A toddler with Down syndrome
Jeffrey was 14 months when I met him. He was born with Down syndrome and a congenital heart defect and had an open heart surgery when he was 6 months old. Jeffrey often got ear infections and had recently had a set of pressure equalizing (pe) ear tubes placed. Jeffrey was not walking and was not yet crawling. Children with Down syndrome do learn to crawl and walk and talk; it takes longer. Recent research and clinical experience suggests that, with regard to talking, these children benefit from early oral stimulation, oral motor awareness and multiple experiences with oral sensory stimulation. As soon as I met Jeffery, we began working on ` mouth wakeup` activities , stimulating his teeth, lips, gums , hard and soft palate, inside cheeks, and outside jaw muscles with a variety of toys and tools, including vibrators. We taught his parents to do the same at home. Another part of getting ready to talk is stimulating receptive language (language comprehension). In speech therapy visits we begin using short descriptive sentences to describe toys Jeffrey picked up (he was in a high chair initially). We dropped direct questions during these periods of indirect language stimulation and encouraged the parents to do the same. After two to three weeks, Jeffrey’s mother became adept at these techniques and began describing his activities as he did them so that he could hear them and associate the object he had with the words he heard. Her continuing work in this area made a very significant difference in Jeffrey’s getting ready to talk.

Physical factor; difficulty (such as crawl and walk), ear infection
Emotional needs; family, friendship, care, constant attention
Intellectual needs; speech therapy, learn at a slower pace, playgroups, educational toys and books. Interactive toys (things that encourage him to learn)

Jeffrey is a kid that was born with Down syndrome and a congenital heart defect. As young kid Jeffrey would be going many different problems, such as physical, emotional, intellectual needs
Jeffrey would find it hard to talk and communicate with other such as telling people his needs , also he will be learning at a slower pace, in order to solve this Jeffrey would need speech therapy, play groups , educational toys and books also things that would encourage him to learn such as interactive toys. Jeffrey would need intellectual needs in order for him to develop.
Attending a speech therapist would be an advantage for Jeffrey because he will be learning at a slower pace and he will be responding slower than the other kids. Also it would be important as he would need to tell his parents his needs.
Case study
Simon is 28 years old and works in a busy estate agents office. Simon is keen to get on and works long hour’s often missing lunch to get work finished. Sometimes he brings work home. Simon likes to `work hard and play hard`, as he puts it and in the evenings he often meets friends in the pub. He usually drinks a few pints of his favourite strong lager and eats a take away meal on the way home. At weekends he plays football with a local team and likes to drink with friends in the pub. Afterwards Simon is a smoker and he gets through 20 cigarettes a day.
Simon has a bad working pattern, the fact that he works long hour’s often missing lunch to get his work finished shows that he has no social life which is an important factor for Simon as he is young and he needs to socialise. Also Simon brings work home which shows that he is not much of a person that has an interest in socialising. The fact that Simon meets his friends in the pub in the evening shows that he does not save some time for himself to rest, as he works long hours he should have some time to rest which will increase his health & wellbeing. Simons working pattern has an effect on his headache as he brings work home and this causes stress. The health risks that Simon could face if he continues to smoke can be lung cancer, throat cancer, yellow teeth, and bad breath. These factors can affect his friendship which might cause stress.
Emotional needs; friendship
Physical factors; stress, substance misuse, diet, smoking, exercise
Elderly with a chronic disorder
Patent h is white woman, 89 years of age who resides in a sickled nursing facility. She is being evaluated due to an hgb level of 8.1 g/dl. She is ambulatory with a rolling walker, generally alert and orientated with some mild cognitive impairment. She I s complain with medical treatments and takes medications as prescribed. Her medical history is positive for congestive heart failure, chronic obstructive pulmonary disease (copd), chronic kidney disease and osteoarthritis. She is oxygen dependant on 2 l/ minute per nasal cannula. She is bright and outgoing and verbalizes multiple vague physical complaints. During her last hospitalization, one year ago for pneumonia, the nephrologist and pulmonologist told patient h there was not much else that could be done for her. Despite the poor prognosis, her multiple medical conditions stabilized and she completed a rehabilitation program. She enjoys participating in activities and has developed activities with some other resident’s .over the past year; she has been treated for multiple infections, including bronchitis and multiple urinary tract infections. ; patient h`s chief complaint is of feeling tired and short of breath at times. She also complains of arthritic pains in her neck and hands. Review of systems is notable for hearing loss, dentures, glasses and dyspena, mostly with exertion. Her bowel movements are regular, and she has not noticed any blood in the stool.
Intellectual needs; cognitive impairment (diificulting learning), enjoys activities, should take part in entertaining activities.
Physical needs; medical treatments, heart failure, oxygen dependant on a 2l minute per nasal cannula, cognitive impairment (cannot learn properly)
Emotional needs; friendships, care from others, constant attention, short of breath at times (needs care from family and friends)
Patient h is a white woman at the age of 89 she currently goes through many illnesses such as chronic heart failure, copd. Patient h`s brain does not function well, and she does not understand much, these will go below intellectual needs, patient h has some cognitive impairment this shows she has difficulty learning and understanding. In order for the old woman to solve this, she should take part in interactive activities. As patient h is oxygen dependant she needs a lot of care as her breath can run out any time. I personally think a personal need for patient h would be constant attention.

Case study
I was 2 ½ years old when I was diagnosed with cystic fibrosis (Cf). My mum and dad took me to the local doctor because I had a constant cold. I had skinny arms and legs and a distended stomach. My mum realized that by patting my back she was helping me feel better, I wasn’t sleeping because I was constantly hungry. I was referred to a consultant who decided to do some tests, one of which was a sweat test. This is a relatively easy way to test for cystic fibrosis. This showed that I had cf as the sodium levels were so high. Since then, I’ve followed a treatment regime.
The reason I got cystic fibrosis is because both my parents carried the gene that causes it. Lots of people carry the gene but it’s only when both parents are carriers and have children that it can manifest itself. My brother doesn’t have cf, though. However, he may be a carrier and could have a blood test to check. I have always had a lot of support from the medical profession since I was diagnosed. I go to the hospital every 6 weeks for checks and every 12 weeks I routinely stay in hospital for treatment., the first thing they do is test my lung function using a lung function test machine. My height and weight are measured. People with cf tend to be very thin as they don’t digest their food properly. This is because mucous inhibits the pancreas from working properly which in turn affects digestion. I have to take enzymes from pigs, to counteract this. Too many enzymes are dangerous so I have to be careful with this. The person would have no energy as he runs out of breath quickly,
Cystic fibrosis is when you cannot breathe properly, and you cough a lot. This shows that the person cannot exercise properly, due to the lack of breath, and that he needs constant attention.
Emotional factor; care from others, constant attention,
Physical factor; medical treatments