Intellectual Disabilities And Care Services In Ireland - An Essay.

The Need for Structured Public Care Services

Question:

Discuss about the Alternative To Home Care In Ireland.

The current study discusses the aspect of care services for the ones with intellectual disabilities in Ireland. It is believed that family based or community based care is the best suited approach for care in Ireland (Murphy et al. 2015). Therefore, public care services are only thought to be convenient options in case the community based care services are not available. Additionally, for longer periods of time the responsibility of care for the intellectually challenged or less able was shifted on the shoulders of the women in the family who continued to do it for free (Taggart et al. 2012). However, amidst the changing circumstances the government has made major changes within some of the healthcare policies in order to accommodate advanced care for the ones with cognitive impairment.

The need for a more structured public care services could be explained with the help of few of important figures and statistics. As per the estimates from the year 2006, there were 113,000 people aged between 12-55 years who were possessing some kind of intellectual disabilities and needed support (Colomer and de Vries 2016). In order to support the mentally less able the government formulated a number of effective policies and programs. This could further help in restoring the autonomy they could have in making choices regarding the kind of support services they would want to receive. The intellectual disabilities could be attributed to the presence of a number of conditions such developmental delay, fragile X syndrome and Down’s syndrome (Millar et al. 2015).

The Irish support care consists of a mixture of public and private care structures. A large portion of supportive care is provided by private market based services. The Irish healthcare relies heavily on women and most of it is unpaid care (Simplican et al. 2015).  Majority of the care services are attended by general medical practitioners within their homes rather than specialised care services at hospitals. As commented by McMahon et al. (2017), extended form of care is provided by some of the healthcare organizations such as providing ‘meal on wheels’ for the ones with limited capacitates. Reports and figures have also suggested that two-thirds within the elderly population of Ireland had functional disability and would prefer to receive support care within the comfort of their homes (Chadwick et al. 2013). However, most of the times the ones with cognitive disabilities are left alone at home by their respective family members who often need to travel out of the country due to work purpose. Additionally, the community based voluntary care services are not comprehensive in its approach and design and therefore lack the basic skills for the delivery of specialised health support services (Doody 2012). As per the breakdown of   residential accommodation, in 61% of the cases the family members of the ones with intellectual disabilities would prefer privatized care services over public support services. As mentioned by Murphy et al. (2015), lack of sufficient infrastructure and less availability of finances deteriorated the quality of mental health care services offered by the Ireland based public health care organizations.

Policies and Legal Frameworks

There are a number of policies and legal framework underlining the care of the disabled population in Ireland. One such framework which could be discussed over here is ‘Towards 2016; Ten -Year Framework Social Partnership Agreement 2006-2015’. Some of the objectives outlined in the Towards 2016 framework are to provide the individuals with intellectual disability the chance to live an independent and autonomous life (Ali et al. 2012). This was to ensure that they are able to make their decisions without depending on others from support. Additionally, the National Disability Strategy (NDS), 2004, was introduced with the aim of improving the participation of people with disabilities within the society. The main legislative structure supporting the policy is the Disability Act, 2005, which focuses upon making such disability services as a part of the mainstream (McCarron et al. 2013). Under this act the people with disabilities were entitled to a number of services such as:

• Having their health needs accessed
• Accessing of individual complaints and appeals

The department of justice and equality has been working together for the integration of the National Disability Strategy and the UN convention on the Rights of People with disabilities (inclusionireland.ie 2018). Additionally, the Equal Status Act 2000 and 2004 promote equality and prohibit discrimination against people with discrimination. One of the most important legislation which was drawn in this favour was the National Housing Strategy for people with a disability, 2011-2016. Most people in Ireland with intellectual disabilities have their services delivered by one organization only (Ryan et al. 2014). These include accommodation needs, medical and social services. The service providers receive funding from the HSE to look after the various needs of a disabled person (Coppus 2013). In this respect, a person is assigned a particular service provider from the very beginning leaving them with very few options for change. As argued by McGlinchey  et al. (2013), this provides the disabled population with intellectual disabilities little or no option to excise their personal choice in the selection of care provider. As per new regulation, people with disability regardless of their housing situation were to be considered for allotment of new housing options under the residential care scheme (Iacono et al. 2013).

Team work is one of the most important attributes of health care and support.  A well coordinated team ensures that effective flow of services is maintained for the maximum welfare of the patient and their respective families. Therefore, undertaking group project and presentation can help me develop teamwork skills and competencies. Working as a part of team and taking part in combined projects requires a number of key skills and competencies. Some of these are communication skills, problem solving skills, listening and feedback skills.  The amalgamation and optimization of such skills can make a team strong.  However, as supported by García Iriarte et al. (2014), individual contribution is necessary for the success of the entire or the whole team in a care setup. Therefore, working as a part of a team in an aged care set up helped me in developing my communication as well as problem solving skills. It was required that I communicate actively across the team in order to understand the different requirements of the care process delivery. One of the manner in which the team communication aspect could be supported is by active note taking.  Note taking and roster formation are some of the habits which can help me prevent the occurrence of an untoward incident within a care set up.  Additionally, participating in group presentations has helped me develop my analytical skills further. The sharing of feedback during preparation of group presentation helped me develop my creative thinking skills.

Teamwork and Competencies in Healthcare

Additionally, practising of active listening approaches can help me  relate better with the grievances faced by the patients as well as understand my tasks well during the team briefing sessions. In addition, dealing with patients with intellectual disabilities often results in situations where the patient may be showing challenging behaviour. As commented by Amado  et al. (2013), practising therapeutic communication approaches with patients  with cognitive disabilities can help me in understanding the issues faced by them.  However, I have also faced a number of challenges working as part of a team. Some of these were regarding communication issues faced due to language mismatch. In this respect, some of my co-workers within the healthcare team were from different nationalities, which resulted in a communication gap. I often felt that lack of support from a supervisor also result in service gaps. As commented by Iacono  et al. (2014), a  number of ethical barriers are faced when dealing with  old age group patients with intellectual disabilities admitted in hospitals.   

The tasks and the roles performed by an individual within a team could be further explained with the help of an UNSTAR model. The model could be broken into fragments such as UN-intellectual understanding, S/T- situation/ task, A-actions and R-result.

Table: Team and self competencies using UNSTAR model

(Source: Author)

The UNSTAR model can help me develop my team work competencies better as it would help in meeting the key objectives of the work process.  Additionally, working under an experienced team can also help me in learning evidence based assessment techniques which could help in analysing the situation of the patient better serving in an acute healthcare setting. One of the most important aspects of working as part of team is that it will help me in understanding my loopholes better. Additionally, working within a team would also mean that I can take help from the seniors in understanding certain jobs and their specific requirements. One of the most important skills which are required working as part of a team is effective negotiation skills. This would help me in settling down the disputes with my team members while working as part of a team. Additionally, working as part of a group would also help me develop better problem solving approach which will help me deal with future challenges affectively.

References

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