[Understanding Specific Needs in Health and Social Care]
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Am social worker at a care home based in London and has met patients with complex needs that require specialized care and others that can be handled at family level or with minimal care giver intervention. Therefore, demands of most of our patients are different and require be analyzing and understanding clearly, so that an intervention that will be used meets the demands of the patient. Holland Park is visually impaired and his family has sought the services of our facility to enable them understand and know how his basic needs can be met. In orders to come up with the best way of helping Mr. park it is prudent that I met him and his family and understand the concept of health , illness, disability and behavior of the patient. After the meeting with Holland park family I was supposed to analyze and report the concepts of disability, illness and behavior in relation to health and social care. Also how perception of specific needs and legislation has changed over time.
Analyze concepts of disability, illness and behavior in relation to health and social care
During the discussion and assessment with Mr. parks family I was able to identify various aspect in relation to the above statement that will be helpful in coming up with the most effective intervention for Mr. park. They include health, illness, disability and behavior which I have defined in detail below.
A person who is healthy should be able to manage any challenge that is physical, mental or social. Therefore, a healthy person should be able to perform his/her daily chores and have access to social services like vocation efficiently without any complication (Gentry et al. 2010 p.103). However, in the case of Mr. Park this has been limited due to that he is visually impaired and at time will require the services of a caregiver for him to accomplish some of his daily activities.
This is defined as a condition such as disease that is prolonged, hence affecting the body and mind of the individual. A person suffering from an illness mainly rely on others for them to accomplish they daily basic needs. This dependency has effect on the mental health of the sick person and also affects the productivity of those giving the services.
Disability is a physical impairment that hinders an individual to have a normal life like moving from one place to the next comfortably, having an education or vocation. Mr. Park is visually impaired hence not able to have an education and to lead a normal life.
When people are faced with health issues they change in behavior. As a result, this person will show visible sign of mental problem brought by depression. Furthermore, they become reserved, poorly gloomed or aggressive (Adreon et al. 2007 p.278). Behavioral change offers information about a patient and how to develop an intervention place that well suits the specific needs of the patient.
When I met with Holland’s park family I discovered that they have observed some behavioral changes with Park. However, it was important for to understand the needs of the patient and the expectations of the family from the social workers.
How awareness of specific needs have changed overtime.
For a very long time people with specific needs have been neglected by their families and government (Fiscella 2000). However, over the years people have become enlightened and more aware that these people are as important as the rest of us only that they require specialized care for them to perform their daily chores (Arndt 2006 p.200). Government in the past had put up hospitals that catered for this individual suffering from physical and mental illness which were later closed down. Most families were not well equipped to give care to needy people and hence sent them to this facilities which became overcrowded and in turn offered poor services.
To improve the services given, the government transferred staffs that were working in the facilities to social care facilities with an aim of boosting the quality of care given. However, social care had its shortcoming especially when giving it to people with learning disabilities who lived and communities and had to compete health care with the rest of the population. As in my case study of Mr. Park I was able to conclude that the major concern of the family is where he can access specialized care that will be customized to his specific need. Increased government intervention, human rights groups and social workers the larger population have become more aware of specific needs overtime (Carson & Dunbar 2007 p.55).
How legislation, social policy and culture affect the way individual with specific need get services
Legislations are important in ensuring the persons with special needs are treated equally without discrimination. They should ensure that those with specific needs get equal access, treatment, outcomes and opportunities (Carr 2010). Furthermore, this person should be treated with dignity, allowed to take part in community activities and also choose the life they want to live without much interference and at the same time been protected from any harm.
To achieve this government and other organization s have come up with initiatives that are revolutionizing health and social care services. They have ensured that patients with special needs get the best health and social care services. Also due to human rights involvement, the government has been pressured to keep on updating these policies to make them better.
Culture and social policies also determine the kind of care that will be given to persons with special needs. Over the years it has been observed that people have discriminated people with illness to the extent of secluding them in social event and at times putting them away when there are visitors around. According to most culture people are discriminated based on their color, political affiliation or region and this result in physical abuse and isolation. People with special need needs to get healthcare services with dignity and respect from caregivers. Current legislation includes;
- Children’s Trust: It is mandated with the task of developing policies that involve children and youths.
- Care Trust: with ten organizations Care Trust has been touted as a complete union of social and healthcare in the country.
- Health Act: this act gives flexibility to care givers on how to pool their budget, develop a leading commission arrangement and integrate their services with other care givers.
HL is an autistic man who has lived with Mr. and Mrs. E as his caregivers after a long time in a mental institution. During his stay with the caregivers HL has had a remarkable improvement on his behavior and the way he relates to people. This has been about by the love and integration that Mr. and Mrs. E have given him. However, in the recent past HL has been exhibiting challenging behavior due to him being forcefully locked up in a mental institution and his driver making picks while with him.
Analyze the care needs of individual with special needs
HL can be categorized as a vulnerable adult that require special care. He is autistic and not able to carry out daily chores without the help of a care giver. However, according to the case study it has been established that HL was having a comfortable life while living with Mr. and Mrs. E but all this changed when the facilities he was going for therapy changed their driver. As a result, HL started to be reserved, uncooperative, and temperamental and anger to others.
As a caregiver I find it necessary that Mr. and Mrs. E should seek services of a professional health care givers especially after HL come home only ate and slept for three weeks. This was a sign of depression and mental problem that resulted from the torture and poor services at the hospital.
After evaluation and studying the case of HL, I have suggested that HL seek treatment as I have indicated below. The said treatment method should be carried at different stages by psychiatrists, occupational therapist, social workers, community nurses and physiologists.
- Before treating HL it is important to first understanding the root cause of his change in behavior
- After understanding the root cause of his behavior, start by treating it.
- According to HL case environment and social factors have contributed to his behavior change, therefore, helping him deal with them will be crucial in his recovery.
- Autistic people like HL have been known to have anger issues. Therefore, a framework on how to manage his anger will be developed with the help of professional care giver
- As an institution mandated with giving care to people with special need, there are policies and guidelines that enable us to be in constant communication with the patient to make sure he is receiving the best care. Also we will communicate with Mr. and Mrs. E constantly to monitor his improvements.
- However, if the above therapeutic methods show no improvement on the health of HL, prescription drugs will be administered with aid of a qualified medical doctor.
Since HL is autistic and unable to communicate or talk for himself, Mr. and Mrs. E will play a vital role during the healing process because he seems to trust them. However, since they are not qualified caregivers they will require to be trained on how to deal with him. As a care giver I will give relevant information to them and they will in turn apply them when dealing with HL. In the case of HL different practitioner will be involved; hence proper protocol should be followed. They should be transparent and communicate with everyone involved by giving information that is not biased to each other. Furthermore, government policies and laws should be followed such as European regulation on drugs been administered to the patient.
Current Systems for Supporting Individuals with Special Needs
According to HL case it has been observed that if there were proper laws that safeguarded his human rights and dignity he could have not gone through the mental suffering he went through at the hospital. The hospital locked him up against his will by taking advantage of the fact that he could not talk and also invoking a clause in the health act. After what happened to HL the government has developed strategies that improve health and reduce inequality that is face by people with special needs.
According to the government, empowering the community with information on how to deal with people with specific needs will greatly improve their health. Therefore, the government has delegated officials in communities that will work closely with different non-governmental organizations, volunteers, local agencies and local authorities to develop a framework that will improve health of the community and in event reduce inequality.
Secondly, a health promotion framework that comprises of health services, community and education approaches was developed with aim of improving and proving best health practices to people with special needs. Furthermore, the framework addresses inequality and social factors of the health of an individual and the community at large. This framework if adhered to it will promote health and curb inequality among people with specific needs.
Services Available To Persons with Specific Needs
Discrimination is very rampant in London and has been touted as the main reason why people are continuing to get poor health services. Furthermore, most of this people having low economic status, and will be at a higher risk of having mental problems (Bradshaw 2000 p.38). The low economic status results in poor education and hence lack of information regarding health and government institutions that can help them deal with the problem. Another group of people that are at risk of suffering from mental health complications are immigrants who are discriminated and lack finances to invest in health policies.
In the long run these individuals will seclude themselves from the community and people. The seclusion will complicate their ailments which can be dangerous. However, there group of professionals that have dedicated themselves to helping people with specific needs. They include general practitioners who offer health services to everyone without discrimination. Secondly, primary care trust who offer preventive care without any bias to the community. Lastly, NHS centers which mainly use phone to offer information to the community.
HL was an autistic man who could not talk or wash himself, but who was okay by any means and his living with his guardians, Mr. and Mrs. E, who had taken him to take of him as their children were all grown up and they lived alone. HL went about his activities within the house normally, and he knew exactly where everything he needed was kept. Unfortunately, when one day after three years a new driver came to take him to the day centre, which he was obligated to visit at least once a week, came and took him through a different route, he got agitated and the resulting outcome was that he was detained illegally leading to court battle in which Mr. and Mrs. E sort to have HL discharged from the mental facility where he had been held illegally.
While autism is a condition that has no cure, people with autism can still enjoy life just as much as any normal person can. It is important that caregivers understand the different intervention methods which they can use in order to attain a level of openness with the autistic individuals and help them engage in activities that other people do with the understanding that they are different (VanBergeijk et al 2008 p.1369). In fact, autistic people are normal, only that they are special in the cognition abilities. Some of the approaches that can be used by caregivers include the following:-
- Help the autistic individuals in using alternative or argumentative communication methods since they are not able to communicate in the standard way. Obviously, these people have a way of expressing themselves and knowing how they use it is a step towards helping them fit in the society.
- Advocacy; includes a wide range of methods and approaches that can be used in changing policies and practices or event attitude s and behavior in the society which discriminate against the autistic and give them an equal platform in the society to function without obstacles(Hammer 2004 p.296).
- Behavioral and developmental interventions; the majority of autistic people are left without much attention from family and the society, denying them opportunities to improve their cognitive abilities, and hence make them dependent on the other members of the society. Unfortunately, that approach is retrogressive and what needs to be done is to improve their developmental abilities through programs that are educative and which use strategies that are accommodative for the special needs of the individuals.
- Autonomy and empowerment; includes ensuring that all opportunities available that could of benefit to the autistic and which have potential to improve the quality of life of the autistic are made available to them. For instance, autistic people may not be sociable within the society, but they could use their talents in the society which they can gain personal satisfaction from such as working in maintenance projects. They only want to be left alone to go about their business without interruption and they are good to go.
- Counseling and psychotherapy; since autistic people know that they are different, and they know that they need to cope with their conditions and aggression, it would be important that they are offered counseling and psychoanalysis which could help them integrate well in the society and to handle issues within the society in a manner that is understandable to the rest of the people (Browning et al. 2009 p.37). During such sessions, the autistics are offered information concerning their disorders, which make it easy for them to cope with the society.
- Physical interventions; this includes a range of activities such as exercise and monitoring the individuals to ensure that they handle their aggression and frustration in a positive and constructive way instead of embarking on self hurting activities. Unfortunately, some autistic people have handled aggression by hurting themselves through pain inducing activities such as pulling off their fingernails, hair and eyebrow. Monitoring their activities go a long way towards prevention of such activities.
- Psychotherapy; reacting to situations in the same way that HL reacted when his usual driver was changed and the subsequent change of the route towards the day centre resulted from failure of the patient to psychologically prepare for change. Other reactions to different situations which autistic people could have include depression, suicidal tendency, personality changes and anxiety. Such reactions can be eliminated by psychologically preparing the individual of changes and eventualities which are different from a routine. HL was initially much institutionalized, but he eventually adjusted to live in the home of Mr. and Mrs. E. Such adaptability should be applied in all activities in the life of the autistic. Proper psychoanalysis would not have raised alarm in HL and he would not have reacted in the way he did.
- They include identification of those tasks that the autistic is talented and which they can use to make financial gains and make them less dependent in the society. In the case of HL, the intervention would help him start getting more into the routine of the outside life and start coping with the society more positively and not restrictive to those people he is accustomed to such as his driver and his immediate family, Mr. and Mrs. E.
The intervention strategies are important because of the positive gains they give to people like HL. Their energy and strengths are rejuvenated through physical intervention, which also helps them in reducing their levels of anxiety and cope with societal expectations. Psychological intervention helps them to understand them better and hence become engaged in personal journey of transformation. Lastly, educational and vocational interventions help the autistics to handle their independence and cope with their special needs in a more positive manner (Wallcraft& Sweeney 2011). Essentially, when the special needs individuals understand about their current conditions and their place in the society, they are able to handle and cope with the challenges that come in their way better than when they think they are being discriminated against due to their special needs.
There are many sociological developments that are emerging which affect the special needs of individuals and they are enhanced by other scientific development including technological and medicinal. All these developments have effects on legislation, changes in policies, regulations, and many other sociological factors at local, regional and international levels. Some of the impacts include:-
- Definition of special needs and fight for the rights of people with special needs
- Government policies on employment and treatment of people with special needs
- Societal integration of the individuals with special needs.
As a social health care practitioner, it is my duty to understand some of the factors that affect the behavior of the disabled in the society and those with special needs in order to help them and other members of the public who come into contact with such people, or even who live with people of special needs. This section focuses on creation of awareness on strategies that are employed in coping with challenging behavior of individuals with special needs such as autism.
There are many challenging behavior that can be exhibited by different individuals in the society such as rebelliousness, temper tantrums, self harming and suicidal ideations, and anger. Usually, these aggressive behaviors are exhibited and directed towards other people. Some of the factors that could induce such behavior include drug abuse, brain injury, learning disabilities, physical impairment and mental health issues. Some of the behaviors considered unacceptable include:-
- Verbal abuse and bullying
- Assault and physical abuse
- Self harm and pain infliction
- Destructive behavior
There are several factors that influence the challenging behavior. They include but not limited to:-
- Physical Disability
- Ill health
- Drugs and alcohol
- Sleep disturbance
- Learning difficulties
- Perceptions and expectations
- Emotional conditions like anxiety, fear, dependency, temperament, frustration or loss.
- There are also several social factors like relationship, culture, and ethnicity
There are several reactions of the society towards challenging behavior that must be understood by social care givers. They include simple and complex reactions such as the isolation of those individuals with challenging behavior from family and friends (Leventhal& Brooks-Gunn p.309). Such isolation leads to inability of the affected individuals to communicate, memory problems, inability to receive care, addiction, and lack of emotional and financial support, which they need direly.
Additionally, due to the sense of guilt that these people develop, and also due to their mental illnesses and disability, they are more prone to abuse. Furthermore, they have high dependency on others and that increases their vulnerability. Sometimes, also, caregivers are stressed in their trying to assist the elderly due to the level of difficulty they pose and that can make the caregiver impatient and abusive as well(Stokes 2007 p.117). Unfortunately, there are risks to both the caregiver and the person with special need. Some of the risk factors for challenging behavior are listed as:-
- Caregiver being unable to adjust and cope with the stress which could lead to depression
- Caregivers withholding their support to their patients
- Substance abuse
- Dementia, anxiety and illnesses among the elderly
- Social isolation and consciousness for personal space
- Domestic violence from patient due to aggression
- Physical and verbal aggression directed towards the caregivers
In all institutions, there are legislations, policies, procedures and code of practices which govern both the employer and the employee. The same applies to social care and these regulations, which define the responsibility of the employer and the social care worker, are set at national and international level. These professionals are expected to adhere to the set standards in the dissemination of services. Unfortunately, the rights of the persons with disabilities and special needs but those of the social care workers are not addressed, making it hard for them because they will always be on the lookout. Proper measures must be laid down to ensure that the special needs individuals and individuals with challenging behavior do not harm the social care workers. Additionally, the current legal partnership legislations have facilitated easier service delivery to the special needs individuals. These partnerships have helped in:-
- Creation of shared principles and values
- Agreeing to the specific shifts in the policies
- Readiness in exploring the new options for services
- Determining the agreed boundaries
- Agreeing to the roles in regard to providing, purchasing and commissioning
- Indentifying the agreed pools of resources
- Ensuring the effective leadership
- Providing the capacity for sufficient development
- Paying extra attention to attitude and mutual trust
It is pertinent to note that the partnerships are based on mutual benefits for the stakeholders which are to meet the goals and objectives of proper social care for all individuals with special needs indiscriminately. It is, however, important to note that some of the consequences of these regulations could be retrogressive, backward and uncouth. In the case of HL, the source of his aggression and his behavior can be determined, and hence it was not necessary for the mental health act to be invoked in order for him to be detained. The illegality with which he was detained in the mental facility despite the fact that he had already adapted very well to life with his caregivers show that that the regulations and legislations were not clear on what constitutes unmanageable challenging behavior. First, the driver was changed without properly notifying HL, and, secondly, the new driver changed the usual route. Looking at those developments, it is clear that the mental facility erred.
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