Children - the Reflection of the Society - Essay Example

Children The reflection of the society Children are the important part of the society. They become what the parents and the society make of them. They watch the adults, imitate them and aim to be like them. If adults want them to behave properly and be good, then adults have to set a good example in front of them. However, there are some children who are victim of negative circumstances in life and so need care and love from the care professionals. The case study : The case study is based on a 13 year old boy (Year 9 student). His pseudonym is Joshua. He lives in a rented house with his mother. He has no siblings, and all his close relatives live over 150 miles away. The family relocated after the divorce of his parents. His father has a history of mental illness (type of illness unknown), and his mother has cited domestic violence being the major factor in their marriage breakdown. Joshua has not seen his father since December 2007. The separation/divorce was believed to have been very acrimonious . Hence the family relocating north by 150 miles. Joshua and his mother have no contact with the paternal family, and only limited contact with his mother’s family. There would obviously be a child protection issue, if Joshua’s father wanted to become part of his life again. Joshua’s mother used to be a manager of a day nursery. But since Joshua’s illness, she has had to give up work, and become his carer. They have currently been turned down for DLA (Disability Living Allowance), due to Joshua, occasionally being able to walk home from school (note that school is only 2 minutes walk away). This highlights the fluctuations in his condition, some days he is unable to move and others he can just about get by. Joshu’s mother is appealing against the decision. Currently they are struggling financially , and they are also isolated from their family, and their normal family activities have been dramatically affected. Previously a very sporty and active young man, he has moderate CFS/ME – symptoms include, sleep problems, noise and light sensitivity, headaches, muscle weakness and pain. Currently he is on reduced timetable at school (timetable was negotiated with specialist nurse and senco and Joshua and mother). Whilst at school, he has the option of going into a quiet room, to get some rest. Initially this was the library but it was found that this still had too much stimulus around (eg, bright lights, and the disturbance from the hustle/bustle of students).People involved in his care are (specialist CFS/ME nurse, consultant, Occupational therapist, SENCO at school). The history of his illness: In September 2008 Joshua saw GP with a throat infection, in October 2008 saw GP complaining of stomach pains and in Nov/Dec 2008 saw GP, complaining of becoming extremely tired, having trouble concentrating in school, and poor appetite and subsequent weight loss. He was admitted to a pediatric ward in January 2009. He was diagnosed with Chronic Fatigue Syndrome/Myalgic encephalomyelitis (CFS/ME) in February 2009. He was recently prescribed 2mg Melatonin (Melatonin, Circadian Rhythms, and Sleep) for help with sleep. Need of service: Joshua was a child who was going through a rough time due to many things going wrong in his life. His parents were separated and he was being raised by single mother. He was an active child full of potential and bright future. However, he became ill and was diagnosed with CFS/ME. His mother had to leave the job and so there was financial burden. His mother herself was going through tough time and was not capable of taking care of Joshua alone. She was well aware that she needed help from the professional health career and also from the school administrators as Joshua, who was good in the school previously was showing signs of lack of concentration due to his physical problems. Any child who is in need of special education, experiences violence at home, has poor nutrition, is likely to suffer depression and has housing issues is a child in need of services (HM Government n.d., p6). Understanding chronic illness: Chronic illness is an illness that has an irregular pattern and continues indefinitely. Due to this reason, it has become a major challenge for the medical world (Lubkin and Larsen, 2005. p4). Chronic illness due to its nature of not getting cured completely, needs continuous, regular and a friendly health care. Due to its nature, chronic illness can create a feeling of worthlessness in a person and particularly in children. It can put tremendous pressure on a child to fight with these conditions and at the same time keep up with the competition and the demands and the expectations of the society and the family (Lubkin and Larsen, 2005. p6). Joshua was a child who was on the brink of adolescence. This is the stage where there are many physical, psychological and emotional changes in human being. This is the stage where people start getting attracted to opposite sex and a new chapter of romantic relationships begin in their life. However, if a person is suffering from chronic illness, the feeling of dependency and helplessness can create a negative effect on the child. There are chances of him losing his confidence and feeling hopeless. This can also affect the way the teenagers develop the interpersonal relationships ((Lubkin and Larsen, 2005. p6). Joshua being at the early stages of adolescence, it was very necessary to help him to manage his studies and personal life in such a way that it keeps his self esteem and confidence intact. Fatigue can also be a result of unhealthy and lazy lifestyle. It could result from poor nutrition, sadness, lack of physical exercise, fear, medication etc(Lorig and Holman 2003 cited in Lubkin and Larsen, 2005. p116). Chronic fatigue syndrome (CFS)/myalgic encephalomyelitis(ME) is one of the common illnesses. Because of its incurable nature and uncertainty about the treatment, it has the capacity to cause tremendous pressure on the person who is suffering from CFS/ME and hence can create burden on the families and the society as a whole. CFS/ME can cause symptoms like headache, malaise, disturbed sleep patterns and difficulty in concentration but also causes weakness through fatigue even by small amount of activity(National Institute for health and clinical excellence(NICE) 2007. p4). As CFS/ME is one of those illnesses that is yet to be fully understood and for which the treatment and management is yet evolving, it is a major challenge for people suffering from that illness and the health care professionals providing the service to those patients. Hence, it needs lot of care and understanding is needed on the part of the patient and the carer ( NICE 2007. p5). What helps the patient to cope with this prolonged illness and the suffering is the relationship with the carer. Hence it becomes very necessary for a carer to have a warm, mutually beneficial and loving relationship with the patient. The treatment and the care patterns should be decided after discussing it with the patient. In Joshua’s case, as Joshua was yet to fully understand his needs and take decisions, the schedule and the needs of Joshua’s were discussed with his mother ( NICE 2007. p6). I also made it a point to discuss his study lessons and his performance at school with his teaching assistance and special educational needs coordinators (SENCO). The most important thing was to make Joshua and his mother feel that even though he was diagnosed by CFS/ME, it was possible for him to improve over a period of time and lead a normal life full of activities. It was found that in case of children, if proper care and routine help from the professionals is followed, then CFS/ME improves drastically ( NICE 2007. p18). The symptoms like sleep disorder and loss of appetite in Joshua led to understand that he needed a proper sleep pattern and diet plan to help him get better eating and sleeping habits. Moreover, he was a vulnerable child so was in need of more care. Children are vulnerable: Children are the product of the environment and the families they are born in. Children from healthy, happy and financially well to do families lead a happy and healthy life. However, children who are from financially challenging background and from the unhappy homes are at great disadvantage. The personal and family life affects their life outside the home and hence they become vulnerable to many negative aspects of life ( Cox 2000, p56). Mother is the most important person in child’s life. She is the first carer of the child and if the child is not able to develop a healthy and warm relationship with his mother, then he develop emotional and social maladjustment in the later life. He is not able to form healthy relationships and gets involved in anti-social activities. This is particularly a case with the child of single mother. Joshua was a child who was going through a lot of problems at home. His mother was a victim of violence at home. This had made her to leave her husband and start her own life. However, it was not easy as Joshua became ill and started facing problems at school. This was a sign that Joshua was a vulnerable child. He was going through emotional pain and was not able to share it with anyone. If children are made to go through emotional and psychological stress due to financial or relationship problems at home, they become vulnerable to stress related problems and also to illnesses (Cox 2000, p60). As they are children, they are not considered mature enough to share their thoughts and feelings. This makes them more miserable and unhappy. This could lead to subconsciously attracting the illnesses and the disruptive behavior so as to attract the attention of people around them. Miseries at home can also lead them to get into the company of people involved in anti-social behavior and take out their anger on others through violence and disruption. Joshua was 13 years of age and this is a vulnerable age. To protect him from getting influenced by negative thoughts and feelings, it was very important to introduce love, understanding, sharing and caring in his life. Development of a trustworthy relationship was main thing so that he can share his true feelings and thoughts and gets the burden out of his mind. His vulnerability made me to spend time with him. When deciding the schedules or daily plans for him, I discussed it with him, took his opinions and explained why certain things were being introduced in his life. This made him feel that he is important and his opinion matters. It helped in developing his self-esteem and maintaining the optimism about life. Children are at risk : According to the Organization for Economic Co-operation and Development (OECD), ‘at risk’ is a term used to describe children and youth who are in danger of failing at school, or in making a successful transition to work. Educational, social and vocational failure are predicted by a range of factors , including poverty, ethnic status, family circumstances , language , type of school, geography and community. Thus the term ‘at risk’ refers in general sense to children and youth from disadvantageous backgrounds ( Day et al., 1997 cited in Cox 2000, p2). Schorr (1998) has described that some personal problems like poverty, unemployed parents, exposure to violence and lack of healthy and good people around are also some of the risk factors ( Cox 2000, p3). The vulnerability of children and the risk factors are interrelated. Due to disadvantageous environment at home, children are vulnerable to negativities of the society. Children who are vulnerable are at risk of getting affected in their life. In Joshua’s case, there are many risk factors like Joshua seeing his father again or losing interest in education and getting involved with wrong kind of people. However, a help at right time and by right people made it possible for him to follow a healthy life pattern. The best thing that happened to Joshua was the help that he got from the school. Children Act 1989: The 1989 Children Act, came into force on 14 October 1991,have been established to give power to children to take decisions regarding their life. The act is written in such a way that it puts the needs of the children first. The following are the important points of the Act (The national Youth Agency n.d.): 1.When a court or local authority is making a decision about a child, the first thought must be what is best for that child; 2. Children should be brought up in their own family whenever possible; 3.Children should not be taken away from their family without the familys agreement, unless the child is at risk of harm; 4. A local authority must give a family help if their child is in need; 5. A local authority must work together with parents and children; 6. A court must put children first when making decisions; 7. When children are being looked after by local authorities, they and their parents have rights. This has decreased the vulnerability and the risk factors of the children . Care program for Joshua: Joshua needed support on all his levels of existence like emotional, psychological, physical and spiritual. It was important to bring peace and love in his life. Getting connected with him emotionally was very important. The first thing that was needed to be done was to gain his trust and friendship. It was seen that Joshua had chosen many subjects for study. This was putting a lot of pressure on him. Moreover, the strain of attending classes for all the subjects was making him more weak and vulnerable. This matter was discussed with his teachers, his mother and SENCO, and it was decided that his subjects should be decreased. Moreover, he was also relieved from the tension of appearing for the exams. He was told that he will attend the classes only for those subjects which he found interesting and enjoyed studying. This made him happy and open to the schedules which were prepared for him. Understanding the risk factors and the possibilities of Joshua going in wrong direction, a good care was taken to develop a program for him where he gets freedom to decide what he wants and how he wants it, stress free environment and pressure free learning. This made him open and excited about the diet and sleep pattern that was suggested to him. The inconsistency of the energy levels makes a person suffering from CFS/ME to have low confidence level about the activities. They hesitate to indulge in activities fearing fatigue and weakness. This happens because of a activity called Boost and Bust where people do a lot on good day and later spend many days to recover from the fatigue. To keep away from this negative pattern, Jishua was suggested to follow some hygienic and healthy sleep pattern. Joshua was asked to do short activities following sort breaks which helped him to use his energy properly. He was asked to keep the record of activities and also set tangible goals without putting any pressure on himself. He was helped to set the goals with the aid of SMART approach which is to set specific goals, which can be broken in small steps, are achievable easily, are within limits and which can be achieved in time without feeling pressured (NHS, n.d.). Joshua’s diet was also discussed to help him conserve more energy. He was asked to eat less and more frequently than eat lot at one time. This helped him to gain more energy rather than feeling fatigued. He was also asked to follow the healthy sleeping habits like going to the bed at the same time, getting up at the same time every morning, keeping the room clean, taking medications regularly as prescribed and exercise lightly (Sleep Disorder Australia 2006). This helps the body to form a healthy routine and make the body clock work according to it. I visited Joshua to discuss all these schedules, habits and suggestions. I used to ask him if he is feeling well and if he needs anything else. This also helped his mother to understand his needs and helped her to understand how to take care of him. Jshua was at risk if his father came to meet hi, However, by making his mother strong and making him believe in her abilities, decreased the risk of he getting influenced by his father or any other negative influence of life. Moreover, my regular visits and follow up also was an effort to make the transition easy when there was time for it. Transition: For the people to lead be happy, healthy, successful and fulfilling life, it is extremely important for the children to grow into adulthood with the aid of excellent education, mature emotional outlook, healthy lifestyle and well-being as a whole. Most importantly, these developments should take place on their own and young people should take the responsibility of their own health rather than depending on others (Department of Health, 2006. pg). This is the aim of good practice guide developed by Department of Health and Department of Education and skills. Today’s young people are living in one of the most gifted times. Life has numerous opportunities, there are number of professions to choose from, internet has given them an opportunity to know whatever they want to know and parents are more than willing to help them get all the resources they need to be a successful person. Hence the transition from childhood to adulthood is becoming smooth. However, there are some children who are not able to take advantage of these possibilities. People like Joshua, who have long tern illnesses have great challenges to overcome before they can achieve this stage of transition. They have to face hurdles of physical pain, emotional maladjustment, social isolations and feeling of being a burden on others. These children who need a friend in a carer to help him survive the emotional distress, depression and lack of confidence have a chance of losing their hope if their transition from the child care services to adult services are not made smooth and emotionally fulfilling (Department of Health, 2006, p7). Joshua being one of those children who needed regular and consistent care and support, it was important for him and his mother to understand the lifestyle and the care that he needed to follow so as to become independent and take responsibility of his health once he reaches the adolescent stage. Transition is a process of making a child and his family capable, knowledgeable and emotionally and psychologically prepared to take the responsibility of the health of the child. Transition is not a single event but a result of productive relationship between carer and a child where a carer makes the child and the family to involve in the practices, explain the nuances of caring and helps them in knowing how to handle all the issues related to the illnesses (Department of Health, 2006, p12). Hence transition can be defined as ‘a purposeful, planned, process that addresses the medical, psychological and educational/vocational needs of adolescents and young adults with chronic physical and medical conditions as they move from child-centred to adult-oriented health care systems’(Department of Health, 2006, p12). Some of the important aspects of successful transition are : 1.Developing an attitude where transition is seen as a process and not an event where you think that now the responsibility is not mine. 2. Developing a mutual relationship between the patient and the healthcare professionals to who the children are going to consult later so that the transition becomes easy to handle rather than create an emotional emptiness in the patient(Department of Health, 2006, p17). 3.Creating an appropriate environment for the adolescents so that they feel at home and not left out. 3. Consulting and making adolescents aware of their physical conditions, their limitations and their potential is very important as it helps them to know themselves better and understand how to take care of themselves(Department of Health, 2006, p18). 5. Rather than keeping chronological age as a rigid criteria for transition, the emotional and psychological preparedness of the patient should be considered a criteria for transition (Department of Health, 2006, p20). 6. Some of the other important points of successful transition are making the patient learn the skills of maintaining his own health independently(Department of Health, 2006, p21) and giving the details of the environment, the practices and the programs plan for the year of the clinic they are being transferred to as it helps the patients to mentally prepare themselves to be a part of that clinic (Department of Health, 2006, p23). Following up with the person from time to time to see if everything is fine helps a lot for a patient to feel supported and cared for. Joshua is a future of the world. He is young, full of potential, at the impressionable age and a positive human being. It was extremely necessary for me to develop a warm and friendly relationship with him to keep him from making wrong choices in life. Not only that, but it was also important for me to give strength and share the best practices of caring with his mother so that she can gain his trust and hence develop a strong image of herself in heart of her son. Only when Joshua and his mother become a happy and fulfilling family and contribute happiness and growth to the society, will I feel that I have done my job satisfactorily. References Cox, Theodore, 2000. Combating educational disadvantage: meeting the needs of vulnerable children Routledge Department of Health, 2006. Transition : Getting it right for young people.[pdf] London : Department of Education and skills Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4132145 [Accessed June 15, 2009] HM Government (n.d.), The common assessment framework for children & young people” Practitioner’s guide. [pdf] Available at http://www.londonscb.gov.uk/files/library/caf_practitioners_guide.pdf [Accessed June 15, 2009] Lubkin, L.M., and Larsen, P.D. 2005 Chronic illness: impact and interventions 6th ed. Jones & Bartlett Publishers National Institute for health and clinical excellence, 2007. Chronic fatigue syndrome/ myalgic encephalomyelitis (or encephalopathy) : diagnosis and management of CFS/ME in adults and children. [pdf] London: National Institute for health and clinical excellence Available at http://www.nice.org.uk/nicemedia/pdf/CG53NICEGuideline.pdf [Accessed June 15, 2009] NHS, (n.d.) The activity cycle. Available at http://www.manchestercfsme.nhs.uk/document_uploads/Links/ActivityCycle.pdf [Accessed June 15, 2009] Sleep Disorder Australia 2006, Sleep Hygiene. Available at http://www.sleepoz.org.au/files/fact_sheets/AT09%20-%20Sleep%20Hygiene.pdf [Accessed June 15, 2009] Read More