APIE Model in Action: A Case Study of Ola Adeyemi with Down Syndrome

This case study focuses on Ola Adeyemi, a 30-year-old individual with Down Syndrome, and his care needs. Living dependently with his aging parents, Ola requires support in various aspects of life, including daily activities, transportation, and employment. The report employs the APIE (Assessment, Planning, Implementation, Evaluation) model to create a person-centered care plan. The assessment phase identifies Ola's strengths, weaknesses, and specific needs, such as speech therapy, special education, physical therapy, occupational therapy, and assistive technology. The planning phase sets goals for Ola's independence, including learning daily activities, using public transport, developing communication skills, and securing employment. Interventions like speech therapy, special education focusing on self-care, physical therapy for muscle development, occupational therapy for skill mastery, and assistive technology for employment are proposed. Social and emotional support is also emphasized to address potential self-esteem issues. The implementation phase focuses on putting the care plan into action, ensuring clear inputs and practical strategies for healthcare practitioners to help Ola achieve his goals and improve his quality of life.

Meeting the Needs of
Service Users

INTRODUCTION
It has been determined that chromosomal error can leads to down syndrome or trisomy
21. Studies concluded that most of individual who are born with Down's syndrome most likely to
have healthy and fulfilled lives. (Bush and et. al., 2018). There are considered phenotype
characteristics of an individual who are born with Down syndrome, which includes facial
features and intellectual disabilities. Also it has been found that individual who are dealing with
syndrome debits wide variability in modifiability and cognitive traits. Down syndrome is caused
by the presence of an extra chromosome number in developing infants inside womb of a mother.
Well, it is most frequent as mother turns out old. It is interlinked with several intellectual
disabilities which termed to vary person to person.
Physical problems which are also related to Trisomy, are issues related to cardiovascular
diseases, hearing defects, problems with vision. There are multiple complicated problems which
are also co-related with down syndrome such as small bowel obstruction, mortality etc. Most of
people gain quality of care, services, rights and support by individualize care professionals in
context of their special needs and health demands. (Hill, 2018). This report underpins the care
needs of Ola Adeyemi dealing with Down Syndrome, which might work on his several aspects
of lacking areas. Moreover, it also cover its acute care plan which might work on his
improvement of quality of life.
MAIN BODY
Case Study
Ola Adeyemi, is 30 years old adult dealing with issues of Down Syndrome and living
dependently living for 30 years with his parents. His parents provided support and care and also
have done several of things for him including daily activities like dressing etc. Ola has never
attain learning of using public transport and also due to his disabilities, he is unemployed. At
present, his parent are frail or aged and struggling with dilemma whether they continue there
support to Ola or they support themselves.
Down's Syndrome:
Studies state that Down Syndrome is a genetic disorder, due to this defect an individual
can counter variety of physical and mental complications. It is prevailed due to extra cope of 21st
chromosome in new born infants. (McKibben, 2019). Mackintosh-Franklin, 2020). According

to studies, it has been determined that as compared to normal being, people who are dealing with
syndrome have slow or delay development learning skills, which also includes daily activities
such as dressing, talking, traveling etc (Taub and et. al., 2017). Eventually, they are able to
learning by observing and learning, it just they require time to grasp learning.
There are common complication of Trisomy 21 which involves depression, anxiety,
obsessive complex disorder, abuse, loss of vision and hearing abilities, spinal cord compression,
periodontal disease an others.(Mengoni and Redman, 2019) Other challenges such as social
acceptance, decay of interest, regression in social as well as cognitive skills. To address needs of
an individual, I will consider APIE model. As this can be appropriate model which is frequently
used by nurse practitioners for holistic care. The Patient's care needs are mentioned below with
the aid of APIE model.
Assessment
It is a initial step, in which critical systematic integration of qualitative and quantitative
data should be performed. Quantitative data involves physiological status of a person such as
routine checkups, temperature, blood pressure, mass, pulse is addressed. Whereas, in the
qualitative aspects of an individual consist concerns, ideas expectation is develop. In the case of
Ola care, for evaluation physical assessment is obligatory. Such as monitoring body weight of an
individual, temperature an pulse rate (Taylor, Vasquez and Donehower, 2017).
It is also important to address individual's strength, weakness, preferences, aspiration as
well as personalized goals. These observation can be helpful to determine final care needs of the
patient. It has been determined that Ola body weight is average, pulse rate are normal, his
strength can be consider as education till 18 years , another strength that can considered the case
of Ola, that he is self concern and interest towards improvement of health conditions in order to
become independent. Fro that, as he needs psychical support for performing basic activities.
Patients should be provided learning in regards with self care, so that he will be able to attain his
desired goal. There is high requirement which follows up learning of use of public transport and
healthy diet. Ola also needs relevant employment, accommodations and also day time activities.
There is demand which is in regards with language therapies, occupational therapies,
development of motor skills and special education.
Planning

A plan should aims on the individual's preferences biological elements which are required
to assure the individual's holistic care plan, which can be recorded, observed, directive which can
be also understood easily. As a social worker, I have determined planning theory with the help of
APIE model of an individual should be person-centered care (Nightengale and et. al., 2017).
Person centered is considered as type of care, under which each determined needs are
administrated by health practitioners along with the relevant health needs which can help an
inidvidual to attain their personal goals, although the model of disabilities can include the social
model.
Goals
The major goals that are included for Ola are mentioned below:
A patient will able to achieve learning of daily activities such as dressing, cooking and
others. He will be able to learn self-care and self-hygiene for himself. The learning of using
public transport also provided so that he will be to travel alone. He will able to develop effective
communication skills in which he will be able to explain his needs and demands to others. Ola
will attain employment and accommodation. In following, there are person-centered care plan in
respect to the needs of a person.
Speech Therapy
As there is requirement of speech in the case of Ola. The speech therapy consist
intervention in which an individual might develop their language, which can be beneficial for
Ola, in order to express himself to others. Communication is a key for independence, by which
an individual might get ample of opportunities to express their demands, to express their feelings
and be able to socialistic in the society.(Sciaraffa, Zeanah and Zeanah, 2018) As the
communication can be developed by speaking and practicing it, so that I will make sure Ola
should make new friends, so that he will be able to develop his language skills more faster.
Along with speech therapy sessions, I will make sure Ola to meet his friends. I will make sure he
also revise therapy learning after these session at his home with his parents.
Addition to this, while addressing the case of Ola, I have also addressed that there is
lacking in self esteem, as it might happen and it is general with people who are with disabilities,
here I will personally provided motivation to learn, so that he will be able to trust me for further
process as well. It has been also observed that atmosphere in which an individual is surrounded

might impact the development of individual. So there is need of self care education. It can be
utilizing for Ola, in order to live independently.
Special Education
In the case of Ola, it has been determined that there are lacking points in self-care skills,
management skills and individualism. For that, maintaining proper hygiene, healthy dietary
pattern, behavior as well as public transportation learning and knowledge should be
acknowledged to an individual, which can help Ola to become more independent (Taub and et.
al., 2017). I will contact Special educators and will inform the case scenario of Ola. For that, I
will also informed that my desired outcome of Ola for individual's effective training session.
Physical therapy
This therapy is one of the most significant step for the Ola, as this can assist him with the
improvement of muscle development, with the guide of which he can turn out to be more
independent to live freely buy his own. Physical therapist assists the patient with acquiring the
muscles qualities and strength, balance, skillfulness and development abilities individually.
(Santy-Tomlinsonand Mackintosh-Franklin, 2020). All in all this load of variables add to the
further developed autonomy with every day exercises and nature of the life.
Physical theory exercises are type of fitness games and activities to expand the muscles
strength, pulling, setting and standing in order to generate further develop development in Ola.
Also, to work on the balance and posture control some key exercises ought to be performed by
the patient on daily basis, such as bouncing, skipping and spilling. Physical therapy treatment
likewise guide or help for the actual second improvement by determination of explicit exercise
and diet fro an individual. Here my job role is to deal with the pshyical therapy session with the
exact scheduled time frame.
Occupational Therapy
Occupational therapist are determined to work with children to have education, training,
psychological development, neurology, therapeutic interventions. They focus on ability of child
in order to master skills for independence.(Bush and et. al., 2018). The intervention which can
be concluded: development of fine and gross motor skills, play and leisure skills, academic
skills such as crafting, drawing, that can help them to foster their creative skills, self care skills
such as feeding, dressing, grooming etc. The stage of OT have involvement to certain stages that
can help Ola to learn self-care skills. An OT can facilitate individual's parents to break down the

skills, so that expectations are relevant, and can able to suggest adaptions which can make child
more independent. In the case of Ola, daily activities can be addressed by the help of
occupational therapist. Here, I will make arrangements and will take appointment with therapist.
Assistive Technology
It is one of the essential learning which should be provided to Ola. There are
responsibilities of staff members that they should always keep attention on Ola, if he might need
assistance while learning the use of technology. This learning might help him for employment. It
can be provided by the help of appropriate supportive tools, example touch screen, three sided
pencil's touch screen, using keyboard along with large graphics. (Taylor, Vasquez and
Donehower, 2017). In order to accomplish, I will make sure there should be availability of
facilities which are required for Ola. Also, I will also like to coordinate with technical specialist
in regards with Ola. I will ask them to give Ola learning specific tools which are easy for him to
operate. The employment factor can be beneficial Ola to promote independence. I have also
shortlisted a jobs and job roles for Ola, and will contact to HR of organization in terms of
technical needs which should be addressed by them.
Social and Emotional Support
As per the studies, it has been considered that people who are suffering with syndrome
might feel low self-esteem, due certain factors such as social acceptance or withdrawal.
(McKibben, 2019).These factors might affect there psychological wellness. In order to minimize
these factors, motivation and emotional should be provided to individuals who are dealing with
syndrome. I will make proper accommodations for Ola, interventions such as group movie
session, social gathering etc.
I will make sure that if I am addressing his all needs and expectations, so that he will be
comfortable to communicate with others in society. I will also take Ola personally for outings, so
that he will able to comfortable with living of society. Within UK, there are multiple campaigns
who are working for encouragement and motivation for people with disabilities. I will make sure
Ola to join any campaign that can make him more motivated and encouraged and can promote
quality of life in an individual.
Implementation-
Another step is to implement the care plan in order to achieve desired goals of individual
(Bush and et. al., 2018). It can be addressed by assuring the clear inputs, which can be

practicable for nurse practitioners. In this step, the learning which is provided to Ola is to
manage his self care, improvement of language skills, improvement of physical movements and
others. In order to implement, I have considered holistic approach towards patient as well as
person centered care interventions. I am glad that I have established therapeutic relationship with
Ola, so that he will be able communicate with me anytime, in regards with healthcare needs and
choices of the care interventions.
On the basis of the Mental Capacity Act 2005, valuing people and care and Care Act I
will like to implement my care plan. As per the Mental Capacity Act 2005, which can be
applicable for Ola, everyone who are involved in the acute care plan, treatment of people who
are suffering from disabilities and support of people who are aged than 16 years old who living
in England, especially those who are unable to take their own decisions for themselves
(Sciaraffa, Zeanah and Zeanah, 2018). It is structured in a way to protect as well as restore power
to those vulnerable individuals who lack of capacity. Whereas, as per the established new
strategy for learning disability for 21st century. The four key principles which are considered as
rights, independence, choice as well as inclusion which lies in the core of policy. The updated
national objective for quality of care and services which should be provided to individuals
Evaluation
the evaluation is a final stage which all lost cover the the process and implementation of
care plan that is considered for an individual. Hence, it is type of clinical integration that can
contains development of nurses and can be considered as major element of learning process. The
determined criteria of determined acre plan for an individual is to identify progression in such
aspects examples: in physical movement of patient, fine and gross motor skills, communication
and how much an individual is involved in social gathering. It can be also identify by the
observation of his independence level (Verkuyl, and et. al., 2017).
At the end, he will able to perform, daily activities which can be beneficial for him to
foster his quality of living. It can also provide facilities to Ola's parents in the management and
administration of Ola. It has also observe that Ola is developing his communication skills by the
help of laguage therapist. Communication may help him to express his needs and demands to
others. The job role which has been decided for him, was termed to be effective, as employment,
is major factor which promotes independence in an individual.
REFLECTION

Description
I achieved learning that a Ola, who was 30 years old and was dealing with down
syndrome. Till present, his parents were providing support and now they are aged, they are
dealing with dilemma whether they should provide themselves or Ola. As a social worker, I have
determined the care needs of patients, that can be attained as improvement in physical
movements, language and social withdrawal. There should be improvisations providing learning
of use of public transport. Here my role is to coordinate with all health practitioners and
therapists, who are assisting an individual to achieve desired goal.
Feelings
At the time of treatment, I really felt compassionate towards the situation of individual
which he and his parents were dealing. The considered goals and objective for Ola, was termed
to be effective to promote progress in an individual. His nature seems to be initiative and highly
oriented towards accomplishing task. I have also determined that his parents were satisfied with
services which were being provided to Ola.
Evaluation
I have learn how to implement care planning framework (APIE model). I also attained
opportunities to learn various models such as care models, valuing care and people plan, social
model of disabilities and so on. I have discovered that patients was also coordinating with me.
Analysis
From the case analyses Ola, I have learn that individual who are with disabilities has
individual right to spend quality of life. I achieved learning understanding that can help them to
manage proper care and planning nurse interventions which can be utilizing to improve over
health of individual (Taub and et. al., 2017). As per my observation, an individual and his family
were satisfied with care intervention which were provided by me.
Action Plan
Through this assessment, I am glad that I am able to attain learning that each person who
are with disabilities should attain support and care at several aspects. There are few patients
whose demand are they require quality of emotional support and where there some, who needs
physical support from service providers.

CONCLUSION
Overall, it can be concluded that Down Syndrome prevail by the cause of genetic
disorder in individual's body. It can impact on variety of aspects, that can lead a patient to deal
with physical and mental consequences. In order to proceed improvements, the responsibilities of
social workers are to identify care needs of individual, implement acute care plan of individual
which s determined for proceeding total improvement of an individual. In this assessment, I am
able to foster my professional skills such as coordination with others, team-work skills and
whereas my personal skills which I developed at the end of assessment are communication skills
and other that can assist my future practice.

REFERENCES
Books and Journals
Mengoni, S.E. and Redman, S., 2019. Evaluating health visitors' existing knowledge of Down
syndrome and the effect of a training workshop. Journal of Policy and Practice in
Intellectual Disabilities, 16(1), pp.30-36.
McKibben, L., 2019. Exploring the value of reflexivity in learning disability research. Learning
Disability Practice, 22(6).
Hill, R., 2018. Planning, Implementation Evaluation Process of (APIE): Nursing and The.
Essentials of Nursing Practice, p.205.
Santy-Tomlinson, J. and Mackintosh-Franklin, C., 2020. How to be a Great Nurse–the Heart of
Nursing. M&K Update Ltd.
Sciaraffa, M.A., Zeanah, P.D. and Zeanah, C.H., 2018. Understanding and promoting resilience
in the context of adverse childhood experiences. Early Childhood Education Journal,
46(3), pp.343-353.
VanZant, J.S. and McCormick, A.A., 2021. Health care transition for individuals with Down
syndrome: A needs assessment. American Journal of Medical Genetics Part A.
Taub, J.W., and et. al., 2017. Improved outcomes for myeloid leukemia of Down syndrome: a
report from the Children’s Oncology Group AAML0431 trial. Blood, The Journal of the
American Society of Hematology, 129(25), pp.3304-3313.
Bush, D., and et. al.,2018. Clinical characteristics and risk factors for developing pulmonary
hypertension in children with Down syndrome. The Journal of pediatrics, 202, pp.212-
219.
Nightengale, E., and et. al., 2017. Understanding hearing and hearing loss in children with
Down syndrome. American Journal of Audiology, 26(3), pp.301-308.
Taylor, M.S., Vasquez, E. and Donehower, C., 2017. Computer programming with early
elementary students with Down syndrome. Journal of Special Education Technology,
32(3), pp.149-159.
Verkuyl, M., and et. al., 2017. Virtual gaming simulation in nursing education: a focus group
study. Journal of Nursing Education, 56(5), pp.274-280.

Appendix 1
Ola Adeyemi centred care plan
Assessment Nursing
diagnosis
Goals and
outcomes
Interventions Implementati
on
Evaluation
The working
areas which
are concerning
which require
impoverishme
nts are fine
and gross
motor skills,
technical
skills, physical
movements,
education of
self-hygiene,
self-
management
and self-care.
Addition to
this. Healthy
dietary pattern
is required for
metabolism
and
nourishments
to an
individual.
Therapies such
as physical
therapies,
speech
therapies,
intellectual,
cognitive
skills which
are considered
barrier for an
individual to
lead
independence.
Extemporizati
on in
language, fine
and gross
motor skills,
promoting a
better
understanding
of awareness
and
knowledge in
regards with
self-care, self-
control, self-
management,
dependency,
achieving
desired job
role.
Need of
special
education,
better
understanding
of use of
public
transport,
socialisation,
therapies such
as speech,
assistive
technologies
knowledge,
emotional and
social support
to individual.
Effective and
better
relationship
that can help
an individual
to grasp
supporting the
process of
care.
Motivation as
well as social
support which
should be
provided to an
individual to
promote his
socialisation
abilities and
able to gain
social
acceptance.
There should
be
improvement
in patient's
self-care and
self-
management.
Ola will be
eligible for
using public
transport, he
will be able to
use public
transport.
These factors
might help
him achieve
independence.