Aging With A Developmental Disability Social Work Essay

Aging With A Developmental Disability Social Work Essay The life expectancy and age-related medical conditions of adults with Developmental Disabilities are similar to that of the general population unless they have severe levels of cognitive impairment, Down syndrome, cerebral palsy, or have multiple disabilities. Some research has indicated that sensory, cognitive, and adaptive skill losses happen earlier for adults with Down syndrome compared to the general population and other adults with intellectual disabilities (Heller, 2011). For adults with Down syndrome, indicators of dementia may often be caused by other conditions that are remediable such as hypo/hyperthyroidism, depression, and sensory impairments (Heller, 2011). The rising numbers of older adults with Developmental Disabilities will intensify the need for services and supports that allow them to maintain functioning and remain living as independently as possible, whether they are living with family or in other residential settings. Examples of such services and supports comp rise of personal care services, assistive technologies, home health care, and other in-home supports (Heller, 2011). Older adults with Developmental Disabilities differ widely in their desire to retire, with many preferring to continue participation in work or vocational activities. Major health issues for adults with Developmental Disabilities living in the community are proper nutrition and sufficient exercise (Heller, 2011). Because adults with Developmental Disabilities are living longer, families have a longer period of care giving responsibility. While there has been an increase in funding for family support programs in the last ten years, these programs represent a small portion of spending for Developmental Disabilities services, and often target families of young children (Heller, 2011). Mindfulness of the growing numbers of individuals with developmental disabilities, who are aging, has directed service providers to focus on the needs of these individuals and the systems capability to assist them suitably. The re-conceptualization of disability from a medical model to a social model significantly affects the service system, the supports required by an individual and the prospects society has for an individual with a disability as he or she ages (Kavarian Long, 2008). Before entrance to a nursing home, a screening must be completed for every person with a developmental disability. Persons with developmental disabilities who are found to be unsuitably placed in a nursing home must be discharged (Kavarian Long, 2008). Unless the individual has a substantial disability such as Down syndrome, cerebral palsy (CP), multiple disabilities, or a severe level of cognitive impairment, the life expectancy and age-related medical conditions of elders with developmental disabili ties are similar to that of the general population (Kavarian Long, 2008). The growth of the service system is grounded in the belief that individuals with developmental disabilities will develop and function optimally if they are included in society and afforded the same skills with the appropriate supports as those without disabilities (Kavarian Long, 2008). A needs-based service system provides customized, particular services, based on the exclusive strengths, needs, and preferences of the older individual, and is the favoured service system for elders with developmental disabilities. Specific health issues are associated with elders with developmental disabilities. However, as seen in the general population, obesity and cardiovascular disease (CVD) can affect all persons with developmental disabilities (Kavarian Long, 2008). Individuals with an intellectual disability have the equivalent, if not a higher, occurrence of obesity than adults without an intellectual disability (Kavarian Long, 2008). Furthermore, it requires a larger effort on the part of caregivers to support obese individuals with intellectual disabilities, thus placing caregivers at greater risk for health problems such as lower back pain and injuries (Kavarian Long, 2008). Individuals with developmental disabilities living in a community need right of entry to supportive care providers and skilled healthcare clinicians who are well-informed about the person, the disorder of the individual, and the arrangement of services and supports available to them (Kavarian Long, 2008). These practices identify that adults with developmental disabilities are aging and with increasing life expectancies, there will be a need for a larger range of wide-ranging, unified services (Kavarian Long, 2008). Decisions about treatment, admission to care accommodations and personal support services, descriptions of ability to make decisions and the selection of a substitute decision maker are governed by the Health Care Consent Act (OPADD), 2008). The Substitute Decisions Act specifies that the substitute decision-maker for personal care may not be someone who is paid to deliver the individual with health care, residential, social, and training or support services unless the person is a spouse, partner or relative (OPADD, 2008). In the event that the person moving to the long term care home disagrees with the appointment of a substitute decision-maker he/she can go to the Consent and Capacity Board to request a review of his/her capacity to make choices for personal care. In a Power of Attorney for personal care, an individual appoints another person to make personal care decisions on his/her behalf in the event that the individual becomes unable to do so (OPADD, 2008). Power of Attorney for personal care allows the substitute decision-maker(s) to make decisions related to personal care, such as health care, shelter, clothing, nutrition and safety. The person named as Attorney for personal care must not be someone who is paid to provide the individual with health care, residential, social, training or support services unless the person is a spouse, partner or relative (OPADD, 2008). With federal and provincial government support, local health experts should develop community-based health promotion programs that are available and modified to aging persons with developmental disabilities. Also, families providing care to an adult with a developmental disability need improved access to the information and services that can support them in this role. Older adults with developmental disabilities themselves recognized the following features as significant for their social integration (Minister of Public Works and Government Services Canada, 2004). The Reena Foundation structured an Ontario-wide conference in March 1999 to address the systemic barriers to gaining access to services by older persons with developmental disabilities and to facilitate partnership between specialists working in the long-term care and developmental disability divisions (OPADD, 2008). With provincial government support, local service agencies should deliver a variety of support services for aging adults with developmental disabilities that include outreach, information, support with activities of daily life such as shopping and banking, modified day programs and assistance in residence planning well in advance of the need for placement (OPADD, 2008). Home care providers should make available respite care and homemaking services to family caregivers of older adults with developmental disabilities. All individual and community service providers and specialists should provide care and services to aging persons with developmental disabilities in a way tha t respects their decisional abilities, their principles and their preferences in order to foster their empowerment (OPADD, 2008). The federal and provincial governments should offer greater safeguards for economically vulnerable older persons with developmental disabilities and their family caregivers. For instance, by increasing disability benefits to persons living at home with family and by permitting refundable tax credits for disability-related expenses (OPADD, 2008). One recent national Canadian survey of developmental disability agencies in Canada puts forward that most remain to have group homes as their main model of residential services, followed by independent apartment living (mainly in Ontario) and then by other residential sites (Minister of Public Works and Government Services Canada, 2004). Services for persons with developmental disabilities are delivered in a way that reflects them as full citizens enabled to be treated with respect for their rights and fully incorporated in society. Cooperation between the seniors and the development disability sectors to deliver support to a mounting population of older persons with developmental disabilities is challenging (Minister of Public Works and Government Services Canada, 2004). This is because each sector has restricted resources and is disinclined to take on another group of clients. Coordinating service distribution between sectors is difficult and service providers are often deficient i n the knowledge and practice with respect to either seniors or developmental disability (Minister of Public Works and Government Services Canada, 2004). All governments should increase the amount and diversity of housing choices for older adults with developmental disabilities and their caregiver parents, predominantly in rural or smaller urban areas. Options should contain supportive housing with access to community services and amenities. Service providers working in seniors and in disability sectors should cooperate to respond in a flexible and coordinated method to the needs of aging persons with developmental disabilities (Minister of Public Works and Government Services Canada, 2004). Adult Day Centers are designed to meet the needs of individuals with dementia and to support their strengths, abilities and independence. Why use an adult day center (Alzheimers Association, 2007). One reason to use an adult day center is to give you a break from care giving. While your loved one is at a center, youll have time to rest, run errands or finish other tasks. Adult Day Centers also offer the person with dementia opportunities to be social with others and participate in activities in a safe environment (Alzheimers Association, 2007). Adult Day Centers can vary. To choose the best setting for the individual with dementia, consult a variety of sources to find an appropriate adult day center (Alzheimers Association, 2007). Call your local senior center or area agency on aging, too. Give the day center a chance. Occasional use wont give you an accurate picture of how the center operates (Alzheimers Association, 2007). In addition, giving the person time to adjust to the experi ence of going to the center is beneficial. While some people may resist going to the center at first, they often look forward to the visit after several weeks of attending, meeting people and joining in activities (Alzheimers Association, 2007). At some point the person with Alzheimers may need more care than the center can provide. Center staff and support groups can help evaluate your needs for future care. The aging population including those with disabilities are faced with many issues. These issues include who takes care of them, financial issues which at times lead to financial abuse, and they are also faced with other types of abuse (Valios, 2007). These other types of abuse may be neglect, physical, verbal, and emotional abuse. Many of the individuals in this population do not have families and have lived in an institution or the residential services all their lives. Others lived with families that are aging, and they can no longer provide the required support their loved one. Much of this population do not have children of their own that can assist with any additional support requirements. Therefore, the aging population are often neglected, isolated, and ignored (Lueders, 2002). When individuals aging with a disability are ill, they may have difficulty in getting a service. Because of this, the aging population become vulnerable to many issues like abuse because of their depende ncy on other people for personal care (Lueders, 2002). Additional difficulties may be with communicating, and sometimes they are faced with guilt and shame of being disabled (Valios, 2007). With better and improved health status, many adults with development /intellectual disabilities are living to old age like à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€¦Ã¢â‚¬Å"typicalà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ã‚  adults. This population is now out living their parents (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Population aging and the deinstitutionalization of persons with developmental disabilities have given to situations where parents in their late adulthood, for example their eighties and seventies are still the primary caregiver of their disabled child in their fifties or sixties (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). As well, siblings often have an important role in providing functional, living and instrumental support. Sibling relationships are long lasting. According to the survey of National Adult Sibling Study, siblings of adults with disability they have special affection, and are more close to their brothers or sisters with disabilities (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Because of long life expectancy due to the developing health system than before , the major concern of adult siblings is who will assist their disabled sibling when the parent are no longer with them, and where they will go. The aged parent sometimes forces the sibling of their child with developmental disabilities, to take over part or the entire care-giving role. Some siblings may be able to accept this role from aging parents; however, the amount of expenses and time they can provide support can be limited (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Aging with disabilities and health issues have direct impact on family memberà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s ability to be direct care. In several recent studies, parents identified concerns surrounding their own relatives and ability to provide ongoing support to their family m ember. In some studies, several people talked about challenges of preparing themselves and their family members for separation (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). The family members of aging adult with disabilities are also concerned about secure housing, independency and dependency. This situation is more complicated for some older adult with intellectual and developmental disabilities because overall they are more dependent on their family members as well as agencies staff (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Older family members are also looking forward to planning, for when they will be not able to provide the care to their relatives. Because families are the principal caregiver for most people with developmental disabilities, they also share this caregiver role with service providers. As people with developmental disabilities age, the transition period brings required changes in t he care giving and support provided by various family members and agencies (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011).

Critical Issues In Community Care Social Work Essay

Critical Issues In Community Care Social Work Essay The purpose of this essay is to Critically examine an area of Community Care provision in mental health services. ideological, political and legislative frameworks will be taken into account, it will also examine the complex relationships between service user movements, professional bodies and the statutory, voluntary and independent sector services in the delivery of community care it will also identify and justify evidence of good practice in the provision of community care The system of community care was aimed to maintain the stability of the social order and to address the disparities and inconsistencies within the existing community care discourse. Mental health services became a part of the community care system early in the 17th century. With time, mental health in community care became an effective element of regulating the state of mental health across different population groups. Today, mental health community care is a two-tier system of community services, comprising health care and mental care provided to vulnerable populations in need for treating and monitoring various types of mental health conditions. The history of community care in the UK dates back to the beginning of the 17th century, when the Poor Law was adopted to make every parish responsible for supporting those who could not look after themselves (Mind 2010). Yet, it was not before the beginning of the 19th century (or 1808, to be more exact) that the County Asylums Act permitted county justices to build asylums supported by the local authorities to replace psychiatric annexes to voluntary general hospitals (Mind 2010). In 1879, the UK established the Mental Aftercare Association which worked on a comparatively small scale and focused on personal and residential care of the limited amount of mental ex-patients (Yip 2007). The association was further supplemented with three more voluntary associations that worked on a national scale and provided community care to mental outpatients (Yip 2007). Those organisations included the Central Association for Mental Welfare, the Child Guidance Council, and the National Council for Mental Hygiene (Yip 2007). Later in 1939 the Feversham Committee proposed amalgamation of all four voluntary organizations into a single system of mental health community care (Yip 2007). In 1890, the first general hospital clinic for psychiatric patients Was created at St. Thomas Hospital, while the World War I became the turning point in the improvement of health care facilities in the UK, giving rise to an unprecedented number of asylums and hospital facilities for mentally ill people (Yip 2007). It should be noted, that the first stages of mental health community care development was marked with the growing public commitment toward institutionalized care: throughout the 18th and the 19th centuries, cure and containment of mental illnesses in the U.K. and in Europe was provided in accordance with the principles of institutionalized care (Wright et al. 2008). The mental health care went in line in the development and proliferation of other institutional solutions, including houses of correction, schools, and prisons (Wight et al. 2008). The asylums rationale, first and foremost, lay in the belief that separation was in the interests of dangerous lunatics, giving them security and maximizing the prospects for cure (Wright et al 2008). Yet, those who ever appeared within such asylums had only one chance out of three to come out; the majority of mental health patients, regardless of the diagnosis, were destined to stay behind the asylum walls for the rest of their lives (Yip 2007 ). Medical professionals considered asylums as an effective means to isolate potentially dangerous patients from the rest of the community: asylums and isolation often served an effective way of investigating the reasons and consequences of mental health disturbances (Wright et al 2008). Many doctors viewed asylums and isolation as the sources of effective moral treatment for mentally ill (Wright et al 2008). Only by the beginning of the 19th century did professionals in medicine and social care come to recognize insanity as a mental illness and not as a product of sinful human nature; yet, years would pass before asylum residents would be given a slight hope to release themselves from the burden of isolation and torture (Wright et al. 2008). With the development of psychoanalysis in the 19th century, mental health became one of the issues of the national concern supported by the active development of psychopharmacology in the 20th century mental illness was finally explained in somatic terms (Wright et al. 2008). Psychopharmacology promised a relatively safe method of treating and alleviating mental health suffering, while the identity of psychiatry within the medical profession was finally restored (Wright et al 2008). Nevertheless, for many years and centuries, mental health community care remained a by-product of industrialized society development, which, under the pressure of the growing urban populations, sought effective means to maintain the stability of the social order. Because in conditions of the newly emerging economies lunatics and individuals with mental health disturbances were less able to conform to the labor market discipline and more apt to create disorder and disturbance in society, asylums were an e ffective response to the growing urban mass and the basic for maintain peace and stability in the new industrialized community (Goodwin 2007). The need for maintaining social order was an essential component of the community care ideology, with institutionalization and local provision support as the two basic elements of mental health care provision. Today, the provision of mental health community care services is associated with several issues and inconsistencies; many of the community care complexities that emerged early in the 19th century have not been resolved until today. Nevertheless, it would fair to say that under the influence of the social and scientific development, the provision of mental health community services has undergone a profound shift and currently represents a complex combination of health care and social care aimed to treat and support individuals with diagnosed mental health disturbances. In present day community care environments, mental health care provision exemplifies a complex combination of health care and social care. The former is the responsibility of the NHS, while the latter is arranged by local authority social services (Mind 2010). It should be noted, that the division of duties between medical establishments, local authorities, and social care professionals has always been one of the basic complexities in the development of mental health care in the U.K. (Wright et al. 2008). In 1954, the House of Commons was the first to emphasis inadequate resorting of mental health community services and to vote for the development of a community-based rather than a closed system of mental health institutions (Wright et al. 2008). Community services proposed by the House of Commons had to be available to everyone who could potentially benefit from them (Wright et al. 2008). As a result, deinstitutionalization became and remains one of the central policy debates within the mental health service provision discourse. Central to the argument for deinstitutionalization and the development of community-based services is the contention that the prognosis of patients is likely to improve as a result of discharge from mental hospitals, and that people with mental health problems already in community will benefit from remaining there rather than being institutionalized (Goodwin 2007). Social care providers in England claim that deinstitutionalization represents a new style of service provision and approach to mental illness which is better and more acceptable than traditional remote mental hospitals (Goodwin 2007). Since the beginning of the 1970s, mental health community care was associated with the treatment of mentally ill patients outside the asylums but, unfortunately, deinstitutionalization did not always lead to the anticipated results and is still one of the major policy debates. The ideology of deinstitutionalization in mental health community care failed and did not improve the provision of mental health services for several reasons. First, deinstitutionalization does not provide mental health patients with an opportunity to reintegrate with their community: being discharged from asylums, many mentally ill patients were transferred to general medical establishments and other facilities, including residential homes as a result, instead of community living, deinstitutionalization for these patients turned out to be a complex form of deinstitutionalization, while adequate funding of community services was constantly lacking (Wright et al. 2008). For this reason, the practical side of the deinstitutionalization policy proved to be less advantageous for the prevailing majority of asylums residents than it was claimed to be (Goodwin 2007). Second, the ideology of deinstitutionalization does not improve health outcomes for patients with mental problems. The current state of research suggests that the process of transferring mental health patients from one hospital to another results in negative health consequences and adverse mental health reactions, including significant deterioration of behaviors and greater problems with social activity (Goodwin 2007). The more complex are the issues with transferring mentally ill patients from and into prisons according to Fawcett and Karban (2007) the process, later called transinstitutionalisation, results in prison overcrowding and the loss of effective psychiatric care for those who are imprisoned. Today, deinstitutionalization as the ideological underpinning of mental health delivery does not work for patients but works against them. It does not improve the state of care provision and reflects in additional costs and adverse health outcomes. Nevertheless, the prevention of unw anted institutionalization is acknowledged as one of the basic principles of care provision (Gladman et al. 2007) and must become one of the basic elements of policy development and provision in community mental health. The third problem is the lack of outpatient monitoring: the ideology of deinstitutionalization in mental health delivery will not be effective and productive, unless policymakers and social workers have a possibility to monitor the destination of the discharged patients and their live in communities. Throughout the period between 1954 and 1994, the number of mental health hospital beds in the U.K. was reduced from 152000 to 43000 which, according to Wright et al. (2008) did not result in a reduction in the number of people treated. Not with standing that since 1997 the Government is the one solely responsible for the development and implementation of programmes of supervision and control regarding mentally ill patients, the quality of their discharge and monitoring leaves much room for improvement (Lehman 2007). The discharge process itself and the destination of the discharged patients represent the two most problematic areas of community care provision: the discharge process is oft en poorly planned, while a very little effort is put into monitoring their quality of life beyond asylums (Goodwin 2007). Discharged patients are believed to live and operate in the community, with their families and friends, but the real outcomes of the discharge into community is highly variable (Ritchie Spencer 2007). Of all patients discharged from mental hospitals, over 45 percent find themselves in residential homes, 7 percent are in locked facilities, and only 22 percent live independently or with their families (Goodwin 2007). The remainder are either homeless or untreated (Morse et al 2007). Deinstitutionalization in its current form and in the way the government implements it does not make outpatients automatically eligible for social care. In present day community care environments, the four basic measures predetermine the quality of outpatients with mental illnesses lives: sufficient material support, emotional support, sufficient care, and the presence of a well-performing social network within which they must be accepted (Goodwin 2007). These are the basic prerequisites for the successful outpatient reintegration with their Community. The only problem to be resolved is the need to develop a clear set of criteria, which will define and determine each patients right for social care services. Today, according to the basic provisions of the National Service Framework for Mental Health, all mentally ill individuals should have 24-hour access to local social and medical services to meet their needs (Mind 2009). These patients and individuals have the right for their needs to be assessed based on the results of the needs assessment social care providers will decide whether an individual is eligible for this particular type of social services (Mind 2009). Finally, deinstitutionalization of care does not provide any opportunity to properly and objectively assess the needs of patients. When developed, the deinstitutionalization ideology in mental health community care implied that all mental health patients would have similar community needs, but the idealistic interpretation of deinstitutionalization is far from reality. Today, needs assessment was and in one of the most problematic aspects of the social care provision for mentally ill. Despite the fact that needs assessment represents and reflects the major policy shift toward better quality of social care provision, social services do not always provide or have an opportunity to fully utilize their service potential and to meet the needs of the mentally ill individuals. According to Mind (2009), needs assessment compromises community care assessment, care programme approach assessment, mental health assessment, and carers assessment. Yet, there is still the lack of consensus on what constitutes need: social care providers tend to define need as the requirement of individuals to enable them to achieve acceptable quality of life and as a problem which can benefit from an existing intervention (Thornicroft 2007). It is not clear whether acceptable quality of life is the notion comprehensible to guarantee that all community needs of mentally ill patients are met (Barry Crosby 2007). More importantly, it is not clear who, when, and in what conditions should engage in the process of needs assessment: do social care providers possess enough education, training, and knowledge to conduct regular assessments? These are the issues which must be resolved to enhance the quality and efficiency of community care in the context of mental health services. Mental health and deinstitutionalization: still effective Despite the problems and failures of deinstitutionalization, community care for mentally ill individuals is effective and reliable, given that it leads to reduced social withdrawal, better social functioning, and increased participation in various pro-social activities (McGuire et al 2007). That, however, does not mean that mentally ill outpatients have better opportunities to find a job; rather, they either participate in specially designed workshops or return to the function of a house wife (Prot-Klinger Pawlowska 2009). Yet, some population groups require additional attention on the side of care providers. For example, in older populations, more than 55 percent of people with diagnosed schizophrenia were never offered appropriate psychological therapies and do not even have any out-of-hours contact number (Parish 2009). As a result, there must be a profound shift toward providing community care based on the need rather than based on the patient age (Parish 2009). People with lear ning disabilities represent the opposite end of the current problem continuum, and social care providers often either omit or neglect the needs of these patients (Thronicroft 2007). Several essential steps should be made to develop the quality of community care provision for the mentally ill. Conclusion First, community care providers must develop a single set of measures as a part of their needs assessment strategy to make sure that all community care providers operate as one, and use the same criteria of needs assessment in different socioeconomic groups. Second, special attention must be paid to the vulnerable populations that are often overlooked by the community care system, including older patients with mental health problems. Third, the principles of deinstitutionalisation require detailed consideration: more often than not, patients who are discharged from closed mental health facilities are transferred to other mental health hospitals or smaller mental health departments and wards, while the governments striving to reduce the number of mental health beds and specialists do not leave these patients any single chance to meet their health and social needs. The groups of patients, who will benefit most from the closure of the mental health institutions, have in many cases fared worst (Goodwin 2007). Finally and, probably, the most important, is that patients who are discharged from mental health institutions should be closely monitored and constantly supported. One of the main goals of the community care is to help out patients successfully reintegrate with their community. The destination of the discharged patients must become one of the social care priorities, and community care providers must engage outpatients in their social network, to ensure that all social and health needs of t hese individuals are met.

Eve’s Apology Essay -- Literary Analysis, Aemilia Lanyer

Is this an apology or blame? In the beginning, God tells Adam not to eat the forbidden fruit. Adam disobeys God by doing so, but most people put the blame on Eve. In the poem, â€Å"Eve’s Apology,† Eve expresses her feelings toward the entire situation and shows how she is not to blame. She blames Adam for the pain we endure today. Eve eats from the forbidden tree out of curiosity. She wants to share it with Adam, so he can feel like she feels. Eve gives the fruit to Adam out of love, but she does not force him to eat it. Adam has control of his mind, so he disobeys God on his own. â€Å"Do not the thing that goes against thy heart† (Lanyer 424). Aemilia Lanyer, the author of the poem, â€Å"Eve’s Apology,† lived in the mid 1500’s and 1600’s. Living in this time period, had much influence on her writing. She published her landmark book, Salve Deus Rex Judaeorum, the same year that the King James Bible and three of Shakespeare’s plays were published (Wilhelm 424). Lanyer brings out the life of this poem with the poetic devices, irony, and unusual language. To begin, the poem, â€Å"Eve’s Apology,† uses many different poetic devices such as alliteration, assonance, rhyme scheme, and simile. The author uses a great number of alliteration, which is the repetition of constant sounds generally at the beginnings of words. Alliteration can be seen in the words â€Å"what† and â€Å"weakness† in line 3. Some more examples of alliteration throughout the poem are â€Å"subtle serpent’s† (23), â€Å"he had him† (24), and â€Å"with words which† (30). Assonance, the repetition of the same or similar vowel sounds in stressed syllables that end with different consonant sounds, is another poetic device that the author uses greatly. Some examples of assonance are found in lines 10 â€Å" The ‘p... ...g this poem, the author reveals older examples of words and phrases that we do not know or use today. Throughout "Eve's Apology," Layner confidently makes her point of female inequality and female injustice by using poetic devices, while continuing to keep an ironic tone and bring out unusual language. She is clearly trying to prove that woman and men are equal. She suggests that because Adam is a man, thus "stronger" than Eve, he should be held responsible for eating the forbidden fruit rather than the "weaker" Eve. Layner believes that men should not look down upon women as lesser and weaker than themselves; she successfully proves that women deserve an equal status with men. Throughout the poem, Layner makes the point that the reason men have always been condescending to woman is dishonest because men are actually more at fault for the pain we endure today.

Painting What We See Within: A Look at the Insides of Art Therapy Essay

Painting What We See Within: A Look at the Insides of Art Therapy One of the most memorable experiences I had last summer was visiting the American Visionary Art Museum in Baltimore, Maryland. (3)At this museum, professional artists had created none of the works hanging on the walls. Visionary art is an individualized expression by people with little or no formal training; the rules of art as a school did not apply here. While I was there, I learned that for many years, the artwork created by patients of mental institutions, hospitals, and nursing homes were disregarded and destroyed by their caretakers. After seeing what powerful and telling work came from many people in these situations, I found this information to be very distressing. Fortunately, the development of art as a form of therapy has changed the medical attitude toward art created by the healing in the past fifty years. While the work created through this therapy is rarely showcased as at the American Visionary, it is aiding therapists and their clients in reaching a new awareness. Art therapy uses media and the creative process in healing, the key word here being process. We all know how revealing the artwork of children can be of their emotions. Art therapy applies this concept across the spectrum in a multitude of situations. It functions in many of the same settings as conversational therapy: mental health or rehabilitation facilities, wellness centers, educational institutions, nursing homes, in private practices or in a client's home. An art therapist may work with an individual or group, in families or couples. While most therapy is based on conversation between the therapist and his or here client/s, art therapy integrates visual communication into th... .... Personally, I don't see why the developments in the study of art therapy shouldn't change our attitudes toward creative arts in general. When was the last time you sat down with crayons and drew a picture, or put on your favorite song and danced just for the heck of it? Sure, if you are creatively talented you might study art or music, but through as we get older we take even our most creative work too seriously. We try to make it good according to external standards rather than doing it for our own good. In the broader sense of things, I don't think art therapy is just for the healing. I believe our lives would be brighter and less stressful if we got into the habit of being just a little creative every day. Internet Sources: 1)http://www.arttherapy.org/ 2)http://www.avam.org/ 3)http://www.artsintherapy.com/ 4)http://www.creativeresponse.org.uk/

Mitch Alboms Tuesdays with Morrie :: Essays Papers

My Tuesdays with Morrie Mitch Albom, author of Tuesdays with Morrie, is flipping through his TV stations one night and he heard these words come from his TV set- â€Å"Who is Morrie Schwartz?†- And Mitch went numb. Mitch found out through the TV show â€Å"Nightline† that his life long friend and teacher is dying and Mitch knows that he has to go and see him. Mitch goes to see his old college professor and what starts out as a one-day meeting turns into a four-month â€Å"class†. The class is conducted in Morrie’s house in the suburb or Boston, there is no books or any other students, just Mitch and Morrie. Throughout this class Morrie teaches Mitch the lessons of life; lessons such as death, fear, aging, greed, marriage, family, society, forgiveness, and a meaningful life. As Morrie’s conditions worsen, Mitch’s condition is getting better, Mitch is becoming a better person with the help of Morrie. Finally Morrie’s life comes to an end, and Mitch graduates from Life 101. â€Å"I felt the seeds of death inside his shriveling frame, and as I laid him in his chair, adjusting his head on the pillow, I had the coldest realization that our time was running out.† (Pg. 59) That is what Mitch, a journal writer for the Detroit Free Press, said as he lifted his old college teacher from his wheelchair to his recliner. His old college teacher is Morrie Schwartz, a man that is dying from ALS otherwise known as Lou Gehrig disease. As the book goes on, Morrie reaches out to people who want to talk and he teaches them about the real lessons of life, while he is lying on his deathbed. Tuesdays With Morrie is an excellent book because Morrie teaches Mitch lessons about marriage, greed, and family that young adults can learn from. â€Å"Love each other or perish†. This quote sums up all of Morrie’s views and beliefs on the topic of marriage and love. This statement says a lot and I feel that young adults can learn a very big lesson from this short quote. Love and marriage are very important because we all need someone to love and to love back, if we don’t we are going to live a very lonely and unhappy life. There is a set of â€Å"rules† that Morrie stated in this book that I feel young adults could learn a lot from.

End-of-life Essay

End-of-life care is a form of medical treatment which is usually provided for terminal illnesses, when the condition is no longer curable and every effort should be made at improving the quality of life rather than increasing the duration of life. Cancer is one condition which is incurable during the advanced stages. End-of-life usually does not involve provision of anticancer treatment but concern for lowering the physical symptoms (especially pain so that the patient is comfortable), addressing the psychosocial issues and the spiritual concerns, so as to improve the quality of life. Often an ethical dilemma exists at the situations under which end-of-life care should be started. The need to provide end-of-life care arises out the physician’s obligation to ensure that the patient can live and die with dignity, compassion, comfort and respect. Two of the cases which demonstrate the physician’s obligations to the patients were the Ann Quinlan case (1976) and the Cruzan V. Harmon case (1988) (Meisel, 2005 & Rekel, 2007). In the Quinlan case, Ms. Quinlan suffered irreversible damage to the brain cortex and was left in a permanent vegetative state. She required ventilator support, artificial nutrition and artificial hydration to maintain her medical and nursing care. She could be kept alive for any duration, but this was morally not required and not in the patient’s best interest. The physician’s refused to remove ventilator support and hence the family had to go to the New Jersey Court. The court in the landmark decision permitted to remove ventilator support as it was not in the patient’s best interest. The court had said that although the patient was in a permanent vegetative state and did not have to ability to make a decision about withdrawing ventilator support, it did not mean that she could not exercise her choice and give her decision. The decision-making could be made by a surrogate who would be doing so in the best interest of the patient. In the Roe vs. Wade case, the court gave the decision that the patient could control their medical treatment and had the right to make decisions. In the Cruzon case, after the ventilator was removed, the patient survived for about 10 years. The Missouri court in this case did not follow the advice of the parent’s on removing life-saving support. The court said that all measures should be done in best interest of the patient, and if there were not clear evidence of the patient’s wishes, then the legal guardian should be acting in the patient’s best interest. The court said that even if there was a need to prolong life through ventilator support, if there was no evidence that the patient’s best interest would be fulfilled. In the case Westchester County Medical Ctr (1988), the New York court said that there had to exist clear and convincing evidence whenever important decisions had to be taken by the surrogate (Meisel, 2005 & Rekel, 2007). Some of the common ethical issues regarding medical treatment have been ‘beneficence’ and ‘non-maleficence’. The physician should do treatment that benefits the patient and does not cause more harm. They should help reduce the suffering and help the patient to return to health. However, in the end-of-life issues, the patient would be dying due to the terminal cancer condition, and using life-sustaining treatment would not have any potential benefits, as it would prolong life, but not improve the quality. In this case medical treatment is doing lot harm than benefits, and hence using it would be inappropriate. However, a clear judgment has to be made in the clinical-decision making and one of the most important issues is whether the patient has made the intention of withdrawing all the life-saving treatment and instead goes into palliative care (in which symptomatic treatment would be provided so as to improve the quality of life during the last few days). Having the patient make this decision is based on another ethical principle known as ‘autonomy’. The patient has the right to choose or disregard whichever treatment he/she wants as the have the right to control any act that is done with their body (Walker, 1999 & Meisel, 2005). Implications of risk management – †¢ Mainly with the use of opioids to manage pain (especially from its prolonged use) †¢ Clinical practice guidelines and protocols should be followed to ensure the greatest amount of benefits for the patient in the form of improved quality of life and lowered discomfort levels (Hoffman, 1998). The right to autonomy of the patient should not be disregarded under any circumstance. The patient has the right to choose palliative treatment or reject it based on their own choices. The patient may also want to undergo curative treatment for cancer even though the survival rate may be low. The patient should be informed of the benefits, risks, options, outcome and costs of all forms of treatment available. The physician should answer all the queries the patient has of all the available forms of treatment. No treatment should be done against the will and intention of the patient. If the patient is not able to make a reasonable decision as they may not be legally competent, then the surrogate (including the family member or a legal guardian) of the patient should make a decision on the patient’s behave, keeping in mind the clear interests of the patient (Walker, 1999, Meisel, 2005 & Rekel, 2007). There may be a lot of competing loyalties between the patient and the organization:- †¢ The organization may try to keep the interest of the patient in mind and may do all that it can to reduce sufferings, improve the quality of life and ensure a peaceful end †¢ The organization may demonstrate a greater opinion towards anticancer treatment as it would involve higher costs (even though it is not beneficial to the patient anywhere) †¢ Even though the patient can benefit to a reasonable extent from anticancer treatment, the organization may force end-of-life care on the patient, as the family members have provided consent. In this case the family members would be having conflicting interests with the patient and may want a faster end to the patient. To prevent any conflicting interest of other parties, it is important that any decision made regarding use of anticancer treatment of initiation of end-of-life care should be clearly justified and documented through evidence-based findings. An ethical approach should be initiated to ensure that all issues are sorted out keeping the patient’s interest in mind:- †¢ The physician should ensure maintaining autonomy of the patient at all stages †¢ If the patient is not competent enough to make a decision by himself, decision-making should be done by the surrogate keeping in mind the patient’s interest and choices †¢ It is the obligation of the physician to ensure that the patient lives †¢ The patient’s competence needs to be determined so that a reasonable decision can be ensured †¢ The patient has to be informed of all the alternative choices available at all the stages †¢ In case of diagnosis of a terminal illness, confirmation should be taken from two physician’s (second opinion) †¢ In case of terminal illness, and the patient choice palliative care, efforts should be made at all stages to improve the quality of life (through symptomatic treatment of physical problems, addressing the psychosocial and spiritual issues), rather than on prolonging life The other issues which need to be addressed include:- 1. Active Euthanasia – This is legal in only a few states of the world including Netherlands and Belgium. The patient should make a reasonable decision, and should be a native from that state in which euthanasia is legalized. The physician himself would take the active step of ending the patient’s life. The patient should be diagnosed with a terminal illness 2. Physician-Assisted Suicide – This has been legalized in the US state of Oregon, PAS has been legalized. The patient would perform the active step of ending life and the physician would merely assist the patient. The patient should be diagnosed with a terminal illness (in which death would be certain within 6 months). The patient should be legally competent to make a reasonable decision (Rekel, 2007). References: Hoffmann, D. E. (1998). â€Å"Pain Management and Palliative Care in the Era of Managed Care: Issues for Health Insurers†, Journal of Law, Medicine & Ethics, 26(4), 267-289. http://www. aslme. org/research/mayday/26. 4/26. 4c. php Meisel, A. (2005). Ethics, End-of-Life Care, and the Law: Overview, Retrieved on August 16, 2008, from Hospice Foundation Website: http://www. hospicefoundation. org/teleconference/books/lwg2005/meisel_jennings. pdf National Cancer Institute (2002). End-of-Life Care: Questions and Answers, Retrieved on August 16, 2008, from NCI Website: http://www. cancer. gov/cancertopics/factsheet/Support/end-of-life-care Rekel, R. (2007). Rakel: Textbook of Family Medicine, 7th ed, Philadelphia: Saunders Elsevier. Walker, R. M. (1999). Ethical Issues in End-of-Life Care, Cancer Control, 6(2):162-167. http://www. medscape. com/viewarticle/417700_1

Race & the workplace Essay

The information derived from the empirical manipulations of race of worker also revealed that depicted race has an influence to the children’s own aspirations in performing different jobs. Primarily, children ranked their own levels of interest in engaging themselves in the depicted novel jobs as notably lower when the jobs had been solely performed by African Americans than when the jobs are exclusively executed by their European counterparts or by both races. Additionally, this information are exceptionally illustrative in the sense that they clearly signify that race of occupational models – independent from the content and operations of these jobs themselves (held constant) – influences the children’s job preferences (Bigler, Averhart & Liben, 2003, p. 578). To supplement the manifestation of racial hints in the children’s assessment about jobs at the group levels, the current information also contribute to our comprehension of influential and group differences in the African American children’s job stereotyping, assessments and aspirations. In conformity with the reality theory developed by Hale (1980) which states that the socio – economic factors do appear to affect the children’s job assessments, especially during their adolescent stage. The older children (11 – 12 years of age) coming from families with lower socio – economic backgrounds exhibited less interest in engaging themselves in common jobs that were dominated by their European counterparts, therefore conceived to be higher in rank. Probably, economic factors are significant in this finding, with children from lower socio – economic backgrounds recognizing that they are financially challenged to seek occupations that demands higher educational attainment (Bigler, Averhart & Liben, 2003, p. 578). Conforming with the patterns for familiar jobs, children 11 – 12 years of age from higher – but not lower socio – economic backgrounds, were notably more attracted to engage themselves in novel jobs that they deemed to be exclusively carried out by their European counterparts or represented both races than they were in jobs that appear to be exclusively carried out by African Americans. Apparently, it is not feasible to identify the determinant of race of occupational worker in children from various age brackets and economic class solely on the grounds this set of information (cited in Bigler, Averhart & Liben, 2003, p.578).. In reference to the findings of Spencer (1985), primarily and in occupational context, the older African American children’s occupational aspirations are affected by their awareness of race prejudice in the society. Financially challenged children may be significantly unprepared to confront the recognized racial prejudice made by the majority (cited in Bigler, Averhart & Liben, 2003, p. 578). There is a possibility that the African American children’s economic constraints concepts lessen their interest in the so – called high – status and difficult – to – reach jobs. Nonetheless, it is certain that as young as 6 years of age, African American children have already formed racial foundations that integrate ideals about occupations. Such foundations substantially influence their job concepts and goals. Then again, these foundations significantly vary in relation to the children’s socio – economic status (Bigler, Averhart & Liben, 2003, p. 578). Acknowledging the presence of the two types of vicious cycles to race and jobs, the comparison shown between the ratings of status as well as the race of workers is disturbing. For one, African American children, specifically the impoverished ones, may be more inclined to aspire low – status jobs. Such jobs were minorities are overrepresented in. As a result, the dominance of the minorities is kept. However, this can result to another generation of twisted models of impoverished African American. In addition, while there may be jobs made available for more privileged African Americans, in time, just because of their race, they may be dismissed as lower in status in society. Furthermore levels of pay and prestige may also be brought down low (cited in Bigler, Averhart & Liben, 2003, p. 578). Ultimately, it is essential to note that this study is but one of the many steps to take in the development of an understanding of how occupational assessments are influenced by race. Socio – economic status is but an estimated indicator of the family incidents that may influence occupational stereotyping and ambitions. Additional studies should be administered to thoroughly observe how financial restrictions formed vocational hopes and ambitions. Moreover, additional studies should encompass considerations of how families talk about occupations, the kinds of role models presented by parent’s own job and how school and neighborhood context influence occupational stereotyping (Bigler, Averhart & Liben, 2003, p. 578). Investigating these issues among other samples of African American children and children from other ethnic and racial groups is also vital. Evidently, additional research is required to provide a deeper understanding of the long – term consequences of children with the aid of racial indication as a factor in shaping their opinions on and interests in employment (Bigler, Averhart & Liben, 2003, p. 578). Race, gender and ethnicity in the workplace must not be an issue. Rather is must be a goal (Ishimaru, 2005). A wide array of skills is very much needed in the American workplace today. Nonetheless, it cannot be delivered by selected group of people alone. This is where workplace diversity serves its purpose. Different people from different culture must share and respect each other’s views and opinions to be able to work out a solution to a problem and eventually affect success (cited in Ishimaru, 2005). Every business must aim to diversify. Simply put, it is the right thing to do after all. Workplace diversity makes a sound business sense. This commands attentiveness, conceptualization and dedication to be meaningful. Moreover, it demands willingness to examine the traditional way of transacting business and what is valued in its workers (Ishimaru, 2005). To be able to create an improvement in the workplace diversity, it is important to reassess one’s values and be able to articulate what merit means. As society continues diversify further, promoting employees who exhibited â€Å"diversity ability† to relate well with co –workers setting aside social demarcation must be stressed (Ishimaru, 2005). Hope must not be lost. Hope in the possibility that life in the midst of cultural diversity is possible. More than a possibility, this kind of life is a must. A life lived in harmony between people of different races is a life lived well. This translates and transcends race lines previously demarcated, all for the purpose of the common good (Racebridges. net, 2007). Researches validate that working in a diversified environment is linked with more substantial interracial relations. In addition more interracial friendships are also built here. A culturally mixed neighborhood is also an example of a diversified environment (Estlund, 2003, p. 10). There are grounds to believe that the noticeably increased prevalence of recounted friendship among different races stems mainly from increased relations and integration in the workplace. However, for the most part, it is not plainly a story of friendship. It is also about the mutual but scattered sense of connectedness that surfaces out of our everyday collaboration, casual amiability, common interests, complaints and triumphs and disappointment among co – employees. Even so, their potential asset is suggested by the incidence with which they build authentic friendship beyond social demarcation. Racial friction and discrimination did not disappear. Nevertheless, they were certainly lessened and combined with feelings of unity, deference, friendship and likeness (Estlund, 2003, p.11). In reality, it is only in the workplace where a more sustained and collaborative interaction can be feasible. It is only there when we can witness this kind of scenario. Everyone must seek ways to be able to collaborate with one another at any given time. This kind of collaboration must be made between people of different races, cultural background and sexual hierarchies. Workplace diversity, relations and collaboration that transcend social demarcation can be counted on to produce increased acceptance and affinity. Moreover, it can possibly create less aggression and stereotyping between different races, culture and tradition (Estlund, 2003, p. 12). In contrast to other generations, we now live in a society characteristically more diverse, mobile and incorporated than ever before. Today we share the world with not just complete strangers but significantly unique individuals (Estlund, 2003, p. 20). On one hand, the chance to establish thick and multi – strand bonds founded on likeness does not come as often. On the other, chances to establish bonds that transcend social demarcation abound. Yet forming the kind of bond that transcends social demarcation is not at all easy. Without the aid of some degree of compulsion, this kind of bond is impossible. Even so, when it does, it is more probably to be slender and more fractious than the kind of bond founded on likeness (Estlund, 2003, p. 20). In effect, these bonds can build trust. It can create a feeling of togetherness, unity for a cause. In time, compounded with the progress towards impartiality and incorporation within the workplace and beyond, trust may be fostered too (Estlund, 2003, p. 20). After all, no man can live alone. It is a dictate of human nature that we need other people in order to survive. The world is a melting pot of different cultures and that thing will remain certain. Other than separating oneself from those he deems to be different, may all people just learn to love and embrace each other’s uniqueness. There is much more to the diversity of this world. It is there to remind man of his individuality. It exists to teach the lesson that differences can indeed be a venue to learn other things and see the beauty of the world from another perspective. References (1989). Racism. In The World Book Encyclopedia (Vol. 19, p. 62). USA: The World Book, Inc. Bigler, R. S. , Averhart, C. J. & Liben, L. S. (2003). Race and the Workforce: Occupational Status, Aspirations, and Stereotyping Among African American Children. American Psychological Association, 39, 572 – 580. Estlund, C. (2003). Working Together: How Workplace Bonds Strengthen a Diverse Democracy. Oxford: Oxford University Press. Ishimaru, S. J. Employment Rights and Responsibilities Committee.(2005, August). Value of Racial Segregation of the workforce today. Retrieved February 27, 2008, from www. bna. com/bnabooks/ababna/annual/2005/001. pdf. Racebridges. net. (2007). We All Have a Race: Addressing Race and Racism. Retrieved February 27, 2008, from www. racebridges. net/schools/2006_2007_lessons/WeAllHaveARace. pdf. Williams, F. T. Gibbsmagazine. com. (2001, April 9). Racism is Still Alive. Retrieved February 25, 2008, from http://www. gibbsmagazine. com/Racism%20Still.