Maisie Sheahan

[email protected]

Health and well-being for people with developmental disabilities

Bachelor of Speech Pathology, La Trobe University

Assessment 4: Written essay on Becoming a Reflective Practitioner

21st of October 2022

Although individuals with developmental disabilities may have an intellectual impairment,

they are still within their rights to make choices and control their own lives. Upon the first read of
Gabriel’s story, several violations of his human rights are evident. Firstly, the rehabilitation program
at the hospital in which he had his surgery failed, subsequently leading to the freezing of his hip joint.
This violates article 25 of the Australian human rights commission. Furthermore, the group home was
legally required (residential Tenancies ACT 1997) to alert the Office of the Public Advocate of
Gabriel’s changed living arrangements. Failing to do so meant that not only did they breach
legislation, but it is also another significant breach of human rights. In addition, the support
coordinator notes that Gabriel did not have any say in his own future and thereby his freedom of
choice was abolished. Overall, Gabriel’s experience highlights the flaws present in the healthcare
system and emphasises the importance of understanding the rights of those with developmental
disabilities. Although there a more than these three incidents in Gabriel’s story, these three will be the
focus of the reflection.

Reporting and responding

Gabriel was a 60-year-old man with down syndrome who tragically died amid the COVID-19
pandemic. Gabriel’s support coordinator explained that he had fallen and broken his hip which meant
surgery had to occur. After surgery, the hospital’s rehabilitation program failed to meet the needs of
an individual with an intellectual disability. This in turn led to his hip freezing and his mobility is
limited to a hoist. According to Article 25 of the human rights commission, the Australian
government recognises that an individual with a disability has the right to the enjoyment of the
highest attainable standard of health without discrimination based on disability. Furthermore, article
25 also states that it is within their human rights to receive health services needed specifically because
of their disabilities. This in turn means it was within Gabriel’s human rights to receive adequate and
influential rehabilitation services that would allow him to not only return to his home but also to
return to a state of the highest attainable health. Simply as a human being, Gabriel deserved better,
and this breach of his human rights only emphasises the flaws that the Australian health care system is
yet to stabilise. This experience made me reflect on my own responsibility as a future health
professional. In future, I must be aware of this and try to ensure I tailor healthcare to meet the needs
of the individual.

As mentioned, the group home that Gabriel resided in was legally required (Residential
Tenancies Act 1997) to notify the Office of the Public Advocate of Gabriel’s changed living
Arrangements. Instead of failing to lodge a Notice to Vacate, the hospital, group home and
transitional aged care facility debated what they would do with Gabriel. Because of this, Gabriel did
not make any decisions about his future. This is a legal issue and should have been resolved.
However, it’s also a human rights issue. According to article 20 of the human rights commission,
countries must take effective and appropriate measures to ensure personal mobility for people with
disability in the manner and time of their choice and at affordable costs. Especially considering,
Gabriel had the funds to support a hoist being put into his group so that he can stay mobile. Funds that
‘could have been invested to aid Gabriel’s rehabilitation or secure housing of his choice. Gabriel’s
mobility needs were not considered, and the group did take the appropriate and legal steps towards
arranging appropriate living arrangements for Gabriel.

Finally, it is evident in the case study that Gabriel’s own wishes were not appropriately
considered by the individuals handling his case. The advocate stated “He was crying the whole time
he was there. He was distressed and afraid, calling out for people from his house who weren’t there.
The emotional health of Gabriel has not been appropriately considered in this experience. Even the
support coordinator noted that they didn’t think it was right and that they “don’t actually think this is
what should be done” after the hospital began pushing to put Gabriel in an aged care home. As
mentioned in “Choice, Preference and Disability’ by Rodger J. Stanciffe, it is important to “support
the individual freedom of person with intellectual, cognitive, or complex cognitive disabilities’’.
Therefore, it is evident, his own personal preferences and desires were not taken into consideration by
the appropriate staff.

Relating & Reasoning

When reading about Gabriel’s inadequate experience with the rehabilitation program I felt
truly sickened. It reminded me of my reflection on the 8 th of September where I noted “as future
health professionals learn more about how to create supportive environments” for clients. In Gabriel’s
experience, a lack of rehabilitation has caused his hip to worsen rather than improve. This led to the
overall decline of his livelihood and mental health and well-being. As a future speech pathologist who
will work in rehabilitation, it is disheartening to see such circumstances are still occurring today. On
the other hand, this also inspires me to continue my studies and help those like Gabriel recover
rehabilitate and get back to the highest attainable standard of health and well-being. The case study
talks specifically about how this will affect his mobility. A lack of mobility can lead to extreme
isolation, especially considering he was away from his closest social connections. This made me
consider whether his unexpected death was influenced by the stress and strain on him.

Furthermore, after the group home failed to notify the Office of the Public Advocate of
Gabriel’s changed living arrangements, I began to feel a deep sense of empathy for Gabriel. This case
study exhibited how poorly handled Gabriel’s situation was. I felt a sincere and deep sadness for him.
Moreover, the situation also made me ponder whether Gabriel’s life could have been saved if the
appropriate measures were taken for his rehabilitation. As a future health professional, I would be
deeply disturbed and disappointed if a situation like this occurred under my care. The circumstances
and the empathy it made me feel, energised me to do everything in my power to help individuals
return to the level of health in which they can live comfortably and freely in. In addition to this, I also
wondered whether proper legal action was taken after the group home failed to inform the Public
Advocate. As stated by the department of health and safety ‘Information is the most important tool we
have to check if health care is safe’. Failing to share this information, is something I believe should
have legal consequences as it jeopardises the state of an individual’s health and well-being. Overall,
my reaction to this, made me reflect on my own future as a health professional and how critical it is
for me to understand and apply the appropriate actions in the workplace.

The final experience I had a significant reaction was the overall lack of say Gabriel had in his own
choices and future. It made me reflect on myself and how I would feel if these choices were taken
away from me or someone I knew. I would be isolated and deprived of basic human rights. Not only
this, but it makes me ponder what mental and emotional state Gabriel must have been in during this
time. I am reminded as a future health professional that while trying to rehabilitate physical health and
well-being I must also be mindful of creating a positive environment for mental health and well-
being. As I noted in the group forum it is ‘critical that we as future health professionals learn more
about how to create supportive environments”. Overall, his experience and this case study are a
reminder for us as future health professionals of what the wrong behaviours are surrounding the
treatment of individuals with developmental disabilities.

Reconstruction

Gabriel’s experience is an excellent teaching point for health professionals to learn about the
implications for present and future rehabilitation practice. In the future, the first thing that is discussed
must be the goals that the patient would like for themselves. A report by the world health organisation
explained that responding to individual preferences can reduce challenging behaviour. For example, if
Gabriel’s biggest goal was to get back to the group home, then above everything the rehabilitation
staff need to work towards it. He would be less likely to become upset or stressed. It is critical to keep
the discussion open and honest between the client and the clinician. Furthermore, I Have learnt how
important it is that the financial status of the client should also be considered so that their personal and
state funds can be used to manage their goals.
Throughout this case study and the content of this subject, I have learnt many lessons about
how to approach and treat those with intellectual disabilities. This has changed my beliefs and
attitudes towards these individuals and opened my eyes on how to better interact with them as clients.
I understand the importance of giving them choices and control of their own lives. I also understand
how critical it is for me, as a future health professional, to follow the rules, laws and guidelines set out
by the department of human health and services. Gabriel’s experience gave me a sense of
accountability, as I must do better and work harder to help individuals achieve the highest attainable
level of health and well-being.

References:

Australian Human Rights Commission. (2022). Disability Rights. Australian Human Rights
Commission.
https://humanrights.gov.au/

State of Victoria, Australia, Department of Health and Human Services. (2020). New laws to improve
quality and safety in the health system. State of Victoria, Australia, Department of Health and
Human Services.
https://www.dhhs.vic.gov.au/sites/default/files/documents/

Stancliffe, R. J., Wehmeyer, M. L., Shogren, K. A., & Abery, B. H. (Eds.). (2020). Choice,
preference, and disability: Promoting self-determination across the lifespan. Springer
International Publishing AG.
https://doi.org/10.1007/978-3-030-35683-5 (eBook)

World Health Organisation. (2012). Early childhood development and disability: a discussion paper.
Chapter 4. World Health Organization, UNICEF.
https://dbb715huzqn8k.cloudfront.net/7b/c5/7bc58aa17da121fab4913d148f0997626126f131?
response