Posted at 11.25.2018
I am a student of the HNC in Sociable Care and I use an organisation that promotes cultural inclusion of Adults with Learning Disabilities with communal support through group work and one to one befriending. Throughout this newspaper I will also make reference to our service participant as Dan and our service as the Group. This isn't the real name of our own consumer or our group. By doing this I am complying with our organisations insurance plan of confidentiality. This insurance policy was made to comply with the (ref 1) Data Cover Act of 1998. This Take action ensures client confidentiality, that any information written about a client is accurate, truthful and any ideas are objective, substantiated by factual information. The Take action also allows the individual to make a formal application to start to see the information held about them by the Group.
To complete this piece of work I have evaluated Dan`s needs and organized out a bit of work which has addressed an determined need.
I read his existing activity plan as a starting place as it got his medical information included, this allowed me to update the information at Dan`s evaluation. This first examination had been done by my manager some time ago and so I discussed Dan`s circumstance with her before I found with him. Our activity programs are flexible enabling the changing needs in our clients. The duty undertaken also complied with our organisations constitution which specializes in social inclusion of people with learning disabilities.
The diagnosis of needs is the first stage in the good care planning process. Our organisation takes a person centred planning methodology. A person centred care plan is devised to 'enable' people, to aid their social addition, and also to ensure people are not devalued within modern culture.
It was necessary for me to hear what my customer needed, to differentiate his needs from his wishes and also to ensure that I possibly could take action to deliver a positive final result. A need is something he really needs instead of a want which is something he would like to have. Evaluating a person for needs is the technique of collecting information, recording the information and interpreting the information.
The assessment occurred at our office soon after his someone to one art treatment as he was comfortable and believed safe here. Under (Ref 2) the Legislation of Good care (Scotland) Act 2001 Dan has a right to feel safe and sound. I did so a Risk Analysis of the areas which complied with the (Ref 3)Health insurance and Safety at work Act 1974. It was very important to me to continue gaining his trust and use good communication skills. I used the SOLER technique which got us both resting squarely facing each other showing that we was being involved, I had developed an open pose implying i was non defensive, I leaned frontward slightly showing a personal interest, I needed regular eyes contact also conveying a pastime in Dan and I got a peaceful manner. I used lively listening which engaged me trying to understand the real issues influencing Dan and acquired a meaningful dialog with him.
Our reaching was timed to go on no longer than twenty minutes as his attention period can be brief if he is bored. I ensured that board maker signs and visual products where available, to guide his attention if he do get bored.
I used both open up and shut questions which allowed me to get factual answers from the sealed questions and his viewpoints and emotions from open up questions.
I discovered his behaviour all the time and I spoke to him in a way he understood. I wrote the info gathered in a concise manner in the form stated inside our organisations policy and procedures. Even as we do not source a attention service, we aren't required to sign-up with the Good care Fee, but we ensure all our procedures and techniques meet their standards.
As all clients under these expectations are officially allowed an assessment of needs and an individualised treatment plan, the form I used was called the Activity Plan.
The Care percentage was create under the Rules of Treatment (Scotland) Action 2001. This Work came about to regulate the treatment and social work force and lay out the principals of proper care practice. During our reaching I was conscious that I needed to explain the care planning process to Dan, and I used the visual products when necessary.
Dan was created in 1949 into a society that had unveiled the IQ test in 1930, whereby those rating low have been considered "mentally defective". By 1946 and the intro of the NHS, this term was transformed to emotionally handicapped and so required "treatment" in companies. Dan was considered as being in this category.
There is not a generally acknowledged description of a learning disability and there is a continued debate of this is. However, there are specific features that are arranged.
Those with a learning impairment have problems with educational success and expansion.
An uneven routine of their human development is apparent i. e. physical, perceptual, educational and words improvements. . (Ref 4)
The (Ref5)NHS and Community Good care Function of 1990 applied in 1993 and (Ref6)the Man Rights Take action of 1998. , observed the closure of the institutions. This observed the motion of people with learning disabilities out of establishments into being cared for locally, either by their own families or in small reinforced housing being cared for by the voluntary sector.
"Exactly like You" strategy of 2000(Ref 7) by the Scottish exec is focused on providing fairness, equality and interpersonal inclusion for adults with learning disabilities. As a result of this strategy the local community create the "Group" to provide socialisation to assistance with social inclusion of individuals with learning disabilities through someone to one befriending and group activities.
Dan lived inside a nuclear family unit where he was presented with the basic real human requirements of food, shelter, clothing, love and socialisation to live on until the era of 6. He was created into a modern culture where it was common for young children with learning disabilities especially people that have Downs Symptoms to be institutionalised. There is also a communal stigma designated to people that have learning and physical disabilities.
Dan's family insisted in caring for him at home until school years, but his educational needs where not achieved. He also is suffering from "anxiety attacks" which his father says he developed at this if six, when taken in to the car for the very first time. He reacted by lashing out and tugging wild hair. The "anxiety attacks" received by his daddy as a justification for Dan`s disruptive behaviour. His behavior was tempered by his mother, who had to be regularly by his part cuddling him and having his palm during his stressed moments. His parents performed everything for him, until he was institutionalised. Here, he was raised where privateness, choice, dignity where missing and he was not permitted to take hazards. Life skills, education and highway work where not given. More often than not in the past, these "patients" where drugged if indeed they showed any indications of disruptive behaviour. Being "locked up" moving into Nightingale wards with communal living and toilets may have also contributed to his "anxiety attacks".
These "anxiety attacks" still triggers Dan to act in a challenging manner if he feels hemmed in, especially in packed places without obvious method of escape. After 1995, when federal government strategies of closing large establishments were executed through the(Ref8) Disability Discrimination Take action 1995 and its amendments of 2003 Dan was presented with a home within supported accommodation as his dad was elderly.
Dan did not like to venture out unless his daddy was with him and tended never to connect to anyone when presented. His "panic disorders" triggers him to be agitated when his exercises change.
He sees it difficult to make selections unless they are simply limited and is also not keen on striving anything new. He is unable to read or write, he does not have any life skills e. g unable to make a cup of tea, make a slice of toast, shop or clean his home, he's unable to cross the road without help. The physical developmental level Dan has reached is that of a grown-up but the emotional level is that of youth between 2-12 years, probably nearer the age of seven or eight. He has been living out with the top establishment for six years now but hasn't learned to improve his behaviour appropriately. This can be therefore of being told by his support employees that he cannot do certain things as they deem certain activities to be a risk. Staffing problems also contribute to having less his change in behaviour as time constraints in assisting Dan learn new skills tend to be given as an excuse for staff not being able to assist Dan attempt new things.
So, I really believe he is still institutionalised although he lives in smaller community shared accommodation. He was presented with no choice concerning where he'd live, who he'd be sharing with or who would be promoting him.
With the assistance of his family, before being institutionalised he was able to meet the bottom level three periods as observed in Maslow`s hierarchy of needs pyramid. (Ref9) Abraham Maslow was a humanist psychologist who developed this model between your 1940s and 1950`s. He stated that human being needs can be set up in a step ladder pyramid which the low level needs must be satisfied before higher levels can be found.
This model consisted of eight levels. He stated that individuals are all motivated by need as developed over thousands of years. He mentioned that we must fulfill these needs in turn, starting with the first. The first need is the physiological need which is e. g having food, air, drinking water, etc, the needs to allow our anatomies to survive. The second need is that of physiological and physical security, whereby there is certainly security from possible unsafe circumstances and things. The third need is belonging and love, which is being part of several relatives and buddies in a loving situation with trust popularity and passion. The fourth need is esteem which is value of self and others. The fifth need is self actualisation which is realising personal potential. The fifth need is Cognitive needs with knowledge and understanding. The sixth need is Cosmetic needs which is the appreciation of symmetry, beauty, order and form. The seventh need is self- actulisation which is realising ones full potential and the eighth need is transcendence which is aiding others to fulfil their potential. Dan, as functionalist sociologist (Ref10) Talcott Parsons (1902-1979) argued, will have gained his primary socialisation and emotional stability within a nuclear family of two parents, a mom and dad, plus his siblings. Principal socialisation can be defined as a means where the norms and principles of culture are trained to children plus they learn to agree to these worth within the family. The functionalist sociologists believe world can be in comparison to a full time income body, with different organs (organizations) having different functions yet all working along to keep the body (world) alive. They consider the family to be a small version of world which operates as a interpersonal, economic and emotional unit.
The turmoil theorist think that society is separated into two classes, with the bourgeoisie and the proletariat who are in odds with each other. The family, discord theorists state is merely another social organizations which contribute to the approval of public inequality. Every member calls for difference jobs at certain times in the family life routine and discord happens within the family when a person challenges those tasks, e. g young adults challenging parental power.
Dan lived within an institution from age six so his extra socialisation was to figure out how to live within the confines of the establishment. This socialisation could have been radically not the same as a family situation. (ref11) Research demonstrated that concerns grew about the treatment given by corporations "quality of good care provided by these corporations in terms of gross physical deprivation
(overcrowding, poor food, clothing and environment), mistreatment (ill-treatment, theft of
possessions and over-use of medication and restraint) and overlook and inactivity (lack
of care, lack of contact and activation and extensive cycles of disengagement and
isolation" personnel and client interaction and proposal in important activities could have been poor. As a result, no chances where available to allow Dan to move to the next degree of Maslows Pyramid of Needs of self-confidence.
(Ref 12) Dan was the youngest member of the family and so regarding to Alfred Adler this would have affected the type of personality that he would develop down the road. The youngest are known to get their own way also to have a better parent bond, which Dan did
Have as he was overprotected and indulged before hospitalisation. But, this cocooning may also be claustrophobic. But, by being institutionalised, regarding to Erikson, his environment would also have damaged Dan`s development and also have had a direct effect on his behavior.
The behaviour Dan often displays can be discussed by the behaviourist theory, that was named (Ref 13)"Learned Helplessness". While experimenting on canines using Pavlov`s theory of Classical Conditioning, which ultimately shows links between the stimulus and the response. Seligman learned that learned behaviour is a results of the belief that the person`s activities are futile. People who have lived in Institutions have learned not to expect to have any control over their lives. Behaviourist theorists believe that if behavior is discovered, then it can be unlearned. Lev Vygotsky and Russian cognitive psychologist assumed that development was guided by culture and social communication with significant parents. Being institutionalised will have reduced Dan`s chances of having regular important communication with a significant adult. Vygotsky explained that to learn a variety of duties that are too difficult on their own, a child must be shown or led by a person who is more educated. This became known as the "Zone of proximal development". This assumes that the kid has the capacity to memorise and the capability to remember the learned experience. This isn't always possible in some with a learning impairment. In the treatment placing where Dan spent his life, the probability of a child being challenged to learn new skills would have been reduced or non- existent. Vygotsky was the first to observe that public isolation caused a delay in both communal and cognitive development.
The "anxiety attacks" Dan is suffering from may also be discussed via Operant Conditioning advised by B. F. Skinner (1953). Operant Conditioning is where behaviour is followed by a outcome.
His behavior of lashing out when he's anxious is because positive encouragement where initially this bad behavior was rewarded by acquiring physical and emotional contact from his mom before institutionalisation and later attention from nursing personnel in the organization.
Positive reinforcement is where the consequence is a confident final result. Now, Dan`s support personnel make an effort to ensure that Dan does not come into a situation that may make him troubled.
After the death of his seniors mom Dan relied totally on his elderly father for just about any ongoing socialisation, as his siblings experienced long kept home to set up their own family life. (stats to be put in)
His dad feared Dan would become isolated, especially as his dad was becoming less in a position to take Dan away. Dan was unveiled to join the Group by his daddy so that they can expose him to new friends, increase his self-confidence and improve his self esteem. His time at the group has seen his self confidence increase. After moving away into the community, Dan was alternatively introverted and shy and would only go out together with his daddy. This worried his ninety yr old daddy greatly, therefore his father came to our company in the anticipation that we could increase Dan`s social group. Dan was assessed when you are asked a number of questions using PIES to establish what his Physical, Intellectual, Emotional, and Public needs were. These details was placed into his activity plan which we use instead of a Care and attention Plan. As under the NHS and Community Treatment (Scotland) Take action 1990 many people are entitled to a good care plan. Dan will have such a plan set up by the cultural work office.
To increase his communal circle as wanted by his father, we included him in a number of activities which includes expanded his range of interpersonal activity and made him less isolated. Dan`s physical needs are attained by social services, but his intellectual needs of mental excitement, his psychological needs of having to increase his self esteem and his interpersonal needs of cultural relationship require attention.
Dan has recently improved his public skills through artwork by now connecting well with our staff and is keen to have his work home showing to his family and carers. His dad has commented how the communication skills of Dan have increased and his confidence has increased. Remembering Maslow`s Hierarchy of Needs, I had fashioned evaluated that Dan would reap the benefits of reaching the fourth stage - Esteem Needs. I felt an activity that may help to improve his self-confidence, his communication skills and make him less anxious in a huge group situation would be beneficial. I spoke to him and noticed him answer my questions. Among my questions gave him a selection of activities to try, I came across that the activity he was most considering was fine art. I coach both at the skill group and on an individual basis, which helps men and women with learning disabilities gain new skills, gain assurance, improve self esteem, socialisation and self
actualisation through ingenuity. Carl Gustav Jung a Swiss psychiatrist B. 1875 to D. 1961 inspired patients to work with art to mention their unconscious feelings. He explained that (Ref14) "drawing, painting, and modeling may be used to bring unconscious materials to light. Once a string has become remarkable, it may easily pass over into the auditive or linguistic sphere and present surge to dialogues and the like. " (1941)
My purpose was to attempt to put coping mechanisms in destination to allow him to have the ability to take part in the graded unit activity which was to allow him to make a work of art and to exhibit at our Malawi Consciousness Night, which we expected to be active.
This activity is to occur some weeks away so that it was very important to me to set up new art work activities over a period of time, to permit him to gain self confidence in being part of a big group. My goal through these activities was to allow Dan the opportunity to increase his self-assurance and communication skills also to develop coping mechanisms to allow him to deal with his fear of large groups. I have used the (Ref 7) task-centred model in planning this exercise; this is a short-term problem dealing with approach over a brief period. This experienced five phases- Problem Identification (evaluation), Contract, Planning goals, Obtaining Tasks and Evaluation. Here, the client will take concrete action to solve the problem. THE ORIGINAL interview or period allowed Dan expressing his need to have more assurance when in an area with an increase of people to become able to enjoy more activities. He wished to complete a painting and also to be present at its exhibition. To accomplish these goals, we decided on the steps and tasks that allowed Dan to achieve his goal. We emphasised the responsibilities that were required to be completed to permit Dan to exhibit his work of art and agree on timescales for the tasks.
Other interviews will needed place to ensure that we were on the right track and that Dan noticed safe and comfortable doing the decided tasks.
With Dan`s arrangement we decided to offer an hourly someone to one befriending art work session of three one hour sessions weekly over four weeks and also to increase these periods to become a group session. To do this I had a need to slowly introduce increasing numbers of people to the group. These were other service users, personnel and volunteers. With agreement of everyone included I helped bring people in one at the same time each session. I did so this by giving each individual a time frame and time to join us at the "Group" premises.
I hoped that by the end of the four weeks he would have the ability to sit in a room gladly with at least twelve noisy people. He had to truly have a positive experience also to have an optimistic connection with the group. Dan liked a regular cup of tea and a chocolates biscuit, therefore i introduced this positive experience to him in the group setting up while he was painting.
I guaranteed he sat facing the door and prepared him that he was able to leave the area at any time. I sat him at the end of the desk to ensure that he did not feel hemmed in.