Understanding Special Needs In Health And Social Care

1.1 Understanding the concept of disability illness and behavior According to Barnes (2004) there are three things that make a person to depend on other people for him or her to survive. They are disability, illness and behaviours issues. Disability is defined Corker and French (1999), as the inability to perform daily activities essential for one to live independent life. Disability can be classified under different category. In one such category it can be classified as acquired disability or prenatal disability. Acquired disability refers to disability that one acquires after his/her birth. Major cause of acquired disability includes accidents, exposure to dangerous chemical, illness among other (Corker and French1999). Prenatal disability refers to disability acquired before birth. There are several factors that contribute to prenatal disability which include genetic disorder, pregnant mother consuming alcohol and tobacco, complication during birth among other factors. Disability can also be classified according to it type which include vision impairment, hearing impairment, mental impairment, physical disability among others. Illness is defined as sickness that has effect both the body and mind of the victims. Illness affects the independences of the person affected. During the period of sickness which might be temporary or long term, the sick person may depend on others. Chronic disease such as cancers, diabetes, arthritis, back pain among other led to permanent disability (Jones 2003) When an individual lack the ability to recognize, control and express his emotions, he exhibits behaviour that are obvious. This condition is commonly known as behavioural issues or behaviour disability. Behavioural disability affects the ability of person to live independently (Emerson 2001). There are two concepts of disability namely medical concepts and social construct. These two concepts differ on how they perceive disability. According to Shakespeare and Watson (2002), medical concepts are a model of disability that argues those disabled people are unhealthy. This concept has be fault on the ground that, it regards disabled people as sick people but not that case. Social construct on the other argues that disability is not the problem, society is the problem. Proponent of social construct theory argues that disability is mere a condition that the society should learn to live with (Shakespeare and Watson 2002). 1.2 Assess how perception about special needs have changed over time. Analysis of the available literature has shown that, there has been a major change in the way disability is perceived. The perception about disability has gone through major changes which are discussed as below. The initial/first perception about disability In the early 1200 through to 1970, disability was seen as curse and evil thing (Abberley 1987). These perception was create by religion belief was very strong by that time. People believed that, when God was angry about someone or his family, he would punish them through disability. This perception influenced how people with disability were treated by the society. According to Barnes (1991), in this period of time the society did not take care or was not concerned about the welfare of the disabled. In fact they were humiliated by being called name such as idiot, mad, nuts etc. they was also oppressed and sometime they were murdered. The second phase of perception Perception of disability as evil thing changed in 1800s onward. This change was triggered by advancement of knowledge in medical field .Due to advancement in knowledge, people with disability were understood to be sick (Barnes 1998). In other word evil perception was replaced with unhealthy perception. It was generally understood that people with disability were unhealthy and such they needed medical treatment. Hospitals was turn to be their new homes and doctors and health care professional was the people they used to see on daily basis Third phase of perception The unhealthy perception of 1800-1900 had been replaced by another more recent percents. In 2000 on word a new perception about disability emerged. People with disability are no longer perceived as unhealthy but were seen as disadvantage. The perception is based on the notion that disabled person are less fortune but that does not make them less important in the society. This perception triggered also of activism activities to fight for the rights of disabled person which were originally denied. Another characteristic that signifies this latest perception is the increase in affirmative action. Organization both private and public created and offered employment to people with disability. 1.3 Effects of legislation, social policy and culture on delivery of services to support individual with special needs In order to ensure health and social care services are delivered to individual with special needs, several legislations have been developed. The major one includes the health and social care act 2012, care act 2014, the equality act 2010 and the mental capacity 2005. The health and social care act (2012) specifies the role of different parties in delivering services to people with special needs, for instances the acts give local authority a legal responsibility to ensure health and social care needs of people in their area of jurisdiction are assessed and addressed. The acts also specify what health and social care organization should do to ensure high level of services is delivered to support individual with special need. For instance the act required patients to be involved in all decision making processed relating to their treatment. Equality act 2010 ensure that individual with special needs are not discriminated against in access to health and social services. The care act 2014 was developed mainly to unsure the is proper spending on money set aside through personal health budget to support individual with special need the mental act 2005 relate to support offered to individual with cognitive impairment. The acts ensure that health and social care services offered to individual with mental illness are in the best interest of the patients. Culture also affects the ways services are delivered to individual with special need. As noted by Armenakis and Kiefer (2007), people have a collective expectation about the health and social care services and it is upon the system to respond appropriately to those expectation Armenakis and Kiefer (2007), also noted that some culture may encourage consumption of health and social care services than others. 2.1 assess the care needs of person with special needs Care need has been classified in several categories by different health and social care professional and academician. According to Hannom (2013), care needs for people with disability can be classified as physical needs, spiritual need, emotional and psychological needs and sexual needs. Hannom define physical needs as those basic necessities that a human being require to survive. They include shelter, clothes and foods. Spiritual needs refer to the freedom of practices religious belief such as fating, prayers, attending church, temple or music. Emotional and psychological need refers to the needs for companionship and emotional supports that is normally provided by loved one such as relatives and friends. Sexual needs refer to the desire to have sexual satisfaction which might be achieved through sexual intercourse, use of toy or oral sex. According to Hannom (2013), all of the above needs might be openly expressed by the individual experiencing them or may not be openly expressed but individual felt them. Hannom noted that the role of care worker is to ensure that those needs whether expressed or not should help the person feeling them to satisfy them. Duck (2012) classified care needs as expressed needs, felts needs, normative needs and comparative needs. According to him expressed needs are those needs that are felt and openly expressed by the person feeling them. For instances when person say he is hungry, he is actually expressing his need for food. Felt needs refers to the desire for something felt by a person with special needs but they are not expressed due to factors such as inability to communicate, fears etc. Normative needs refer to the essential requirement need by service user that is identified by health care professional especially through studies and researches. For instances, when health and social care professional recommended that all kids should be vaccinated against a certain prevalence disease, then, vaccination become a normative needs. Comparative needs refers to a essential requirement that is not currently available to a person who needs it while at the same time there is another person or group of persons who similar needs is satisfied (Duck 2012) 2.2 currents system of supporting individual with special needs The several successful government has tried to establish and ideal system to support individual with special needs. Much has been done in term of policy and legislation development. The current system is governed by several laws and policy which include the health and social care 2012 Act, care Act 2014, and SEND green paper and personal health budget. Health and social care Acts 2012 and the Care Act 2014 provides a legal framework that guarantees delivery of high quality health and social care services to individual with special needs. Health and social care Act 2012 ensures that individual with special needs receive personalized services, they are treated with respect and their dignity is uphold, their views, opinion and choice of services is taken into account and health and social services is made readily available to them through local, authorities. Care acts 2014 on the other hand ensure that money set aside for people with disability are not misused. The Act put limits on personal health budget. The send green paper is a policy that was developed specifically to ensure people with special needs are included in the main stream schooling system (Ministry of education 2012). The policy ensure that not children with special learning need is segregated when it come to education. The policy guaranteed children with special need access to education in regular schools from elementary school up to university. It also empowers parents of those kids to choose the best schools for their kids. As mentioned by ministry of education (2012) the major objectives of Special education need and disability (SEND) policy is to improve the life outcome of children with special education needs by adopting an early intervention approach where children as young as two years old are assessed for special education needs and intervention taken where necessary. The personal health budget on the other hand is a funding program developed by government to enable people with special needs pays for health and social care services they needs. With the personal budget, people with special needs are empowered to access health and social care services and products of their choices (DH 2013) 2.3 Availability of services to cater for individual with special need in Royal borough of Greenwich Health and social care services to cater for individual with special needs are readily available in almost every locality. In Royal borough of Greenwich there are several services designed by the local authority specifically to support individual with special needs. The local authority conduct simple and regular hearing impairment test on children as well in adults with the aim of offering support to individual with hearing impairment. It also offers hearing aid equipment where necessary. Other that hearing impairment services, the local government also provided services to other form of disability including mobility and blindness where it facilitate acquisition of the necessary equipment to promote independent living (Royal borough government 2015). Other than the services offered by local government, there are other offered by private organization. For instances, the new lodge riding centre offer specialised services where children with disability are taught how to riding horse. The centre also allows the children to feed and groom the horses (new lodge riding centre). Services such as these one not only help the children with special need to stay healthy through exercises put also provided them with an opportunity to mingle and make new friends therefore improving their social life. 3.1 approaches and intervention to support individual with special needs Approaches are defined as a method of doing something. In health and social care context, approaches refers to those method adopted in delivery of health and social care services. The most common approaches used include partnerships approaches, self management approaches and the evidence-based approaches. Partnerships approach refers to a collaborative method of delivering health and social care services. In this approach, several different party work together toward the achievement of certain objectives (Eldridge and Martins 2006). For instances, the general practitioner, the nurse, the social worker, the patients and his family may all work together toward management of certain health condition. As noted Eldridge and Martins (2006), this approach has not only results to delivery of high quality services but has also resulted to innovation of better ways to manage a certain condition resulting to improvement in health and wellbeing of patients. Self management approach refers to a method of delivering health and social services by empowering the patients with the right information and equipment where necessary, to self manage their condition even in the absences of health and social care professional (the health and social care Scotland N.d). As long term condition prevalence continue to increase in UK, the need for self management approaches is also increasing and will continue to increase. This approaches help reduce care burden on care workers but also at the same time contributed to improved health condition of patients as they understand their condition well than anybody else Evidence based approaches is a ways of delivery health and social care services based on evidence. In this approaches, any intervention to be used on patients must be scientifically proven to be effective (marsh and Fisher 2005). National institute for care excellence is the organization mandated to provide guideline on the intervention strategies which are supported by evidences. This approaches replaced the risky trial and error approach. The use of evidenced based approach has not only resulted to improved health and wellbeing of patients but has also resulted to a decrease in medical related errors (Marsh and Fisher 2005) There are two intervention strategies that are common in health and social care services .i.e. pharmacology and non-pharmacology intervention. Pharmacology refers to the use of drug to treat a certain condition or diseases (Meunch and Hamer 2010). Drug such as anti depressant, anti dementia and other are good example of pharmacological intervention. Non-pharmacological intervention on the other hand is the use of other ways to managed and treats conditions and disease other than using drug. There is several type of non-pharmacological intervention which includes cognitive behavioral therapy, environmental therapy, and music therapy, among others ((copper et al 2013). 3.2 The effectiveness of the pharmacology and non-pharmacology intervention Several studies have been conducted to establish the effectiveness of pharmacology and non-pharmacology intervention as used in health and social care study. A meta-analysis conducted by Bannuru et al (2015) found that pharmacology intervention was the most effective in dealing with pains associated with special needs. However, pharmacology intervention has been found to be ineffective in dealing with actual cause of special needs. According to a study by copper et al (2013), Pharmacology has little effect on dementia one of the leading causes of challenging behaviors. This finding was supports by a literature review and meta-analysis conducted by Megan et al (2015). Despite pharmacological intervention being effective in reduced pain related to causes of special needs, it side effective on user make it unattractive option. As noted by the use of pharmacological intervention to manage challenging behaviours may do more harm to an individual rather than good, in some cases it pharmacological has been blame for turning patients into zombie like human being (Meunch and Hamer 2010) Non-pharmacological on the hand has been found to be the most effective especially when dealing with cognitive impairment and behavior related issue. According to Cooper et al (2013), Non- pharmacological intervention is very effective in changing in dealing with challenging behaviors. For instance, environmental adaptation has been found to be effective in reducing the occurrence frequency of wandering for people with dementia (Cooper et al 2013). 3.3 Assess the impacts of the current development to support individual with special needs Major development to support individual with special need has been recorded in the recent past. One of the major developments is the continued emerging of assistive technology. Assistive technology is define by VODG (2013) as the used of modified devices to help people with special needs perform day to day live activities such as cooking, mobility, bathing, etc all essential for independent living. There are a lot of assistive technology that has emerged in recent years including powered wheel chairs and scooter, modified bed, modified kitchen item, modified computer and their accessories, modified transport facilities and many others all specifically design to enable people with various special need live more quality live. As technology continue to advance, it is likely that most of today’s barrier faced by persons with special will be no more. However, as noted by ADASS (2013) technology break barriers while creating new one at the same time. It is likely that some barrier will be created. 4.1 explain the concept of challenging behaviors Challenging behaviors is any behavior that is culturally incorrect or behaviors whose intensity and frequency put the life of other in risk (Emerson 2001). NHS protects (2014), define challenging behaviors as behaviors that are not obvious. There are several factors that can contribute to challenging behaviors including environmental factors, cognitive factors physical and psychological factors (NHS protect 2014) There are three concepts of challenging behaviours that has been developed over the years. The first concept to be developed was known as the lay model or the concept of oppression as called by Abberley (1987). This model was developed pre-industrial era, when people believed that challenging behaviours was and evil. This concept associated challenging behaviours with evil and as such people with challenging behaviours was seen as possessed by evil spirits. They were therefore oppressed and left to die (Abberley 1987). Lay model relevance diminished as medical knowledge advanced. Lay model was therefore replaced by medical model. In these concepts challenging was understood to be a medical condition. People who exhibited challenging behaviours were now seen as unhealthy people who should be in hospitals. This concept contributed a lot to the establishment of mental health facilities as well as increased hospitalization of individual with special needs (Barnes 1991) The third concepts are the social construct model. According to Shakespeare and Watson (2002), the social concept is a thinking that people are born different and it is upon the society to learn how to live with people with diverse body structure and ability. 4.3 impacts of challenging behaviors to care organization The equality act 2010 requires NHS organizations to offer services that are not discriminatory on any ground including mental disability. To comply with this regulation a lot of adaptation in environment is required to support various challenging behaviours in an organization. These adaptations may prove costly for care organizations as challenging behaviours vary from individual to another. Additionally some of challenging behaviours expressed by patients are aggressive in nature and May results to damages in property or harm to individuals in health and social care facilitates(NHS protect 2014). These may not only increases operation cost for the organization but may also paralyze operation especially when the damaged property or injured person is essential to services delivery. As noted by NHS protects (2014) the ways in which care organizations respond to challenging behaviors can have impacts on it reputations. In the process of dealing with challenging behaviors, organizations may attract bad publicity and increased litigation cost especially where the governing laws such as equality acts 2010, mental capacity Act 2005, Human rights Act 1998, health and safety Act 1974 are not followed (NHS Protect 2014). 4.3 Strategies for dealing with challenging behaviors Challenging behaviors may be a stressful thing to deal with. Proper strategy to manage challenging behaviors is therefore needed. However as noted by skill for care (2013), there is no singles strategy that is appropriate for dealing with challenging. This therefore means that challenging behavior need a personalized strategy. The strategy developed to deal with challenging behaviors should respects the patients, uphold his/her dignity, be in the interest of the patients, promote independence of the patients and uphold the choices of the patients or those of his family(skill for care 2013) According to Powell, et al (2006) the effectiveness of any strategy to manage challenging behaviors depends greatly on the level of involvement in the process. Powell, et al (2006) Advice that it is better to involves a behaviors specialist to help identify factors that trigger the behavior. It is only after such understanding is made that appropriate strategy can be developed. The response strategy to be developed may includes adaptation to environment, therapy, use of drug among other. Conclusion There is a lot that is being done to ensure individual with special needs live more quality life. Attempts have been made to integrate them into the main society through the implementation of social construct thinking. Despite the major development, individual with special needs rely heavily on hospital and care organization for supports as well as care worker .The quality of life for people with special need can be improved further if the government can invest heavily on assistive technology. The government should make assistive technology available and avoidable to individual with special need so as to promote independent living