Adult Service User Groups

            Adult service user groups are considered as those adults who are either in constant need of health services, are disabled, or are potential recipients of health promotion and public health services (NIHR, 2007). A user group must have similar needs and concerns and ideally live in the same area for reception of services or to ease their access to the same. People with physical and sensory impairments are some of the service user groups social workers are involved with. These individuals are especially disadvantaged in society in view of their great need for care and support. Their dependence might be viewed by some as bothersome and therefore they are usually neglected and hence the need for proper care is as immense as it is essential.


1. Visually Impaired Adult Service User Group

The visually usually have impairments which include low vision, color blindness, and blindness (Stanford, 2000). Blindness is one of the most devastating of the three and is part of sensory impairment which may lead to reduced or absent visual acuity. This may lead to difficulty in the perception of visually presented information even in the presence of visual aids such as spectacles. People develop mentally through the information they acquire primarily through visual and audio information (NHS Ealing, 2009). Visual information is important in that it is the primary source of information and communication. Therefore, subtle differences and intonations provided by visual information are missed by people with visual disability and they are subject to communication problems. People with visual impairments are faced by many challenges since for one to function and interact with other people; one must have a common channel for exchanging information with them. Since visual information exchange is extensively used by people, the visually impaired are a great disadvantage.

1.1. Diagnosis and features Associated with Visual Impairment

Blindness is caused by genetic conditions, diseases like glaucoma, diabetic retinopathy, cataracts, retinitis pigmentosa, age related macular degeneration, and corneal opacity among others. Injuries and abnormalities can also cause blindness especially for people who get occipital lobe injuries. Genetic effects such as albinism and Leber’s congenital amaurosis can contribute to blindness from birth. Another newly discovered genetic defect, the Bardet-Biedl syndrome, also causes blindness or low vision (NHS Ealing, 2009). Other causes for blindness include poisoning and willful actions. Methanol is known to cause blindness when it breaks down in the body and often causes blindness for alcoholics who may take methylated spirits as a cheap substitute for alcohol but the spirits contain methanol.

Diabetic retinopathy is a complication of diabetes and is caused by damage to the small blood vessels in the retina which causes blindness. Some of the blood vessels may burst and the retina may break loose from the back of the eye. Treatment includes reattachment of the retina and sealing of broken blood vessels. Glaucoma is common in both developing countries and developed countries and causes about one in every eight or seven cases of blindness. In glaucoma, the excess fluid in the front part of the eye does not drain normally therefore causing excessive pressure to build up in the eye. The structure of the eye is damaged by the pressure which may cause blurriness progressing into total blindness with time. The condition may be controlled if it is discovered early enough. Another cause of blindness is cataracts which are opacities which cloud the eye’s lens. They mainly cause blurred and double vision and may be corrected though surgical removal of the lens and through corrective glasses.

With increased age, the inner retina may degenerate slowly therefore reducing the quality of the image observed by the individual. The condition may be treated by the use of laser treatment and by the removal of tissue that has grown beneath the eye. Retinitis pigmentosa begins with night blindness at a young age and degenerates into blindness in adulthood. The problem is caused by damage to the retina and the choroid. The problem is hereditary and has various variations in its development but usually causes blindness by the time the individual reaches young adulthood. The condition has no known treatment for the condition. There are many other causes of blindness which are however not as prevalent.


1.2. Disadvantages and Difficulties associated with Visual Impairment

The visually impaired are faced by many problems all of which are related to their lack of the ability to access visual information. This leads to their lack of mobility or problems associated with mobility and in their development especially education-wise. This is especially apparent if they do not have access to educational facilities that cater for their specific needs. Therefore, most of them rely on others for guidance on how to move from one place to another especially for environments that are changing continually. Since public spaces are subject to a lot of changes, visually impaired people have great difficulties in navigating through them. For public transport systems, there are difficulties for the visually impaired in that they are not regular in their placement and structure. Buses do not stop at the same place and there are different models of trains therefore a lack of uniformity means the visually impaired may hit obstacles or be in danger of injuring themselves.

Changing environments are therefore a danger to the visually impaired and therefore some of them avoid such places when they do not have guides. Though the use of guide dogs may help them in moving about, the complexity of some situations may be above the dog’s ability to navigate and therefore may lead to dangers for the individual. The ability of the dogs depends on its training and the knowledge of individual about the layout of the area. This is because they are required to instruct the dog on where to go and the dogs then helps them to navigate obstacles and avoid dangers.

Visually impaired people have problems in accessing educational facilities such as books since they do cannot see or have problems with the size of the text. Therefore, they need support in the translation of books into Braille which would facilitate their access. Due to the lack of educational resources, the visually impaired are often restricted to a few texts and so they are likely to remain in the lower educational brackets when standard texts are offered to both the visually impaired and those who have no disability. They therefore face problems in the acquiring of education and consequently cannot get well paying jobs (Bakar, 2008). When their lack of well paying jobs is coupled with their greater need for money which they could use in getting assistance and other helping devices, they are forced to live in dire financial conditions. Therefore, financial inability is a common feature among the visually impaired.

The lack of employment is another cause for their problems in since employment is usually an important source of finances for people. The problem stems from employers who see the impaired as dependent people rather than people with the capability to produce something at their area of competence (, 2009). Poverty ensues from this lack of employment and for them to improve the quality of their lives; actions are needed to improve their employability and employment chances.

The fact that they cannot access visual information is also a problem for them in their accessing information about public transport system and other public facilities. Often, public transport and address systems are confusing or are badly marked. This may lead to problems for them since they may not be knowledgeable of the direction to which they are going. Reading visual warnings may also be a problem for them and the lack of audio warnings which are often disregarded in the public service providers may constitute more disadvantages for the visually impaired. Therefore, the visually impaired have a hard time moving from one place to the other independently (Uslan, Peck, Wiener, & Stern, 1990). These problems, especially the problem of mobility, face almost all the visually impaired and therefore if they were to be solved, they would increase the stature of these people in society and lift them from poverty and the fear of moving in public places.


1.3. Types of Support needed by the Visually Impaired

To help the visually impaired to improve their quality of life, some support systems are needed to make then productive members of society. This can be provided by looking at the general problems and individual problems facing them and the provision of solutions to their problems. The solution for the lack of proper educational facilities would be emphasis by the government on increasing these facilities and the provision of books in Braille which would help them improve the wideness of their subjects and improve their chances in the job-market.

Adult visually impaired people have a need for moving from one place to another. This would improve their ability to get jobs since they would not be hampered by a lack of means to move around. One of the best ways for reducing their fear of the public transportation system and public places would be the involvement of orientation and mobility trainers who would increase their confidence in their ability. Orientation and mobility training would also teach them the best ways in which to react given a certain situation.

With this training and the presence of enhancers such as guide dogs, they would have greater freedom of movement and exploration of possible employment options (Dryden, 2000). To aid in their being able to move around aids to them should be put in public spaces which include audio warnings and announcements in the public transport system and other public spaces. By making transportation easier for the visually impaired, it does not mean that they automatically gain the confidence to move about. Therefore, they need to have the orientation and mobility training to supplement changes in the transportation system. The trainers could also provide motivation for those involved therefore increasing their confidence to venture out (Dryden, 2000). Through these methods, the visually impaired become more independent and are empowered to increase mobility and therefore lead more fruitful quality lives. The image of dependency could also be shed therefore increasing the probability of their getting employed for jobs in which they are competent.

The giving out of direct payments could also help the visually impaired to overcome poverty or if they are in great need of finances. The independence produced by this kind of payment is however subject to the definition of the word independent. This is because they would still be dependent on the government to provide this funding for them to live well. Therefore, in the long run, provision of such kinds of financing could prove detrimental since some of them could become dependent on handouts. Therefore, training is the best method that could be used to promote them by providing them with means through which they could provide for themselves. This independence could improve their stature in life as well as lessen the load the government would have to bear since they would be able to produce for themselves.

2. Physically Disabled Adult Service User Group

            Physical impairment is a condition in which the ability to move, coordinate movement, and perform physical activities is significantly limited, delayed, or fraught with difficulties (Stanford, 2000). This brings about trouble in the execution of physical and motor skills, moving independently, and the performance of basic life functions. Physical disability causes mobility problems and may be coupled with the lack of self-esteem as a result of stigmatization by society.


2.1. Diagnosis and features Associated with Physically Disabled People

The causes of disability include cerebral palsy, congenital anomalies, arthritis, amputations, and fractures and injuries that adversely affect a person’s movement (Stanford, 2000). Injuries to the spinal cord could also result in disability since they could cause paralysis and the level to which the person is paralyzed depends on the height of the lesion. Other medical conditions that could cause physical impairment include muscular dystrophy, multiple sclerosis, carpal tunnel syndrome, diseases of the nervous system, respiratory problems, arthritis, musculo-skeletal disorders, genetic conditions, and post polio syndrome.

Spinal injuries cause paralysis below the area in which they occur because the limbs below the damage since messages cannot go past the region and therefore one’s control of those features is lost. Muscle spasms in the damaged areas could also increase the effects of the condition. The damage done is often permanent and there are no known methods for repairing damage. The condition could cause paraplegia, quadriplegia, or autonomic paralysis. If the person is paralyzed from the neck down, they are termed quadriplegic since they cannot move any of their limbs. Quadriplegics may also have problems breathing since thei9r chest muscles could be paralyzed. The term paraplegia is used for people who are paralyzed from the cervical region downwards and they may have partial or full use of their hands. Autonomic paralysis occurs when the autonomic nervous system is affected by the damage. The autonomous nervous controls the involuntary muscles and therefore this type of paralysis may cause death (, 2009).

Arthritis causes pain in the joints such that they cannot be moved and may also cause muscular weakness. Cerebral palsy occurs before the brain is fully developed and may occur before or after the brain has developed. It is a type of injury to the brain which causes stiff movement and difficulty in movement. The damage results from lack of oxygen, high temperatures, and injuries to the head and it is not curable. A distorted sense of balance, depth and uncontrolled motion may result from the condition. Head trauma in adulthood may also be another cause of physical disability and may vary with the extent to which the brain is damaged. Stroke is another cause of physical disability and is caused by a part of the brain stopping to function which may be caused by a blood clot in the brain. Multiple sclerosis is a disease in which is caused by the destruction of the material that covers nerve fibers and it is a very common neurological disorder. Other causes of physical disability include Lou Gehrig’s disease which is fatal given time and the loss of limbs through trauma and surgery (, 2009).


2.2. Disadvantages and Difficulties associated with Physical Disability

The physically disabled have as one of their greatest disadvantage the lack of mobility especially for those who do not have functioning legs or are paralyzed in the legs. The lack of functioning limbs such as the hands could also prove to be problem in the performance of certain essential tasks. Due to a lack of limbs one is forced to rely on others or gadgets that could perform the same function. People who are completely paralyzed may also prove to very dependent since they would rely on others to perform essential tasks such as eating or bathing.

People with physical disability are often ostracized by society; they develop negative self-confidence issues (, 2009) and therefore do not seek the spotlight. This also applies to high profile jobs and positions which contribute to their low stature in society. Since people with physical disability can often not move from one place to the next, they often lack exposure to job opportunities and they are also not eligible for some types of jobs due to their disabilities. Due to the ostracizing done by the society the physically disabled are often the abused by people especially those close to them as a result of resentment in which the individual is blamed for their condition.

Transport or movement from one place to another may be cause for problems faced by physically disabled people especially in places that are not designed with their plight in mind. Finances are also a common problem for people with physical disability since they lack jobs or the ability to do the jobs. Most of them lack the minimal facilities which would enable them to live comfortably. The problem of proper housing is another concern facing the physically disabled since most of them lack the proper facilities for accommodating their disabilities. Embarrassments may result from such effects of paralysis as incontinence and may result in the loss of freedom to move into places where the embarrassments may occur and may also bring about low self esteem (Goodwill & Chamberlain, 1988).

Isolation by people may also occur as a result of ostracizing done by the society so that socialization becomes hard for those involved. This may also occur if those involved have routine care activities such as changing of catheter bags for those who have incontinence. Lack of mobility may also contribute to the lack of socialization.


2.3. Types of Support needed by the Physically Disabled

Since the greatest problem they face is the lack of mobility, provision of implements such as wheelchairs and clutches are useful in increasing their ability to move about. Therefore, people with physical disability need facilities in public spaces which would enable them to move around easily such as inclined slopes in the place of stairs. This would make them more mobile and would provide means through which they would become more self reliant and independent. The involvement of counselors on the activities they could get into and provision of forums through which they could interact with other people like themselves or with other people could also prove beneficial to their self-esteem.

This would also prevent isolation which could have adverse effects on the psychological wellbeing of people. Once they come out in society and are seen to be productive members of society, stigma could reduce and their job prospects could also improve. This is because potential employees could be changed into seeing the potential of the disabled rather than their incapacity. Through the proper training, the physically disabled could be able to exploit their abilities therefore they would be able to increase their stature in society. Their financial woes would also be reduced if they were to exploit these abilities.

Therefore, though direct payments and assistance may be helpful in lifting up the economic condition of the physically disabled, it would be better to provide assistance in the form of training which would improve their economic condition permanently as well as taking away the burden of providing for them since they would be needing assistance all the time. Their ability to provide for themselves could also boost their confidence and would enhance the quality of their lives. Through these means it would be possible to enhance their lives as well as reduce expenses incurred by the government in supporting them.


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