Impact on My Life since Acquired Brain Injury - Case Study Example

Acquired Brain Injury Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Instructor Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Section A- Statement of the Case Study I am a 37 years old male living in Barcaldine in Central Queensland. I live with my wife and my two sons who are in their teenage years. I suffer from Acquired Brain Injury, an illness that has adversely impacted on my life ever since. My home is low set, but with four steps and 2 levels inside. My bedroom and the bathroom are on the upper level. I encounter several challenges living in my current home as it is because of my disability. I have difficulties accessing my bedroom as well as the bathroom, a condition that has led to being very independent on other family members during my everyday functioning. This has some effects on my mind for utterly relying on others is not very desirable, bearing in mind that this are some of the things I had managed to evade for a long time. I feel that I have totally lost my independence and I am a bother to people who I am left at their mercy. Acquired Brain Injury has had severe implications on my life to an extent that it is causing significant challenges to my quality of life. That tremendous change of evens has been detrimental to the way I normally carry out my activities. It has particularly affected my daily activities connected to household tasks and social interactions. As such, I can no longer be able to work in my previous occupation which needed commuting to and from office on a daily basis. This means that, some of the things I would do by my self and the resources I would acquire by myself are incapacitated. I can only work for a minimum of four hours per week considering the fact that I cannot wake up very early to report to work. Therefore, even for those minimum hours that I have to work, I am always forced to report to work very late. More so, living at my present home proves to be more and more difficult each day. This is because I have to seek physical assistance from my family members whenever I need to use the toilet. I also have to be escorted to my bedroom every evening before I sleep. This is making it difficult both for me, my wife and my sons. More so, they are supposed to rely on me, but on the contrary, I am relying on them and they are left with no option that to reschedule their activities so that they can be there for me. This is detrimental to the quality of life I am living and that of my family. Relying on other on some issues that maybe considered private is not simple, but this condition has left me with no option. Section B: Disability Awareness Acquired Brain Injury (ABI) is an illness that involves multiple disabilities which arise from damage to the brain after birth (Rushworth 2009, p. 50). It is caused by several factors including stroke, accidents, alcohol and other drug abuse as well as infections. ABI might also be brought about by degenerative neurological disease (Rushworth 2009, p. 50). The consequences of ABI on my body have been very complex, profound and devastating. I have encountered severe physical problems including headaches, seizures, poor balance and lack of coordination. During a normal day, I will experience several symptoms such as fatigue, visual and hearing imbalances and chronic pain in several joints of the body. In this context, the psychosocial-emotional problems that are associated with my condition are very debilitating. The physical effects of ABI include damage to specific regions of the brain (Fowler & Mccabe 2011). These could result into haemorrhage as a result of the rapture of the cerebral vasculature. While primary injury occurs to the brain at the time of the impact, secondary injury will usually evolve over a period of time (Fowler & Mccabe 2011). During other times, I will encounter difficulties in the use of my language, memory functions, impulse control, and judgement, and initiation, social and sexual behaviour. According to Fowler & McCabe (2011), damage done to the frontal lobes which are involved in performing motor functions in the body could cause the above problems. Unintentional falls are also a common incident in my everyday living with ABI. According to Rushworth (2009 p. 52), unintentional falls are a leading cause of all hospitalized injury in patients with ABI. These can cause considerable injury to the body. It also leads to unexpected trips, slips and stumbles. The World Health Organization (WHO) notes that injuries that arise out of falls can at times be very fatal to the patients. For instance, in the year 2002, a total f 391,000 was estimated to have died globally out of the falls (Rushworth, 2009).In 2003 and 2004, a total of 3,158 Australians were estimated to have died out of falls related injury and the falls keep increasing each and every year. Notably, the consequences of ABI have been devastating not only to me but also to my immediate and extended family members. According to them I have changed considerably in my cognitive, behavioural and emotional responses. I have had several emotional outbursts, at times much uncontrolled that it has affected my wife and my sons. My family as well complains of several impaired judgements I have made including difficulties in arriving at decisions of the things I want, poor decision making, poor planning and a big deterioration in my behaviours (Mahar & Fraser 2011). This has been the case over the last seven months or so, a situation that I fell is impacting negatively on my social relationships not only with my family but also with my extended family. There are international, national, state and local organizations that can help me cope with my condition (Chleboun & Hux, 2011). Internationally, the WHO works closely with the International Classification of Functioning, Disability and Health (ICF) in measuring health and disability at individual and populations levels. ICF information is accessible on the internet and helps users to understand its basic classification of concepts and damage (Eubank 2010). The Queensland government has set up the Department of Communities, Child Safety and Disability Services where patients can request for assistance, access disability information services and post their feedback and complaints.. It is an initiative that enables people with disability and their family to have a level of control and choice of their disability, support networks and services (Chleboun & Hux, 2011). There is also the Community Living Initiative which gives services for people with disability as well as to their families and carers. Community Living Initiative and the Department of Communities, Child Safety and Disability Services is the organizations I can closely work with to help me holistically manage my own daily activities of living (Chleboun & Hux, 2011). As such, these would adequately provide me with support and information services. They will also provide mw with domiciliary nursing, community nursing and community respite services (Kelly & Parry 2008) Section C: Daily Living Living a day with ABI is no easy task. It gets worse from day to day. I have encountered unimaginable difficulties going about my daily activities and household chores. Some of the issues which were the easiest for me are nowadays the most difficult for me to handle. This has not been easy for me to synthesize all. However I am left with no other wise. My story is not ordinary. I go shopping only on rare occasions and I rarely drive. My life revolves around the schedules of others for I can barely make it by myslelf. At times, I have had to take easy and lighter jobs so that I do not push myself to exhaustion. Which means that, I totally rely on others and most of the tasks I am expected to perform I can because of my condition. Life has never been the same again and it takes courage and perseverance to manage my day to day life. The table below summarises my average daily living routine, the ease and difficulties encountered and the cost implications that go with my condition. Time/Activity Ease of doing an activity or participating Barriers/ Facilitators I have encountered My solutions to Overcome the Barrier Approximate Financial Cost Incurred 7am: I wake up and get out of bed 2 No bed rail to use An electronic bed would help 5 dollars a day 7.15am: Going to the Toilets 3 When I am experiencing immense fatigue Physical assistance " 7.25am: Showering and Cleaning up 3 Unable to stand Require personal assistance 10 dollars a day 9.00am: Washing Utensils 4 Memory loss- forgetting completely to wash the utensils Require personal assistance 5 dollars a day 10.00am:Washing Clothes and hanging 4 Physical assistance Required 15 dollars a day 12.00 noon: Preparing my lunch 4 Fatigue and dizziness Requires physical assistance 5 dollars a day 12.30pm: Unhanging laundry and Pressing 4 Immense tiredness Physical assistance 15 dollars a day 4.00pm: In my Study for some Reading 2 Fatigue and tiredness I need more resting Nil 5.00pm: Preparing tea and Snacks for the Children 4 Tiredness Requires physical assistance 5 dollars a day 8.00pm Preparing Supper and Serving 4 Tiredness Requires physical assistance 10 dollars a day 9.00pm: Retire to Bed 3 Absence of rail bed Need electronic bed 5 dollars a day This therefore means that, maintaining my condition is expensive bearing in mind that I can no longer work as I used to. I must have a person to cater for me even in some issues which are minimal and this means that, I have to pay for some tasks which are even minimal, for my condition does not allow me to strain. Each day has its challenges and I have to braze myself for the days ahead. Section D: Challenges The International Classification of Function, Disability and Health (ICF), have been used to describe the various social restrictions that patients with Acquired Brain Injury (ABI) have had to face (Chleboun & Hux, 2011). The disability has touched several aspects of my social life especially in a negative way. I can say that it has affected me directly or indirectly through my experiences with friends, family, colleagues at work and even members of the community at large. Generally, there are negative attitudes from the society and stereotypes which are a major disabling factor for the affected (Crewe et al., 2012). Some of the social restrictions that I have had to face include: Constrained relationships exist between me and my family members. For instance, there is complete change of roles in my family. Behavioral, cognitive and personality changes that have followed my condition have had significant impact on my family members. Perlesz, Kinsella, & Crowe (1999, p.7), such changes will often have negative impact on the family. Moreover, relatives of people with ABI have been proved to be severely distressed (Perlesz, Kinsella & Crowe 1999, p. 7). In a review by Perlesz, Kinsella, & Crowe, (1999), on TBI family outcome literature, most relatives had stress and burden in caring for patients with ABI. It can impact on the spouse, siblings and children (Dalton et al., 2012). At times, my wife experiences high levels of anxiety and distress due to my condition. She cannot predict my moods and emotional outbursts and this leaves her distressed and anxious. it affects her psychologically. Sometimes it starins our social relationships.I also have a feeling that my children are being affected psychologically. Having this condition has had at least some negative consequences on my ability to parent (Doering et al., 2011). There has been substantial increase in the problems encountered between me and my children. Much of the responsibility of taking care of the children has largely shifted to the mother. As a consequence, they seem to be more closer to their mother than they are to me. Poor family and marital adjustment is evident in families that deal with ABI (Sander et al., 2007). It is also hard because we are currently experiencing financial hardships due to the increased costs incurred due to my condition. In essence, more levels of friction have been reported within families with a potential trend of the conflict increasing within the first 12 months after the injury (Eriksson, Tham & Fugl-Meyer, 2005). More so, negative personality changes have a greater tendency of causing problems within the family (Fowler & Mccabe, 2011). A day will not pass without quarrels and friction. This has adversely affected my family relations of which I think is in dire need of professional psychological counselling. According to Duff (2006, p. 9), families need expert guides to help them grasp the impact that ABI on their lives and the magnitude that it can have on the relationships. There are also several community and environmental challenges I have encountered. ICF indicates that these are socio-cultural factors, the services available to me and the physical architectural space. These restrictions result from the fact that I am unable to interact successfully with my environment. In Mahar & Fraser (2011),is clear the consequences of acquired brain injury are very profound and debilitating. The changes that occur following the disease are often difficult to understand and as a consequence, many of the patients are unable to integrate successfully into the community (Kearney & Pryor 2004, p. 166). The reason for facing social restrictions in the society and for encountering a lot of environmental challenges is because the community has developed perceptions that patients who suffer from ABI are fully impaired and are thus not able to serve any constructive purpose in society (Kelly & Parry 2008, p. 295). Moreover, people with acquired brain injury are extremely intolerant, incapable of restraining themselves and are unable to resist an impulse or temptation (Langlois, Rutland-Brown & Wald 2006, p. 375). As such, they do not receive very good treatment from the society. Their impatience and irritability are prone to adverse reactions from the rest of the society members. Moreover, aggressive behaviour is often associated with ABI (Mahar & Fraser 2011). It is one of the most aggressive and disruptive aspects in patients with ABI that impede social interactions and reduce a person’s social opportunities (Shames et al. 2007, p. 1389). Most of my social restrictions are faced because of my aggressive behaviour and sudden moments of depression that I sometimes display as a result of my condition (Svestkova et al. 2010, p. 69). Many patients, including myself, display level of impulsivity and disinhibition, social withdrawal and impaired judgements (Eriksson, Tham & Fugl-Meyer 2005). These have made me face a lot of environmental and social restrictions. Irritability has at many times precluded me from social assistance and appropriate care. As a result of the environmental and social challenges, I have had to make various adjustments and changes in my life. I have rescheduled my work schedule; I always do domestic chores whenever I can so as to ease some burden from my wife and children. There are also some environmental changes that could lead to full community participation. For instance the provision of occupational therapy may help people like me to simplify some work tasks. Since fatigue is sometimes aggravated by hot environments, provision of cool environments to me at the work place and even at home may have positive impacts. Provision of wheelchairs will actually help in times of extreme fatigue and dizziness (Wolters et al. 2010, p. 588). More so, strategies like employing people with disabilities who have skills and expertise will also help in the workforce population, which is a good strategy towards encouraging community participation of people with Acquired Brain Injury (Tsaousides et al. 2009, p. 399). Measures must also be taken to help the patients to reintegrate into the family and community life. Challenging behaviours displayed by ABI patients pose great difficulties for the families and the society to accept and adjust the conditions surrounding the same victims (Kelly et al. 2008). As the behaviour deteriorates individuals face social restrictions and a lot of environmental setbacks (Kelly et al. 2008, p. 457). I may react to my disability in a negative way. I may hate myself, blame myself and at times blame fate and destiny. But I have been advised that the best way to deal with the concepts of self-image, my self esteem as well as my body concept to see beyond my disability (Fowler & Mccabe, 2011). There are many negative attitudes and moral stereotypes in society that will actually fight to disable me more and bar me from fully participating in work and community life. But the best I can do to myself is to work on overcoming the barrier of misconception and the prejudice I face and work solely towards aspiring to be a useful asset in the society. In dealing with my body image and self conception, I may be required to deal with some issues like examining short term and long term broad consequences of my disease and then come up with ways to deal with them positively(Chleboun & Hux, 2011). Another probable and recommendable strategy is to maybe share some personal information about myself, in my counselling sessions for instance. Just the fact that I suffer from ABI does not mean that I do not have dreams that I aspire to attain. It good that I also share some of these dreams, ambitions and aspirations with the teams that are sent from the Queensland Society as well as the local organisation of the area. This will help a great deal in helping me cope with the situation while still maintaining and improving on my self-esteem. To boost my body image, I should not also let my dreams to be affected by the disease (Chleboun & Hux, 2011). I should also adopt a strategy that will help me deal with instances of denials, maybe in the family, in the community or at the workplace. High levels of anxiety, depression and emotional outbursts need to be put in cheque. Failure to comply with the therapist will also affect my motivational spirit. I should work hard to maintain it. The only way that will help me maintain myself concept, as I have been advised is to cultivate the ability to accept my changed body image, which will boost my self esteem high and also improve my levels of competence in any work that I undertake. The professionals treating people with the disability are mostly volunteers of the charitable organisations that are engaged in such work. The ones from the Community Living Initiative for instance, are mostly referred to as the caregivers. Normally, they are most often the spouses of the patient, due to their closeness and their availability. At times there could arise issues of pity and paternalism when in the course of carrying out their work (Fowler & Mccabe, 2011). There is an aspect in societal view of the sick that they are meant to be pitied. This is because they are mostly seen as not being able to determine their own needs and meet their desires. Therefore, they are assumed not to be able to achieve the same status as their counter parts who are not physically disabled. Such an attitude is in contrast with the code of ethics of professionals which dictates that the social workers should embrace the concept of empowerment (Eubank 2010), i.e. imparting in the patients with multiple sclerosis information on how they can empower themselves (Caroll & Coetzer, 2011, p. 291). Self-efficacy and the independence displayed by the health professionals towards their patients if of great importance (Eubank 2010). According to the World Health Organisation definition, the social workers must encompass capabilities such as self esteem, self efficacy and confidence, autonomy, which equals independence and ability (Barnes, 1999). These factors are what contribute to the positive empowerment of the people with disability. Generally, an empowered individual is supposed to display certain qualities (Eubank 2010). These are the ability to be in control of their own life as well as the personal health of the individual these aspects are very important in contributing to ones quality of life including the ability to decide, act, and also gaining the ability to influence the political grounds either through communication or even through physical manipulation. One of the major core responsibilities in professional responsibility of social workers when dealing with patients with disability is the duty to promote the self empowerment of the patients. 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