Hospital Staff
Ward Stays
Pre-existing Health Conditions
In these scenes, you will again meet Jeff and Amelia, his disability support worker, and Cassandra and Johnno, her disability support worker, and you will meet Frank, her father.
Applying the Framework
Knowing that
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Patients with intellectual disabilities often have health problems that may not be the reason for their current hospital stay, for example, epilepsy, swallowing difficulties and mobility problems.
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These health problems can worsen when their daily or medication routines are disrupted.
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Noisy or unfamiliar environments can also worsen health conditions.
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Accompanying people will often worry about the hospital stay triggering these health conditions.
Informing
Ask the accompanying person
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about the patient's other health problems
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what can exacerbate them
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strategies to avoid them
Tell accompanying people
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about ward routines
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adjustments you can or will make
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Collaborating is when you
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are willing to listen to concerns of accompanying people
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seek their advice about adjustments
Supporting
Patients with intellectual disabilities will be supported when you​
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act on concerns of family and disability support workers
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make adjustments to reduce the chance of triggering health problems
​Personal Care Needs
In the first scene, you will meet Curtis, a young man with intellectual disabilities, Johnno, his support worker, and Olivia, a nurse on the ward. In the second scene, you will again meet Cassandra and Frank, her father, and nurses, Yasmin and Glenn.
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Applying the Framework
Knowing that
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Patients with intellectual disabilities have varied personal care needs.
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Many patients need help to eat, drink, or get to the toilet .
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Some will not be able to call for help, but may use gestures or signs, which are easy to miss.
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Some may show distress or discomfort through their facial expressions or behaviours, which must be interpreted.
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Visual cues, such as showing, can help patients understand.
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Family or direct support workers may anticipate problems based on previous hospital experiences.​​
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Direct support workers are not usually funded to support a person with disability in hospital
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Direct support for an NDIS participant in hospital might be included in their funding for personal care needs directly related to their disability.
Informing
Ask accompanying people to tell or show you about the person's communication, such as,
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how to read their facial expressions, vocalisations or behaviours
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any type of communication system they use, such as communication books, iPads with communication apps, other electronic devices, or signs or gestures
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how you can communicate with the patient to help them understand
They can also tell you
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about the patient's specific personal care needs
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whether the person is an NDIS participant
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if the person has a personal care plan
Tell the accompanying person
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whether hospital staff can provide for their specific personal care needs
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if there is a Disability Liaison Officer and how to contact them
Collaborating is when you
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listen and learn how to support the patient's communication and personal care needs
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take the concerns of accompanying people seriously
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work with them to solve or avoid problems
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share information and strategies with other hospital staff
Supporting
Patients with intellectual disabilities will be supported by you
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noticing and responding to all their ways of communicating
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acting on concerns of family and disability support workers
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ensuring they are eating and drinking
Rehabilitation
Here you again meet Cassandra. She is with Marieke, an Occupational Therapist, and Manon, a Physiotherapist.
Applying the Framework
Knowing that
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Routines are very important to people with intellectual disabilities.
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Routines help them know and anticipate what will happen next.
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Incorporating instructions into familiar routines help patients follow them.
Informing
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Ask family or disability support workers to explain a patient's usual routines.
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Ask them to suggest ways to help the patient understand instructions.
Collaborating is when you
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incorporate what you have learned from family or disability support workers into rehabilitation activities
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work with other staff to adapt to the patient's needs
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share information from family or disability support workers with other hospital staff involved with a patient
Supporting
Patients with intellectual disabilities will be supported when you
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meet their health and personal care needs
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notice and respond to their communication and keep trying if you don't understand
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use familiar routines to help them understand and engage in activities
Summary
Previous hospital experiences can influence how family and disability support workers interact with hospital staff. They will be reassured if you listen to and acknowledge their concerns. These concerns often extend to the potential for pre-existing medical conditions to be exacerbated in the hospital environment, or from disruptions to medication or other factors. Also, some people with disabilities will require assistance to eat, drink, adjust themselves in bed or get to the toilet, causing anxiety for family or disability support workers who often provide this care at home. Disability support workers are typically not paid to assist a person in hospital .
Familiar routines and environments are particularly important to patients with intellectual disabilities. These are disrupted during hospitalisations and can lead to adverse events. Developing creative solutions in collaboration with accompanying people will reduce the risk of adverse events or poor outcomes.
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​You can find further information in Resources about intellectual disability frequent health concerns, communication and people with intellectual disabilities, the National Disability Insurance Scheme (NDIS) and the NDIS and hospitals.
Activities
These are provided to support your learning, individually or in a group. You can write responses in the workbook sections available for download.
In the scenes of Cassandra with the allied health therapists,
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Identify who was involved in the collaboration.
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Describe how they worked together to help Cassandra understand and follow the therapists' instructions.
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Explain why incorporating instructions in a familiar routine would help Cassandra to follow instructions.
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Describe other ways that knowing about a patient's usual routines might help in delivering quality hospital care.
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List questions you might have for an accompanying that would help you understand a patient's typical routines.