Adriana is a 23-‐year-‐old young woman with cerebral palsy (spastic quadriplegia and dyskinesia) GMFCS IV MACS level IV CFCS II She is non verbal and uses an AAC device to communicate, she also has some swallowing problems, difficulty with thin liquids, and therefore struggles to maintain a healthy weight given the length of time it takes her to eat and drink She currently lives at home with her parents but wants to move out of home and live in a flat nearby with a friend who also has a disability. She currently works one day a week in a school canteen. Her role is to put the sandwiches into glad wrap before lunches. She doesn’t interact with the kids but is in the kitchen each day. She has carpel tunnel syndrome from typing on her AAC device and this is exacerbated by the tasks she does in the school kitchen. She currently has an electric wheelchair which is operated by a switch on the right hand side. This is the side where she has most pain and this can sometimes make it difficult for her to operate the chair. Adriana loves Opera music and will often play her iPod with Opera on it or watch DVDs of her favourite Operas. She enjoys chatting to her friends on social media. She finds that she can “chat” on Twitter or Facebook with people all over the world. She uses a laptop and also an iPad for this. She has many friends who also have Cerebral Palsy around the world and she really enjoys chatting with them. Adriana has a history of depression that started when she was in school. She attended her local public school where she had an assistant with her during the day. She found that the other children just ignored her and she would sit at recess and lunchtime with her assistant. When she was 12, she refused to go to school at all for several weeks and would stay at home with her mum. Her mum wasn’t sure what to do and did speak with the school about supporting Adriana to interact with her peers but nothing they tried was very successful. It wasn’t that the children were mean to her or bullied her but just that they lacked patience to wait for her to tap out a message on her speech generating device and so they would try to guess what she wanted to say and eventually Adriana gave up trying to interact with them. She was very lonely and isolated. Adriana has a lot of adaptations to her parents home to allow her to function well. The kitchen is equipped with a section of benchtop at a lower height so that Adriana can make her own food. It has a kettle, microwave and some basic utensils. If her mum is going out in the evening, Adriana can put the food into the microwave and eat it herself but she has not done any real cooking on her own before and this is something she is very excited about moving into her own home. Adriana is currently in hospital having had a fall at home 2 weeks ago. She has been referred to your team for discharge planning. She has become quite depressed in hospital and is worried about going home and whether this means that she won’t be able to move out and live alone. The focus of the team at this point is supporting Adriano to be discharged from hospital Issues you might want to address – Communication with the nursing staff on the ward – Eating and drinking – Adaptations to the home to avoid future falls – Planning for moving out of parents home – Physical therapy following the fall – Ongoing management of depression
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