Care for the Challenged Person

CARE FOR THE CHALLENGED PERSON

Challenged person is one who deviated from normal health status either physically, mentally or socially. Children who are affected that way require special care, treatment and education.

The Challenged Children can be classified as follows

∙ Physically challenged children: e.g., blindness, deaf, mute, harelip, cleft palate, crippled – polio, cerebral palsy, heart diseases, road accidents, burns and injuries.

∙  Psychological challenged: orphans, maternal deprivation, emotional deprivation, and maladjustment

∙  Mentally challenged children: feeble minded, mental defect and mental retardation

All these problems may be genetic or due to certain specific diseases, injuries, social factors or nutritional factors.

From the community point of view it is essential that such children in need of help should be taken care. Parents of such children should also play a major part in planning the care.

The objective of the care in such situation is to improve the physical condition, prevent further damage and then to help, secure a suitable occupation.

Major Causes

•            Malnutrition – is another major disability causing factor

•            Accidents on the roads and play at home can be another cause

•            Genetic disorders and birth defects

•            Effects of drugs

The aim of home health nursing is to assist the individual who has a disability and/ or chronic illness in restoring, maintaining and promoting his or her maximum health. This includes preventing chronic illness, and disability. The home health nurse is skilled at treating alternations in functional ability, and lifestyle that result from physical disability and chronic illness.

Responsibilities Of The Home Health Nurse

•            To guide the parent in getting early treatment to prevent further damage and improve the physical condition, e.g., physiotherapy, through which the deformities could be corrected. This knowledge has to be imparted to parents, e.g., as in case of polio

•            To provide occupational therapy. A child who is challenged can be trained to choose any craft according to his ability such as carpentry, painting, cloth weaving or mat weaving

•            Prosthetics: to provide guidance in obtaining artificial limbs or a device like an artificial hearing aid

•            Vocational guidance: the parent must be educated and convoked that the child can be restored to function as a useful member. Such vocational guidance, as it is called, is given in several schools in India.

1.         Occupational and physical therapy school at Mumbai

2.     Occupational therapy school at Nagpur

3.        All – India Institute of physical medicine and rehabilitation, Mumbai

4.         Institute of physical medicine and rehabilitation, Christian medical college and hospital, Vellore

Besides these, there are schools specifically for the deaf and dumb, and for the blind, which are run by private organizations or by government.

•            Preventive activities: Preventive steps can be adopted to limit the extent of disability. Some disabilities, e.g., due to polio or accidents can be prevented. Adequate nutrition can be maintained, so that mental retardation due to malnutrition can be prevented

•            Education: Nurse can arrange for community education on the above aspects to enlighten the people. Specially, in India people associate the mishaps to ‘fate’ or curse from God. So guiding them in the right way is essential

Interdisciplinary approach in providing care to the disabled by the home health nurse

•            Families are often the primary care givers of family members who are disabled. It is important to identify strategies that promote family functioning, stability, growth, and coping

•            Nursing interventions should include assessing the entire family as a unit of care

•            Nurses need to assess their personal feelings, which can inhibit or enhance their ability to function effectively with persons who are disabled

•            Nurses focus on preventive strategies for people who already have potentially disabling conditions to limit the occurrences, impairment and functional limitation

•            Nurses promote self care, self management and self advocacy

•            Nurses provide health education interventions which include teaching clients about their conditions, community resources, self management, self care and self advocacy

•            Nurses assist clients in learning how to find and utilize community resources

Mental Retardation

Mental retardation is a condition of both clinical and social importance. It is characterized by limitations in performance that result from significant impairments in measured intelligence and adaptive behaviour.

Mental retardation is defined as:

•  Significantly sub average general intellectual functioning (IQ below 70)

•  Significantly deficit or impairment in adaptive functioning

•  Which manifests during the period of development (before 18 years of age)

Types

•            Mild mental retardation (IQ 50 - 70) 85% of the total mental retardation

•            Moderate MR –(IQ 35 - 49) 12% of the total MR. Most of them can talk and learn

•            Severe MR(IQ 20 - 34) 7% of the total MR. Only few of them learn to care for themselves completely

Responsibilities of home health nurse in care of the mentally retarded

Primary prevention

•  Good antenatal check – up

•  Improving socio – economic status •  Education

•  Facilitating research to identify the genetic counselling cause

Secondary level

•  Early detection of defects and correction

•  Prevention of child abuse and sexual abuse

Tertiary prevention

•  Treatment of physical and

psychological problems

•  Behaviour modification

•  Physiotherapy to treat the rehabilitation disability

Effects of MR on the family

•  Distress

•  Depression, guilty feeling

•  Over indulgence

•  Social problems

•  Marital disharmony

•  Dissatisfaction about medical and social services