Dealing with People with Brain Injuries - Assignment Example

Brain Injury Table of Contents I. Organizational Structure, Purpose, Position and Duties 3 II. Extent to Which Psychological Theories Apply to WorkExperience, Dealing with People with Brain Injuries 5 III. What I Gained From My Work Experience 8 A. Skills Developed, Skills Already Possessed 8 B. Work Experience Expectations Versus Reality 9 C. Central Challenges, How Addressed 9 D. What I Would Change About My Approach to My Career Development/Work Approach Based on My Work Experience 10 10 1References 12 I. Organizational Structure, Purpose, Position and Duties SweetTree Home Care Services is organized around teams, and the staff members are grouped into four teams in all: Brain Injury, Learning Disabilities, General Care/Elderly, and Dementia teams. Apart from these four care teams, there is a general management group made up of the founder, the Human Resources Manager, the Management Accountant, and the Assistant Accountant. Each of the care teams in turn are organized around a support manager function, a service manager function, and a coordinator functions. Some teams have several members in each of those functions. In Brain Injury, where I belong, three people occupy brain injury support manager roles, one occupy the neurological support manager role, one person occupies the brain injury service manager role, one person occupies the brain injury service coordinator role, and two people occupy the brain injury service coordinator role. There are eight people in this team in all. This is also the biggest among the four teams in the facility, followed by the General Care/Elderly group, which has seven members, Learning Disabilities team which has three members, and Dementia which has two members. The general structure of the teams center on manager and coordinator roles. In our Brain Injury team, there are manager and support roles for two key care categories, neurological care and brain injury care (SweetTree Home. Care Services, 2014). The purpose of the organization is to be able to provide the care and support services necessary to the communities that it serves with excellence, and to enable its clients to have the capability to achieve the highest possible levels of well-being and independence leading to the highest quality of life achievable (SweetTree Home Care Services, 2014b). The duties and responsibilities for my job role are in support of the above mandate to provide support and care services to our customers, and in particular as they relate to Brain Injury customers/patients/service users. The services provided are personalized to service user needs, and are also guided by the car plans and assessments prepared by the specialist manager and/or the Operations Director as necessary. Some indicative responsibilities are the provision of support for rehabilitation for impairment on the physical and cognitive levels; providing executive skills teachings support, including budgeting and helping with the correspondences; support provision for the management of behavior, emotions; personal care and living support; social support and employment support; liaison work with vital service user relationships, including friends, outside agencies, families to aid in securing the well-being and interests of the service users/customers. In the performance of these duties and responsibilities, I am expected to secure the dignity, privacy, and self-esteem of the service user, as well as the service user’s privacy, guided by a concern to preserve the individuality and the integrity of the service user’s human rights and personal space. The Health and Safety Act of 1974 also provides additional guidance and structure to the way the work is to be conducted and the relationships with co-workers and the service users established. The overall work mandate is to be available for the provision of assistance to the service user with regard to the performance of the service user’s daily life activities. This work too is to be done in accordance with the work responsibilities and roles as defined by the manager and the operations director, and refined on a day to day basis in reaction to service user needs and realities on a day to day basis. The law, organizational mission statement and mandate, and the defined job roles and responsibilities define and guide my work role in the facility. The careful adherence to the care plan too is a big part of the work, together with a careful documentation of the important aspects of the provided care, and a close monitoring of service user responses and overall quality of life day to day at the facility, to the provided care (SweetTree Home Care Services, 2014 (c)). II. Extent to Which Psychological Theories Apply to Work Experience, Dealing with People with Brain Injuries Our team is focused on providing care to Brain Injury service users, and the goal of the team is to give the highest possible levels of care and support services to this group of service users, making use of the best available care using both theory and our practical knowledge of brain injuries and neurological care in order to elevate the quality of lives of our customers and enable them to live the fullest lives possible. The overall assessment is that theory helps guide action, and that actual experience dealing with the immediate needs of service users with brain injuries likewise ground theory and help make them more relevant. Theory informs our actions and guides the way we intervene. Theory also helps us make sense of what is happening. Theory has worked as a kind of overall map that has ordered the way we deal with service users with brain injuries. At the top of the team structure and the organizational hierarchy, our team manager crafts the programs and the interventions grounded on sound theory and on years of practice, and on our end theory informs the way we undertake the work of implementing the plan and putting it to work to improve service user life outcomes. From experience too, the academic training which forms the underpinnings of our theoretical education helps us in big and small ways when it comes to providing a perspective to understand service users, in the way we formulate and write our service user logs and in the way we observe and make sense of the problems and challenges that brain injury service users face on a day to day basis. As an initial example, literature on the role that the recognition of emotions of people with brain injuries in helping them come to terms with the reality of their day to day living is explored in the theory, and having this insight into theory on the importance of recognizing emotions in turn help us provide better care and support to our own service users. This insight then gets baked in a sense into our care programs and in the way we relate to our service users on a day to day basis. This initial example gives an indication on the openness too, of the facility in general and of the team in particular, to craft our programs and daily interventions according to the findings of studies in the literature. Sound theory here grounds what we do and how we think about the care and support we provide to people with brain injuries (Henry et al., 2006; Bazarian et al., 2005). The case histories detail specific cases of people who have been under the care of the Brain Injury team and who have had specific day to day needs challenge the care providers with regard to how to make the most of the care being provided and the time available to rehabilitate and to improve the general life and care outcomes for the service users. Many of the cases involved traumatic brain injury, and established theory and medical knowledge helps in the day to day understanding and grounding of the behaviors and actuations of the service users on some of the physiological aspects of brain injuries, especially traumatic brain injuries. For instance, in the logs, some cases of problems with short term memories, energization, and with the structuring and long-term pursuit of plans and intentions are rooted from theoretical understanding of how damage to certain parts of the brain diminish the abilities of the service users in those aspects. Brain damage impairs the ability to plan coherently and for the long-term, and also damages the ability to form short-term memories in the way that normal people do. These impairments in turn translate into specific behaviors. Having knowledge of theory helps in making sense of service user behaviors and also helps guide the formulation of interventions and in the crafting of overall strategies for managing service user interactions with the care providers, so that the service users are given the most appropriate care to help speed up recovery and to provide opportunities where the service user can heal the most. In these concrete examples culled from the case histories, therefore, one can see the tight interplay of practice and theory. Without theory guiding actions on a strategic and day to day basis, the provision of care and support services for brain injury patients can be a hit and miss affair, inefficient, and fraught with difficulties for both the service provider and the service user. Theory helps ground actions and interventions in this sense, outside of which only experience can be relied on, and sometimes experience may not be consistently relied on to provide answers. Theory on the other hand can be construed as organized insights from a vast body of experience, from the literature and from structured studies. Therefore they have wide-ranging use. Elsewhere too one can see from the logs of daily patient interactions the absence of grounding in theory can make daily interactions with patients seem ad hoc and not generally helpful. Impulsive reactions and other behavior that are not understood from theory are poorly understood and so interventions can devolve into just going with what the patient demands on a moment to moment basis. On the other hand, where theory informs interactions, behavior of service users are better understood, and interactions with the service users are more structured and more conducive to improving their lives and the quality of the care provided to them (Patient Logs, 2014; Hoofien et al., 2001; Fleming, Strong and Ashton, 1996; Cicerone, 2002; Cernak, 1999; Nakatomi et al., 2002; Davalos et al., 2005). III. What I Gained From My Work Experience A. Skills Developed, Skills Already Possessed There are many new skills that I have developed and are still developing as a result of my challenging work experience at SweetTree. Chief among these are people skills. In my line of work technical knowledge of brain injury is important, and I need to get myself informed by reading and researching on brain injury as they pertain for instance to helping patients deal with the details of their daily lives. I will touch more on this later. On the other hand, the provision of care and support to brain injury service users require more than technical knowledge. First it requires meeting service users from the perspective of one human being meeting another human being and being able to empathize with their condition. In my experience I learned that people skills such as empathy needs constant practice, and there is so much to learn everyday with regard to being able to relate well with people of all kinds. Empathy and general people skills are tough to master, and the arena for mastering is daily life and the arena of work with brain injury service users (Patient Logs, 2014). Going back to technical skills, on the other hand, I learned new skills relating to researching and making use of what I read to inform my work. For instance, literature on the ways that people with brain injury differ in the way they process new experience and the world in general helps me to apply the insights from that research into how I relate to the people who use our services. Taking a step back, the research skills in themselves are important for me to be able to learn new things everyday as I go through my work. I learned that these research skills are invaluable as I try to navigate through the different cases that I handle. Because every service user is unique, our interventions are always tailored specifically for each service user. The research also therefore must always be fresh and on-going (Patient Logs, 2014; Henry et al., 2006). B. Work Experience Expectations Versus Reality Theory and actual practice sometimes are separate by a huge disconnect, and the actual reality of dealing with people with brain injuries is far richer and challenging than the theory and what I had in mind before I started working at SweetTree. At SweetTree theory has to give way to the daily demands of the service users, and from experience we have to make sure that the interventions we use are tailored to specific needs. This latter insight means that while we have expectations on how service users will progress based on what we know from the books, sometimes the service users will not respond as expected, and so we have to be careful to stay in tune to what is actually happening rather than what we think is supposed to happen. The reality therefore, from what I have seen so far, is the more important consideration. I had to throw my preconceptions and my expectations of the work when I was thrown into the actual experience of dealing with people with brain injuries and the different people that are connected to the service users. The reality is far more complex, and in fact the learning is on-going rather than static, as what I had hoped it would be when I first started working (Patient Logs, 2014; . Hoofien et al., 2001). C. Central Challenges, How Addressed In general, the central challenges in my work have to do with dealing with the particular needs and situations of specific service users. These challenges make me aware that indeed, people are different, and crafting case interventions has to be an on-going process of tweaking and revising, and adapting, to make sure that they are relevant and effective. The literature points out that even the understanding of brain injuries in general is an evolving exercise, one that is informed as much by the realities on the field as it is by the basic sciences and psychology research. The challenges are tied to human nature itself being very complex, and that I myself am subject sometimes to my own biases. For instance, with one case the challenge is to be able to adhere to the care plan, while at the same time recognizing that J was a flesh and blood person who has the freedom to do what he wants in the main. The way to address this, I found from experience, is to have two feet on separate grounds. One foot has to be firmly planted on the care plan, and the other foot has to be firmly planted in the subjective reality of the daily interactions with the subject. This is a balancing act that requires the guidance of the manager as well. Another way to address this is to simply be totally present to the service user. Presence I find is therapy in itself. Also, by being totally present in my daily interactions with the service users, I am able to relate to them better, and I am better able to understand what their needs and wishes are. Also I am better able to reach them and to course them through the care plan more successfully (Patient Logs, 2014). D. What I Would Change About My Approach to My Career Development/Work Approach Based on My Work Experience I found from my work experience that there is simply no substitute for experience. Theory can only get you so far, and by just studying theory and the academic aspects of brain injury and providing care and support to such afflicted persons, something vital is lost. On the other hand experience teaches much. At the same time, experience can be limited. One can spend a long time dealing with just one case. There is something to be had too from understanding a wide range of cases and conditions. There is therefore a kind of balancing act that must be present. Theory can provide a wide perspective, and experience can ground the academic studies to actual realities. I find therefore that on balance the approach that I have been using to further my career is ideal. It is not set in stone, but something that is evolving. My natural interests have led me to take up my major, and in my work experience my interest is deepening and I am beginning to understand that I need to expose myself more in the work and to read up more in order to be more effective dealing with brain injury service users. What I would change if anything is that I would expose myself earlier to actual work experience, and to do so in as extensive a manner as possible (Patient Logs, 2014). 1 References Bazarian, J. et al. (2005). Mild traumatic brain injury in the United States. Brain Injury 19 (2). Retrieved from http://www.ph.ucla.edu/epi/faculty/publications/Kraus_BrainInj_02-05.pdf Cernak, I. et al. (1999). Neuroendocrine responses following graded traumatic injury in male adults. Brain Injury 13 (12). Retrieved from http://www.researchgate.net/publication/12684854_Neuroendocrine_responses_following_graded_traumatic_brain_injury_in_male_adults/file/d912f5016e46dc89cc.pdf Cicerone, K. (2002). Remediation of ‘working attention’ in mild traumatic brain injury. Brain Injury 16 (3). Retrieved from http://www.researchgate.net/publication/11487298_Remediation_of_working_attention_in_mild_traumatic_brain_injury/file/e0b49516d6adf50d10.pdf Davalos, D. et al. (2005). ATP mediates rapid microglial response to brain injury in vivo. Nature Neuroscience 8 (6). Retrieved from http://www.med.nyu.edu/skirball-lab/dustinlab/pdfs/davalos2005-NN.pdf Fleming, J., Strong, J. and Ashton, R. (1996). Self-awareness of deficits in adults with traumatic brain injury: how best to measure? Brain Injury 1 (10). Retrieved from http://www.researchgate.net/publication/14522149_Self-awareness_of_deficits_in_adults_with_traumatic_brain_injury_how_best_to_measure/file/72e7e52718778cb714.pdf Henry, J. et al. (2006). Theory of mind following traumatic brain injury: The role of emotion recognition and executive dysfunction. Neuropsychologia 44. Hoofien, D. et al (2001). Traumatic brain injury (TBI) 20 years later: a comprehensive outcome study of psychiatric symptomatology, cognitive abilities and psychosocial functioning. Brain Injury 15 (3). Retrieved from http://www.researchgate.net/publication/12071540_Traumatic_brain_injury_(TBI)_10-20_years_later_a_comprehensive_outcome_study_of_psychiatric_symptomatology_cognitive_abilities_and_psychosocial_functioning/file/9fcfd50be5638c5a84.pdf Nakatomi, H et al. (2002). Regeneration of Hippocampal Pyramidal Neurons after Ischemic Brain Injury by Recruitment of Endogenous Neural Progenitors. Cell 110 (4). Retrieved from http://www.cell.com/cell/abstract/S0092-8674%2802%2900862-0?cc=y?cc=y Patient Logs. (2014). Patient Log and Case History Reports SweetTree Home Care Services. (2014). Meet the Team: A Little About Us. SweetTree.co.uk Retrieved from http://www.sweettree.co.uk/?about=meet-team SweetTree Home Care Services. (2014b). Mission Statement and Charter. SweetTree.co.uk Retrieved from http://www.sweettree.co.uk/?about=mission-statement-charter SweetTree Home Care Services. (2014c). Brain Injury Care Support Services Duties and Responsibilities Documentation Read More