Identifying Developmental Issues - Term Paper Example

?Assessment- Identifying Developmental Issues Case Study 1. Identify the physical, cognitive, social and emotional changes that are present in Elsie. The aforementioned descriptions clearly show that Elsie has been going through some alterations in the different aspects of her well-being. As a person ages, he encounters changes in various areas of his life (Santrock, 2010). Particularly with people who are in the old age stage, there are a number of limitations observed. Generally, cells degenerate and this leads to a weak body. In turn, the other dimensions of development are affected. 2. Describe the ways in which you could assess Elsie’s developmental status. As what is stated in the Aged Care Assessment and Approval Guidelines (2006), Aged Care Assessment Teams (ACATs) utilize multi-dimensional and multi-disciplinary methods. “As part of the process, a person’s medical, physical, social, and psychological needs are assessed to determine the person’s care needs and the type of services that would be most appropriate to meet those needs” (p.4). Elsie must be assessed face to face to determine her specific needs. Her relatives and health care providers are also involved in developing a health care plan. Information regarding her physical capability must be observed such as mobility (walking, transferring, climbing stairs), maintaining hygiene (bathing, grooming, toileting, continence, dressing), eating and drinking, and ability to manage health conditions. As for her cognitive and behavioral aspects, signs of depression, delirium, or dementia may be perceived through several symptoms. These are verbal and physical aggressiveness, self-destructive behavior, confusion, and/or impaired judgment. Tests from Elsie’s medical practitioner are also significant to be taken noted of. Concerning her social factors, support network and social need should be identified. Moreover, the needs of her main care givers should be considered. When assessing, it is important to be vigilant to significant details. It is also quite helpful to observe Elsie in a natural environment setting. This way, she can be evaluated in the most realistic approach possible. Complicated assessments such as those for ruling out dementia should be done by professionals. Conclusions regarding diagnoses must first be confirmed by medical doctors. 3. Identify the range of information that you would want in order to assess this situation more fully. (What would you want to know that you don’t know now? Identify who you could speak to, to obtain this information.) It is beneficial to consider relevant information in the 4 core developmental dimensions. Factors such as nutrition, exercise, endurance, and stamina should be taken into account in assessing Elsie’s health. It would be valuable to determine the acuity of her eyesight. She may be asked regarding Joan’s twice a week visit and how do they do their shopping, laundry, and banking activities. Her state of cognition may also be gauged by knowing her decision making skills, memory sharpness, and perception acuity. It is important to take note of her social activities and the people she usually mingles with. Moreover, her usual moods and sentiments are ought to be recognized. Hence it is valuable to talk with Elsie’s relatives to gather significant information. They can give insights to the changes that she has gone through in various settings and topics. For instance, it would be of help to clarify certain issues with Joan such as why didn’t they see the doctor. It would also be relevant to know how many times Elsie fell as well as the locations and time of her accidents. Furthermore, it would be significant to ask the signs of dementia that they have observed. Doris can also give more information about her concerns regarding her mother. In addition, the house cleaner can also be interviewed since she regularly visits the household. She may be asked about her personal observations regarding Elsie such as her activities and the general condition of the house. Besides the people that she regularly communicates with, it is also advantageous to consult professionals such as Elsie’s general health care provider. Her doctor can provide necessary medical history. Certain specialists can also give professional advice concerning senior citizens. For example, a geriatrician can be asked whether Elsie really needs to be in a facility or not. Other doctors such as psychiatrists and neurologists can confirm cognitive impairments. 4. Identify the developmental issues that are present in Elsie. What are the causes of these issues? What are the risks associated with these issues for Elsie? 5. What indicators are present in the scenario that there may be serious issues in Elsie’s life? As what is stated in the case, there are a couple of signs that there may be critical issues. Joan and Allen believe that Elsie is showing symptoms of dementia. According to the scenario, there are some discrepancies in Elsie’s bank account. In the past 12 months, the amounts were immediately withdrawn as soon as they were deposited. Since poor judgment is one of the indications, this could be one of the reasons why Elsie did not question Joan’s motives in handling her investments, bank transactions, and other properties. Secondly, the housecleaner remarked that she is glad that Elsie has gotten over her “falls”. Apparently, Elsie has had bruises on her face and upper arms. Joan should have notified Doris about these accidents when they happened. The doctor said that Elsie has had no appointment for the last 6 months. If Joan really cares for her mother-in-law’s well-being, she should have taken Elsie to the doctor. 6. What strategies are available for investigating these issues further? Who would you refer to for further assessment of these issues? Concerning Elsie’s dementia, there are several assessments available such as the Mini Mental State Examination (MMSE). This is the most commonly used assessment for memory problems (“The Mini Mental State Examination”, 2012). It can be utilized by clinicians to aid in the diagnosis of dementia. This kind of tool is also helpful in monitoring the severity of the disease. Other techniques such as physical exams, neurological assessments, and psychiatric evaluations may be used. Specialists such as geriatric psychiatrists, geriatricians, gerontologists, neurologists, and neuropsychologists may be referred to regarding dementia. As for Elsie’s accidents, fall risk assessments for older adults may be used. An example is the Heinrich II fall risk model. This was validated in a large group of geriatric population (Gray-Miceli, 2007). This model can be used in determining the risk of fall according to factors like gender, mental and emotional status, and dizziness symptoms. Professionals who specialize in elderly care such as geriatricians, gerontologists, and geriatric nurse practitioners may be consulted regarding this issue. Case 2 1. What questions or observations might you ask/make to obtain information about Shane’s developmental status? Regarding his physical aspect, it is significant to observe his activities and other factors in relation to his health. It is also important to ask the range and if possible, the causes of his poor motor skills. It is relevant to know how much he is in control with his physical faculties. Furthermore, being familiar with his Intelligence Quotient is important in clarifying his cognitive developmental status. Asking whether he goes to school, the kind of education he receives, and talking to his teachers is beneficial as well. As for his social and emotional domains, it is valuable to have questions concerning his family and friends. Observing his relationship with his parents and other relatives gives insights in his personality. Knowing how he acts when he is with a friend may also show other features of his character. Keenly observing his behavior when in a crowd, with someone, and alone in different settings is advantageous in knowing more about his social skills. Talking to him and asking about his feelings regarding certain situations and topics will give light to his emotional dimension. Moreover, it is helpful to know the current intervention and provision he is having. This will let me know whether he needs more support. It would also be a good idea to ask his family and residential care workers about their expectations on Shane’s development. Lastly, it would be enlightening to know the kind of condition or disability that he has. Being informed of his special needs is pertinent in analyzing his overall state. 2. How might you apply your knowledge of lifespan development theories to clarify Shane’s developmental status? Include cognitive, social, moral and psychological theories in your answer. Developmental theories are valuable in better understanding an individual’s growing status. Several theories such as Jean Piaget’s stage theory of cognitive development discuss changes on thinking process and abilities (Wadsworth, 1996). Supposedly, Shane should be in the Formal Operational Stage. This means that he ought to be able to have deductive logic and abstract thinking. However, he cannot talk and is only able to understand basic information. It indicates that his cognition is below the standard level. According to Erik Erikson’s psychosocial theory, Shane would be on the Identity vs. Role Confusion stage. In here, social relationships are important in the outcome of his development (Miller, 2011). Shane ought to be looking for ways on how to develop a sense of self and personal identity. However, since he is socially inept and can sometimes be aggressive, there is a need to find other ways of enhancing his social awareness. With his great dependency on others, his social development is mostly affected by his care takers. Lawrence Kohlberg’s moral development theory states that the family is vital in molding a person’s definition of what is right and wrong (B. Newman, & P. Newman, 2011). At this point, Shane should at least be in the level of conventional morality. This means that he should be adept at interpersonal relationships and in maintaining social order. However, he screams out at unpredictable times and has aggressive tendencies. It is then most probable that Shane is still mostly at the preconventional level of morality. Sigmund Freud is one of the most notable theorists in psychology. His psychosexual theory states that Shane would be in the genital stage wherein he experiences physical sexual changes and directs sexual feelings towards others (Sugarman, 2001). It is possible that Shane’s aggressiveness is his way of channeling these feelings. Moreover, his sucking on his fingers and other items may be interpreted by Freud as oral fixation. It is probable that Shane was either orally spoiled or deprived when he was an infant. As a result, he exhibits dependency, aggressiveness, and oral gratification behavior. 3. How suitable might it be for Shane to be: a. Given personal care support? Since Shane is in a residential care in a home for children with disabilities and is incontinent, it is clear that he needs personal care support. He requires assistance in his bowel movement and urination. Furthermore, his poor motor skills make him in need of support in a number of tasks. Self-grooming movements prove difficult for him to accomplish. Hence, activities such as taking a bath and shirt buttoning necessitate aid. b. Taken to a movie? As of this time, it is not yet suitable for Shane to be taken to a movie. With his social ineptness, it would be difficult for him to follow norms especially inside the cinema. His aggressive behavior may also hurt others. In addition, his screams would cause disturbance for other viewers. It is then recommended that he watch movies at home. c. Involved in an activity constructing a model plane? Constructing a model plane involves fine-motor skills. With Shane’s developmental status, it would be challenging for him to accomplish such activity. It would be hard for him to fold papers and efficiently hold pencils and scissors. Nonetheless, he could still be able to construct a model plane with some prompts. Furthermore, exercise that help in enhancing fine-motor skills are helpful in honing his abilities. 4. How comfortable do you think you would feel working with Shane on your own? Consider your own values and abilities. I feel mostly comfortable in helping Shane develop his potentials. I believe that each individual has the right to be given adequate education. With sufficient knowledge and experience, I am confident that I can efficiently work with him. Of course, there would always be challenges such as his aggressiveness. Nonetheless, there are several techniques and interventions that may help in addressing such difficulties. I know that caring for a child with special needs takes a lot of effort and patience. With this in mind, I can better understand their uniqueness. I am also open for further training concerning providing care for children. In addition, I find it quite rewarding to give hope to others’ lives. I think that I can do something to invoke positive change in people like Shane. 5. If Shane displayed signs of abuse (such as bruising, fear, or anxiety) following a visit to his family, what action would you be legally required to follow? According to the Department of Health, Western Australia, “The Child Protection Unit (CPU) see cases not only where there are concerns of child abuse but also cases where long and short term protection are issues of concern” (2010). As a support worker, I can refer the child to the noble organizations such as CPU. Moreover, CPU specifies the following cases that would be appropriate for referral: *Children who have injuries or have had previous injuries that may be inflicted injury. *Neglect- eg physical, medical *Children who have been or thought to have been sexually abused by any person. *Non-organic faire to thrive. *Children whose social circumstance puts them at risk of injury, neglect, or further abuse. *Children who upon discharge may not receive adequate care and protection for whatever reason. Hence, if Shane would display bruising, fear, or anxiety, he should be referred due to signs of neglect and/or abuse. Generally, if a person thinks that a child is in peril because of abuse, he should call the Child Abuse Squad on 9428 1500 (Western Australia Police). In reporting child abuse, a statement is made regarding the situation’s specific details. Local detectives or those from the Child Protection Squad will then conduct investigations. The progress of the investigation will then be made known to the one who made the report. Regarding protection, the Department for Community Development provides such services. 6. Identify 3 potential risk factors associated with Shane’s developmental issues. Firstly, Shane is not able to talk. He uses symbol boards or pointing to communicate. This condition poses risks for low academic achievement since there is a difficulty in transferring messages. This issue affects the growth of his social relationships. Since expressing oneself is vital in relating with others, it is indeed challenging for him to interact with others. This situation is aggravated by his social ineptness particularly when he shows aggressiveness. Secondly, his need of assistance in personal care presents risks for emotional and behavioral development. Due to Shane’s incontinence, his dignity as he gets a sense of awareness is most probable to be affected. Similarly it would be taxing to travel or attend certain social functions with this condition. Being unable to control bowel movement and urination also poses risks for poor hygiene. If unmonitored regularly, Shane could have urinary tract infection or rashes. Lastly, his poor fine-motor skills deprive him to successfully engage in a number of activities. Tasks associated with dexterity and fine motor control are influenced. This affects Shane’s ability to eat, dress, and even use a computer. Hence, other aspects of his life are likewise affected such as his education, leisure activities, and grooming. He may engage in therapy and other programs to improve his skills. 7. What are some key features of reporting and documenting as required by organizational policies and procedures? According to the Western Australia Police, reports may be made anonymously though it is usually more helpful for authorities to have contact information. Nondisclosure of the reporter’s identity to the alleged perpetrator may be done for necessary protection. The justice system requires concrete evidences. Therefore, it is important for proofs to be adequately documented. It is valuable to record the date and the time of the abuse. Be as detailed as possible. For instance, the color and approximate size of the bruise should be written down. It is also valuable to include the names, opinions, and comments of the individuals involved. In addition, the Department for Child Protection, Government of Western Australia states that an abuse, neglect, or risk may be described to the Department of Child Protection. After hours reports may also be directed to Crisis Care. Regarding the child’s immediate safety, the Police must be contacted (2012). The department then makes further decisions regarding appropriate actions that need to be taken. As for mandatory reporting, there are different rules in various areas. According to the Australian Institute of Family Studies (2010), those who are mandated to report in Western Australia are court personnel, family counselors, family dispute resolution practitioners, arbitrators or legal practitioners representing the child’s interests, licensed providers of child care or outside-school-hours care services, doctors, nurses and midwives, teachers, and police officers. Reference List Aged Care Assessment and Approval Guidelines.(2006). Aged care assessment and approval guidelines. Canberra: Commonwealth of Australia. Alzheimer’s Society. (2012). The mini mental state examination. Retrieved from http://alzheimers.org.uk/site/scripts/documents_info.php?documentID=121 Arenson, C., Busby-Whitehead, J., Brummel-Smith, K., O’Brien, J., Palmer, M., & Reichel, W. (2009). Reichel’s care of the elderly: Clinical aspects of aging. New York, NY: Cambridge University Press. Australian Institute of Family Studies. (2010). Mandatory reporting of child abuse. Australian Government. Retrieved from http://www.aifs.gov.au/nch/pubs/sheets/rs3/rs3.html Department of Health, Western Australia. (2010). Child Protection Unit. Consumer Health Services Directory. Retrieved from http://www.health.wa.gov.au/services/detail.cfm?Unit_ID=309 Department for Child Protection (2012). What to do when you are concerned that a child is being abused or neglected. Government of Western Australia. Retrieved from http://www.dcp.wa.gov.au/ChildProtection/Documents/WhatToDo.pdf Gray-Miceli, D. (2007). Fall risk assessment for older adults: The Heindrich II fall risk model. Try This: Best Practices in Nursing Care to Older Adults, 8. Retrieved from http://www.childwelfare.gov/systemwide/laws_policies/statutes/manda.cfmhttp://consultgerirn.org/uploads/File/trythis/try_this_8.pdf Miller, P.H. (2011). Theories of developmental psychology. New York, NY: Worth Publishers. Glenner, J.A., Stehman, J.M., Davagnino, J., Galante, M.J, & Green, M.L. (2005). When your loved one has dementia. Baltimore, MD: John Hopkins University Press. Newman, B., & Newman, P. (2011). Development through life: a psychosocial approach. Belmont, CA: Wadsworth Cengage Learning. Santrock, J. (2010). Life-span development. New York, NY: McGraw-Hill. Sugarman, L. (2001). Life-span development: Frameworks, accounts, and strategies. New York, NY: Taylor and Francis Inc. Wadsworth, B.J. (1996). Piaget’s theory of cognitive and affective development. Harlow, England: Longman Publishers. Read More