Understanding Needs in Healthcare

Introduction

It is important to demonstrate an understanding of the specific needs in health and social care. The first part will revolve around analyzing the concepts of disability, illness, and behavior in relation to health and social care service users as well as exploring the impact of legislation, social policy, society, and culture on the ways that services are made available for individuals with specific needs. For those seeking assistance, healthcare dissertation help can provide valuable insights. The second task will revolve around, demonstrating an understanding of how health and social care services and systems are used to support an individual with specific needs. The third task will revolve around demonstrating an understanding of approaches and intervention strategies that support individuals with specific needs. The fourth and final task will revolve around demonstrating an understanding of strategies for coping with challenging behaviors that are associated with specific needs.

Task 1: Understanding Perceptions of Health, Disability, Illness, and Behavior

1.1 Concepts of Disability, Illness, and Behavior

Before understanding how perceptions of health, disability, illness, and behavior have changed over time, it is important to understand what the terms mean. According to the World Health Organization (2019), “health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The definition by WHO is interesting because it encompasses various facets of being. If an individual is asked what health means, they may most likely misconstrue it as the absence of illness in their body or physical wellbeing. However, as shown by WHO, health is physical, mental, and has an aspect of social well-being. Disease is a pathological process that leads to a deviation from the biological norm (Boyd, 2000). Illness is an experience of unhealth, which at times is personal, and interior of the patient (Boyd, 2000). It is important to note that at times, illness accompanies a disease, and in other times, an illness may exist where disease cannot be found. An important aspect of the definition is that there is a personal element to illness while disease is more objective since it presents accompanying physical or psychological symptoms. Behavior is the way in which one conducts themselves in relation to their own person and more so in relation to other individuals. Disability is the condition whether physical, mental, or psychological judged to be a significant impairment when compared to the usual standard of the group or individual (Disabled World, 2019). The term may refer to physical impairment, cognitive impairment, sensory impairment, intellectual impairment as in the case of mental illness, and various types of chronic diseases. There are two stages of disability, primary standard, and secondary standard. Primary standard disabilities tend to revolve around the brain and the central nervous system due to prenatal exposure to alcohol. Secondary standard disabilities revolve around disabilities that one was not born with. In the case study given, Hannah’s disability would be considered as a primary standard disability since she has cerebral palsy. There are two models that are used to understand disability, The Medical Model and The Social Model of Disability. The Medical Model focuses on the impaired health condition of the individual since the disability is considered to be the main issue. In The Social Model of Disability, it is considered that the disability is a function of how society is arranged and organized. As such, it focuses on removing the various barriers that the individual will experience as they go through life. Therefore, the aspect of disability that the health and social care practitioner will focus on will depend on which model they apply.

1.2 Changes in Perceptions of Specific Needs Over Time

There have been changes in perceptions of specific needs have changed over time. The good thing is that the majority of the changes that have taken place are very positive. UNICEF (2012) notes that perceptions around disabilities and special needs tended to revolve around stigma, superstitions, ignorance, communication, and neglect. According to Fillingham (2013), in the 16th century to the early 1900s disabilities were pathologized, which resulted in individuals with disabilities being on the receiving end of oppression. The main issue was a lack of communication because individuals did not have information concerning disabilities. Due to a lack of communication, many communities came up with their own views on disability, and they usually revolved around metaphysical causes of special needs and disabilities. Bunning et al. (2017) note that in many communities more so in Africa, if and when an individual was born with a disability it was considered that their parents might have done something to anger the “gods” and that child, as well as the family, was marked with stigma for the rest of their lives. The West has not been different since individuals with disabilities were always treated in a negative manner that was fueled by ignorance. One could argue that the 16th century to the early 1900s was a very challenging time for an individual to be disabled since life was more challenging during those particular eras. Therefore, if one was disabled in one way or another it meant that they could not contribute to the general wellbeing of society which resulted in some disabled people being killed (Bunning et al. 2007). While there is no justification for murder, it seems that superstitions were key in the negative perceptions revolving around disabilities.

However, as time has passed and as individuals have grown to learn more about disabilities, the ignorance has waned, and the stigma around disabilities and special needs have changed. People have become more aware that disabilities are caused by medical issues and that having a disability does not mean that one’s life is doomed. UNICEF (2012) notes that technological and medical advances have done the most to lift the veil of stigma of disabilities. Additionally, changes in political movements which belief in the right of life for every individual have contributed to the changes in the negative historical perspectives that dogged disability. Individuals have become more aware that disability is not inability and individuals with a disability have access to better schooling, to more opportunities in the workplace, and they even have opportunities to run for public office which will put them in a position to shape public policy.

1.3 Impact of Legislation, Social Policy, Society, and Culture

Legislation, social policy, society, and culture have had a great impact on the ways that services are made available for individuals with specific needs. The changes in legislation and social policy reflects changes in attitudes and modifies attitudes in relation to having inclusion policies, community care initiatives and improving other facets that make it easier for individuals with specific needs to be able to access services. One of the relevant acts in the Human Rights Act of 1998. The Human Rights Act is a UK law that was passed in 1998. Its purpose was to compel, the government and public organizations to treat individuals with equality, fairness, and dignity regardless of whether they are able-bodied or disabled, gender, race, ethnicity, religion and other facets (UNESCO, 1998). This Act ensured that every individual is treated in a fair manner, regardless of their status. One of its effects is that it has helped an individual with specific needs have better access to resources and services. Another legislation that has had an impact is the Disability Discrimination Act of 2005. The Act simply maintained that an individual should not be discriminated based on their disability and helped improve access to services by individuals with specific needs. Pope and Bambra (2005) noted that as of 2005, the Act had not helped close the employment gap between able-bodied and disabled individuals. However, that does not translate to them being denied services as a result of their specific needs. Culture has changed and transformed to become more tolerant and accepting. There was a time when differences would have led to an individual being shunned and ignored, but an increasingly tolerant culture has led to greater acceptance of individuals with specific needs. Social policy has also improved access to services. According to the Joseph Rowntree Foundation (2011), social policy has led to major improvements in the socio-economic experiences of disabled individuals, which have given them more access to services. Still, more needs to be done to help people with specific needs access to better services. However, as it stands, legislation, social policy, society, and culture have improved on the ways that services are made available for individuals with specific needs.

Task 2: Understanding How Health and Social Care Services and Systems Support Individuals with Specific Needs

2.1 Care Needs of Individuals with Specific Needs

It is important to understand the care needs of individuals with specific needs. The care needs include but are not limited to physical, social, emotional, language, intellectual, sexual, and spiritual care needs. In terms of physical needs, the key issue is mobility depending on how severe the specific need is. According to the State Government of Victoria (2019), mobility will revolve around how the individual will move from one place to another. For some, it may be through the aid of a cane, and for others, it may require the use of a wheelchair. The issue of mobility raises the question of access more so in relation to a wheelchair. Access will revolve around putting ramps that will make the individuals have an easier time when they are trying to access buildings and ensuring that things are at a level which they can access. In the case study, Hannah was using a wheelchair, and she performed all her activities through the use of a wheelchair. The other needs type of care needs is social and emotional needs. Social and emotional needs tend to be intertwined. According to Hankova and Vavrova (2016), note that social needs revolve around maintaining friendships built on trust. For many individuals with specific needs, maintain friendships with able-bodied individuals tends to be a challenge due to the fact that they may feel that the individual is doing so because they pity them. A core social and emotional need revolves around interpersonal communication (Hankova and Vavrova, 2016). Interpersonal communication is born from shared experiences. In Hannah’s case, she has always attended mainstream primary school in Hastings before moving to secondary school at Vallance School and completing her education at Treloar. Given that she has been in mainstream education one can surmise that she has cultivated interpersonal communication rooted in shared experiences with her fellow students. Also, a key need in relation to social and emotional needs is a desire for independence. This is seen in Hannah’s case because she has a desire for independence. He has decided to move to Shinewater Court, and she believes that the building will meet her needs at least in relation to mobility and accessibility. Language and Intellectual needs will depend on the degree of severity of the disability. If the issue is cognitive and intellectual, then the individual will need to be coached on how to express themselves in a relatively coherent manner. It is important to know the specific needs before the needs can be met.

2.2. Current Systems for Supporting Individuals with Specific Needs

There are a number of current systems for supporting individuals with specific needs. A system is simply a set of inter-connected or independent elements that work in tandem to achieve a specific outcome. In the UK, there is Specific Education Needs and Disability (SEND), which is an organization which takes care of individuals from the age of 0-25. The organization helps if an individual is identified as having special educational needs (SEN) (National Health Service, 2016). As long as the individual is in training or they are in education SEND will support them. It is important to note that the degree of support will depend on the specific needs of the individual. In Hannah’s case, she was identified as having specific education needs due to cerebral palsy, and she has received educational support from primary to college. Another organization whose role may be ignored is the police. The police provide protection to the public, and the public comprises of individuals with specific needs. The police force has a statutory mandate to support individuals with specific needs. The support may come in the form of protecting them from those who may harm them, helping them find their way in various situations, or even recommending them to various statutory, and non-statutory organizations where they can receive more specific and special help. Another organization that helps individuals with specific needs is MENCAP. MENCAP is a learning disability charity which works for a better life for every individual that may experience mental distress (Mencap, 2019). An interesting aspect of MENCAP is that they provide care not only for the individual with the specific needs but also for their families and primary caregivers too. There are a number of other organizations that deal with supporting individuals with specific needs. The ones listed above are only a few of them.

2.3. Services Available in a Chosen Locality with Specific Needs

The chosen locality is Wales. A key organization that is located in Wales and which offers different services for individuals with specific needs is known as Disability Wales. Disability Wales is an organization that champions the rights, equality, and independence of all disabled individuals in Wales (Disability Wales, 2019). Given the size of the organization, the organization receives funding from the Welsh government and the Fawcett Society. The organization has helped improve access to information by educating the general public about the various aspects of specific needs. The organization has helped ensure that individuals with specific needs get better access to educational opportunities, job opportunities, and has also supported the families of individuals with specific needs. It provides health and social care, transport access, and means of recreation. Disability Wales has helped champion the rights of individuals with specific needs within Wales and the UK as a whole.

Task 3: Understanding Approaches and Intervention Strategies that Support Individuals with Specific Needs

3.1. Approaches and Interventions Available to Support Individuals with Specific Needs

There are various approaches and interventions that are available to support individuals with specific needs. It is important to note that the interventions are usually specific to the issue at hand. A key approach and intervention that is available is referred to a Cognitive Behavioral Therapy (CBT). According to Hofmann et al. (2012), CBT is an amalgam on interventions that maintain that mental disorders and psychological distress are all caused by cognitive factors. The intervention has a cognitive aspect and a behavioral aspect. The cognitive aspect revolves around an individual’s general beliefs about the world, society, and a sense of self. The behavioral component revolves around the actions that the individual does. The key purpose of CBT is symptom reduction, improving an individual’s functioning in society, and eventually remission of the disorder (Hofmann et al. 2012). CBT has become particularly attractive as an intervention due to is malleability when treating various disorders. It has been proven to treat depression, anxiety issues, substance abuse issues, various behavioral problems, and even post-traumatic stress disorder (PTSD) (Hofmann et al. 2012). Due to its adaptability, it is applied as an intervention in many instances and circumstances. Service-based interventions also exist. The purpose of service-based interventions helps in educational development, employment development where they help individuals access and keep jobs, and social care services. An approach and/or intervention that is considered to be more challenging is evidence-based approaches. According to Bergmark, Bejerholm, and Markstrom (2019), implementation of evidence-based programs is a very delicate undertaking more so within a community-based setting. Evidence-based interventions require very rigorous preparations before the programs start. A key facet of rigorous preparations that may make or break the program revolves around the organizational level in matters of financing, collaboration, and assessing the dependability of the program by and large. Therefore, if the preparations before the evidence-based program is applied are not up to par, then the probability of the program being successful reduces significantly.

Another intervention is known as SPELL (Structure, Positive approaches, and expectations, Empathy, Low arousal, Links). SPELL is an intervention that is specifically tailored for individuals with autism. According to the National Autistic Society (2019), is a framework that recognizes the unique needs that each child and adult has and emphasizes the idea that planning or intervention should revolve around that idea. Therefore, when planning for an individual, the framework should be applied in an individualistic manner. Such a view is important when it comes to interventions since it agrees that each individual is unique and they should be treated in such a manner.

3.2. Effectiveness of Intervention Strategies for an Individual with Specific Need(s)

Intervention strategies are only helpful if they are effective when applied in the context of an individual with specific needs. The intervention applied will depend on the specific needs of the individual. Substance abuse is a specific need, and when not kept in check, it leads to the requirement for intervention strategies. Strategies employed when it comes to substance abuse are effective because they helped replace destructive behavior with one that is more fulfilling. According to Das et al. (2016), school-based programs and family-based intensive interventions are the ones that are most effective when treating issues revolving around substance abuse. It is important that the issues are handled when an individual is an adolescent since they are relatively easier to handle than when one is an adult. There are interventions that revolve around emotional abuse. Such interventions are usually effective more so when assertiveness training is employed. The purpose of assertiveness training is to teach the individual to stand up for themselves and to make themselves heard. Assertiveness is an evidence-based treatment, and a variety of research has shown that lack of assertiveness leads to a host of other clinical problems (Speed, Goldstein, Goldfried, 2017). When assertiveness training is incorporated into the intervention, the individual becomes less likely to become a victim since they are able to stand up for themselves in various ways. It would be challenging to go through the efficacy of every intervention, but it is important to note various tensions that may exist in the interventions. There is tension between the alleviation of needs and remedial therapy. Alleviation of needs is short-term and direct, and the individual will notice an immediate difference. Remedial therapy is a long-term solution since it requires that the individual become aware of their own thinking style. There is a part for both to play, and it is up to the health and social practitioner to be aware of which one to apply. The other tension is between choices and preferences. The individual may have certain choices that they need to make, but they may have specific preferences that they want to be met. It is up to the health and social practitioner to be aware of such tensions and know how they can be alleviated to improve the effectiveness of a given strategy.

3.3. Potential Impact of Emerging Developments on Support for Individuals with Specific Needs

There are emerging developments that may relate to technological advances, changes to legislation and policy, and shifts in the national and international perspective. A shift in national and international perspectives that has a profound impact is in relation to increasing awareness of mental health issues. According to Burnett (2018), there is an increase in mental health awareness, and that is a good thing. Such a shift impactful since it means that the stigma that revolved around mental health is reducing and more and more people are seeking help. Awareness leads to action being taken and shift in national and international perspectives is good. Another shift in national and international perspectives revolves around people being more tolerant of individuals that are different from them as in the case of disabled people. In terms of medical technology, there are strides being made in STEM cell technology and understanding various diseases such as Alzheimer’s. Such changes are impactful because they will help in improving the quality of life for all individuals that are involved.

Task 4: Understand Strategies for Coping with Challenging Behaviors Associated with Specific Needs

4.1. Different Concepts of Challenging Behavior

Challenging behavior is basically a behavior that deviates from the established societal norm. The challenging behavior may arise as a factor of learning disabilities, ill health (physical and mental), physical impairment, brain injury, and drugs and alcohol. According to the National Institute for Health and Care Excellence (2015), learning disabilities have been known to lead to challenging behaviors. Learning disabilities tend to occur when an individual grasps things at a slower rate than their peers. Due to this, individuals may act out because they feel that they have been embarrassed and in some, they may become more anxious. On the outside, it may appear as if the person is temperamental, brusque, angry, or timid, but the challenging behavior can be traced to learning disabilities. Physical impairment and brain injury may also have the same effect. In brain injury, the person may not have the ability to conceptualize and grasp societal norms, and they may act out simply because they do not know better. Alcohol and drugs will affect cognition, and when one is inebriated, they are more likely to exude challenging behavior. Understanding the cause of the behavior will help in coming up with an intervention.

4.2. Potential Impact of Challenging Behavior on Health and Social Care Organizations

There are various impacts of challenging behavior on health and social care organizations. The most obvious impact is that it makes it very challenging to interact with the individual. Societal norms help to reduce the inevitable friction that would arise if and when individuals act in any manner they deem fit. Therefore, when an individual is exuding challenging behavior, it is extremely challenging to deal with them or even to come up with intervention practices. It will also lead to overall frustration. Health and social care practitioners may ask themselves why they have to put up with such behavior even though that is the line of work that they have selected. It may lead to impatience, drug consumption, or even physiological effects such as headaches, or chest pains. Another impact is that it will lead to a shortage of staff. After an individual has dealt with people with challenging behavior, they may believe that they cannot do it again. As such, staff turnover rates may increase exponentially. On top of that, it may lead to more work-related stress, which may also increase staff turnover rates. The potential impact of challenging behavior on health and social care organizations is chiefly negative.

4.3. Strategies for Working with Challenging Behaviors.

There are various strategies that can be employed in relation to challenging behaviors. The one that has proved most efficacious, according to the literature is Cognitive Behavioral Therapy. CBT will cover the cognitive root of challenging behaviors and lead to behavioral changes. The key disadvantage is that it may take a relatively long time when an immediate solution is required. Setting clear boundaries is also a great strategy. The individual with the challenging behavior will know that once they are within the confines of the organization, they are expected to act in a particular manner failure to which a punitive action may be carried out. If it is a child, a time-out may suffice. Punitive actions for teenagers and adults will be much more challenging. Medication is another strategy more so if it is an issue such as bipolar disorder syndrome where their challenging behaviors arise due to hormonal imbalances. Communication should be the basis of all strategies for working with challenging behaviors.

Conclusion

As a health and social care practitioner, there are various responsibilities that one will bear. Some of those responsibilities will revolve around assessing the specific needs of individuals will disabilities, analyzing their care needs, and also evaluating strategies for giving support to individuals with challenging behavior. However, before a health and social care practitioner can take on those roles, they have to have an understanding of the specific needs in health and social care.

References

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