School of Health and Social Care

Question: Case Study 1: Sally is a 42-year-old female who presents to her GP with complaints of tingling and numbness in her left foot, 18 months later she also complained of double vision. Consultation with a neurologist at that time results in a diagnosis of multiple sclerosis. She is placed on disease-modulating medication and educated about lifestyle changes to avoid fatigue, which manages her double vision, with the exception of long workdays. The GP refers her to a vision specialist for management of the impairment of double vision that interferes with activities and participation in her job as an account executive. The GP has also requested the assistive technology specialist to provide information and education about other assistive devices that are available should she develop additional impairments. A vision specialist recommends an eye patch for use when warranted and suggests she stay in touch with the assistive technology specialist should other problems arise. Two years later, Sally returns to her GP with complaints of weakness and numbness in her right side (upper and lower body). These new impairments interfere with her ability to drive to and from work and chauffeur her children to soccer and other after-school activities. Her function at work has been greatly compromised as well. She is experiencing difficulty with typing, maneuvering around the building, holding her lunch tray, and performing other activities of daily living. She is referred to the Occupation Therapist for an ankle-foot orthosis (AFO) for the right foot and a cane to improve her mobility, and she is also referred to the Assistive Technology Specialist for consideration of alternate input methods for the keyboard. A keyboard was chosen that covered a larger surface with large black letters surrounded by a yellow background. Both specialists worked together to identify other aids to facilitate additional activities, such as Sally's personal care activities using a dressing stick and toothbrush handles; cooking using kitchen aids, including jar openers, recipe card holders, and large-handled pots and pans; and gardening using adapted gardening tools. The GP refers her to a driver's trainer specialist to adapt her vehicle with a spinner knob and left foot accelerator and to train her in this new way of driving. At this time, the GP also referred her to a social worker for support and counseling regarding her finances, work, and personal life decisions. Throughout the previous 4 years, Sally's family has noticed changes in her memory function. After the psychologist completes a cognitive evaluation and identifies strengths and weaknesses, Sally is provided a hand-held personal digital assistant (PDA), called the "PocketCoach," to aid in her memory skills. This device enables her to push a single button to remember "what to do next." It assists her to remember to complete task activities and to manage important aspects of her healthcare, such as taking medications and nutritional supplements. Task 1 - Essay 1.1 Explain how technology can be used to support users of health and social care services in living independently. 1.2 Analyse barriers to the use of technology to support users of health and social care services in living independently. 1.3 Explain the benefits of these technologies to health and social care organisations and their users. Task 2 - Essay 2.1 Explain health and safety considerations in the use of technologies in health and social care. 2.2 Discuss ethical considerations in the use of assistive technologies. 2.3 Explain the impact of recent and emerging technological developments on health and social care services, organisations and care workers. Task 3: Mini Report Case Study 2: Maggie is a 62 year old lady who has early onset dementia. She recently lost her husband. She is an extremely active lady who goes out on a number of occasions each day. She is disorientated to the day and time. Her family has significant concerns that Maggie is leaving her home at night and reports from her neighbour confirm this. A fortnight ago her daughter, Lisa paid her a visit and she found water flowing out of her door. When she pressed the door bell there was no answer because Maggie was not home. On occasions homecare arrive early in the morning and Maggie is already out which means she can miss taking her medication and is skipping meals. A risk assessment highlighted an unknown prevalence of Maggie leaving her home. 3.1 Identify Maggies specific needs for support to live independently. 3.2 Recommend appropriate assistive devices in order to support Maggie to continue living independently. 3.3 Evaluate the usefulness of technology for users of health and social care services. Answers: Task 1 1.1 A system that helps a person to carry tasks that are otherwise impossible to carry out by them and also increments the safety and the ease of the tasks is the basis of assistive technology in health and social care services. The assistive technology are an extra help to the individuals with disabilities and helps them live their lives independently at home or somewhere outside. The assistive technology provides safety at home as they come with smoke, gas, temperature and flood detectors. The technologies also help in controlling a lot of work like switching the fan, operating the door etc. all from a single remote controls. Like in the case study Sally was provided some aids like dressing stick and toothbrush handles; cooking using kitchen aids, and large-handled pots and pans to carry out the daily activities at home. These ease the life of people living at home (Easterbrook, 1999). They also help in providing health and personal safety. Like in the case study of Sally the visio n specialist gave her an eye patch so as to correct the eye impairment and improve her health. Sally was provided with an AFO to safeguard and to relief her foot pain. In some disease like epilepsy these technology helps a person from falling and getting lost. The assistive technology also supports communication in the disabled people by means of phones so as to call someone in case of emergencies (Lothian Philp, 2001). They also help in social care by using technologies that gives prompts and reminders that are audio visual. They are generally clock calendars, memos, medicine reminders etc. Like in the case study Sally was provided a Pocket coach so as to help her to remind her about her work, meetings and activities that are to be carried by her. In the case study mainly assistive technology that are used by Sally like pocket coach, AFO, eye patch, helping aids at home etc. are all providing independence to her and her prescribed by GP on her wish only that is by her autonomy onl y (Brownsell, et al, 2003). 1.2 There are some barriers to the use of assistive technology in health and social care services. First is the services are provided by some institutions and organizations, in these there is less support and training staff, low support by staff, inadequate assessment, investments at low levels, difficult and unorganized managing and planning and time constraint. Second barrier is unawareness and low knowledge level about the assistive technology products among the people (Brooks, 1991). The patients family, friends and other significant ones are unaware about the assistive devices and are more afraid to adapt a new lifestyle in patient lives. Third barrier is difficulty in operating the assistive technology by the illiterate and older people. They face a lot of difficulty in operating these technologies. Fourth is these technologies are generally developed on individual basis and are developed for a specific individual after the assessment process is completed. So a lot of time is n eeded after assessment to make up the assistive device, in a way they are not provided immediately to help the individuals disabilities but are provided after some time which act as a barrier of time (Hammel, Lai, Heller, 2001). Fifth is they lack the communication, the emotional support and the attachment feeling, even after helping the disability people a lot they lack in providing the emotional touch and the feeling that can only ne fulfilled by communicating to someone. Sixth is these assistive technologies lack funding support from the governmen (Doughty, Burton, 2002) The government is providing little amount of funds so as to lead the research and the development of new assistive products. Hence further new products are finding a difficult way to emerge and provide help in health and social care services. 1.3 The benefits of assistive technology in health and social care organizations are underlined as follows: They provide independence to the people who are unable to work on their own and perform daily activities (Myatt, ED and Rogers, 2001). They help in daily day to day activities of cooking, having foods, opening or switching of electronics and personal gadgets etc. It ensures safety to all the individuals who are using the devices at home or in a health and social care organization. It reduces the falls and accidents that are caused at home. It detects a fall beforehand and provide an alert to the individual so as to prevent from the fall. It decreases the risks of acute hospitalization. The people are safe when using these devices so risks of major accidents is minimized and so the hospitalization is also minimized. It reduced the need for nursing car (Barlow Venables, 2003). The devices helps in daily activities so the care that is to be provided by a nurse is reduced to a certain level. It also help the ones who wish to die at their home and with dignity. In health and social care centers like hospitals it helps to provide alert alarms so as to help the patient to detect their location, provide alerts like flood detectors. It also provides preventive services to the individuals Shone (Stickel, Ryan, Rigby Jutai, 2002). It improves the quality of life as it supports independent living in the disables individuals. It helps to provide assistant to the patients who are suffering from major disease, Alzihmers disease, Parkinsons disease, Dementia, Multiple sclerosis etc. It also helps to provide accurate location of individuals if lost or suffers from a memory loss or impairmen (Balas Iakovidis, 1999). Task 2 2.1 For the general population it is believed that the assistive technology will improve the health, safety, quality and efficiency and costs. But some people consider the technologies also contribute to some errors and adverse events (Curry, 2002). The main aim of the technology is to provide health and safety to the patient, patients family and friends and the health staff working in the health center. For the safety purposes the technologies assist in following ways: Assessing the hazards that is reviewing the patients safety issue which the supplier systems might encounter. Mitigating the hazards that is systematical designing of the controls that are used to identify the hazard. Evidences that are used to ensure that the control used up are proving effective and efficient in the managing the patients risk. In case of safeguarding health the assistive technology are used by nurses, doctors and the patients itself so as to avoid any errors and adverse event of misinterpretation, medicine error, delay of treatments etc. The assistive technology is a boon for safeguarding the patients health as it decrease the chances of errors and tells that a error is about to occur before hand only (Jedeloo, Witte, Linssen Schrijvers, 2000). The other considerations are to achieve patient satisfaction and improving the productivity. The health and safety considerations like transmission of infections between the patients or from the patients to health care staff, appropriate hygiene level, appropriate disposal of wastes etc. are also met up easily by using assistive technology like sterilizing the equipments used and disposing the wastes. 2.2 The ethical considerations in the use of assistive technology are based on the four principles. They are autonomy, justice, beneficence and non maleficence. The technology tries to solve the problems in different ways but sometimes people analyze that the solution is rooted to the conflicting values or not. The family and friends tries to combine the values and the persons situation with the technology. This is a condition for ethical dilemma (Dunnell, 2008). The ethical principles interpretation depends on different contexts like individuals perception and legal and professional values. For the beneficence, it involve to achieve the balance between risk tolerance and risk aversion. So ethical dilemma is between beneficence and safety and independence. Moving on to autonomy arises the ethical dilemma of independence but still isolation persists among the individual. These technologies provide independence but isolation and depression are also an add up to the health. The justice here is providing appropriate technology to all the individuals equally. But it is not the case the facilities are provided upon the money given by the patients or patients family, here also the ethical values are underpinned. Intuitionism is also an aspect that exists in the ethical framework ( Gitlin Burgh, 1994). The other aspect is cultural sensitivity that is to what scale is the biomedical framework is culturally transferrable, here the autonomy and family obligations are being questioned. The ethical questions that arise in the use of assistive technology are: Do the old ones and the individuals with problems are getting a share of the benefits in the new technology? Are there variety of solutions provided to carry up the daily needs Are the interest in the development of technology exists? Do individuals who are not form the staff have an access to information society skills (Neville-Jan, A, Verrier Piersol, C and Kielhofner, 1993). Is the development is too fast to meet up the requirements and the needs of the old peoples? Do any alternatives to the technology exist? 2.3 The benefits of assistive technology to health and social care on the users basis are explained as follows: It gives an independent life to the patients and help them take their decisions and carry life activities without being a burden on any body. It offers a safe and more secure living to the patients (Finlayson Havixbeck, 1992). It gives a dignity, respectful and private lifestyle to the individuals. It provide assurance to the family members about the quality of the care provided. The technology are cost effective and efficient too. It has decreased the mortality rates among the patients to a certain extent (Demers, Weiss-Lambrou, Ska, 2002). It helps in day to day activities like going to toilet, cooking food, managing work. The provision of tele health and tele care is itself a boon for the disabled patients. The re hospitalization of the patients has been considerably reduced due to the use of assistive technology by the patients (Department of Health, 2003). At the user level the technologies are assisting them to provide a fast and increased improvement in their health and well being. The benefits of assistive technology to health and social care on the health and social care organizations are explained as follows: It has reduced the errors that occur due to wrong assessment by the nurses (Barlow, singh, bayer, cury 2007). It has provided ways of treatment that are easy to understand by the common people and produce much positive results in the patients. The adverse events are organized before hand only by the nurses and the health staff with the help of the detectors so the reoccurrence of adverse circumstances is reduced (Thornely, G, Chamberlain, MA and Wright, 1977). The technologies also help the general practitioners to reach a correct diagnosis of the patient conditions. The treatment and the medications are proved to be more effective when using these technologies is used up by the nurses and the patients (Parker Thorslund, 1991). Task 3 3.1 The specific needs for Maggie so as to have independent living are as follows: First is to set a proper routine for her that would include working in the day and having proper sleeps at night time (Aged Care Standards and Accreditation Agency Ltd, 2009). It is to assess her routine and make a proper timetable for her work, resting and sleep patterns. Second is to set a proper routine so as to let Maggie take her meals properly all the three times in a day (Nugent, 2005). Proper nutrition intake is the most important need for Maggie so as to prevent any further impairments in her life. Third is to set a routine that would include proper medicines intake. A time table that would keep her reminded when Maggie has to take the medicines (Barratt, 2004). Fourth is encouraging and supporting her at the emotional level as she has undergone a huge loss of her husband recently (Aggarwal, Vass, Minardi, Ward, Garfield Cybyk, 2003). Due to the loss of the life partner Maggie is unable to overcome this loss and because of this only she is suffering from dementia. So anything that could replenish this loss is needed by Maggie. 3.2 The appropriate devices to support Maggie to live independently are as follows: Reminder message: It can be used by Maggie to tell her to close things like water tap, lights and remind her to take the keys and all the necessary belongings needed by her (Abbey, Casey, Fottit, 2004). Clocks and calendar: It can be used by Maggie to prevent disorientation of the day. It can help Maggie to set the proper regime of work and sleep. It will also let her know days and the time Medication aids: Dossette boxes or automatic pi dispensers can be used by Maggie to help her to take medication at appropriate time. It will help Maggie in the medication process. Bed occupancy sensors: They can be used for Maggie as she is getting up at night time and going out (McCreadie, Wright, Tinker, 2006). These can be an alarm for the family members of the Maggie to check her where she is going and she is fine or not (Janzen, 2001). Work timers: They can be useful for Maggie as they would tell her what is to be done and at what time it is to be done (OSullivan, 2008). They would help her to stay at house and would keep her reminded that the work she has to do at home or out of the home and what work she has to do and at what time. Sensors to monitor daily activities: It can be useful for Maggie as it would be helpful to her GP to recognize the devices that can be used by her to carry out the daily activities easily without any much difficulty (Calkins, Briller, Proffitt, Perez, 2001). 3.3 The usefulness of technology for users of health and social care services are explained as follows: It helps the individual to attain the proper personal lifestyle without any disruptions. It promote autonomy and independence for the person who is suffering from dementia and also to the ones who are surrounded by them (Cunningham, 1992). It also helps to manage potential risks that are in and around that person when he/she is at home or out from home (Dijken, Hoof, Kort, 2006). It reduces acute hospitalization and reentry in to the home care centers and hospitals. It facilitates memory and recalls everything that is important to the individual. It reduces the stress of the care givers, family, friends and also the patients suffering from the disease (Perez, Proffitt, Calkins, 2001). If the disease are recognized at an early stage than the chances of improving from the condition are more. It helps the individual to prevent the disorientation of day and night in their lives. References Abbey, J. Casey, V. Fottit, J., 2004. Measuring and managing a good death for people with dementia. 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