Disability is generally defined as a restriction or loss of functionality ability as a result of body or mind (Wiebers, Feigin & Brown, 2006, p7). In light of this definition, disability is therefore perceived as a problem. Disabled people accounts for 10-20% of the total world population, therefore, they are part of our community and are entitled to access the same public utilities as the general populace, including Healthcare facilities and services. However, specialized care is required when dealing with disabled people especially in the healthcare setting. The healthcare professionals ought to understand effectively how to work with people with disability so as to deliver quality care to everybody irrespective of their physical or mental status. In this paper, I will seek to discuss in depth the contemporary issues regarding service delivery to individuals with lifelong disability in the form of stroke while in a healthcare facility. Additionally, I will expound on how a speech pathologist would be of great help to this particular patient.
- Stroke: The Disabling Impairment
Stroke, also referred to as Cerebrovascular Accident (CVA), occurs after a rapid loss of brain function as a result in the disturbance of the blood supply to the individual’s brain. The disturbance of blood supply may have resulted from a blockage in the arteries or a hemorrhage. Consequently, the affected parts of the brain are unable to function properly thus resulting to an inability to move a certain part of the body, impediment in the formulation of speech, and the inability to understand (Tanner, 2007). There are different types of stroke that may occur to a patient; one of them is the transient Ischaemic attack (TIA), this is a temporary blockage of blood supply to a part of the brain leading to a short-lived type of stroke. It normally takes few minutes, hours or a maximum of a day to disappear (Daniels, Brailey, Priestly & Herrington, 2005). The other types of stroke are the ischaemic and haemorrhagic stroke; these forms of stroke are more long lasting and in many occasions may lead to permanent disability. I will focus my attention on the long–lasting forms of stroke that ultimately leads to partial or complete disability.
Speech pathologist: The recommended health profession
A number of researches show that In Australia, stroke is the second leading killer after Coronary heart disease (Morrison, Johnston, & Walter, 2012). In 2012, more than 50,000 Australians were reported to be suffering from both recurrent and new strokes. In addition, about 430,000 Australians live with the effects of stroke (Morrison, Johnston, & Walter, 2012). Moreover, more than two-thirds of the people who suffers from stroke ends up with disability. However, with the immediate help of a medical or rehabilitation specialist, in due course, the stroke victims might be able to reclaim all, or some of their former abilities.
In my opinion, the best medical professional to handle a patient with stroke disability is the speech pathologist. This is because, the most prevalent stroke-related disability treated in hospital setting mostly involves language, speech skills and swallowing. This occurs because stroke affects different parts of the brain and the complications that patients experiences may vary widely. For instance, when a stroke attacks the left part of the brain, speech and language becomes impaired, whereas if it occurs in the right side, the cognitive functionality of an individual such as memory, reason and problem solving ability is affected (Stryker, 1981). The professional background of a speech pathologist includes an academic completion of a master’s degree in speech pathology and be duly registered and licensed by the state that they wish to work.
There are key issues that relate to the participation of a patient suffering from a stroke attack. These issues mostly directly affect the individual’s lifestyle, career, family relationship, recreation among other activities that they used to do when they were in their normal state. Their participation in activities that requires a lot of movement is discouraged. They often encounter a lot of difficulty when trying to communicate or when eating. This results because a stroke normally impacts the areas of the brain that are responsible for the movement of muscles, throat (Pharynx), and the laryngeal (includes vocal cords) (Wiebers, Feigin & Brown, 2006, p47). In addition, there are other life-course issues revolving around the stroke patients social, cultural and structural contexts. According to a qualitative research carried out by Glymour and Berkman on the lifecourse social conditions in the incidence of first stroke, the social economic status (SES) may be used to predict the stroke risk in adults. Life course disruption which results from a stroke or a subsequent attempt by the stroke victim to restore their continuity is discussed further in this medical journal.
- International Classification of Functioning, Disability And Health (ICF)
The ICF is a framework that has been formulated by the World Health Organization (WHO). It is designed to provide a standard and unified language for the explanation of health and health-related states. The international Classification of functioning, disability and health seeks to describe functioning at three distinct levels: The body, societal, and person. The first part normally deals with functioning and disability while the second part majors in contextual factors. The ICF global notion of health is that it is whereby a person is in complete physical, psychological, spiritual and social well being ( Flasher & Fogle, 2012, p342). The aspect of functioning and disability is a multi-dimensional experience that results from various interactions between patients with a particular disability or a health condition and their social and physical environment.
The ICF is generally composed of a hierarchy of domains and components, these includes the body function, activities and participation, body structure and environmental factors that affect the patient. The body function component of ICF includes; mental functions, voice and speech functions, functions of the digestive endocrine and metabolic systems. The activities and participation component on the other hand involves learning and application of knowledge, communication, domestic life, and general tasks and demands. In addition, the Body Structure domain is composed of structures normally involved in speech, structures such as the ear, eye, and also the structure of the nervous system (Gresham, Phillips, Wolf & Dawber, 2004). Moreover, the environmental factors in ICF involve issues such as natural environment and human-made changes, support, relationships and attitudes.
The ICF provides a great framework to better conceptualize the participation is of a patient with stroke related disability. After a ‘generic ‘ qualifier scale is identified and records the extent of the problem in relation to the stroke-disabled patient’s impairment, participation restriction and activity limitation, the ICF thereby becomes a vital tool for us in any community based life and healthcare endeavor. I consider ICF as an imperative structure which can be used to rehabilitate a stroke patient by ensuring that they maintain an optimal functioning in interaction with other people and the environment. When combined with other rehabilitation measures, the disabled person’s participation and activities levels will be improved. This is because Rehabilitation process and the ICF framework contribute to the individuals’ maintenance and achievement of functionality in the society (Daniels, Brailey, Priestly & Herrington, 2005). It prevents, restores, compensates or slows down the loss of function in the patient suffering from stroke disability.
- Provision of support by the healthcare profession
When a stroke patient is admitted to the healthcare facility, a speech pathologist is required to check on the patient within 24hours. The stroke-disabled patient is observed by the speech pathologist during the process of clinical evaluation at the bedside. Mostly, it is the eating and the swallowing ability which is observed at this phase. This is because patients with stroke disability tend to have a lot of problem during swallowing food or a drink due to lack of movement in the muscles of the mouth (Wiebers, Feigin & Brown, 2006, p22). This problem usually puts them at the risk of aspiration i.e. some particles of food may be passing into the lungs. Aspiration becomes more fatal in the elderly disabled persons because it might lead to pneumonia (Johnson, 2007). In this case, the speech pathologist determines how best a patient with instances of stroke disability would be able to move food from the front part of the mouth to the back of the throat. They simply asses how safely and effectively a patient swallows.
In addition to monitoring the swallowing process of the disabled patient, the speech pathologist examines all the parameters of communication. These parameters include language comprehension and the ability of the patient to finding the right words to express themselves in a coherent manner. The quality of voice and the patient’s ability to articulate clearly is also assessed by the speech pathologist. One this healthcare professional has determined the capabilities of the disabled patient and ultimately discovers the difficulty in speech, they then proceed to developing various treatment strategies that can help improve the communication ability of the patient. It is imperative that patients who have stroke disability are able to communicate their needs. In case a person has totally lost their ability to comprehend whatever is being said to them, then it is the role of the speech pathologist start building those skills (Tanner, 2007). The context of primary healthcare and accommodation are the key areas that support is required most. In order to maximize on the services of the speech pathologist, a stroke- disabled person should be offered accommodation in the healthcare facility.
The speech pathologist can use different approaches that enable the disabled patient to fit and interact effectively with other people in the society. One of these approaches is the improvement in communication. The speech pathologist trains the person with stroke
disability to improve on their speech. This therefore enables the patient to talk freely and communicate effectively with other people in the society despite their predicaments. Communication is arguably the most important ability in a human being that helps in interaction. It is for this reason that I find a speech pathologist as a very important physician to help a stroke disabled patient to regain full or part of their former social lives.
The other approach undertaken by a speech pathologist in regard to improving the social lives of patients with stroke related disability is through emotional and moral support to the patients. After surviving a stroke, many patients normally have feelings of frustration, anxiety, anger, sadness and a sense of grief for their disability caused by physical and mental losses. These feelings are natural. In addition, it is characteristic of stroke survivors to develop clinical depression. This is a form of hopelessness which eventually leads to sleep disturbances, social withdrawal, self-loathing and to some patients, it may lead to suicidal thoughts (Tanner, 2007). However, since a speech pathologist is also trained in analyzing the cognitive and psychological stature of the patient, they are able to create confidence where hope had been lost. This is a very effective approach to enabling the disabled patient regain their social and interactive lives. This strategy further promotes the functioning of the patient as outlined in the International Classification of Functioning, Disability and Health (ICF).
In conclusion, it is evident that offers multidimensional experiences which are interactive and varies with the environment. It becomes a call for concern when the world Report on Disability reports that there are more than a billion individuals with various forms of disability and suffers significant difficulties in their everyday lives (Daniels, Brailey, Priestly & Herrington, 2005). However, with the adoption of the ICF as the major technical standard and statistical framework to monitor the progress of the disabled persons, most of these patients will be able to effectively interact with their body functions, environment and most importantly with the society that they live in. In the context of my discussion, I feel that the difficulties that may be facing a patient with stroke disability would be greatly reduced if the services of a speech pathologist would be availed to them.
ReferencesTop of Form
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