1. INTER-PROFESSIONAL LEARNING CASE STUDY DAVID Jackie Hand Tina Lashbrook Deb Low Louise Vickary

2. SLIDE 1 PHYSICAL & PSYCHOLOGICAL ISSUES HOMELESSNESS No income resulting in lack of basic human needs eg: food, drink, clothing, shelter. Lack of sleep due to weather conditions, fear of personal safety, being moved on & lack of bedding. Social isolation, lack of self-esteem, loneliness, depression, substance misuse. Social attitudes eg: stigmatisation, ignorance, fear, annoyance, anger all which reinforce lack of self-esteem. “Homeless people present with multiple needs in 62% of cases.” (www.homeless.org.uk 2004)www.homeless.org.uk DAVID PARANOIDRESISTANT DUAL DIAGNOSIS AGGRESSIVE ALCOHOL ABUSE SKIN CONDITIONS FOOT COMPLAINT MALNUTRITION POOR CIRCULATION & RESPIRATION

3. SLIDE 2 COMMUNICATION & INFORMATION GATHERING GAINED FROM CLIENT/SELF REPORTED EXPLAINATION RE: WHY INFO REQUIRED & CONFIDENTIALITY ISSUES INFO REQUIRED – FULL NAME & DATE OF BIRTH, LAST KNOWN ADDRESS, CONTACT DETAILS OF FRIENDS & FAMILY MEMBERS, DETAILS OF LAST KNOWN GP, DETAILS OF ANY BENEFITS ADVANTAGES OF SELF-REPORT ARE PERSON KNOWS THEMSELVES BEST, HELPS THERAPEUTIC RELATIONSHIP DISADVANTAGES OF SELF- REPORT CAN BE INACCURATE, MISLEADING INFO OR NONE ! DAVID CALM/PATIENT APPROACH ALLOW PLENTY PERSONAL SPACE NON- JUDGMENTAL & EMPATHETIC ATTITUDE RESPECT SILENCES CLEAR/CONCISE RESPONSES GAIN TRUST/ THERAPEUTIC RELATIONSHIP

4. SLIDE 3 SHORT/MEDIUM/LONG TERM NEEDS (Maslow Hierarchy of Needs) SHORT TERM: ADVOCATE (Social Worker),IMPROVE NUTRITIONAL STATUS,SELF-CARE eg: bath, shave, haircut, SELF & SECURE ACCOMMODATION, MEDICAL CARE eg: foot complaints, skin conditions, medication, ALCOHOL DETOX PROGRAMME.SHORT TERM: ADVOCATE (Social Worker),IMPROVE NUTRITIONAL STATUS,SELF-CARE eg: bath, shave, haircut, SELF & SECURE ACCOMMODATION, MEDICAL CARE eg: foot complaints, skin conditions, medication, ALCOHOL DETOX PROGRAMME. MEDIUM TERM: CONTINUE SHORT TERM NEEDS, ADDRESS FINANCIAL ISSUES eg: benefit entitlements, CARE PLANNING (CPA) in conjunction with MDT.MEDIUM TERM: CONTINUE SHORT TERM NEEDS, ADDRESS FINANCIAL ISSUES eg: benefit entitlements, CARE PLANNING (CPA) in conjunction with MDT. LONG TERM: EVALUATE/REVIEW CARE PLAN INC. DAVID, MEDICATION ISSUES, RE-SKILLING eg: cooking, budgeting, RE-TRAINING eg: educational/vocational, THERAPY eg: art, CBT, Solution Focused, Self-help Groups (should be co-ordinated Van Doorn & Williamson 2001)LONG TERM: EVALUATE/REVIEW CARE PLAN INC. DAVID, MEDICATION ISSUES, RE-SKILLING eg: cooking, budgeting, RE-TRAINING eg: educational/vocational, THERAPY eg: art, CBT, Solution Focused, Self-help Groups (should be co-ordinated Van Doorn & Williamson 2001)

5. SLIDE 4 MULTI-DISCIPLINARY TEAM & ACCESS TO SERVICES NHS WALK IN CENTRES INFO RE: SERVICES FROM OTHER HOMELESS PEOPLE DROP IN CENTRES (“Drop in centres & day centres meet service users needs better than professional services.”Barker.P 2003) Churches Big Issue Benefit Services Outreach Services DAVID CONSULTANT PSYCHIATRIST MENTAL HEALTH NURSE OCCUPATIONAL THERAPIST PODIATRIST SOCIAL WORKER DIETICIAN DRUG & ALCOHOL SERVICES HOUSING & BENEFITS SERVICES SOCIAL SERVICES STATUTORY & NON STATUTORY SERVICES ADVANTAGES: HOLISTIC & PROFESSIONAL CARE DISADVANTAGES: COMMUNICATION BREAKDOWN, TIME/FINANCIAL/POLITICAL CONSTRAINTS, CONFLICT OF OPINION, INTIMIDATING TO CLIENT