which he takes Nitroglycerine tablets sublingually as required. His vision is deteriorating and he wears bifocals, which were prescribed and fitted within the last four months. He suffers from presbycusis, which was identified three years ago in a full audiometric evaluation as a bilateral, mild-moderate sensorineural hearing loss. He was prescribed a behind-the-ear (BTE) hearing aid for the right ear but does not wear it. Mr. Springfield also suffers from prostate problems, which prevent him from sitting down for long periods of time.
Presenting Problem
Mr. Springfield suffers currently from recent memory problems and confusion, which, according to his wife, have been increasing slowly in severity over the past year or so. Mr. Springfield wanders from his home, now more frequently than ever especially during the late afternoon. He gets lost easily. Mrs. Springfield has been spending more time watching out for her husband because of his increased wandering. She has not yet sought support from any outside agencies.
The presenting problem is that two days ago, while Mr. Springfield was out wandering the downtown core area, he was hit by a car as he was crossing the street. He struck his head quite hard on the pavement. He was not wearing his hearing aid at the time. An ambulance took him to the Victoria Hospital in Halifax where he was seen in the Emergency Department by the attending emergency care physician. Mr. Springfield was admitted to an acute care medical ward for a 24-hour observation period with multiple bruises and a mild concussion. A CT scan was performed to determine the extent of cerebral pathology, if any, as a result of his head injury.
Nursing staff reported that Mr. Springfield was behaving strangely upon admission. This was dismissed as being concussion-related. His wife was contacted (based on personal information that the nursing admitting staff found in his wallet). She arrived shortly after he was admitted to the acute care medical floor. While on the ward overnight, Mr. Springfield showed confusion and engaged in inappropriate behaviour (wandering the halls aimlessly, repeatedly searching through the drawers and closets of other in-patients, urinating in a garbage can, climbing into the wrong bed, etc). When asked by the nursing staff about his behaviours (e.g., ‘What are you searching for?’), Mr. Springfield insisted that he wanted to go home but could not find his way there. He accused the nurses of keeping him against his will and kept repeating that he wanted to go home.
Nursing staff reported that he was upset emotionally by the unfamiliar environment of the floor and that his associated anxiety and frustration made him quite agitated. Mrs. Springfield reported the next morning that these were strange behaviours indeed but that he had exhibited similar ones at home with her over the past few months.
The next morning, the nursing staff requested a consultation with the geriatric assessment unit team (GAU) of the Victoria Hospital in Halifax. The GAU sent over a multi-skilled worker to complete their standard assessment protocol. The worker’s assessment included administering the following:
a) Functional Independence Measure (FIM),
b) the Geriatric Depression Scale (score: 8/30),
c) Standardized Mini-Mental State Examination (score: 16/30), and
d) Reisberg Global Deterioration Scale (score: Stage 4).
As well, a case history was collected through an interview with Mrs. Springfield. The results of the assessment were reported to her.
Discharge from the acute care ward is imminent. Only 24 hours maximum is allowed due to severe financial cutbacks in funding. Discharge planning therefore, is urgently needed.
Answer the following questions with at least 250-300, but no more than 400, words and use references, in APA format, to support your answers.
1. Identify the type of team model that was used in this case.
2. With respect to the model used in this case, discuss:
-its benefits,
-its drawbacks,
-the role(s) of the professions within the framework of the model,
-how other team models would function in this case
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