Meeting Individual Care and Support Needs

In this unit coursework, I will be centring my work around two case studies of individuals with extra support needs. These two people are Tremayne and Valerie.

Tremayne is 54 and has autism. He broke his leg in three places and was moved into a community hospital because he attempted to remove his own cast numerous times- he was deemed not ready to return home. He has a wheat allergy but continues to eat foods that trigger this and does not understand why he feels ill.

He is also ‘disruptive’ and frequently has anger outbursts, which cause distress to other service users. Tremayne normally lives on his own but has a team of carers who visit and support him.

Valerie is 24 and is obese, has mental health problems and has a hearing impairment. She is also a vegetarian and a victim of bullying from local teenagers in her area. She had a surgery following a burst appendix and is at the community hospital whilst she heals and recovers.

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Her surgical wound is healing however she is reluctant to go home in fear of the bullying resuming. Valerie is unemployed and receives universal credit, and lives in a flat provided by a housing association- it is unclear whether she lives independently or with others.

Equality, Diversity and Discrimination

In general society, and specifically the health and social care sector, everyone, regardless of their beliefs, race, age, or quality of life, deserves and is given the same rights/opportunities. This does not mean that everyone requires the exact same treatment, it does however mean that every person should receive and have access to the treatment most beneficial to them and their wellbeing.

This is equality- the belief that everyone is equal.

Diversity is a range of differences. To value diversity is to respect someone’s cultural beliefs even if you do not share them. The same values apply when understanding disability, age, gender and ethnical background. Respecting these differences and not allowing them to interfere with quality or care is a legal obligation for those working in the health and social care sector.

A multicultural society is one in which healthcare professionals and service users come from a diverse range, such as background, race, age, disability etc. A multicultural environment is an opportunity to change, grow and learn, using the influence of a wide range of cultural diversity.Discrimination is when a person acts upon a prejudice, in a physical or verbal way, therefore treating a specific group a different way. Discrimination can have damaging effects on a person’s mental wellbeing, their self esteem and even life opportunities. There are four general types of discrimination. Unfair discrimination is when a person is treated unfairly, despite having the same qualifications or level of experience, an example of this, is hiring a white person over a person of colour as a result of prejudice and internalised racism. Direct discrimination is when someone is rude, hostile, offensive, or even aggressive to someone because of their differences to them, for example, a person verbally abusing someone of a different sexuality or gender. Positive discrimination is treating someone favourably based on a ‘protected characteristic’, an example of this is offering a job to a candidate, who is possibly not the best candidate for the role, in order to fulfil a quota. Indirect discrimination is when a healthcare professional/provider has a practice, policy or rule which applies to all service users but has a negative effect on some because of who they are; factors are gender, age, disability, race, religion and sexual orientation, for example a care home for the elderly may have a period of exercise daily that the residents take part in; the exercise will be beneficial to those who have full mobility, but may cause some service users to feel discriminated against if they have reduced mobility or are potentially in a wheelchair. Discrimination can lead to very serious consequences, such as negative effects on mental health and self-esteem, perhaps even leading to depression, anxiety or even suicidal thoughts. Another few examples of the negative effect of discrimination is the potential damaging effect on their social lives, ability to work or ability to live amongst others, amongst many other negative effects.

Initiatives Aimed at Preventing Discrimination in Care

These are ways in which services can be adapted to tailor to specific needs and prevent discrimination. The first way involves access, and making care environments accessible to all people, this could include ramps and wider doors for wheelchair users, hearing aid accessibility in community spaces or prayer rooms and meal options for those who follow certain religions. The second is diet, this can be altered to all care users by providing meal options which include vegetarian, vegan, kosher and halal meals, as well as catering to specific allergies which a service user may have. The third initiative is support; providing appropriate resources and information in a range of accessible formats such as foreign languages and braille, in order to ensure everyone is aware of and has access to support resources. The final initiative is the use of advocacy services; an advocate can offer support to vulnerable and disadvantaged people, and ensure their rights are being upheld, by speaking or making decisions on behalf of someone who is unable to do so themselves (someone may not be able to speak/communicate due to a disability, or a disease which affects cognitive abilities or them not understanding the language being spoken). Another kind of resource which can be provided is things like stair lifts for the elderly/wheelchair users, walking aids (sticks and frames) for those who struggle with mobility, sock aids to allow people to dress themselves, pick up and reach equipment for those who may struggle to bend in order to pick something up, bathing equipment for people with reduced mobility and telecare systems for the elderly, disabled and vulnerable who are liable to falling or serious injury and may struggle to get the help they need, especially if living alone. There are many other pieces of equipment which can be offered to those who need it. Resources like this allow people to retain independence and feel empowered at times where they are most vulnerable/in need of care. The ability to do things for themselves, may improve a service users wellbeing and prevent them from declining emotionally, even if they are declining physically. These resources may also give carers a feeling of peace and ease, as they are able to allow the service user to carry out tasks for themselves, that a carer may have previously had to do.

To provide non-discriminatory care, as well as promote diversity and equality, everyone needs their care/treatment plan altered in order to cater for their specific needs.

For example, Valerie has mental health problems, low self-esteem, obesity, a hearing impairment and is a vegetarian. She is also a victim of bullying when she is at home, from the local teenagers, due to her obesity. Valerie does not want to go home after her wound heals, in fear of the bullying resuming. In order to provide non discriminatory care, her care needs to be personalised. Her care plan needs to consider her needs and what may set her aside from other patients. Due to her obesity and vegetarianism, her meal plan may be altered to provide her with the most healthy, nutritious meals whilst she is being cared for; these meals need to be suitable for vegetarians, as well as low in fats and sodium in order to prevent her from gaining even more unhealthy weight. She should however, be offered a choice in meals, so that she has the autonomy to decide what she wants to eat, instead of others deciding for her, which may potentially make her frustrated, or feel discriminated against because of her weight. Valerie’s mental health problems may affect how she deals with discrimination and being treated differently, as well as her stay in the hospital/the thought of returning home, and she should be offered mental health services (such as a therapist/psychiatrist) in order to make this more bearable for her. Her care should also include a plan of action for her hearing impairment, she may need to be offered a hearing aid, or given general support for her hearing, to give her the same opportunities a fully hearing person has. By preventing discrimination towards Valerie, her self esteem may start to lift, and she may find her mental health problems easier to cope with. She may also find, that with positive encouragement she begins to lose weight, and starts to understand why obesity is unhealthy and damaging to her body. In turn, she would find herself comfortable going home, and she would potentially feel empowered in her ability to make healthy and conscious choices for herself.

Tremayne, like other people with autism, are often a target of discrimination because of their disability, which is an ‘invisible disability’ and is often misunderstood by people. He has frequent outbursts of temper and is causing other service user’s distress and is said to have continually tried to remove his cast. He also has a wheat allergy, but continues to eat foods which trigger this, and does not understand why he feels ill. It is obvious he needs further support whilst at the hospital, and if he were to return home, he would also need a team of around the clock carers to provide him with the care and support he needs. Because of his autism, Tremayne may not understand why he feels certain things, or why other people’s behaviour may frustrate him. It would be a good idea for a care provider to explain why he needs a cast and why he cannot eat certain foods, so he does not feel like he is being discriminated against due to his disability.

This is important to him because it would prevent him from feeling frustration/feeling upset, and his care plan would suit his needs more specifically. By preventing discrimination towards Tremayne, he may find himself in a better state of mind, and his likelihood of having angry, distressing outbursts would reduce. He may also, after extensive explanation of why he should not remove his cast and eat wheat products, be deemed safe to return home, with the guidance of carers. His return home may make him feel more empowered in his ability to make choices and care for himself, and may make him feel more valued and respected, and raise his self-esteem.