Acquired Brain Injury - Case Study Example

Name: Tutor: Title: Acquired Brain Injury (Traumatic- 12 months post injury). Institution: Course: Date: Section A: Statement of case study: Acquired Brain Injury (ABI) (traumatic- 12 months post injury) I am a 35 year old female living in Cloncurry in North Western Queensland with my husband and 1 small child. I have ABI following a fall that I had one year ago. My situation has greatly affected my daily living including using a wheelchair. Section B: Disability Awareness Acquired brain injury is the medical conditions which affect the brain hence changing its functioning (Brain Injury Association of Queensland, 2011). Some of the conditions include and not limited to traumatic injury to the brain, anoxia, brain tumor, brain hemorrhage, stroke, and other brain diseases that are non-degenerative. Injury to the brain is an event that is life-altering and affects each area of an individual’s life including relationship with members of the family as well as those close to the affected person (Dell & Power, 2007). Research shows that injury to the brain can disturb perception, self-awareness, alertness together with concentration, learning and memory, planning, reasoning and solving problems, motor control, language and speech, and emotions (Brain Injury Association of Queensland, 2008). This is actually demonstrated in my case since after having acquired brain injury, I am always confused as exhibited by the way I confuse tasks/times in activities’ schedule; as well as present and past events. I experience hardships in remembering as evidenced by inability to remember fresh information. I always get distracted easily because my attention is greatly disturbed. I find it hard to make decisions. I have a child; when she makes mistakes needs to be corrected appropriately. However, my condition has altered the way I make decisions because the decisions I make are either potentially harmful or inappropriate. My motivation is also greatly affected as seen in the way I find it difficult to initiate an activity. I am also much disorganized; something that is significantly exhibited in my current life. I put on clothes inside out. In terms of spatial relations, I often mistake the locality of a seat when I sit down. Mood swings and fatigue are other effects of the disability. Injury or illness to a member of the family affects the entire family as well as the extended members (Kelly et al, 2008). My condition has also affected my family unit. For instance, the roles in my family have greatly changed since I have added new responsibilities to my daily routine. My family members together with some friends have continuously provided emotional support and companionship, besides physical care. Dell & Power (2007) argue that it can be very overwhelming for someone to be a caregiver, and adjusting to these alterations is challenging. One of the major challenges that occurred to me is sexuality. Affection, sexual feelings and love are healthy desires of a person (Brain Injury Association of Queensland, 2011). In case these desires are misunderstood or not expressed, distress, confusion and inadequacy feelings may occur. Since an individual with injury to the brain may not easily distinguish sexual cues, or may not show response to the partner (Dell & Power, 2007), I found it hard to instigate sexual activity. There are various sources where I can get support concerning ABI. For instance, there is Synapse, previously known as the Brain Injury Association of Qld Inc. This is an organization that is non-profit, devoted to enhancing the life’s quality of individuals who live with or are affected by ABI or individuals with demanding behavior. The contacts for Synapse can be reached via telephone (0731377400), fax (073137752), e-mail (info@synapse.org.au), website (synapse.org.au) or the physical address which is Level 1, 262 Montague Road, West End, Qld, Australia, 4101 (Disabilities Info Centre, 2010). Another helpful source is the brain injury Australia. This is a national body which ensures that every individual living with ABI has access to the resources and supports he or she needs to optimize his or her economic and social participation (brain injury Australia, 2013). This organization can be reached via phone (02 9808 9390). One of the organizations in my area which would help me to holistically manage my own daily activities of living is the Acquired Brain Injury Outreach Service (ABIOS). This is a professional rehabilitation service that is community-based in Cloncurry established to boost the system of service for individuals with ABI as well as their families. The mission of this outreach service is to help individuals with ABI within Queensland, their carers and families to obtain a better life quality in addition to community integration via increased opportunity, choice, independence as well as access to proper and approachable services (Queensland Government, 2013). Section C: Daily living Time/Activity Ease of doing an activity (0-4) 0=no difficulty, 4=complete difficulty Barriers or facilitators you have encountered Your solution/s or overcome the barriers Approximated financial cost to you 7.30am: Getting out of bed 3 No railing to use Electronic bed might be of help US $ 599.00 7.45am: Toileting 3 Not able to stand alone Assistance from husband n/a 8.00am: Bathing 2 Assistance Continuous help US $ 230.50 8.30am: Dressing 2 Assistance Continuous help US $ 230.50 9.00am: Breakfast 3 Very slow More time required n/a 9.30am: Boarding a bus 3 Poor accessibility Availability of wheelchair ramps at bus stations US $ 6000.00. To buy a car. 10.00am: Work 3 Difficulty in comprehending some tasks Start a personal business US $ 4000.00. 3.00pm: Going home 3 Poor accessibility Availability of wheelchair ramps US $ 6000.00. To buy a car. 4.00 -5.00pm: Playing with my child 3 Poor interaction Continuous therapy sessions US $ 55.50 per session. 8.00pm: Dinner 3 slow Extra time needed n/a 9.00pm: Sleep time 1 Assisted to move around Continuous support from husband n/a Section D: Challenges Social restrictions I experience due to my disability in terms of maintaining family and friend relationships The International Classification of Functioning, Disability and Health, also known as ICF, was invented by the World Health Organization (WHO) and offers a typical language as well as structure for health description and other states that are health-related (WHO, 2001). According to ICF, functioning as a term means the entire body functions, participation and activities, whereas disability is correspondingly an umbrella name for activity limitations, impairments and restrictions on participation. Additionally, ICF also outlines environmental elements that relate with each and every one of these components. With respect to the above classification, it is then right to state that an injury to the brain not only affects the person injured but the entire family from social upheaval and financial challenges to job loss and isolation. It is not very easy for me to maintain family and friend relationships. This is because of the behavioral, personality and cognitive changes brought about by ABI and are prone to pose a considerable and mostly negative effect on members of the family. Due to the demanding care that my situation requires, my family and friends go through a considerable extent of anxiety as well as depression. There are a lot of changes in terms of intimacy and marital adjustments; this is principally due to the larger financial strain and psychosocial maladjustment secondary to ABI. It appears to be normal that when a family member is affected by brain injury, some adjustments need to take place in terms of relationships with the family and friends. Frequently in the course of this switch, the affected individual together with his or her family members turn out to be discouraged with responsibilities’ changes (Dell & Power, 2007). Due to the stressful moment that the caregivers (both family and friends) go through, it is only rational that sufficient support be provided so that they may be able to successfully adjust to these changes. Seeking appropriate social support that is community-based can assist in reduction of loneliness and stress. A lot of communities and Cloncurry is not exempted have centers and support groups of brain injury for autonomous living that is able to assist in making relationships with other individuals who have related needs and concerns (Brain Injury Association of Queensland, 2011). It is important that I uphold contact with my family and friends in order to discuss my concerns or having fun. It is also vital that I join a group that is supportive since such groups entail sharing concerns and problems. Individuals with related issues will understand what I am feeling. Guiding and counseling is very important for family and friends of the affected individual. Community or environmental challenges I face, and how I have adjusted to them. The ICF framework appreciates the fact that environmental factors also affect a person with ABI. This is so because disability is recognized as a complete human experience. In addition, ICF considers the disability’s social aspects and it does not view disability merely as a biological or medical dysfunction (WHO, 2001). This is why a person with ABI ought to face a number of environmental or community challenges. The incentives for individuals with injury to the brain to take part in recreation and sport are similar like everybody else’s within the community; which is for fun and enjoyment, to interact with others and have a better feeling. Taking part in meaningful recreation and sport activities is among the most potent, yet uncomplicated methods to enhance the value of life among ABI individuals. However, it is argued that individuals not recommence participation in physical sports for around six to twelve months after an injury to the brain (Brain Injury Association of Queensland, 2011). The rationale is to provide enough room for recovery since physical sports may just exacerbate the problem. This is a major restriction that I have since I cannot take part in physical activity that involves community participation. On the other hand, I have managed to overcome this challenge because participation does not at all times imply playing. I take part in volunteering and coaching. Installing wheelchair ramps at community level is very vital so that people with ABI can be able to move around with a lot of ease. Lack of this facility proves to be quite challenging because I cannot be able to move freely using my wheelchair when everybody else is using the pathways. The Community Approach to Participation (CAP) entails flexible, patient-centric standards at its center and is devised on interventions of participation (Sloan et al, 2009). This is a highly recommended remedy that involves a patient’s friends and family as well as significant community contacts in order to enhance integration in accordance with patient’s interventions and goals to optimize capacities. Therapy can extend for years, adjusting to the needs of the patient over the years lived, so the remedial relationship has a considerable role in the extent of success obtained in interventions designed and planned to make community participation potential within roles in life significant to an individual. Environmental modifications and skill development have been deployed to reduce restrictions to my participation. CAP’s basic principle is that individuals with injured brain are able to achieve independence as well as fulfillment in life regardless of the extent of influence of multifaceted, occasionally lasting impairment affecting psychological and physical health (Sloan et al, 2009). My reaction in terms of self-concept, body image and self-esteem Disability means the incapacity to carry out some principal life activities due to impairment, which can either be mental or physical (Dell & Power, 2007). Even though a number of Disabilities Act in various countries help guarantee equal accessibility to vital things such as employment, education, housing, public facilities, and health care, individuals with disabilities are still facing the day to day problems of being seen as inferior or different (Brain Injury Association of Queensland, 2008). Experiences like these can have overwhelmingly negative impacts on body image, self-esteem and self-concept. Within our society, a lot of significance is put on physical abilities as well as appearance. Social principles of desirable and acceptable body and face features, capacities and shapes are linked to competency, health, success, and independence. Disability is frequently seen as an individual problem or tragedy. Body image refers to the inner perspective of the outer appearance. Body image concerns arise ranging from negative awareness and image, and ability dissatisfaction to isolation feelings, depression, and issues with eating (Howes et al, 2005). This is why I ought to have a positive image about my body so as to avoid going into depression and dissatisfaction issues. As a woman, at first I had a lot of difficulties appreciating the whole changes that occurred to me. I could not imagine myself in a wheelchair someday. However, knowing that self-esteem is the way we perceive our worth as human beings, I had to appreciate my current situation and learnt to live with my situation hence initiate a positive health outcome. It is stated that when people have a positive and healthy self-esteem, they are able to appreciate the way they are. Since self-esteem is likely to be influenced by various variables while an individual is developing self-concept, I am grateful to my family and friends who convey a positive attitude towards me hence fostering my self-esteem in a positive way. To enhance my self- esteem, I have set a number of realistic goals that will promote my health outcome. Self-concept implies how people view and evaluate themselves (Vickery et al, 2005). Self-concept directly relates with one’s self esteem. Self-esteem that is high will enable someone to have self-view that is positive and the reverse is actually true (Vickery et al, 2005). A self-view that is negative will reduce my self-esteem because I will be just concentrate on my disability which eventually will result in self confidence that is low. It is very imperative that I view my body in a positive manner so as to increase my healing process which is achieved through a holistic approach. The concepts of pity, paternalism, self-efficacy and independence in relation to rehabilitation and health care professionals treating people with a disability Negative attitudes to people living with disabilities are frequent within the society. These attitudes are expressed in various ways and act as hindrance to the complete human potential realization. Professionals in health care as well as other health practitioners within rehabilitation facilities hold attitudes to individuals who are disabled that are equal to the ones of community entirely, and they might be real perpetuators of this restricting practice (Kendall & Clapton, 2006). Characteristic emotional responses when seeing a person with disability entail fear, guilt, and pity, which entirely are described by a universal discomfort feeling. Health care professionals need to encourage people living with disability rather than showing negative attitudes towards them. This is achieved through counseling and supporting them to persistently be submissive to their medication. Understanding and empathy should be practiced by healthcare professionals rather than pity. In the context of healthcare, paternalism takes place when a professional of health care makes decisions and choices for a client with no clear patient’s consent (Ashcroft et al, 2007). Decision making in health care is mainly considered as paternalistic. Accordingly, healthcare decision might very well not manage to involve a client in the course, and might also go contrary to his or her wish, or overlook the patient’s perspectives in various ways, provided the patient is advantageous. One major argument in healthcare with respect to paternalism is that medical providers have such infinitely superior practical knowledge concerning medical situation in terms of diagnosis certainty, nature of management options and likely benefits, as well as the involved risks, hence the provider takes the lead to assess the alternatives and establish the decisions (Ashcroft et al, 2007). Self-efficacy is regarded as the predictor of dealing with stresses in life (Vickery et al, 2005). It is recommended that health care providers have sufficient knowledge of self-concept when dealing with people living with disability so that they can help them manage the obstacles in their current lives (Ashcroft et al, 2007). Since self-efficacy is also an attitude to our self, it is vital that disabled people be encouraged to have a positive attitude towards themselves so as to live a positive life. Autonomy or independence is a personal rule concerning self and is not controlled by interferences from personal restrictions and by others that prevent significant choice. In healthcare setting, respect for independence is a major fundamental principle of medical ethics (Ashcroft et al, 2007). Healthcare providers have a duty to create environments essential for autonomous preferences in others. Bibliography Ashcroft, R. E, et al, 2007, Principles of health care ethics, Chichester, West Sussex, England: John Wiley & Sons. Brain Injury Association of Queensland, 2008, Acquired brain injury: The facts : the practical guide to understanding and responding to acquired brain injury, Milton, Qld: Brain Injury Association of Queensland. Brain Injury Association of Queensland, 2011, Responding to challenging behaviour: Following an acquired brain injury, Milton, Qld: Headway Queensland. Brain injury Australia, 2013, Retrieved on 1 April, 2013 from http://www.braininjuryaustralia.org.au/ Dell, O. A. E., & Power, P. W., 2007, The psychological & social impact of illness and disability, New York: Springer Pub. Co. Disabilities Info Centre, 2010, Retrieved on 1 April, 2013 from http://www.disabilitiesinfocentre.org/browse-by-services/science/synapse-brain-injury-association-of-qld.html Howes, H. F. R., Edwards, S., & Benton, D, 2005, Female body image following acquired brain injury, Brain Injury, 19, 6, 403-415. Kelly, G., Brown, S., Todd, J., & Kremer, P, 2008, Challenging behaviour profiles of people with acquired brain injury living in community settings, Brain Injury : [bi], 22, 6, 457-70. Kendall, E., & Clapton, J, 2006, Time for a shift in Australian rehabilitation?, Disability & Rehabilitation, 28, 17, 1097-1101. Queensland Government, 2013, The Acquired Brain Injury Outreach Service, Retrieved on 1 April, 2013, from http://www.health.qld.gov.au/abios/ Sloan, S., Callaway, L., Winkler, D., McKinley, K., Ziino, C., & Anson, K, 2009, The Community Approach to Participation: Outcomes following Acquired Brain Injury Intervention, Brain Impairment, 10, 3, 282-294. Vickery, C, et al, 2005, Self-concept and quality of life following acquired brain injury: A pilot investigation, Brain Injury, Vol. 19, Issue 9, pp 657-665. World Health Organization, 2001, ICF - International classification of functioning, disability and health, Geneva: World Health Organization (WHO). Read More