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Unit 5 Health and Social Care Nusrat and Maria Case Studies

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Janine Owens

This study aims to explore the healthcare experiences of people with learning difficulties and their carers. This area has become highly topical as a result of recent national health and social care policies that have emphasised the social inclusion agenda and the right of individuals to have a say in decisions that directly affect their health and well-being. This study exposes tensions between individual and social models in accounting for the healthcare experiences of people with learning difficulties. The decision-making process is complex and traditionally many people with learning difficulties have been judged incompetent to make their own healthcare decisions. However, the recent Mental Capacity Act 2005 proposes that people with learning difficulties should, like other people, be presumed to be competent (to make decisions) unless there are strong contra-indicators. This proposition is tested in the study. To capture the voices of people with learning difficulties, particularly those with limited articulacy and no speech, ethnographic and narrative methods are used to include voices that may otherwise remain unheard. These methods were informed by a constructivist approach that involved working as closely as possible with informants in order to reach a shared understanding of their experiences. Recent policy proposals suggest that all parties within the healthcare encounter need to work ‘in partnership’ and ‘collaboratively’ to provide a more ‘person-centred’ healthcare encounter for people with learning difficulties. An attempt is therefore made to deconstruct these ideas and to examine what light they shed on the lived experiences of people with learning difficulties in relation to their healthcare encounters in mainstream and specialist services. The study can be seen as adding to the growing literature about the lived experiences of people with learning difficulties, to narratives about their everyday lives, to a questioning of tacit assumptions by staff about capacity and best interest, and to the power struggles people with learning difficulties continue to face in their everyday lives. The findings also demonstrate how situational and contextual factors mediate experiences, re-emphasising the importance of the social model of disability.

Wanda Baranowska

Journal of Intellectual and Developmental Disability

Teresa Iacono , Christine Bigby

Roy McConkey

Ontario Federation of Indigenous Friendship Centres

Kimberley Anderson

Amila Hewagajanayakage

Matthew Cock , Richard France , Anna Fineman , Melanie Sharpe

A major barrier to disabled people visiting museums is the lack of advance information. Museum websites are key tools for providing visitor access information, and the absence of this contributes to the ‘disability engagement gap’; where people with a disability are less likely to be regular or frequent visitors of museums than those who are not disabled. The State of Museum Access 2018 comprises guidance to help museums create or review the information that they provide online, in order to welcome potential visitors with disabilities, inform them of any barriers to access at the museum and reassure them that the museum has worked or is actively working to remove them. Together with the guidelines are statistics from an audit of the access information found on the websites of 1606 accredited UK museums in Spring 2018.

AGOSCI in Focus (V7, p77-99)

Shoshana Dreyfus

This paper presents a framework for the description of the semiotic world of a male adolescent (17 years) with a severe intellectual disability who does not use speech as his primary form of communication. The framework is based on selected aspects of systemic functional linguistic theory, including exchange structure analysis and affiliation theory. The framework is based on a proficiency model, showing what a person can do, rather than what they can’t do. It presents a new way of describing nonverbal multimodal communication. The research was conducted by a linguist, who happens to be the young man’s mother.

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Integrated care in practice: a case study of health and social care for adults considered to be at high risk of hospital admission

Integrated care is pursued globally as a strategy to manage health and social care resources more effectively. It offers the promise of meeting increasingly complex needs, particularly those of aging populations, in a person-centred, co-ordinated way that addresses fragmentation and improves quality.

However, policy to integrate health and social care in England has led to programmes which have had disappointing effects on reducing hospital admissions and costs. My concern with the...

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