Understanding the Client's Situation This case study draws upon the two processes of understanding and negotiating that are used when individualizing intervention (identified by Copley et al.,...

Understanding the Client's Situation

This case study draws upon the two processes of understanding and negotiating that are used when individualizing intervention (identified by Copley et al., 2008). Val is a woman in her eighties who lives with her husband in a high-set house not far from a major regional centre. She has severe rheumatoid arthritis, particularly affecting her hands and hips. She has lived with her condition for many years but seeks assistance from healthcare professionals at times when the deterioration in her condition means that the routines and methods she has in place no longer support her participation. When working with her, the healthcare professional first tries to understand her particular situation, with a focus on what has worked for her in the past, her current concerns and circumstances and her goals for the future and expectations of the healthcare professional. He listens closely for any cues that might indicate her attitudes to certain interventions or courses of action. He also pays attention to details about her circumstances, considering matters such as what she can afford and who is available to help her. While listening to Val, he is thinking about what is known about the issues being raised and other clients with whom he has worked previously and considers the relevance of all of this to Val's circumstances. As understanding of Val's situation and possible courses of action develop, the healthcare professional works towards a shared understanding with Val. In coming to this shared understanding, he has combined knowledge from a range of sources into the process of shared decision making.