MID 503: Assessment 3 Aged Care Case Study

 Assessment requirements

Relevance: 

This case study provides an opportunity for you to engage with realistic and emotionally complex perinatal scenarios, enhancing your preparedness for midwifery practice. You will develop skills in trauma-informed decision-making, interdisciplinary collaboration, and critical reflection, all essential for supporting women experiencing psychosocial adversity during pregnancy.

Case Study:

Audra is 27 years old and 16 weeks pregnant with her first child. She is seeing you for the second time, and she tearfully shares her social situation and what she describes as her “alcohol dependency” with you….

Audra arrived in Australia on a skilled migrant visa from Nepal two years ago. She is a registered nurse and is working in an Aged Care facility. Audra had met Allan, a gardener at the same facility, shortly after she arrived in Australia, and he had moved into the flat with her, as he had been couch-surfing and did not have a place of his own to stay. Allan had made Audra feel very special and he taught her how to be an “Aussie”, including introducing her to alcohol for the first time in her life. However, Allan gradually became more and more controlling and demanding of Audra. He insisted that because she was an Aussie now, she needed to break ties with her friends and family back in Nepal, and his friends could now become her friends. He convinced Audra that because he was an Aussie, he knew how the banks and finances worked and it was in her interests if he took control of the finances. For the first time in her life,

Audra was drinking alcohol and found that it helped to stop her from missing her family and friends back in Nepal, and the two glasses of wine helped her to feel more relaxed as she cooked Allan’s dinner (he was getting more and more demanding and critical of her cooking). Audra believed Allan when he said that a couple of glasses of wine with their dinner would bring them closer as a couple, and a couple of nips of spirits would help her to sleep. Not long after, Allan pointed out that she needed his support if she wanted to stay in Australia, as he told her, he had contacts in the Immigration Department who would deport her if he reported that she had turned into an “alcoholic”. He also threatened to tell the Aged Care facility that would make sure she was deregistered as a nurse if they found out about her alcoholism. This led to her becoming increasingly more anxious and depressed and needing to drink more alcohol. Allan would often take Audra out to expensive restaurants, buy her expensive wine, and make her feel like an absolute princess. However, at other times, he would say they had no money and couldn’t afford to go out for dinner, and she needed to stop nagging him for some of her money to spend, because she was “doing his head in”. Three months ago, when Allan was at work and Audra was at home on her day off, a debt collector came to her door and demanded the $10,000 that Allan owed but left when he realised that Audra was unable to give him any money. When Allan got home from work, Audra told Allan about the debt collector. At first, Allan was angry but eventually shared with Audra that he had lost some money gambling but would soon be able to pay back what was owed.

The next morning, Audra went to work, and when she got home, Allan and all his possessions had disappeared from their flat. He had resigned from his job (effective immediately), blocked her number from his phone, and she had not seen or heard from him since he left. A couple of weeks later, Audra had done a home pregnancy test, and it was positive. 

Task:

Substance use and misuse are fairly common for the perinatal woman with a history of trauma. This assessment requires you to refer to Audra’s case and write an essay where you critically review, discuss and reflect

• Using self-sourced literature, critically review the links between trauma (including intergenerational trauma), social vulnerability and substance-use disorder in pregnancy.
• Based on these findings, critically discuss:
• Public health strategies that could be used to reduce the incidence and impact of perinatal substance use disorder in the community;
• Midwifery strategies that could be used to support a woman to reduce the impact of substance use disorder on both her own health and the health of her unborn baby.
• Critically reflect using the Bass Model of Holistic Reflection on your own personal thoughts/feelings/beliefs and values that may influence your midwifery partnership with a woman who is socially vulnerable and living with substance use disorder.

Brief of Assessment Requirements

Purpose: Critically review links between trauma (including intergenerational trauma), social vulnerability and perinatal substance-use disorder (SUD); then discuss public-health and midwifery strategies to reduce incidence/impact; finish with a Bass Model of Holistic Reflection on personal beliefs and how these may influence midwifery partnership.

Core tasks

• Use self-sourced, peer-reviewed literature.

• Critically review trauma ↔ social vulnerability ↔ substance use in pregnancy.

• Critically discuss public-health strategies (population level).

• Critically discuss midwifery strategies (individual/clinical level) to reduce harms to mother and unborn baby.

• Reflect using the Bass Holistic Reflection model on your attitudes, values, feelings and how these shape care.

• Integrate evidence, policy and culturally safe, trauma-informed practice throughout.

Key pointers to cover in the assessment (checklist)

1. Clear introduction & thesis — define terms (trauma, intergenerational trauma, social vulnerability, perinatal SUD), scope and aims.

2. Literature synthesis — epidemiology, mechanisms linking trauma → SUD, role of social determinants (migration, isolation, financial control, coercive relationships).

3. Critical analysis — weigh conflicting findings, note gaps/limitations in literature.

4. Public-health strategies — prevention, screening policies, community supports, harm reduction, culturally appropriate outreach, policy/regulatory recommendations.

5. Midwifery strategies — trauma-informed care, screening & brief intervention, referral pathways, multidisciplinary collaboration, antenatal care adaptations, safety planning, confidentiality & legal/ethical issues.

6. Reflective section — apply Bass Model: describe experience, analyse feelings/assumptions, evaluate influence on practice, create action plan.

7. Conclusion & recommendations — concise, evidence-based.

8. Academic rigour — APA referencing, critical voice, balanced citations, word counts respected.

How the Academic Mentor Guided the Student — Step-by-Step Process

Below I outline the mentor’s approach to turn the brief into a strong essay. Each step includes what the mentor asked the student to do and brief guidance on content and style.

1. Clarify the brief & plan (Orientation)

Mentor action: Reviewed the assessment rubric and learning outcomes with the student; set deadlines and a word-count plan.
Student task: Write a 100–150 word draft outline and a proposed thesis statement.
Why: Ensures focus and prevents scope creep.

2. Define terms & craft introduction (Foundation)

Mentor action: Suggested concise definitions for trauma, intergenerational trauma, social vulnerability, perinatal SUD and coached a 3-sentence thesis that frames argument.
Student task: Produce a 200–300 word introduction that situates Audra’s case as an exemplar and states essay aims.
Tip: Use one sentence linking Audra’s scenario to broader determinants of health.

3. Literature search & selection (Evidence base)

Mentor action: Taught targeted search strategies (databases e.g., PubMed/CINAHL), inclusion criteria (last 10 years unless seminal), and how to prioritise systematic reviews and high-quality qualitative studies.
Student task: Compile 12–15 high-quality sources, create annotated bibliography (one paragraph per key source).
Why: Ensures evidence is current and relevant.

4. Structure the literature review (Synthesis)

Mentor action: Recommended thematic organisation rather than source-by-source — e.g. (a) trauma mechanisms, (b) social vulnerability & migration, (c) impacts of perinatal SUD.
Student task: Write 600–700 words synthesising evidence, explicitly linking to Audra’s case (immigration stress, partner coercion, financial control).
Guidance: Critically appraise methodology and inconsistencies; highlight gaps (e.g., limited research on migrant nurses in perinatal SUD).

5. Public-health strategies (Population level critique)

Mentor action: Prompted the student to separate prevention, early identification, and system responses. Suggested examples: antenatal screening policies, community outreach for migrant communities, harm-reduction messaging, accessible addiction services, and social policy to reduce economic coercion.
Student task: Write 250–300 words critically discussing each strategy’s evidence, feasibility, and limitations (equity lens).

6. Midwifery strategies (Clinical/practice level)

Mentor action: Coached on trauma-informed midwifery care: safe, nonjudgmental screening; brief interventions; confidential referral pathways; collaborative care planning with social work, addiction specialists and culturally appropriate interpreters; safety planning for coercion.
Student task: Produce 250–300 words with practical examples and cite clinical guidelines where possible (e.g., antenatal SUD protocols). Include measurable outcomes (reduced substance use, improved antenatal engagement).

7. Reflective practice using the Bass Model

Mentor action: Explained each Bass Model stage (Description, Feelings, Analysis, Action/Plan) and modelled an example reflection (safe, concise, professional). Emphasised ethics of self-disclosure and power dynamics.
Student task: Complete a 300–350 word Bass reflection: describe emotional reactions to Audra, identify biases (e.g., moralising about substance use), analyse how those could affect partnership, and make a concrete plan to mitigate bias (supervision, training in trauma-informed care, use of structured screening tools).

8. Conclusion, proofreading & referencing (Polish)

Mentor action: Reviewed draft for flow, logical coherence, and critical tone. Advised on concise conclusion that links back to thesis and offers clear recommendations. Checked referencing format.
Student task: Final edits, word-count check, produce 10–15 referenced sources in APA.

How the outcome was achieved (brief summary)

• Plan + evidence: A clear plan and targeted literature search produced a robust evidence base connecting trauma, migration/social vulnerability and perinatal SUD.

• Critical synthesis: The student moved from description to critique — assessing strengths/weaknesses of public-health and clinical strategies.

• Applied to case: Each theoretical point was explicitly connected to Audra’s lived situation (coercion, financial control, isolation), improving clinical relevance.

• Reflection & professional development: Using the Bass Model transformed personal feelings into actionable learning goals (supervision, cultural competence, trauma-informed screening).

• Academic quality: Draft revisions focused on argument clarity, balanced critique, and polished APA references.

Learning objectives covered

1. Evidence appraisal — locating and critiquing literature on trauma and perinatal SUD.

2. Critical thinking — linking social determinants to clinical outcomes; weighing interventions.

3. Trauma-informed care — demonstrating principles in midwifery strategies.

4. Interdisciplinary collaboration — proposing realistic referral and team-based care pathways.

5. Reflective practice — using Bass Model to identify and mitigate personal bias.

6. Professional communication — writing a clear, evidence-based academic essay with correct referencing.

Get Expert Guidance for Your Midwifery & Aged Care Assignments

Looking to understand how to approach complex case studies like Audra’s scenario? You can download this sample solution to see how professional academic mentors critically analyse, structure, and reference their work. This file is designed to help you learn the right approach to research, reflection, and academic writing.

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