This week we will look at health assessment in relation to developmental stages. Our primary focus in the discussion will be on adolescence. Case Study Paul Ramen is a 17-year old Caucasian male who was placed in foster care at the age of 11. His biological father was incarcerated at the time for illegal drug sales. His mother has a substance abuse history of both alcohol and heroin. Paul’s foster care had been stable up until 3 months ago when his foster mother passed away suddenly from an aortic aneurysm. Paul was removed from her home and placed in a temporary foster home situation.
He ran away after 3 days in the new setting. He has not returned to school and his whereabouts are unknown to his social worker. Paul has been living on the streets, obtaining food from garbage cans and buying food when he begs for money from individuals on the street. He has lost 25 pounds since living on the street. His current weight is 130 lbs. and his height is 5 ft. 9 inches. He is not able to meet his self-care needs in relation to bathing, clothing or shelter. He sleeps each night in a different place on the streets, seeking shelter where he feels somewhat safe and hopes he doesn’t get beat up. He had three occasions when he was awoken from sleeping by adults who have taken the few possessions that he ran away with. Paul’s thoughts were flowing as he settled for sleep this evening.
He realized that he was extremely hungry and scared. He couldn’t remember what it was like to have a roof over his head and go to school with friends. He also realized that the memories of his parents are now so faded he can’t really remember what they looked like. As he drifted off to sleep, he had the realization that he doesn’t care. It doesn’t matter to Paul if he wakes up the following morning and he feels as if no one would even notice. He woke to intense pain in his head. He was beaten and someone removed his shoes. As a result of the beating he lost consciousness. A runner going through the park found him 3 hours later and calls 911. He was brought to the emergency room at the local community hospital. He remained hospitalized for 5 days and was released to a foster home in a suburban community 20 miles from the city. The social worker hopes that this transition will help Paul.
One of the requirements of this placement was that Paul receives a health assessment at the local community health center. The plan of care will provided to the social worker with updates every 3 months until Paul turns 18. You have been given Paul’s history from the social worker and have completed his health assessment. Please answer the following questions in your initial post.
1. Identify the priority three objectives from the Adolescent Health goal found in Healthy People 2020 ( that should be addressed in Paul’s plan of care.
Discuss your rationale for choosing these objectives.
2. Do you have concerns about Paul’s mental health status? If so, identify your concerns and the evidence that supports these concerns. What additional questions would you ask Paul regarding his mental health status?
3. What is Paul’s nutritional status at this time? What is the priority short-term nutrition goal for him (Please write in SMART format)?
4. How does Paul’s family history of substance abuse impact his health? Suggest an intervention based on assessment and provide supporting evidence. 5. Based on Paul’s health history, discuss his developmental needs. Consider his childhood and the potential success of achieving his previous development goals according to Erikson.
How will you assess this and help support successful achievement of future developmental goals? 6. What resources are available to Paul in your local area? Consider online resources as well? (Helpful Hint: ask your institutions Social Worker or Care Coordinator for suggestions).
