Traumatic Brain Injury, Disability Awareness - Case Study Example

Traumatic Brain Injury xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Lecturer xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date Traumatic Brain Injury I am a 37 years old female living in the city of Charleville in western Queensland. I live with my family which includes my husband and two small children who goes to school. My home is a low set one, with 4 steps, and has 2 levels inside with my bedroom and bathroom on the upper level. Being a disabled woman after having a traumatic brain injury for the last one year, challenges such as cognitive, physical, emotional or independent functioning exists in me. Section B: Disability awareness The disability that i am living with has affected me in different ways. Since i suffered the brain injury which led to this disability, at first i experienced problem in recalling the traumatic event. In most of the times i become so confused and having difficulty in learning as well as remembering any information that is given to me. In addition, the speech was affected such that i cannot speak consistently, and the body always shake. Lack of coordination was another problem experienced whereby it was impossible for me to maintain the relationship between the relatives and the friends as well as vision and hearing what other people were saying. The disability that emanated from brain injury made it impossible for me to do housework such as cleaning the house, washing utensils, laundry, ironing clothes and attending to my two children (Breivik 2006). It affected my family members emotionally and financially. Walking was also another problem and i used to walk using skates. It was hard for me to go to the toilet alone and i needed assistance in that area. Caring for my body was not that hard such as brushing was not a problem to me because my family is so supportive and used to give me the requirements needed and i do it myself, dressing was through the help of my carer while eating and drinking i do it myself. My personal assistant used to acquire goods and services for me for instance shopping; i was in a position to prepare the meals with the help of my children and the husband, but the carer used to cook. Assisting other people was not possible for me because of my situation. Effects of Disability in the family There are various factors that affect the well being of the family both immediate and extended. One of the factors is the emotional and physical health of the parents; this is because a parent is the heart of the family. A parent deals with the issues that are related to children’s health, provides care to the family members (World Health Organization 2003). In addition, a parent deals with issues of the children’s school and the professionals working with the children. The relationship between my families has been a factor that has influenced the well being of the family and especially the immediate one. Despite the disability, my family and relatives kept close to me, and this realization that there are people who cares despite the situation as, makes one strong. The support and understanding I got from the family and relatives helped me to ask for the assistance whenever I needed it. The family and the relatives made an effort to ensure that they reduce the problem that was connected to the disability through problem reducing actions. They maintained and convinced me that change as well as the relief is likely and assisted me in fighting feelings of passivity or giving up. Their attitudes were reflected in different actions such as efforts in training the impaired functions, helping to learn compensatory techniques as well as training how to use technical aids. Thought they sometimes seem to be worried much over me, sometimes I feel it is not good for them to make decisions for me. This is important because it helps one to be independent and fight feelings of helplessness as well as beliefs that result uncontrollable, depending on chance, or in the hands of other people (Person & Ryden 2006). Supportive Organizations Organization Support information BlueCare: through internet Modifies houses to suite people with disability and refers clients to more specialized services where essential Prescribe and support use of specialized equipments for disabled people Queensland Government: through non-governmental organizations Provide accommodation support Information and support for carers Disability information and support (Queensland Government UnityCare Community: through internet Offers disability support services Shared care and family support services for people with disability (UnityCare 2013) Organizations and their Services Organization Services provided Domiciliary care services Offers home care support which includes personal are, meal preparation, domestic tasks as well as shopping Holiday escort, outings and special events escorting Short term holiday support Night sitting or sleep services Respite care Residential (live in) care which enables one to maintain independence in the comfort of home Respite care Mostly offers emergency services to people such as incase of unplanned situations or unexpected trips which make a need for an urgent care by an alternative caregiver Offers personal care Home health aide services such as assisting the patient in bathing, dressing, toileting as well as exercising Gives companionship services to people with companionship and supervised activities Offers homemaking services or maid services such as laundry, shopping as well as preparing meals Skilled care services assists with medication and other medical services Assist the client to adjust in environment Section C: Daily living Table Time/activity Barriers or facilitators You encountered Your solutions to overcome the barriers Approximate financial cost to you 8am: getting out of bed Use of skates A suitable bed that is about a 100cm bed height ( floor to top of mattress) $ 549.00 (GetPrice 2013) 8:10am: toileting Unable to stand Helped by personal assistance $ 78.00 per day (Open UniversityAustralia 2013) 8.30am: bathing Unable to self bath Assisted by personal assistance 9.00am: dressing Unable to stand helped by personal assistance 9.30am: taking breakfast Unable to walk Served by personal assistance 11am: exercising Have impaired functions Assisted by medical profession $ 167 per day Open UniversityAustralia 2013) 1pm: taking lunch Unable to cook Cooked and served by personal assistance 3.pm: going for shopping Done by the care provider 4pm: washing the children and giving them some drink Unable to serve them Served by the carer 5pm: supper preparation Unable to stand Done by the carer 7pm: taking supper Unable to walk Done by personal assistant 8pm : watching movie Unable to stand Done by the children 10pm going to bed Unable to walk Assisted by personal assistant Section D: Question 1: Maintaining Relationships Maintaining family relationship There are many social restrictions that a disabled person faces; one of them is maintaining the relationship between the families. A family is a vital resource for a disabled person because they help in adjusting. Sometimes it becomes hard for them to bear with the disabled person whereby they needed advice in order to assist them in coping with the disabled person. The advice they got minimized the stress as well as disturbance which was within the family. The care in which they were advised to provide to me was focussed on how a potential stressor can interact with family resources for dealing with crises as well as the meaning in which the family is attached to the event. For instance, my caregiver was at some point over-reacting to challenges, which resulted to stress in me. In this case, I would have preferred a caregiver who is adopts a calmer problem solving approach to the challenges (Organization 2003). Maintaining relationship with friends Despite being one of the vital factors for a disabled person maintaining a good relationship with friends, it became hard for me because of the situation. For instance, I was not in a position to maintain the relationship with friends, this is because I was not in a position to walk, I walk using a wheel chair. In this case, it was hard for me to attend to social gatherings, birthday celebrations and such. Despite having invitation, the hotels that the gatherings were taking place were not that accommodative to people with disability. They lack the facilities to accommodate disabled people, which in other words is a physical restriction to access the place as well as the services for people with disability. This made me feels excluded and made me get social stigma. on the other hand, I was always making an effort to keep the intact relationship with my close friends by inviting them for a cup of tea(Organization 2003). Relating with strangers As a disabled person, I did not understand how other people will behave towards me, and this made me fear to meet them. I had a perception that strangers might reject me because of my disability and I feared that they might stare at me as a way of rejecting me. This affected me so much and I feared that it might turn out to be a permanent problem that might affect my future social life. My first time to appear in public since I became disabled was an event of great anxiety and distress. I experienced uneasiness which repeatedly occurs every time that I appear in public. My family supported me and encouraged me not to be distressed as well as not to pay much attention to the ones staring at me (Organization 2003). Question 2: Environmental Challenges Trauma brain injured adults are faced with environmental factors like physical, social and attitudinal which forces them to change their former status to cope with new reality. I had to adapt to low social profile created by too many restrictions imposed to my life in order to deter my movement, I had to change my free lifestyle where I used to visit my friends anytime. Sound was also irritating because of too much noise from our children and other electronic devices insulted in our house. I had already developed sensitivity in noise whereby any kind of noise was irritating something which I had to cope with. Sometimes the light was problematic but I had to change to accommodate it. I had to be denied free movement and most of time I was locked up in a room to avoid escaping or interacting with others (Winkler et al. 2011). I had to accept this new reality in order to live happily with my family and society at larger. I lack space because most of times a spent indoors without choice. Lack of choice was unavoidable which affected me psychologically. I was no longer responsible of my daily and actions but someone else was to assume that responsibility of ensuring that everything goes as stipulated. In addition, before the trauma I used to express myself freely without fear but now everybody is keeping close eye on my actions. Furthermore, my privacy is jeopardized and nothing is private with most of activities requiring assistance from somebody else. I have to change from independent to dependant because I cannot walk, bath, shaving, drying, dressing, drive and even lift or carry any object (Keysor et al. 2010). On social arena, to interaction with my family members had changed a lot and are not interacting freely with me as their used to be. They treat me like a child and sometimes handle me with caution thinking I might be aggressive to them. Visits are kept at bay to avoid my contact in fear of harassment. I find it hard to stomach these but am forced to change my attitude to accommodate such changes. Most of drugs stimulate me too much to a point of influencing my emotions. At this point people think am totally traumatized which is not the case. Use of transport means like motorbikes, vehicles, train and plane is no longer convenient to me since I use skates and wheelchair as a means of transport (Winkler et al. 2011). The community needs to provide professional skills to all stakeholders in health care of trauma brain injured patients for better care. Wheelchair, skates and other equipments for such patients need to be provided with affordable prices. Carers and health care providers need to understand well the needs of their patients to improve the care. Through therapeutic program the patient will come to accept his/her new environmental realities and live happily. Free of choice sometimes is needed for the patient to free better accept. This will be possible if the care is person-centered to cater for patient’s preferences and decisions. Society needs to interact with them freely and show concern to boost their perception (Soeker 2011). Question 3: self concept, body image and self esteem Self concept and self esteem are important variables for people with disability. This is because, the identity configuration among the individual with disabilities is normally powerless by the way society represents them as outsiders in the current world. As a person with disability, am always aware of the negative concept that society has towards people with disability, which they regularly present as being immature, are ridiculed and sometimes considered as a threat and which I shared sometimes. I feel that the society that we live in fail to acknowledge the boundary between having impairment as well as being able bodied. It never recognizes that we as disabled persons qualify as able bodied along all dimensions of functioning throughout our lives. Disability should be viewed as part of the human condition rather than basis of setting an individual apart, or a characteristic lessen one’s humanness. On the other hand, at some point I compared myself with other people and this was the outcome of the low social esteem I got. In regards to this, much negative information that derived from this procedure was as a result of significant limitations in the intellectual functioning. In addition, any of the adaptive skills has been a great threat to my self esteem. Some of the customary limitations I face are conceptual, social, as well as practical adaptive skills. In most cases, people with disability frequently loss self, sometimes, I go a procedure during which I negotiate my life in such a manner as to be common as possible and therefore hold on to some contacts with desired life worlds. I become incorporated and have to follow some directives that will render me acceptable by doing the best I can. I refer the conformity as normalization, but in the real sense it is assimilation since I strive to live a life of a non-disabled while am disabled. Despite the fact that people with disabilities are entitled to exercise their civil social, economic or cultural rights on an equal basis with the rest, the disability summarize a great number of distinct functionality limitations which happens in any residents of any country in the world. As a person with disability, I always withdraw from various family activities, and avoid travelling with public transport routes. In addition, sometimes I get trouble expressing my thoughts or feeling and I have to let the people around me understand by having some body movement. As women with disability, am often stigmatized because of the violation of norms of my body aesthetics and body shape. I always internalize body norms as well as reacts to the nonconformity to the societal body standards. This also makes me feel as if am rejected and results to anxiety as well as loss of social support. Question 4: Paternalism, self efficacy and independence Rehabilitation is at the heart of nursing practice across the continuum of care, despite of the patient’s age, diagnosis or setting. Maximising the patient’s potential is the goal of nursing. Nurses in the rehabilitation centre helps patients and their families to make sense of what has occurred, what is occurring to them and what might happen in future, especially where the parent is the patient (Pryor et al 2008). They build up a good relationship with patients and family members and offer emotional support. The nurse and family members of the patient should maintain normal bodily functions emphasizing on prevention as well as physical protection. It is the responsibility of the nurse to assist the patient to incorporate new learning, in relation to their activities of daily living, into their daily lives. Self efficacy is the extents to which the patients believe they have the ability of perform certain work. This may entail any new movement or manoeuvre that they are taught that might form part of an activity of the daily life. The confidence of the patient in his or her ability, influence the adoption of healthy behaviour model, as well as maintain those patterns in the face of difficulty and minimize the body’s physiological to stress. Self efficacy can be evaluated by asking the patient direct how hard he / she consider a particular rehabilitation activity to be. For instance, consider that the target skill is learning to relocate from bed to chair securely and independently. The patient can also be asked how confident he/he is in doing this task daily for the next one week. It is necessary to use a percentage scale from 0 to 100 whereby 0 represents no confidence and 100 is full confident, the numbers between represents different degrees (Larner 2004). The rehabilitation approaches of a disabled person should be client centred; this means that the client should be viewed as the most important person in guiding the kind of intervention offered. The disabled person in the rehabilitation cannot be independent, this is because, and most of the people in that place are not in a position to do things on their own because of their condition. Therefore, they always need someone to support them in toileting as well as pushing the wheelchair. The client should always be involved in making decisions regarding their health. In addition, the disabled person needs a health profession who assists in exercising the impaired part of the body in order to heal quickly. Additionally, the patients need medical practitioners for medication reasons. Despite this, the quality of the care given to the patient may turn out to be ineffective if the health professionals fail to take into consideration the needs of the disabled person. In this the rehabilitation need to be client centred (Shaheed et al 2012). References BlueCare Queensland 2013, Available at http://www.bluecare.org.au/Care-and-Support/By-Service/Disability-Services.aspx GetPrice 2013 [Online] Available at: http://www.getprice.com.au/single-bed-beds-mattresses.htm [Accessed Friday November 2013]. Government of Queensland 2013, Available at http://www.communities.qld.gov.au/disability/support-and-services/our-services http://www.uccommunity.org.au/disability Keysor, J, Jette, M, LaValley, P, Lewis, E, Torner, C, Nevitt, C, & Felson, T 2010, Community environmental factors are associated with disability in older adults with functional limitations: the MOST study, The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 65(4), 393-399. Larner, S, 2004 Common psychological challenges for patients with newly acquired disability. Nurssing Stanadrd, 19(33), p. 3. Open University Australia 2013 [Online] Available at: http://www.open.edu.au/careers/community-service---not-for-profit/social-workers [Accessed Friday November 2013]. Pryor, J, O'Reill, K, Bonser, M 2008 Rehabilitation for the Individual and Family. Ryden, L, Pearson A 2006 Themes of effective coping in physical disability: an interview study of 26 persons who have learnt to live with their disability. compilation journal, Issue 20, p. 355–363. Shaheed, M, Rensburg, V, Travi, A 2012 Are rehabilitation programmes enabling clients to return to work? Return to work perspectives of individuals with mild to moderate brain injury in South Africa. Are rehabilitation programmes enabling clients to return to work?, Volume 43, p. 172. Soeker M, Rensburg, V, Travill, A 2011, Are rehabilitation programmes enabling clients to return to work? Return to work perspectives of individuals with mild to moderate brain injury in South Africa, University of the western cape, Belville. UnitingCare Community Queensland 2013, Available at Winkler, D, Farnworth, L, Sloan, S, & Brown, T 2011, Moving from aged care facilities to community-based accommodation: Outcomes and environmental factors, Brain Injury, 25(2), 153-168. World Helth Organization 2003 ICF Checklist, Australia: World Health Organization . Read More