Long case

Question 1

Social issues to ask

Answer 1

1. Accommodation
   Rental vs. mortgage
   Single vs. double; steps?
   Modifications
   Rooms in house
2. Transport
   Who can drive
   Modifications
   Transport allowance
3. Finances
   - Work
   - Carer’s allowance / payment
   - NDIS
   
   • What does this cover (allied health, carers, equipment, supplies e.g. nappies)
   • How would you rate? Great vs. avg vs. terrible
   • Equipment that you need but don’t have
     
     • Healthcare card - if not how are medication costs covered
     • Transport card
       Other
4. Health cover
   - Ambulance
   - Private
5. Supports / religion / respite = CRSH + DV
   - Crisis plan
   - Respite - planned, emergency
   - Support groups
   - Holiday
   - Drugs and alcohol
   - Violence
6. HEEAADSS + BC
   Home - see below
   Education (school)
   Employment
   Activities / fun
   Ambitions
   Drugs + alcohol
   Suicide / mental health
   Sexuality (BF/GF)

6Fs - function, family, fitness, friends, fun, future

Body imaging / self esteem
Contraception

In younger children this opportunity to ask about school
* Mainstream vs. special
* Aids - people, equipment (e.g. communication boards)
* Progress at school - grades, social

Question 2

Systems RV

Answer 2

Acronym: TEEE, FUPS, MIBBS, PPH
TEEE - teeth, ears, eyes, ENT

FUPS - feeding/growth/nutrition; urine; poo (constipation, incontinence); sleep/OSA (inc sleep arrangements and naps)
* Feeds - is this stressful for family, how long does a meal take for the child, a/w cough? Gags?

MIBBS - mental health; ID; behaviour; bullying; smoking (in family)

PPH - pain; procedures; hospitalisations

Systems based:
Growth, development, nutrition
Neuro - seizures
Resp - recurrent infections
Cardiac
GIT - reflux
Bones
Puberty
Infection

Question 3

Impact and future planning questions

Answer 3

7. Impact
   - How does X illness impact the family?

-> Siblings
How are they coping?
Have they missed on things due to X illness?
Any issues with sibling rivalry or jealousy?
Any physical or mental health concerns?

-> Parents
How are you coping?
How is other parent coping?
How has this impacted your relationship?
Do you have mental health issues?
Who supports you?

8. Forward / future planning
   Goals - what is your biggest goal
   Hopes - if you could change one thing
   Fears - what is your biggest fear?
   Understanding - what do you expect for the future? In 5 yrs time?
   ACP

Where do you see X in 5 yrs time? 10yrs time? Do you think they will live at home with you?

QOL - what impacts on QOL the most

Question 4

Opening spiel and questions to parent

Answer 4

Spiel about only having an hour, try to get history done in 40min and then examine and start write up in last 20min. Pressured for time so may need to redirect the conversation if we go off track, apologies in advance.

What is your name
What is child’s name and age

List all medical issues, most impt first - just a list for now, we will go into details later.
If we could address 3 issues what would they be?
Which do you think is main issue? Why? (e.g. QOL, difficult to Mx etc)
What did examiner focus on?

Care teams

Meds

Allergies

Immunisations

Family structure (name and ages), where do they live, what sort of school do they attend
Are there any financial concerns?

Question 5

Developmental condition (CP) - things to cover relating to dev and function after primary diagnosis

Answer 5

1. Physical disability - GM and FM, any AIDS
2. ID - language (expressive and receptive) and social (relating to others and also to self care)
   — any cognitive testing?
3. Vision and hearing
4. ADLs
5. Continence - urinary and bowels
6. Fun/fitness/enjoyment