Page 17 - Adult C Overview Report - FINAL

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Learning Point 1: MARAC is a response to domestic abuse incidents and not an ongoing
plan for protections. It does not replace effective multi agency working. MARAC does not
provide a key worker role.
Learning Point 2: Addressing housing needs is an important part of planning for
protection from domestic abuse.
Learning Point 3: Understanding and assessing perceived retaliatory violence may
protect from further controlling behaviour from perpetrators.
Learning Point 4: Use of civil orders and processes to manage perpetrators is an
important part of protection of victims.
Learning Point 5: Understanding and working with co-dependent couples requires
different approaches
Learning Point 6: GPs are the central hub for all health-related information and
therefore their information for MARAC and knowledge of a person subject to MARAC is
an important element of providing holistic and safe care.
Learning Point 7: Information for professionals can be improved by providing clarity as
to which process is relevant in any given case.

Understanding and Managing Alcohol Dependency

7.24. There was early recognition and diagnosis of the alcohol dependency with substance misuse

services offering expertise and support tailored to the needs of Adult C, with changes being
made to an appointment centre for ease of access. This review identified this as good practice
and in response to Adult C’s stated barriers to attendance.

7.25. Adult C had been alcohol dependent over several years. This impacted on her physical health
with evidence of withdrawal seizures, deranged liver function, fatty liver and, vitamin and
mineral deficiencies. It is also known that long term alcohol dependency can cause other
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physical health issues and has an effect on the body’s immune system . The cited research
indicates alcohol dependent individuals are especially at risk from pneumonia with increased
morbidity in this group of people.

7.26. Adult C saw her GP regularly who made appropriate referrals for alcohol dependency and its
physical health impacts. Knowing these impacts did not lead to agencies having a
conversation with the GP regarding concerns for her health. Psychiatric liaison assessments
and hospital discharge letters were sent to the GP, but the GP had no multi agency
engagement.

14 Trevejo-Nunez, Giraldina et al. (2015) “Alcohol Use As a Risk Factor in Infections and Healing: A Clinician's Perspective.” Alcohol research :
current reviews vol. 37,2 (2015): 177-84.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590615/

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