Jacob 

i am unable to reflect upon this case study as the information was not available. 

Ameena 

i can relate very much to  'There was a delay in her being referred to a specialist at first and her GP suggested over the counter painkillers'. this is something i hear on a regular basis. also ' Ameena was referred to the respiratory team and a neurologist. The neurologist suspected MND but a referral was made to a specialist neurologist for confirmation. A definite diagnosis of MND with respiratory type symptoms was then made following a full neurological examination'. This is currently how i see the process happen for all of our patients. Also i noticed the patient is from Liverpool - which i also am, therefore i feel this is a true presentation of what usually occurs. With regards to the management and outcomes - 'Ameena’s condition is rapidly deteriorating and she requires regular specialist input to manage these changes'. i feel very passionate about this, because this is also an accurate description of what usually happens. i feel that regular follow up in paramount. Paitents are routinely invited back to clinic every 4 months, however the MDT needs to communicate with each other during that period as sometimes 4 months can be too long without any support.  

reflecting on the videos - i thought it was so significant that the points of view from both professionals where very different. The clinical team focused heavily on looking at how her needs now require potentially a hospice, and how they need to work with social services - they felt that the PEG would probably not be appropriate. However watching the physios discussion - they wanted to explore the option of PEG a bit more, in terms of cough and saliva management. This is an example how much important it is for all members of the team to discuss together as they are all thinking about the patients needs from difference perspectives based on their experiences. 

Faisal 

when reading the first statement 'It has become apparent that his cognitive function has deteriorated. He becomes confused in new surroundings, is resistant to change, finds understanding complex language difficult, and cannot easily understand or recognise other people’s emotions'. - my first thought was that pehaps he has FTD and that the MDT  would possiblly need to refer the patient to a neuropsychologist. 

It was interesting to then watch the video and see that the team also highlighted this, and then discussed how this relates to diet and nutrition. Watching this, i learnt how this would then relate to how the patient would be considered for a gastronomy - as i hadn't initially thought of this. 

It was also interesting how the discussion was very focused on how a care plan would suit his individual needs - and how lots of careers attending the home wouldn't be appropriate. they also highlighted that the patients cultural beliefs need to be considered.