Describing and Illustrating the Rehabilitation Process - Visual Impairment - Case Study Example

Outline Assessment a. Introduction of the terminology b. Visual impairment statistics c. Characteristics of the chosen fictional client d. Psychological aspects of living with the impairment e. Functional limitations caused by the impairment f. Social aspects of living with this impairment g. Societal attitudes and stereotypes h. Environmental barriers and facilitators i. Family issues j. Issues of sexual intimacy/relationship k. Recreational life l. Employment issues m. Financial issues 2. Planning through IWRP a. Services related to physical restoration b. Services related to vocational restoration c. Services related to social restoration d. Services related to independent living 3. Provision of services 4. Return to previous life roles 5. Follow up Assessment: Introduction of the terminology: Visual impairment as well as blindness is defined as impairment in vision which refers to abnormality or aberration of eyes, the optic nerve or the visual centre for brain that even after correction affects an individual performance. Visually impaired individuals will have difficulty in performing their daily activities even with glasses, contact lenses, medicines or surgery. These can be avoided, treated or cured with widely available well known and inexpensive measures. “There are four levels of visual function: 1.normal vision 2.moderate visual impairment 3.severe visual impairment 4.blindness” (Visual impairment, 2009, para.2). Vision rehabilitation is a process in which training and counselling is carried for blind and visually impaired individuals for developing skills and strategies to live with dignity and independently. During this process a specialist based on extent of disability attends to a patient and formulates the sessions in such a way that it enables the visually impaired individual to deal with lost vision, daily activities, travelling, and career objectives and take pleasure in leisure activities. Rehabilitation specialists guide blind and impaired persons to live smoothly with their abnormality. Some individuals are provided with optical aids for better vision. Visual impairment statistics “According to the RNIB, there are about 80 different eye conditions which can affect sight in various ways” (Shepherd, 2001, p.14). Some of conditions are cataracts, colour blindness, glaucoma and short- and long-sightedness. WHO statistics show that there are 314 million people who are visually impaired around the globe among which 45million are blind. Risks can be categorized by gender, age and geographically. Worldwide, females at all ages and older people are at higher risk to become visually impaired. 82% of visually impaired people are age 50 and above. Blindness in children is a major problem globally where 1.4million are below age 15. Visually impaired children are more than 12million at age 5-15 because of uncorrected refractive errors. 87% of people who are visually impaired belong to developing countries which indicate that they are not distributed evenly through out the world. Activity limitations and barriers to participation: Visually impaired individuals experience difficulties in a variety of tasks based on the eye condition such as macular degeneration. In cataract the far and near vision is badly affected. Visual impairment impacts on capabilities like ability to see, contrast sensitivity, colour vision, adjustment to changing light levels, visual field width, altering focus, considering moving images and glare sensitivity. “Visual impairments were often misunderstood by others and the absence of facial recognition was experienced as a severe barrier to social interaction” (Diana, et al, 2008, para.1). Characteristics of the chosen fictional client: The character in this study is Mr. John Vas, 52 years old and was the director of a multinational IT company in Manhattan before meeting with a fatal accident which damaged his optical nerve there by rendering him blind. The doctors have ruled out the chances of bringing back vision although money can be spent through insurance and self finance. Mr. John had really led a very busy life with his office work, family – wife and two kids and his social partying in the weekends. His favourite hobbies were blogging on the internet and watching and playing basket ball. Psychological aspects of living with the impairment: Mr. John had to quit his job immediately after the accident and failed surgeries. He was largely confined to his room in his house in Manhattan and required constant attention and a bye-standee for all activities. A person who was a successful professional and quite dynamic was now psychologically hit as he thought himself as a parasite. Suicidal tendency was also on high after being constantly felt helpless. Functional limitations caused by the impairment: Mr. John was indeed a parasite and required assistance even to go to the washroom. He was to be fed by a nurse or his wife and he lived in complete isolation from the rest of the world. His family was become sublime and ceased the weekend hangouts. He could no longer think of working and playing basket ball. He could only listen to the commentary of his favourite Chicago bulls basket ball matches. His car was now lying unused and his laptop and gadgets were on the deck. Social aspects of living with this impairment: The family isolated themselves after his blinding and there were only a few friends who would turn up to there house to see their helpless friend. He developed a sort of ego and wanted to know about his friends who were doing well in their life. Societal attitudes and stereotypes: Mr. John’s social circle was elite and highly educated and therefore the stigma of stereotyping was not observed. The sorry faces and pitiful attitude of his neighbours however made Mrs. Alexandra very sober. Environmental barriers and facilitators: All the visual display mechanisms meant nothing to Mr. John. All the important equipments were to be replaced with talking facility. On screen talking software on his computer, talking watches and Braille papers and books facilitated to keep apace with society at least partially. Family issues: Frustration at the helpless situation was seen many times initially within the family. The constant attention required by Mr. John had crippled the otherwise social Mrs. Alexandra that often it resulted in heated arguments. But Mrs. Alexandra was patient enough and supported her husband in the rehabilitation process through her consistent support and encouragement. Issues of sexual intimacy/relationship: The mindset was completely shattered and intimate relationship was off for quite a long time until Mr. John was able to regain confidence and start over his new life. Recreational life: There was no recreation for quite a long time. He could only listen to the commentary and not see any games. His blogging was slowed down because some one else had to read it before publishing. Unaccompanied travelling was not possible in the initial days before the rehab process was completed. Employment issues: His Employer did not ask him to quit and were ready to wait. They were also kind enough to extend medical benefits to treat him. There was no job which he could take up. Financial issues: Although an affluent person, reserves of his account was spent on his treatment. They had to travel to distant places across the globe to get expert ophthalmologists’ opinion. This led to a situation where Mrs. Alexandra had to think about getting an employment. Their sons were studying abroad and had high fees for their graduation. The loan of their magnificent house was now a burden. Planning though IWRP Title: Individual Written Rehabilitation Plan Client Name: Mr. John Vas Address: 308, LVDR Avenue, Roosevelt Island, Manhattan, NY Client Phone: 0012488547556 Alternative Contact Person: Mrs. Alexandra Vas -- TO BE FILLED BY CUSTOMER Desired goal: The objective of the plan is to provide a defined plan for rehabilitation of Mr. John Vas who is a visually impaired person to avail the federal benefits. Specific Objectives: 1. To counter, adapt and overcome the socio-economic problems faced by Mr. John. 2. To engage in activities to delve into working mode through vocational therapies 3. To be able to sustain independently in day to day activities 4. To be able to regain lost social contacts through proactive interaction and community works. 5. To restore financial stability to the family through sustainable employment 6. To be able to use devices aiding Mr. John during travel and walks. 7. To come out of the groove and start over a new life as a person with special ability 8. To regain the lost charisma in personal life by improving self confidence 9. To participate in recreational activities this suits him now including outdoor games and special interests. 10. To maximize the federal benefits which can be availed for a better life Services related to physical restoration Physical restoration services are those medical and allied services that are necessary to correct or significantly change within a reasonable duration the physical or mental condition of a visually impaired personal. Prominent Service providers are: 1. Queen Alexandra College, Birmingham 2. Vision Development Center, Pennsylvania 3. Blind in Business, London Services related to vocational restoration: These services aim to provide vocational training based on their prior experience or knowledge so that there would be a better chance of obtaining jobs, attending trainings or in any activities matching their potential and interests. 1. Minnesota State services for the Blind, Minnesota 2. Access Technology Institute, Arizona 3. Association for Education and Rehabilitation of the blind and visually impaired (AER), Toronto Services related to social restoration: These enable a visually impaired person to return to his social normalcy in terms of ability to travel in public transportation and to pursue interests such as playing possible outdoor games are facilitated by: 1. St Joseph’s Centre for the Visually Impaired, Ireland 2. American Foundation for the Blind, Texas 3. Career Support and Development Centre, Hong-Kong Services related to independent living: These should provide the individual the ability to carry out his/her daily chores without assistance by providing adaptive aids and devices. The paradigm shift from dependent due to impairment to independent although impaired acts as a big morale booster for the person. 1. Services for Blind and Visually Impaired, Department of Education, Concord 2. Barnet Independent Living Service, London 3. Inspire Community Trust, Kent Provision of services: “Emotional and behavioral adjustment to blindness and visual impairment is often one of the most challenging issues faced by individuals” (Coordinated service for veterans who are blind or visually impaired, 2009, para.22). In the case of Mr. John also, these needs to be focused by specialists using the following services: 1. Vision Rehabilitation 2. Orientation and Mobility 3. Occupational 4. Social 5. Technology The following recommendations would be given specific to Mr. John: 1. His exceptional written and computer skills should be considered by the technology services by providing him the best software available for his use. 2. Training in Braille to aged clients is not successful. But he is determined to learn and make use of it. This is an exceptional case and trainers should start working on this as early as possible in the rehab process. 3. He had a vast social circle through his professional life and e-networking. He has to be given motivation and training to keep them in reach. 4. Special attention should be given to his attitude because of his intense and extreme feelings post injury. 5. More gadgets above and apart from the white stick and currency identifier should be provided to him and trained upon. Return to previous life roles: The success of a rehab process can be measured on how much the client comes back to his previous self. In this case study my expected outcome about Mr. John is: 1. He is able to set right his personal life within his family and friends 2. As a person with high experience and qualification, he could be a consultant and can take-up management sessions to professionals over internet. 3. He is able to perform his daily activities and travel with no assistance and effective use of devices meant to aid him. 4. Become mentally strong to understand that the impairment is a reality in his life but it does not mean end of hope. He should also refrain from reacting to any stereotyping. 5. He begins doing something that he liked best – going out and ‘feeling’ the basket ball matches in the stadium and blogging using the software for voice follow-up. Follow up: As a case manager, I would like to see Mr. John back to his normal days in the best possible way in the shortest time. I would have constant interviews with Mrs. Alexandra to keep a tab on the progress of Mr. John on various aspects. Interaction with Mr. John and putting across topics that hindered his thought process before the rehab started and monitoring/analysing the answers is a good way to understand the progress of psychological shift back to normalcy. Taking Mr. John out on a nearby vacation with his family and allowing him to be independent there will be a good way to see how he uses his rehab learning’s effectively. Bringing up a situation where help is not provided for procuring information about some data from the internet, I would see how he uses the available voice software on his laptop to his own help. Overall, I would present myself as a friend to him rather than a case manager to ensure that he discusses his slightest of discomfort during the process. Reference List Coordinated service for veterans who are blind or visually impaired. (2009). United State Department of Veterans Affairs. Retrieved March 28, 2010, from http://www1.va.gov/blindrehab/page.cfm?pg=60 Diana, M.B. (2008). Limitations in Mobility: Experiences of visually impaired order people. British journal of occupational Therapy, 71(10). Social Care Institute for Excellence (scie). Retrieved March 28, 2010, from http://www.scie-socialcareonline.org.uk/profile.asp?guid=7fb5622c-612b-4a4c-9d0e-9243b92af80f Visual impairment. (2009). World Health Organization. Retrieved March 28, 2010, from http://www.who.int/mediacentre/factsheets/fs282/en/index.html Shepherd, I. (2001). Providing learning support for blind and visually impaired students undertaking field work and related activities. University of Gloucestershire. Retrieved March 28, 2010, from http://www2.glos.ac.uk/GDN/disabil/blind/blind.pdf Read More