Hasan is 48 years old; he lives with his wife Salima and their 4 children Fahemma 5 years old; Nadir 7 years old; Amira 10 years old and Hussain 13 years old. The family lives in a terraced house, close to the city center of Bradford. The area has high levels of deprivation, including unemployment, crime, poverty, and poor educational attainment. There is little access to green urban space and the local high street has many takeaways and limited shops supplying fresh fruit and vegetables.
Hasan was diagnosed with Type 2 diabetes 4 years ago; he also has high blood pressure, and his BMI is 32 putting him in the obese weight range. Hasan has struggled to manage his diabetes and frequently has high blood glucose levels due to his poor diet, which is high in fat and carbohydrates. Hasan says he doesn’t really understand his medication regime, how to monitor his blood glucose, or his dietary requirements. His GP has recently told him that he needs to lose weight or there is a serious risk he will have to start injecting insulin and might develop the cardiovascular or renal disease in the future. Hasan is also a smoker, he smokes approximately 25 cigarettes per day, he does very little physical activity, because he gets breathless easily and the GP is arranging tests for chronic obstructive pulmonary disease.
Hasan does not drink alcohol. Hasan works as a taxi driver, mainly shift work 9 pm till 5 am in the morning, he does manage to use a vape when at work as he can’t smoke in his taxi. The family is classed as a low-income family and Hasan often finds himself in debt and must work overtime to manage the household bills. Hasan has told his GP that he feels stressed a lot of the time and is not able to take control of his own health due to all the external family problems, which often result in him missing his diabetic hospital appointments.
He is the main carer for his wife who was diagnosed with post-natal depression and psychosis after the birth of their son Nadir. Salima was sectioned under the MHA when Nadir was 3 months old and spent 6 months as an inpatient at a local psychiatric unit which limited early bonding with Nadir, who has developed behavioral difficulties and has a diagnosis of Attention Deficit Disorder. Salima’s mental health problems have persisted, she frequently feels tired, withdraws to her bedroom, and does not like leaving the house due to her anxiety.
Salima has regular visits from a Community Mental Health Nurse, who is working with her to try and encourage Salima to access a local Asians Women’s Support Centre, however, both Hasan and Salima are very reluctant to this suggestion as they believe that the family should deal with and support each other with health problems. Hasan does the majority of shopping and cooking for the family and takes and picks the children up from school. Hussain tries to help his Dad around the house and with caring for his younger siblings, however, he has started to fall behind with his schoolwork and has been increasingly getting into trouble at school for not doing his homework and playing truant.
Hasan has extended family that lives close by, both his parents live with his brother and sister-in-law and their 3 children. Hasan’s mother Aziz is 74 years old and has dementia, she has limited English language, and her family act as interpreter when she needs to attend the hospital. Hasan doesn’t want to talk to his brother about his own problems because he knows the family is struggling to cope with caring for Aziz. Hasan visits his local Mosque regularly and ensures his children attend Madrasa, he says he finds great spiritual comfort in his beliefs and the community support at the Mosque.
The GP refers Hasan to you, the social prescribing link worker for support with his current physical and mental health and social problems. Hasan says he has tried to lose weight, stop smoking and take up more physical activity but just can’t seem to change his lifestyle with all that is going on. He is willing to attend the appointments with you and says he understands his health is a risk he is very worried about this because if something happened to him then the family would really struggle to cope, however, he can’t seem to find the motivation to change his lifestyle behaviors.
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