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David - Homelessness

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

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  1. David - Homelessness By John Palmer, Rachel Clark, Luke Fuller, Heidi Beattie, Michelle Grant, Lynnette Bush, Lucy Webber

  2. 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

  3. 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

  4. 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

  5. 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

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