I am a pupil of the HNC in Social Care and I work with an administration that promotes societal inclusion of Adults with Learning Disabilities with societal support through group work and one to one befriending. Throughout this paper I shall besides mention to our service participant as Dan and our service as the Group. This is non the existent name of our client or our group. By making this I am following with our administrations policy of confidentiality. This policy was designed to conform to the ( ref 1 ) Data Protection Act of 1998. This Act ensures client confidentiality, that any information written about a client is accurate, true and any sentiments are nonsubjective, substantiated by factual grounds. The Act besides allows the person to do a formal application to see the information held on them by the Group.
To finish this piece of work I have assessed Dan`s demands and planned out a piece of work which has addressed an identified demand.
I read his bing activity program as a get downing point as it had his medical information included, this allowed me to update the information at Dan`s appraisal. This first appraisal had been done by my director a few months ago and so I discussed Dan`s instance with her before I met with him. Our activity programs are flexible leting for the altering demands of our clients. The undertaking undertaken besides complied with our administrations fundamental law which concentrates on societal inclusion of grownups with larning disablements.
The appraisal of demands is the first phase in the attention be aftering procedure. Our administration takes a individual centred planning attack. A individual centred attention program is devised to ’empower ‘ people, to back up their societal inclusion, and to guarantee people are non devalued within society.
It was necessary for me to listen to what my client needed, to distinguish his demands from his wants and to guarantee that I could take action to present a positive result. A demand is something he has to hold every bit opposed to a privation which is something he would wish to hold. Measuring a individual for demands is the method of roll uping information, entering the information and construing the information.
The appraisal took topographic point at our office merely after his one to one art session as he was comfy and felt safe here. Under ( Ref 2 ) the Regulation of Care ( Scotland ) Act 2001 Dan has a right to experience safe and unafraid. I did a Risk Assessment of our countries which complied with the ( Ref 3 ) Health and Safety at work Act 1974. It was of import for me to go on deriving his trust and usage good communicating accomplishments. I used the SOLER technique which had us both sitting forthrightly confronting one another screening that I was being involved, I had an unfastened position connoting that I was not defensive, I leaned frontward somewhat demoing a personal involvement, I had regular oculus contact besides conveying an involvement in Dan and I had a relaxed mode. I used active hearing which involved me seeking to understand the existent issues impacting Dan and had a meaningful conversation with him.
Our meeting was timed to last no longer than twenty proceedingss as his attending span can be short if he is bored. I ensured that board shaper marks and ocular AIDSs where available, to direct his attending if he did acquire bored.
I used both unfastened and closed inquiries which allowed me to acquire factual replies from the closed inquiries and his sentiments and feelings from unfastened inquiries.
I observed his behavior at all times and I spoke to him in a manner he understood. I wrote the information collected in a concise mode in the signifier stated in our administrations policy and processs. As we do non provide a attention service, we are non required to register with the Care Commission, but we guarantee all our policies and processs meet their criterions.
As all clients under these criterions are lawfully allowed an appraisal of demands and an individualised attention program, the signifier I used was called the Activity Plan.
The Care committee was set up under the Regulation of Care ( Scotland ) Act 2001. This Act came about to modulate the attention and societal work force and set out the principals of good attention pattern. During our meeting I was witting that I had to explicate the attention be aftering procedure to Dan, and I used the ocular AIDSs when necessary.
Dan was born in 1949 into a society that had introduced the IQ trial in 1930, whereby those hiting low had been considered “mentally defective” . By 1946 and the debut of the NHS, this term was changed to mentally disabled and so needed “treatment” in establishments. Dan was considered as being in this class.
There is no by and large acknowledged definition of a learning disablement and there is a continued statement of the definition. However, there are certain characteristics that are agreed upon.
- Those with a larning disablement have troubles with educational success and growing.
- An uneven form of their human development is noticeable i.e. physical, perceptual, educational and linguistic communication developments.. ( Ref 4 ) [ two ]
The ( Ref5 ) NHS and Community Care Act of 1990implemented in 1993 and ( Ref6 ) the Human Rights Act of 1998. , saw the closing of these establishments. This saw the motion of grownups with larning disablements out of establishments into being cared for in the community, either by their ain households or in little supported lodging being cared for by the voluntary sector.
“The Same as You” scheme of 2000 ( Ref 7 ) [ three ] by the Scottish executive is committed to supplying equity, equality and societal inclusion for grownups with larning disablements. As a consequence of this scheme the local community set up the “Group” to supply socialization to assist with societal inclusion of grownups with acquisition disablements through one to one befriending and group activities.
Dan lived within a atomic household unit where he was given the basic human demands of nutrient, shelter, vesture, love and socialization to populate until the age of 6. He was born into a society where it was common for immature kids with larning disablements particularly those with Downs Syndrome to be institutionalised. There was besides a societal stigma assigned to those with learning and physical disablements.
Dan ‘s household insisted in caring for him at place until school age, but his educational demands where non met. He besides suffers from “anxiety attacks” which his male parent says he developed at the age if six, when taken into the auto for the first clip. He reacted by floging out and drawing hair. The “anxiety attacks” were given by his male parent as an alibi for Dan`s riotous behavior. His behavior was tempered by his female parent, who had to be systematically by his side snuggling him and keeping his manus during his dying minutes. His parents did everything for him, until he was institutionalised. Here, he grew up where privateness, pick, self-respect where lacking and he was non allowed to take hazards. Life accomplishments, instruction and route work where non given. More frequently than non in the yesteryear, these “patients” where drugged if they showed any marks of riotous behavior. Being “locked up” life in Nightingale wards with communal life and lavatories may hold besides contributed to his “anxiety attacks” .
These “anxiety attacks” still causes Dan to act in a ambitious mode if he feels hemmed in, particularly in crowded topographic points with no obvious agencies of flight. After 1995, when authorities schemes of shuting big establishments were implemented through the ( Ref8 ) Disability Discrimination Act 1995 and its amendments of 2003 Dan was given a place within supported adjustment as his male parent was elderly.
Dan did non like to travel out unless his male parent was with him and tended non to interact with anyone when introduced. His “anxiety attacks” causes him to be agitated when his modus operandis alteration.
He finds it hard to do picks unless they are limited and is non lament on seeking anything new. He is unable to read or compose, he has no life skills e.g unable to do a cup of tea, do a piece of toast, store or clean his place, he is unable to traverse the route without aid. The physical developmental phase Dan has reached is that of an grownup but the emotional phase is that of childhood between 2-12 old ages of age, likely nearer the age of seven or eight. He has been populating out with the big establishment for six old ages now but has non learned to alter his behavior consequently. This may be as a consequence of being told by his support workers that he can non make certain things as they deem certain activities to be a hazard. Staffing jobs besides contribute to the deficiency of his alteration in behavior as clip restraints in assisting Dan larn new accomplishments are frequently given as an alibi for staff non being able to help Dan try new things.
So, I believe he is still institutionalised although he lives in smaller community shared adjustment. He was given no pick as to where he would populate, who he would be sharing with or who would be back uping him.
With the aid of his household, before being institutionalised he was able to run into the bottom three phases as seen in Maslow`s hierarchy of demands pyramid. ( Ref9 ) [ four ] Abraham Maslow was a humanist psychologist who developed this theoretical account between the 1940s and 1950`s. He stated that human demands can be arranged in a measure ladder pyramid and that the lower degree demands must be satisfied before higher degrees can be met.
This theoretical account consisted of eight phases. He stated that we are all motivated by demand as evolved over 1000s of old ages. He stated that we must fulfill these demands in bend, get downing with the first. The first demand is the physiologicalneed which is e.g holding nutrient, O, H2O, etc, the demands to let our organic structures to last. The 2nd demand is that ofphysiological and physical security, whereby there is protection from possible risky fortunes and objects. The 3rd demand is belonging and love, which is being portion of a group of household and friends in a loving state of affairs with trust credence and affection.The 4th demand is esteemwhich is regard of ego and others. The 5th demand is self realization which is gaining personal potency. The 5th demand is Cognitive demands with cognition and apprehension. The 6th demand is Aesthetic demands which is the grasp of symmetricalness, beauty, order and signifier. The 7th demand is self- actulisationwhich is gaining 1s full potency and the 8th demand is transcendency which is assisting others to carry through their possible. Dan, as functionalist sociologist ( Ref10 ) Talcott Parsons ( 1902-1979 ) argued, will hold gained his primary socialization and emotional stableness within a atomic household of two parents, a female parent and male parent, plus his siblings. Primary socialization can be defined as a agency by which the norms and values of society are taught to kids and they learn to accept these values within the household. The functionalist sociologists believe that society can be compared to a life organic structure, with different variety meats ( establishments ) holding different maps yet all working together to maintain the organic structure ( society ) alive.They consider the household to be a little version of society which operates as a societal, economic and emotional unit.
The struggle theoretician believe that society is separated into two categories, with the middle class and the labor who are at odds with one another. The household, struggle theoreticians province is merely another societal establishments which contribute to the credence of societal inequality. Every member takes difference functions at certain times in the household life rhythm and struggle happens within the household when a individual challenges those functions, e.g adolescents disputing parental authorization.
Dan lived in an establishment from the age of six so his secondary socialization was to larn to populate within the confines of the establishment. This socialization would hold been radically different from a household state of affairs. ( ref11 ) Research showed that concerns grew about the attention given by establishments “quality of attention provided by these establishments in footings of gross physical want
( overcrowding, hapless nutrient, vesture and environment ) , maltreatment ( ill-treatment, larceny of
ownerships and over-use of medicine and restraint ) and neglect and inaction ( deficiency
of attention, deficiency of contact and stimulation and extended periods of detachment and
isolation”staff and client interaction and battle in meaningful activities would hold been poor.As a consequence, no opportunities where available to let Dan to travel to the following degree of Maslows Pyramid of Needs of ego regard.
( Ref 12 ) Dan was the youngest member of the household and so harmonizing to Alfred Adler this would hold affected the type of personality that he would develop subsequently on in life. The youngest are known to acquire their ain manner and to hold a stronger parent bond, which Dan did
Have as he was overprotected and indulged before hospitalization. But, this cocooning can besides be claustrophobic. But, by being institutionalised, harmonizing to Erikson, his environment would besides hold affected Dan`s development and have had an impact on his behavior.
The behavior Dan frequently displays can be explained by the behaviorist theory, which was named ( Ref 13 ) “Learned Helplessness” . While experimenting on Canis familiariss utilizing Pavlov`s theory of Classical Conditioning, which shows links between the stimulation and the response. Seligman discovered that erudite behavior is a consequences of the belief that the person`s actions are ineffectual. Peoples who have lived in Institutions have learned non to anticipate to hold any control over their lives. Behavioristic theoreticians believe that if behavior is learned, so it can be unlearned. Lev Vygotsky and Russian cognitive psychologist believed that development was guided by civilization and interpersonal communicating with important grownups. Bing institutionalised will hold reduced Dan`s opportunities of holding regular of import communicating with a important grownup. Vygotsky stated that to larn a scope of undertakings that are excessively hard on their ain, a kid must be shown or guided by person who is more knowing. This became known as the “Zone of proximal development” . This assumes that the kid has the ability to memorize and the capacity to remember the erudite experience. This is non ever possible in some with a learning disablement. In the attention puting where Dan spent his life, the opportunities of a kid being challenged to larn new accomplishments would hold been diminished or non- existent. Vygotsky was the first to detect that societal isolation caused a hold in both societal and cognitive development.
The “anxiety attacks” Dan suffers from can besides be explained via Operant Conditioning suggested by B.F.Skinner ( 1953 ) . Operant Conditioning is where behavior is followed by a effect.
His behavior of floging out when he is dying is a consequence of positive support where ab initio this bad behavior was rewarded by having physical and emotional contact from his female parent before institutionalisation and ulterior attending from nursing staff in the establishment.
Positive support is where the effect is a positive result. Now, Dan`s support staff attempt to guarantee that Dan does non come into a state of affairs that may do him dying.
After the decease of his aged female parent Dan relied wholly on his aged male parent for any continued socialization, as his siblings had long left place to put up their ain household life. ( stats to be put in )
His male parent feared Dan would go stray, particularly as his male parent was going less able to take Dan out. Dan was introduced to fall in the Group by his male parent in an effort to present him to new friends, increase his assurance and better his ego regard. His clip at the group has seen his assurance addition. After traveling out into the community, Dan was instead introspective and diffident and would merely travel out in the company of his male parent. This concerned his 90 twelvemonth old male parent greatly, and so his male parent came to our administration in the hope that we could increase Dan`s societal circle. Dan was assessed by being asked a figure of inquiries utilizing PIES to set up what his Physical, Intellectual, Emotional, and Social demands were. This information was put into his activity program which we use alternatively of a Care Plan. As under the NHS and Community Care ( Scotland ) Act 1990 everyone is entitled to a attention program. Dan will hold such a program set up by the societal work section.
To increase his societal circle as requested by his male parent, we included him in a figure of activities which has expanded his range of societal activity and made him less stray. Dan`s physical demands are met by societal services, but his rational demands of mental stimulation, his emotional demands of necessitating to increase his ego regard and his societal demands of societal interaction require attending.
Dan has already improved his societal accomplishments through art by now pass oning good with our staff and is acute to take his work place to demo to his household and carers. His male parent has commented on how the communicating accomplishments of Dan have improved and his assurance has increased. Remembering Maslow`s Hierarchy of Needs, I had assessed that Dan would profit from making the 4th phase – Esteem Needs. I felt an activity that would assist to better his assurance, his communicating accomplishments and do him less dying in a big group state of affairs would be good. I spoke to him and observed him reply my inquiries.One of my inquiries gave him a pick of activities to seek, I found that the activity he was most interested in was art. I mentor both at the art group and on an single footing, which helps grownups with larning disablements gain new accomplishments, addition assurance, better ego regard, socialization and ego
realization through creativeness. Carl Gustav Jung a Swiss head-shrinker B.1875 to D. 1961 encouraged patients to utilize art to convey their unconscious emotions. He stated that ( Ref14 ) “drawing, picture, and mold can be used to convey unconscious stuff to visible radiation. Once a series has become dramatic, it can easy go through over into the auditory or lingual domains and give rise to duologues and the similar. ” ( 1941 )
My purpose was to seek to set get bying mechanisms in topographic point to let him to be able to take portion in the ranked unit activity which was to let him to make a work of art and to exhibit at our Malawi Awareness Evening, which we expected to be busy.
This activity is to take topographic point some hebdomads off so it was of import for me to set up new art activities over a period of clip, to let him to derive assurance in being portion of a big group. My end through these activities was to let Dan the opportunity to increase his assurance and communicating accomplishments and to develop get bying mechanisms to let him to cover with his fright of big groups. I have used the ( Ref 7 ) task-centred theoretical account in be aftering this exercising ; this is a short-run job work outing attack over a short period. This had five phases- Problem Identification ( appraisal ) , Agreement, Planning ends, Achieving Tasks and Evaluation. Here, the client takes concrete action to work out the job. The Initial interview or stage allowed Dan to show his demand to hold more assurance when in a room with more people in order to be able to bask more activities. He wanted to finish a picture and to be present at its exhibition. To accomplish these ends, we agreed on the stairss and undertakings that allowed Dan to achieve his end. We emphasised the undertakings that were required to be completed to let Dan to exhibit his work of art and hold on timescales for the undertakings.
Other interviews will took topographic point to guarantee that we were on path and that Dan felt safe and confident making the in agreement undertakings.
With Dan`s understanding we decided to hold an hourly one to one befriending art session of three one hr Sessionss per hebdomad over four hebdomads and to increase these Sessionss to go a group session. To make this I needed to slowly present more and more people to the group. These were other service users, staff and voluntaries. With understanding of everyone involved I brought people in one at a clip each session. I did this by giving each person a day of the month and clip to fall in us at the “Group” premises.
I hoped that by the terminal of the four hebdomads he would be able to sit in a room merrily with at least 12 noisy people. He had to hold a positive experience and to hold a positive association with the group. Dan enjoyed a regular cup of tea and a cocoa biscuit, so I introduced this positive experience to him in the group puting while he was painting.
I ensured he sat confronting the door and informed him that he was able to go forth the room at any clip. I sat him at the terminal of the tabular array to guarantee that he did non experience hemmed in.
[ I ] Mention 1:
Data Protection Act 1998. hypertext transfer protocol: //www.opsi.gov.uk/Acts/Acts1998/ukpga_19980029_en_1
[ two ] Reference 2: Regulation of attention Act ( Scotland ) 2001 hypertext transfer protocol: //www.opsi.gov.uk/legislation/scotland/acts2001/asp_20010008_en_1
Mention 3: Health and Safety at Work Act 1974: hypertext transfer protocol: //www.hse.gov.uk/legislation/hswa.htm
Mention 4: hypertext transfer protocol: //www.childdevelopmentinfo.com/learning/learning_disabilities.shtml # What is a larning disablement?
Reference5: NHS and Community Care Act 1990 hypertext transfer protocol: //www.opsi.gov.uk/ACTS/acts1990/ukpga_19900019_en_1
Mention 6: The Human Rights Act 1998: hypertext transfer protocol: //www.opsi.gov.uk/acts/acts1998/ukpga_19980042_en_1:
Mention 7: The Same as You scheme: hypertext transfer protocol: //www.scotland.gov.uk/ldsr/docs/tsay-01.asp
Mention 8: Disability Discrimination Act 1995: hypertext transfer protocol: //www.opsi.gov.uk/acts/acts2005/en/ukpgaen_20050013_en_1.htm
Mention 9: Maslow: hypertext transfer protocol: //www.businessballs.com/maslow.htm
[ three ] Reference 10: Talcott Parsons: Elizabeth Bingham + . ( 2009 ) . Sociology of Family. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 124 -125.
Mention 11: hypertext transfer protocol: //www.kent.ac.uk/tizard/staff/documents/Mansell % 202003 % 20JARID % 20Resident % 20involvement.pdf
Elizabeth Udall. ( 1996 ) . How the household picking order affects you. Available: hypertext transfer protocol: //www.independent.co.uk/life-style/how-the-family-pecking-order-affects-you-1363578.html. Last accessed 28/03/10.
[ four ] Reference 13: Elizabeth Bingham + . ( 2009 ) . Working in Partnership with people who have a Learning Disability.. In: Heinemann HNC in Social Care. Edinburgh: Heinemann. 266 -267.
Mention 14: Cathy A. Malchiodi. ( 2007 ) . Creativity- Pulling on Process. In: McGraw-Hill Art therapy Sourcebook. 2nd erectile dysfunction. New York USA: McGraw-Hill. 65.