Health and Well-being for Individuals with Specific Needs

• DOINA BORSAN

How the health and social care and system support individuals with specific needs

After meeting Mr. Holland family, I can give you a report about his medical and physical state. He had hearing and visual impairment, over the years due to these impairments develops dementia which make him aggressive with people coming in close contact with him. His famil were looking for a placement for him where to have all support and assistance needed in his daily life, and they find that out Care Home is it perfectly fit with Mr. Holland.

Mr. Holland has various care needs, for some of them we are fully compliant with it, for other we have to ask support for other professional organization.

Visual impairment, in their 10^th revision, WHO definitions for visual impairment, low vision and blindness was given in the International statistical classification of diseases, injuries and causes of death. In their surveys about visual impairments they said that the largest proportion of blindness is related to ageing. Although cataract is not a major cause of blindness, glaucoma is the second cause of blindness globally; age-related macular degeneration (AMD), is the third cause. Other causes of visual impairment are: corneal blindness which may be attributed to trachoma, trauma and vitamin A deficiency depending on area of living; diabetic retinopathy; childhood blindness; onchocerciasis. Jette and Branch in 1985 said that visual impairment as physical disability is it not related with increasing social disability, these are concepts having different determinants. Due to this disability Mr. Holland has a lack of non-verbal communication and misunderstanding of others attitude and behaviour. The commune way to assisting Mr. Holland is to provide his glasses clean, walking stick if necessary and use style of communication that can minimize the difference that exist such us large print books, colourful/lighting signs and symbols what can help him to deal in the new setting.

Hearing impairment,(HI) as a loos or reduction of ability to hear clear , is it other barrier to communicate effectively. As a person who use hearing aid, we had to ensure that is working properly, fitted correctly, had working batteries and is it clean to improve Mr. Holland hearing. Risk factors for HI other than age are genetic liability, infections, trauma, toxicity , diseases and noise exposure. Reduced speech perception and perception of non-verbal sound is it affecting people with HI and their opportunities to communicate effectively is made difficult, and create harmful psychosocial effects of HI. To help Mr. Holland to adapt in our environment due to his hearing impairment we can use a translated typewriter for phone calls, or passing an information, speak clear that he can read on our lips and if this impairment will evolve in time we will ask help for British Deaf Association, which can provide us a qualified British Sign Language, a form of sign language using hands and body language. MAKATON, a system who uses speech, signs and symbols can either help in communication process.

Challenging behaviour, defined by WHO as a culturally abnormal behaviour indicated by individual or groups , which causes others problems, and which significantly interferes with the quality of life of all concerned. Causes of challenging behaviour are various, social isolation; stress ;clinical factors – medication, inadequate glasses, empty or no battery in hearing aid; frustration of not doing things like before; mental illness; disempowering by lack of ability to communicate. Some of the signs of challenging behaviour we can see in Mr. Holland by aggression towards others or self harm. The staff need to undergo training to ensure awareness of the types, causes and effects of Mr. Holland behaviour while we are a Care Home with less contact to respond effectively to triggers, signs and symptoms of challenging behaviour.

Dementia comes from Latin, demens= dement “out of one`s mind”, describe brain disorders, a loss of brain function that is usually progressive and severe. A compulsive behaviour, aggression, increasing lack of personal care and personality change is a form of dementia. The damage caused to the brain cannot be repaired but we can learn to live with or to work with people having dementia. In our case Mr. Holland, can be involved in activities that can stimulate his creativity, speech problems can be helped by the appropriate therapy .Using GP`s support to provide help with medication and special investigations , Psychological and Mental health support from professional bodies to make easy integration in our environment.

Following the legislation of Equality Act, Discrimination Act, Mental Capacity Act, Human Rights, Confidentiality Act, Institutional Policies and Procedures who protect the individuals in every position, care taker or receiver and CQC Standards which protect de system and make sure that the care standards are up, out Care Home is it aware of legislation in force.

Sometimes it can be very hard to really understand people`s needs and we are tempting to rely on stereotyping, not making differences in individual`s needs. With adequate training and well informed about the issues we have to deal with, we can have a good idea about reactions and expectations of the individual. My conclusion is that we are able to coop with Mr. Holland needs and with some support of other organization we can give him an opportunity to live his life at the higher standards of caring.

References :

Ager A.&O`May F.(2001),Journal of Intellectual and Developmental Disability ,Issues in the definition and implementation of “best practice” for staff delivery of interventions for challenging behaviour,Vol.26, Issue3,Pp. 243-256

A.C.Davis ,(1989),The Prevalence of Hearing Impairment and Reported Hearing Disability among Adults in Great Britain, International Journal of Epidemiology, Vol.18, Pp. 911-917.

Berrios,G.E.,(1989),Non-cognitive symptoms and the diagnosis of dementia: Historical and clinical aspects. The British Journal of Psychiatry, Vol154(Suppl 4),Pp. 11-16.

Gilbert CE, Anderton L, Dandona L, Foster A.(1999), Prevalence of visual impairment in children: a review of available data. Ophthalmic Epidemiology,Vol.6:73-82.

Jette.A.M& Branch G.L.,(1985),Impairment and disability in the aged, Journal of Chronic Disease ,Vol.38, Issue 1

World Health Organization. Prevention of blindness and deafness. Global initiative for the elimination of avoidable blindness. Geneva: WHO; 2000,Rev2.

World Health Organization. International statistical classification of diseases, injuries and causes of death, tenth revision. Geneva: WHO; 1993

Wilson DH, Walsh PG, Sanchez L, et al, (1999). The epidemiology of hearing impairment in an Australian adult population. Int. J. Epidemiology, Vol. 28, Pp.247-52.

Links

http://www.bmj.com/content/343/bmj.d4681

http://www.scielosp.org/scielo.php?script=sci_serial&pid=0042-9686&lng=en&nrm=iso

http://www.sciencedirect.com/science/article/pii/0021968185900086

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