As we proceed we will be seeing how the patient with the help of psychotherapy and the help of the Multidisciplinary Team (MDT) will be trying to live her life, making it at least a little less hindrance to both herself and her family.
I would first like to say that permission has been sought from the family and their attorney authorizes me to discuss this case. However the names and some of the details have been changed to maintain and preserve confidentiality in conformity with NMC Code of Conduct (2004).
Meena was born as the first child to Mr. and Mrs. Pandey, who lived in a remote village in the State of Bihar in India. She was a hale and hearty child until one unfortunate day when the doctors confirmed that she had contracted meningitis. Meena was just a year old.
Subsequently for treatment her Cerebrospinal Fluid (CSF) was removed by lumbar puncture and analysed. But it was too late. Soon it became evident that Meena had become paralysed. She could just about move her limbs. Movement was slightly better in the upper limbs. She was now in a near vegetative state. The child was just two years old then.
Today Meena is a 35 year old woman. She is intelligent but cannot speak properly. Most of the time she behaves like a child. She is demanding, self-centred, and uncompromising. Yet at times, she seems to perceive the grief of the family, her own state and somewhat reluctantly tries to listen to what she is told. She tries to adjust and mend her ways. It is this childlike quality, this innocence which had prompted me to select Meena as the patient.
Body- Observation and Diagnosis
Meena has been cared for, for all these years by her mother. Her mother today is no more. It had been a moral and emotional issue for Meena's mother to take care of her. But today, she is in the care of her brother and sister-in-law. They want Meena to be able to accept her circumstances and live life to the best of her ability. Moreover, Meena has also set into a mental development and needs help to overcome that.
RATIONALE FOR PATIENT CHOICE:
Friendly and innocent
First to assess properly the Aspect of Care we must understand that the patient is not mature enough to understand that she is dependent on others for everything. She thinks it is normal to depend on her family members and demand their time.
Emotionally she requires constant care and reminders that she is loved. Knowingly she