Affect the Brain's Ability to Receive Processor Store Information - Essay Example

Rev. SOCIAL WORK- Social Circumstances Report - Case Study Introduction: Background information: Ruksana is a 19 year old Muslim girl. She lives in East America. Her parents migrated to United Kingdom (UK) in 1974. Her family consists of seven members- grandmother, father mother and three siblings; two elder brothers and a younger sister. Her grandmother came to UK 20 years back for living with her son and his family. Her father Mr. Awan is into real estate business , her mother Mrs. Awan is engaged in family business. Among her two brothers elder one is an employee and younger one a student. Her sister is a school student. Ruksana is fond of wearing modern dresses and watching Bollywood films. She likes to spend time with her grandmother and learn Gujarati from her. Till this age she has not dated or selected her lover. She comes from a conservative family background. In their family culture they respect Muslim traditions and follow their customs. Ruksana suffers from certain disabilities like learning disability and physical weakness. Many people in the world faced this problem in their childhood. “Learning disabilities are problems that affect the brains ability to receive process, analyze, or store information.” (Learning disabilities 2009). Her speech is impaired and she struggles due to phonological disorder. These two problem forces her to take help from others in her personal chores. She travels short distance by electric wheelchair. She completed her schooling from a residential specialist school. Students of such schools are different from normal students. They cannot learn like normal students. They are physically weak and have learning disability. According to a report about safeguarding disabled children in residential special schools “protection from abuse of disabled children living in residential settings has received much less attention than the protection of children looked after by local authorities.” (Paul, Cawson & Paton 2006). Part A: Provide an analytical overview of what the situation is; distinguish objective realities from assumption or prejudice: People need patience to communicate with her. It indicates that one reason for her impaired speech may be lack of attention from her parents or other close relatives. Had they given more attention to her in her childhood, this problem could have been solved to an extent. Her speech and language therapist Mr. Jean helps her for this. He adopts computerized assistive voice technology and she is interested in this computer based study. Usually such people seek help from learning and speech therapists when they face problem in learning and reading (About academic language therapy 2004). Here Ruksana did not get help at the initial stage. When she got such a facility she utilized it very well. Her therapist gives proper attention to her and he succeeds in his attempts to meet her needs. So she shows interest in computer. She had limited deftness in fingers and toes. Ruksana gets help from a resource centre and from a care agency. People from the care agency provide their services two or three times in a day. On days when she goes to resource centre, they visit her twice. They help her in dressing, showering and they prepare food for her. They encourage her to involve more in leisure time activities and assist her in her administrative works. On each visit they spend one and half hours with Ruksana. But she is not fully satisfied in their evening visit. Time of their evening visit is 7 to 8.30. This forces her to go to bed earlier than she actually wishes. For the last one year she attends a resource centre, called Hopefields Resource centre. It is a local authority centre for people with learning disability. She usually visits this resource centre three days in a week. She got a different kind of help from here. They arrange arts, craft and social forums for this kind of people. But they do not allow members to go outside without their escort, because this centre is located near the road, so authority pays extra attention to member’s safety. But she feels irritated with this kind of restrictions. She is not fully happy or satisfied with their help; she feels frustrated and bored. Ruksana keeps an informal friendship with her key worker, whose name is Kerry. Kerry has a sort of lesbian character. Ruksana has some other friends at this centre. This centre respects all religions and celebrates their festivals. The authority has a plan to conduct a social inclusion review. By this way they try to bring the people here to mainstream of the community. They think that if they do so people like Ruksana can visit the community centre attached with mosque. Last month also she seemed as depressed as ever. This is reflected in her behaviour. She expresses this depression through her words. She shows indifference to attend Hopefield and spend time with family. According to Jean, her therapist’s point of view there is some valid reason for this depression. Since she is a 19 year old girl she had a lot of worries about her future. She feared that if the Hopefield was conducting a social inclusion programme she will be forced to visit mosque. She doesn’t like that. Even though sometimes Hopefield’s atmosphere was boring, it was helping her to solve her problems to a certain extent. She loves Kerry’s presence. She thinks that her carers are not giving proper consideration to her. Sometimes they reach her home too late and other times her mother cancelled the transport to Hopefield. There are occasions when they finish their duties very fast without interacting with her. She wished to see her friends and spend time with them. She shows interest in internet but not in mobile phone, because telephonic conversation is a difficult process for her. For using internet she needs other’s help. When her elder brother comes home, he helps her to operate internet. Other times she does not get opportunity to use Internet. Her mother tries to find a boyfriend for her. She is worried when she thinks about a boyfriend; at the same time she does not like her loneliness. In front of her parents, she is very quiet and happy. According to her mother they struggle to take care of Ruksana when she stays at home due to the late coming of care agency. Her mother thinks about setting up an arranged marriage for Ruksana. She knows that it is not an easy task. When she spoke to Ruksana about this, Ruksana appeared indifferent. In reality she is not happy in her life. She misses her school life and friends. She does not get enough freedom from her home or from the day centre. She got this only from her school. Moreover she feared about the social inclusion plan of the daycare and her parents’ plan about her marriage. She thinks her mother cannot deal with her in a nice manner. She feels she is a burden for her mother and she is simply frustrated about her life. From the above mentioned points one can reach into some assumptions. Ruksana loves her school days. She loves her schoolmates very much. But now she can’t enjoy that life. It may increase learning disability. In the current situation she is afraid of the plan to shutting down of Hopefield Resource Centre. It is a genuine fear. If such situations arise she will be separated from Kerry and other friends at this center. This will cause loneliness in her life. In the case of people who have learning disability or physical disability, loneliness will cause more and more problems in them. Another point is her parents are thinking about her marriage. It may be a forced marriage. Her mother is pressurising her into an illegal forced marriage. Another factor that lurks in Kerry’s mind is that if her marriage is conducted with a Bangladeshi boy, she will immigrate to Bangladesh, and she would lose contact with her. This may also cause many difficulties in Rukshana’s life. This kind of thinking causes changes in her character. Girls with her age naturally think about this kind of problems. Part B: Explain the likely policy and legislative framework which underpins the scenario as it is and that may assist this situation: It is now necessary to consider legal aspects that surround the case of Ms. Rukhasana Awan, 19, who is having learning difficulties (LD). The main legal issues that impact this case are: Possibility of forced marriage under Islamic laws, by R’s parents, as against consensual marriages, acceptable to both partners. Closing down of the Day Care Hopefield Resource Centre, which is primarily responsible for R’s daytime activities, like arts and crafts, discussions and social interactions, and most of all interacting with her mentor, Kelly. Need to reassess R’s needs in the current situation and offer remedies in line with social influences including assessment of need for R to visit community centre attached to local mosque, visited infrequently by R’s parents.. NHS Community Care Act 1990: This is an act that regulates health care and social services in UK. It enunciates that provision of care is based on their needs and requirements and the surrounding circumstances. Thus, states should act as providers of health care to patients on the basis of their assessed needs, made usually by local authorities, and resources thus allocated need to be regularly provided, irrespective of lowered resources in later stages. (Encyclopedia: NHS and community care act (1990) 2005). Applying the aspects of NHS community care act in the case of R, it would be difficult to state whether R would be able to gain much benefit in terms of community care. Disability Discrimination Act 1970: Under the provisions of Section 15B of the DDA 1970, it is illegal to show differentiation to disabled persons, who may be members of the authority, or to deny or obstruct opportunities to receive training, and also cause detriment to disabled person who wishes to gain training, or other opportunities. (Disability discrimination act 2005 ). Applied in this case, it could be in terms of R being deprived of access to Hopfield Care Centre due to financial constraints that is forcing the governing body of this care centre to close down the unit. This has upset the patient, R who will now not be able to interact with her friend and mentor, Kelly, with whom she shares a special rapport and liking. The prospects of losing audience at the Centre have upset R, who, apparently has begun to suffer from mood swings and erratic conduct, including use of abusive language and misconduct towards her carers at home. A good option in the case of this learning deficient patient, R would be in terms of seeking companionship with Kelly, who could act as her carer and mentor, at R’s home, provided Kelly is persuaded to teach R from the latter’s (R) home. Another aspect would be in terms of seeking care at the community centre in the mosque, which R is not keen upon accepting, possibly due to lack of knowledge, or the fact that she would not have access to cosmopolitan culture that she enjoys at Hopefield Resource Centre. It is now necessary to consider aspects of Mental Capacity Act 2007, (MCA) with regard to mentally and physically deficient patients, like R, suffering from learning difficulties. She is not able to judge things for herself, pass judgments, or take decisions regarding her life on her own. The carers need to concern themselves in protecting her best interests and it could be in terms of best care, based on her deficits. The Mental Capacity Act has instituted Independent Mental Capacity Advocate (IMCA) service. The service helps vulnerable people who cannot make some or all important decisions about their lives. This is specifically directed with regard to people who lack the capacity or will to take charge of their own lives and to take independent and informed decisions regarding aspects of daily living. (The mental capacity act n.d.). In this case, although R is not having chronic ailments, she is brain deficient, and needs carers to help her with daily aspects, like bathing, dressing and taking food, which she is not able to do independently. Coming to the question of nearest relative who could help out in caring for R, it could be said that her grandmother who has been living with them, for minimum five years could be termed ‘nearest relative’ for the purpose of this act, since father and mother may not be very keen upon taking up caring needs of R. (The mental capacity act n.d.). The nearest relative, as the case may be, is empowered to apply for mandatory evaluation of R’s needs in terms of treatment, or seek assistance from patient’s social service in the neighbourhood, if need for evaluation and could take decisions regarding the enforcement or detention in health care centres, whether for examination, or treatment, should such occasion arise. Finally coming to the most important aspect that a social worker needs to concern him or herself, is with regard to marriages made against the consent or full will of the party(s) which may be contrary to the Forced Marriage (Civil Protection) Act 2007. (Forced marriage (civil protection) act 2007 n.d.). Under the provisions of this law, it is quite possible for the Court to order restraint, or issue orders that could restrict or contain the proceedings. In such cases, the Courts need to consider best interests of the parties and the detriment and harm such marriages may wrought on them. In the case of R’s Case, it is seen that there are possibilities that she may be vulnerable, due to her deficient learning personalities, plus the fact that she is entirely dependent upon her carers, for physical and mental succour. Therefore, it is necessary, that if needed, the State needs to come forward, and take charge of her case, based upon the surrounding facts and her needs. What the local authorities need to consider, in the event her parents do not respond positively, is the fact that UK human rights consisting of the right to live one’s live according to one’s choice, whether to accept or reject medication, or interventions and the need for seeking and receiving counsel and carers as laid down by law, needs to be respected and granted. Part C: Recommendations: Discuss the social work interventions which would be required in this scenario: what would you need to do and how you would approach the scenario? Critically The social work intervention in the situation of Ruksana Awan seeks solution to many problems the hapless disabled people in our society have to face. It is also an opportunity to think about the attitude of society and the government machinery towards these less fortunate people and effectiveness of care and protection given to them. This particular case of Ruksana Awan who is disabled in many areas deserves special attention and the possible interventions to support her are explained below. The care assessment of Ruksana points to the fact that she receives some degree of care and support from different sources even though not all are adequately executed and not in full favour of Ruksana as an individual who needs special attention. A social worker’s role in this situation is to establish a professional relationship with these resources such as family, staff of the institution and her friends and encouraging them to adopt more creative measures in dealing with Ruksana. A better understanding of her condition as a physically and phonologically disabled will definitely assist the helping people in providing quality care to Ruksana. Also, a social worker has to try for policy options that regulate funds for the welfare of institutions even though such measures are found expensive. Need Assessment To assess the needs of Ruksana, the Need Hierarchy theory of Abraham Maslow can be used as an effective tool. This theory explains that human beings are motivated by unsatisfied needs and satisfaction of low level needs will lead to seeking higher level needs. According to Maslow there are general needs such as physiological, safety, social or love and esteem needs. By meeting all these needs a person can act selflessly, a state called self –actualization. (Maslow’s Hierarchy of needs 2009). When looking at Ruksana’s needs with the perspective of Maslow’s theory we can understand that her physiological needs are sufficiently met. She can avail facilities like electric wheel chair and computer to travel and to communicate. But she feels lonely when forced to remain inside the institution whole day because the policy doesn’t allow the members to go out. The assessment of Ruksana’s psychological needs is very important since the thoughts and feelings of a disabled girl who is at the peak of her adolescence are very complicated. The fact that she has become withdrawn and quiet over the last one month and started using abusive words and emotional outbursts at Kerry are indicators that her psychological needs are not sufficiently met. Her opinion that she misses her friends is a pointer to her unsatisfied social needs. Her self-esteem is also poor since she is not happy with her present life and experiences boredom. Social worker can provide necessary counselling service to Ruksana to boost her self-confidence and assertiveness and also encourage her to actively participate in leisure time activities. Improving her computer skills is also helpful in removing boredom from her daily life. Strengthening her social support system is one of the most appropriate social work interventions possible in Ruksana’s case. This includes talking to her parents about her needs and encouraging them to respond pro actively to them. Ruksana feels that her mother cannot cope with her at home. This may be because of the busy schedule of her mother in administration of their family business. Unfortunately her mother is more concerned about ‘marrying off’ her daughter though finding a boy is very hard. It is the responsibility of the social worker to convince the family that marriage is quite a personal matter of Ruksana and they cannot force her in this regard. Further, this intervention in family should aim at improving her status among its members because she feels isolated and suppressed there. A personal meeting with Ruksana and establishing rapport with her can lead to discussion about her future and concept of marriage. Obviously marriage of a disabled girl like Ruksana is difficult but chances are there for a noble person to offer a helping hand. If that happens Ruksana has to be informed well about marriage life and prepare herself to a new beginning. Social support system also includes support from her friends and staff of the institution. The Hong Kong based study ‘Social Support and Life Satisfaction’ explains that “Emotional and instrumental supports from staff and friends have different predictive power and importance on individual’s life satisfaction.” (Young, 2006). Other possible solution is referring Ruksana to a more specialized institution. Many experts today advocate Community Based Rehabilitation (CBR) which aims at providing equal opportunities and social integration to the disabled people. (Community based rehabilitation (CBR) 1994) Recommending her to a main stream college is found to be an unfeasible idea. She is having difficulty in speech and is also physically disabled. So allowing her to pursue education in a college that offers special care and attention to students like her is the suitable solution for this problem. Conclusion: The case of Ruksana Awan tells the story of a young woman with learning and physical disability trying to adapt to the changing environment around her. It is also the depiction of the feelings and aspirations of a 19 year old adult girl who needs assistance in most of the activities pertaining to daily living and whose future cannot be predicted to go in a certain path. The case study offers insight into problems faced by disabled people in our society and an opportunity to think about more creative measures that should be adopted in dealing with people like Ruksana. They suffer from multiple problems having psycho-social dimensions. The background information throws light on the plight of a disabled person who is neglected at home and finds it difficult to adapt to changing environments in the institution she belongs. This facilitated the need to understand the policies and legislations about the problems faced by disabled people and this in turn helped in suggesting solutions to some of them, associated with the physical and learning disability of the person about whom the case study is conducted. Moreover, the entire process helped to critically analyze a case by evaluating all the parameters to reach possible conclusions. In dealing with an adult like R, it is necessary to be patient, concerned and have genuine liking for the person, in order for the social workers to be able to provide long term benefits for the cared. In the case of R, the critical issue has developed due to apparent closure of the Day Care Centre where she spent time with people of her age, mixing with other young people and trying out new skills like arts and craft. This provided kind of personality development for her and also made her forget her trials and tribulations as a deficient child with learning disabilities. This has been accentuated by indifferent attitudes by her mother, who wished to dispose her off through forced marriage, which is illegal under UK Laws. According to the Home Officer minister, Alan Campbell, "We are determined to do all we can to support victims of forced marriage, prevent others from becoming victims and provide police and other agencies with the tools and powers they need." (New laws against forced marriages 2008). While this may just be a risk in R’s case, it is quite possible that R needs to build self-confidence and mental skill sets to take care of herself at one point of her life. It would be better if she is admitted in a special college for persons of her kind, who would be able to take good care of her needs, physical, mental, psychological and social. Through these interactions she would be better disposed to take care of herself and live a more convenient, comfortable and care free life. Reference About academic language therapy: Spanish translation, “about academic language therapy” 2004, ALTA: Academic Language Therapy Association, viewed 14 June 2009, http://www.altaread.org/ Community based rehabilitation (CBR) 1994, viewed 14 June 2009, http://www.cbrresources.org/ Disability discrimination act 2005: Chapter 13 2005, viewed 14 June 2009, http://www.opsi.gov.uk/acts/acts2005/pdf/ukpga_20050013_en.pdf Encyclopedia: NHS and community care act (1990) 2005, Nation Master.com, viewed 14 June 2009, http://www.nationmaster.com/encyclopedia/NHS-and-Community-Care-Act-(1990) Forced marriage (civil protection) act 2007: 2007 chapter 20 n.d., OPSI: Office Of Public Sector Information, viewed 14 June 2009, http://www.opsi.gov.uk/acts/acts2007/ukpga_20070020_en_1#l1g1 Learning disabilities: what are learning disabilities 2009, Teens Health, viewed 14 June 2009, http://kidshealth.org/teen/diseases_conditions/learning/learning_disabilities.html Maslow’s Hierarchy of needs: father of modern management & leadership by employee motivation 2009, Abraham Maslow: Father of Modern Management, viewed 14 June 2009, http://www.abraham-maslow.com/m_motivation/Hierarchy_of_Needs.asp New laws against forced marriages: clear message 2008, BBC News, viewed 14 June 2009, http://news.bbc.co.uk/2/hi/uk_news/7747267.stm Paul, A, Cawson, P & Paton, J 2006, Safeguarding disabled children in residential special schools, NSPCC: Cruelty to Children Must Stop. Full Stop, viewed 14 June 2009, http://www.nspcc.org.uk/Inform/research/Findings/safeguardingdisabledchildren_wda48261.html The mental capacity act n.d., Directgov: Public Services all in one Place, viewed 14 June 2009, http://www.direct.gov.uk/en/DisabledPeople/HealthAndSupport/YourRightsInHealth/DG_10016888 Young, K M 2006, Social support and life satisfaction: abstract, International Journal of Psychosocial Rehabilitation, vol.10, no.2, p.155-164, viewed 14 June 2009, http://www.psychosocial.com/IJPR_10/Social_Support_and_QOL7_Young.html Read More