Concepts of Disability Rheumatoid Arthritis - Case Study Example

Name: Tutor: Title: Concepts of Disability Course: Date: Concepts of Disability Rheumatoid Arthritis Section A: statement of the case study I am a 35 year female living in Mt Isa in North western Queensland. I live with my husband and one child who is small. My home is set at lower levels, with a number of steps towards the door and staircases for the upper floor.. All the bedrooms, bathrooms and the study are in the upper floor. I can only work for 5 hours a week since my figures are knobby with nodules. This has affected my quality of work and forced me to quit. The cocking up of my toes and presence of calluses at the bottom of my feet limits my movement. My movement at the stairs and steps is also limited since my knees and Knuckles’ joints are swollen. Section B: Disability awareness Rheumatic arthritis causes inflammation in the joints and tissues around the joint. According to Shiel et al (2012), the body immune system attacks the body system which is considered to be a mistake. He states that, the disease affects the usually activities of the infected such as driving, cooking dressing and even sleeping. Synovitis causes swelling in the synovial membrane around the joints and the tendon sheath. The joints become and movements limited, this spreads to other joints in the body like the cervical spine, hands and feet. Majithia &Geraci (2007) note that, the stiff connection of the tissues limit movements and corrode the surfaces of the joints leading to malformation and less functioning. Apart from the stiffness, the disease also cause pains in the joints. Apart from the joints, Rheumatic arthritis also affects the skin. Rheumatoid nodule is one of the skin deformities where the skin around the infected tissue forms a firm touch. This is normally caused by positive Rheumatoid factor, severe corrosive arthritis and titer most commonly in the elbow and fingers. Rheumatic drugs also expose the skin to infections Schoenstadt (2012). Drugs such as the corticosteroids mimic cortisol, a natural hormone and can cause contraction in the skin and expose it to bruising. Non steroidal anti- inflammatory drugs also cause the skin’s sensitivity to the sun. The skin is also exposed to rashes by the drugs. The biologics category of the disease modifying drugs (DMARDs) may cause rashes on the skin around the injected parts. The disease has affected my eyes, which have become painful and red. It has affected the white part of the eyes. It has also led to Sjogren's syndrome where by my eyes generate tears as a result of the immune system attacking the lachrymal glands. I feel dryness and coarseness in the eyes. This can cause scratching in outer membrane that covers the eye. The mouth also becomes dry due to reducing production of saliva. Rheumatoid arthritis causes fibroids in the lungs and affects the functionality of heart and blood vessels and the kidney. It causes pericardium effusion, which is the accumulation of fluid between the pericardium membrane of the heart and the heart. This condition can stiffen the membrane and destroy the functionality of the heart if it persists. Rheumatic arthritis causes rheumatoid lung disease (Robins et.al, 2010). Chronic inflammation can lead to renal amyloidosis of the kidney by attacking the glomerulus (Groot, 2007). Being a mother of a small baby, the disease affects my relationship with my baby since I cannot always carry or be with him. According to Chai (2010), children need care which a parent suffering from RA may fail to provide.since my son is of a tender age, understanding the condition is hard for him. Fatigue and pain caused by the disease leads to depressions, and lack of intimacy which puts marriage at risk. Communication is also limited by this aspect and this leads to rejection. It reduces the earning capacity in the family since the disease reduces the ability to work and forces the patient to quit employment. Some extended family members might find it as a bother to cope around a patient with Rheumatic arthritis. Daily activities are limited by the pains, limited mobility and loss of energy. This makes social interactions almost impossible. World health organization is an international organization that protects people with disability and also engages in research for diseases affecting people worldwide. The organization offers health information on diseases and statistical data through online sources like its website (www.who. Int/en) and support services via the telephone. It also offers local support services through partnerships like the AusAID-WHO partnership. Australian Institute of Health and welfare is a national organization that also offers support and information on rheumatoid arthritis. North West Hospital and Health service is the organization in my area that will help me holistically manage my daily activities. It is located in the Gulf of Carpentaria, in the North western of Queensland and offers services to the local communities within the area. The hospital provides services on management of chronic diseases such as cancer and rheumatoid arthritis. The hospital also provides counseling services for spiritual and psychological help through volunteers and support groups. Section C: Daily living The disease puts barriers in the my activities of the day from the early morning activities like getting out of bed, to shopping and even visiting the toilet. Activity Ease of doing activities (0-4) 0 = No difficulty 4 = Complete difficulty Barriers and facilitators encountered Solutions to overcome the barriers Approximate financial costs Getting out of bed and moving up and down stairs 2 Unable to get up without support Adaptive standing and walking aid  $99.95 Dressing 2 Unable to pull zips bottoms or adjust straps Ring zipper pull. Button aids, Velcro straps $3.95 Visiting the toilet 3 In ability to stand   $99.95 Feeding 2 Lack the grip to cutlery Good grip utensils set $39.95 Hygiene and grooming 3 Unable to hold and grasp objects Utensil cuff (small utensils like toothbrush) $ 8.95 Shopping 2 Unable to carry heavy stuff Use trolleys and taxi or family drive Watching television 0 Remote control Fixed channels 0 Driving 3 Unable to control the steering well Quit driving 0 Working (writing) 3 Inability to hold pen for long Ring Pen $9.95 The disease can lead to over dependence on help from family, friends and caregivers. However, although costly, gadgets can be used to facilitate independent living. Physical exercise and therapies eases the arthritis condition to a large extent (Tourinho, 2008). Although diet has little significance to the condition, vegetable and plant oils, more of fruits and vegetables, bread, fish and less meat help. Section D: Challenges Social restrictions Social activities Rheumatoid arthritis poses challenges in the patient’s interactions within the society. There are social restrictions that I face as a result of my disability. Shopping sprees with friends and family become a once in a while activity where walking is restricted. The disease affects individual energy and walking becomes tiresome. Holding and carrying the shopping mall carts also become a problem. However, not always do I not go shopping, but the number of times especially for a normal mother and family person reduces. I miss going for sports, dances and walks, since even if I attend such events, my movement and participation is limited. However, these activities are part of the physical exercises that help get through with the disability of the feet and fingers. The doctor allows walking and other involving activities but advises that they should not be over-done. Skiing and aerobics are my favorite sports; however the system cannot support heavy sporting. Needle work, however exhausting and risk because of hurting, is also a good exercise for the fingers. Family and friendship relationships Every mother desires to play around with the child and family, and have fun together. Rheumatoid Arthritis limits these activities since the level of activity is limited. The pain brought about by the disease causes depression, and family and friends find it hard to cope with such attitudes thus affecting relationships. Talking helps me relieve the pain and cope better with my relationships. Support from friend and family, especially my husband also helps in managing the attitude. He offers emotional, financial and physical support and becomes more understanding. Friends help me with shopping and at times child care. They understand that the shopping frequency reduced, and instead help me do it. The gadgets for independent living also reduce dependency and helps in maintaining good relationships. Since most of the time I am home, I try to spend more time with my son, although I do not carry him much so that he might not feel neglected at a tender age. Sexual relationships RA causes pains and affects sexual relationships. Talking with my husband has helped a great deal in managing our relationship. Organizing joint appointments with the doctor and arthritis specialists improves understanding and helps in managing the disease and relationship. Environmental challenges RA also involves community and environmental challenges that need adjustment and understanding. Limited movement and physical involvement are the major effects of rheumatoid arthritis. This has also been my major problem. CDC and ICF is dedicated to developing the environmental needs for arthritis victims, and provide these needs to make the community suitable for both the people with disability and those without (Bruyère, 2005). However, I have had to adjust my life before the organization AID comes in by getting involved in community activities such as disability campaigns, using my movement supporting gadget. Movement does not also prevent me from keeping the home clean and avoid pollution around. This has also changed my activities and reading habits. Since RA limits physical movement mostly and not the brain, apart from loss of energy, time spent reading about the disease and other books is also good since it helps when meeting with other victims and also explaining to family and friends. It also reduces pressure and serves as a way of managing stress and attitude. Discrimination both n the positive and the negative is part of the community challenges. People in the community tend to treat people with disability differently. This includes favors in public places, shopping malls and within the family. Although it is a symbol of kindness, it also demeans since at times it makes me feel less of a person when people know my condition and treat me with favors. People in the community need to treat people with disability well but at the same time, should not deny others with more ability what they deserve for the same reason. Some people in the society also view disability as something unwanted. This leads to discrimination in services, places of work and gyms. Having a positive mind and understanding such people helps me cope around them. Suggestions Support organizations need to develop easy sports for all people with disabilities with an effort to help the disabled. This sports should involve less energy but beneficial to the individuals. Since the support equipments are expensive, such as electronic beds, wheelchairs, the government, through support organizations should provide such facilities for free for those who cannot afford. This also includes counseling services and therapies, where the government can provide subsidies. Holding campaigns against discriminations (negative) and public training forums will help reduce discrimination. Trainings allow a wider range of people to understand RA condition and improve their interaction with patients. Campaigns and legislations warn discriminators of harsh penalties against such practices. The legislation should also set laws requiring ramps for all institutions and facilities for wheelchairs. Personal perspective Self concept Rheumatoid arthritis is definitely a crucial disease that strikes fear. My perspective from self concept, the condition destroys someone only if they allow it too. The diagnosis of the disease causes rejection of oneself in the early stages. I thought I was going to die soon because of the decease. Personally, the disease is like a death sentence but getting to know it better proves this wrong. It changes one’s life from an independent strong and performing person to a dependent person relying on people’s favor and sympathies. RA changes people’s lives around, forcing changes in order to adjust to the existing condition. The difficulty in commuting and pains can lead to frustrations and without counseling, people develop nasty attitudes. Although working becomes tiresome and might not be able to do some things at work ,than one was used to, an RA patient will tend to be resentful even to help offered by coworkers and might find it difficult to ask for help from them. This leads to excuses to get involved with people and some team members will not understand the limits of one’s strength when suffering from arthritis. Body image and self-esteem A personal perspective on body image and self-esteem is that, however the diseases deforms and might trigger loss of self-esteem, knowing and understanding oneself helps to keep the head high and focus on other goals in life. RA leads to body deformities and although some are to visible to other people, a patient tends to think the whole body has lost its image and that is completely deformed. This affects self esteem and personality of an individual. The stiffness of feet and fingers completely changes the body image at developed stages. Modes of dressing and movement also changes in order to cope with the sickness. While still working the aspect of self realization might be lost and job satisfaction might no longer be a priority. Reading, therapy and counseling helps to revive the continuing spirit. Rehabilitation and health care professionals Pity should not be part of health care professionals while rehabilitating people with disability. However, they should be friendly and understanding. Pity demeans the disabled and makes them feel they are nothing and they can do nothing. They must also communicate this to their patients that self pity will not help but destroy them. Health care professionals must avoid paternalism by behaving that they are in control of everything. Rehabilitation involves reviving the individual and they should be allowed to understand that they are in control of their own activities, in order to boost their morale. The professionals should be able to determine the Self efficacy of patients rehabilitated and note their paths of development. This will enable them understand better the needs of patients, what they already have and to what extent they need support in order to be fully rehabilitated. Independence in rehabilitation improves trust between the therapist and the patient. The trust contributes to the healing time that a patient under goes since they are motivated. Conclusion At 35, mother of a small child and wife, having RA is a very big challenge developing and maintaining family and friendship relationships and on a personal perspective. Attending counseling and support from families help cope with the difficult times. The environment and social restrictions also pose challenges; however, support organizations and the government intervention make it possible for existence of the disabled. Heath care professionals also serve a major role in the rehabilitation of people with disability. References Shiel, J.W,C., MD, FACP, FACR (2012). Living With Rheumatoid Arthritis medicine. http://www.medicinenet.com/rheumatoid_arthritis/article.htm Majithia, V. G. SA (2007). "Rheumatoid arthritis: diagnosis and management". Am. J. Med. 120 (11): 936–9. doi:10.1016/j.amjmed.2007.04.005.PMID 17976416. Schoenstadt, A (2012). Effects of Rheumatoid Arthritis. eMedTV. Robbins, S.L., Kumar, V., Abbas, A.K., Cotran, R.S., Fausto, N. (2010). Cotran pathologic basis of disease. Elsevier. p. 205. ISBN 978-1-4160-3121-5. Groo, K (2007). "Renal manifestations in rheumatic diseases". Internist (Berl) 48 (8): 779–85.doi:10.1007/s00108-007-1887-9. PMID 17571244. Chai, A.F (2010). Family effects of Rheumatoid Arthritis. Bollot & Woyzbun (2009). A picture of Rheumatod arthritis in Austarlia. Australian institute of health and welfare(AIHW). ADAM RINDFLEISCH, J & MULLER, D. (2005). Diagnosis and Management of Rheumatoid Arthritis. Queensland health hospital (2011). Profile for North West Hospital and Health Service. Tourinho T.F., Capp E., Brenol J.C. (2008). Physical activity prevents bone loss in premenopausal women with rheumatoid arthritis: a cohort study. Rheumatol Int. Bruyère , S., VanLooy, S., & Peterson, D. (2005). The International Classification of Functioning, Disability and Health (ICF): Contemporary literature overview. Rehabilitation Psychology, 50(2). Read More