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Case Study 1: Jamie – Supported Living AgencyJamie is a 35-year-old female with autism and an intellectual disability. She often uses assistivetechnology on an iPad to communicate with others. Jamie lives in a supported living agencywith other adults with disabilities. Her mother is elderly, so Jamie relies primarily on theadvocacy and support services at her supported living agency. When her mom comes to visitone week, she notices a change in Jamie’s behavior. Jamie is typically very happy andinterested in being active. Her mother observes unexplained violent episodes, disinterestinterest in eating her favorite foods and it seems like she may have more trouble balancinglately. Jamie’s mother requests she be taken to the doctor for a check-up.A workforce shortage to staff supported living agencies means there has been a high turnoverrate for care providers of people with ID and often caregivers are stretched beyond capacity.Jamie’s newly assigned caregiver only sees Jamie on Tuesday’s and Thursday’s during theafternoons while another caregiver sees her in the mornings and nights. Reluctantly, because ofher novel experience, Jamie’s caregiver takes her to the doctor. Jamie becomes anxious whenrequired to wait in the lobby while her caregiver completes a stack of required paperwork. Thelobby is noisy, the door chime keeps going off, and there are loud phone conversationshappening at the front desk. Since her caregiver is new, she doesn’t know how to help Jamiefeel less anxious and there are no quiet spaces available in the facility for them to wait. Inaddition, the caregiver becomes frustrated because she is being called back to the agency totend to another client and doesn’t have all the required medical information to accuratelycomplete the paperwork. When it comes time for the appointment, the physician speaks only toJamie’s caregiver and rushes through the appointment because it is only scheduled to be 30minutes long. At the end of the appointment, Jamie’s physician prescribes her antipsychotics tocontrol the violent episodes.How would you address the facility experience from your profession’s perspective?What questions would you ask the patient to best care for and address their needs in this scenario?What additional information do you need to make informed decisions?What are possible avenues to obtain the necessary information to enable you to provide best-practice care in this case? (e.g., Patient, family member, caregiver, EHR, managed care organization)Practice how you would go about asking each member of the patient’s support group for additional information. Start with the patient themselves.What challenges would you anticipate and how might you address those challenges from the beginning?
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