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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)
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Care Planning, Restorative Care, Documentation, and Community Support for Mrs. Gregg following her Stroke
Introduction
Mrs. Gregg is a 55-year-old widow who suffered a stroke two weeks ago, leaving her paralyzed on her left side and with difficulty speaking. As her personal support worker, developing an effective care plan is crucial to support her recovery goals of regaining mobility and speech, maximizing her independence, and preventing health complications. This article will discuss care planning, restorative care activities, documentation, and community support strategies to help Mrs. Gregg achieve her optimal level of functioning.
Care Planning
The care plan should incorporate information about Mrs. Gregg’s medical history, personality, home environment, family support system, and long-term recovery goals outlined by her healthcare team (Sawatzky et al., 2015). Learning about her background as an active lawyer and avid reader provides insight into her values and interests to engage during care. Her close relationships with adult children and grandchildren who visit also present opportunities for social engagement and motivation. Performing an assessment of her home can help identify any safety or accessibility issues to address.
The care plan should outline specific interventions and responsibilities of the personal support worker across each shift in areas like mobility, speech therapy, activities of daily living, safety monitoring, and psychosocial support (Batchelor-Murphy et al., 2017). Short-term goals may include increasing independence with transfers, using an adapted utensil for eating, and communicating basic needs through gestures or a communication board. Progress should be regularly evaluated and the plan updated accordingly.
Restorative Care Activities
Restorative care aims to prevent avoidable disability and promote the highest possible level of independent functioning through an individualized program of planned interventions (Sawatzky et al., 2015). For Mrs. Gregg, restorative care activities could include:
Mobility exercises like assisted walking practice with a walker to regain strength in her left leg and improve balance.
Range of motion exercises for her left arm and leg to prevent contractures from limited use.
Speech therapy using picture cards, writing words, and repetition of sounds and phrases to stimulate language areas of the brain and improve intelligibility.
Cognitive stimulation through reading aloud, discussing current events, playing simple games to challenge memory and problem-solving.
Life skills retraining for activities like dressing, grooming, and meal preparation to promote independence in daily routines.
The personal support worker should encourage Mrs. Gregg’s participation, provide positive reinforcement of efforts and accomplishments, and record progress in restorative goals.
Documentation
Thorough documentation of all care, interventions, and the client’s response is essential for continuity of care, monitoring progress, and meeting legal and professional standards (Batchelor-Murphy et al., 2017). Notes should include:
Details of daily care tasks and assistance provided with activities of daily living.
Observations of the client’s functional abilities, mood, pain levels, and other changes in status.
Specific goals and exercises addressed in restorative care sessions along with the client’s participation and performance.
Communications with family members and updates on visits or concerns relayed.
Instructions received from supervising healthcare professionals and the plan of care.
Any incidents, falls, or issues that arise and how they were managed.
Documentation promotes accountability and provides a historical record of the client’s clinical picture and experience over time. Consistent, objective recording supports the care planning process.
Community Support
Where possible, community reintegration strategies can enhance quality of life and independence. For Mrs. Gregg, the personal support worker could explore:
Accompanying her to appointments, grocery shopping, or her church choir practice with mobility aids for gradual exposure (Batchelor-Murphy et al., 2017).
Supporting visits with family at her home to maintain important relationships and social engagement.
Referring her to a local stroke support group for peer support and information on community resources (Lui et al., 2016).
Researching transportation options, home care programs, or adult day programs she could access with assistance as needed.
Assisting her to reconnect with hobbies like reading or crafts at a level she finds meaningful and motivating.
With a client-centered, holistic approach across these domains, Mrs. Gregg’s personal support worker can effectively promote her recovery and quality of life following her stroke. Regular re-evaluation allows adapting the plan to her changing needs and capabilities over time.
References
Batchelor-Murphy, M., Woodward, J., Beanland, C., Lockwood, C., Sinclair, A., & Murphy, K. (2017). Care planning for stroke survivors: A qualitative study of the experiences and perspectives of stroke survivors, family members and healthcare professionals. Disability and rehabilitation, 39(19), 1931–1940. https://doi.org/10.1080/09638288.2016.1223442
Liu, L. F., Harvey, J., & Wu, J. S. (2016). Stroke support groups: A systematic review of their benefits on health and social outcomes. Clinical rehabilitation, 30(8), 747–756. https://doi.org/10.1177/0269215515603085
Sawatzky, R., Keough, L., & Dennis, C. L. (2015). A Scoping Review of Restorative Care: Defining Concepts and Theories. Health care management review, 40(2), 99–108. https://doi.org/10.1097/HMR.0000000000000026

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