In this essay I will review a selection of different issues of professional communication that arose with a client who had Profound and multiple learning difficulty (PMLD) presenting autism and anxiety. Communication became difficult when he displayed challenging behaviour and was uncontrollable because his routine had been disrupted.
1. Difficulty understanding both verbal and nonverbal communication.
2. Difficulty in calming down after a stressful and anxious episode of a disrupted routine.
Gibbs Reflective Cycle (1988) will enable me learn from my involvement in the process and will enhance my personal and professional development.
The essay is written with BASW (England), PCF, and HCPC guidelines in mind. Peoples names have been changed to protect identity. I refer to the service user as M.
The situation that i reflect on happened in a care home setting where i worked as a key support worker before i joined university. M was a 37 year-old-man whose care plan detailed compelling learning difficulty and highlighted problems with verbal communication.
He also prefered routines and schedules and a disruption of any of these would result into much distress and anxiety for him. I will use an example that happened one day on a planned day trip to the day centre where he routinely went every monday to socialise, interact and engage others.
After our visit to the day centre this monday, it was time to go back home, at this point i got a phone call from the driver implying he had a flat tyre and could not come.
I immediately informed my manager who suggested i arranged another pick up van or taxi. Upon overhearing my conversation, M became acutely distressed and began to display challenging behaviour like hitting his head backwards towards the cushion, biting his hand and screaming. However i managed to calm him down by reinforcing behaviour that was positive by praising and singing to him as it’s one of the calming methods outlined in his care plan.This was a communication barrier.
The importance of supporting those with learning disabilities cannot be overemphasised and can also be found in the (Health and social care Act 2008), (the National health service and Community Care Act 1990), the (Disability Discrimination Act 1995) (Care Act 2014), The importance of supporting those with learning 95), which promotes Empowerment , whistle blowing and service user focus. Further support is provided by the UN Convention on the Rights of Persons with Disability 2006 to which the UK is a signatory. Brammer
My daily role ensure that i am constantly finding out how my client feels they are being treated, so i attend and chair the resident meeting every monday and ask them simple questions like do you feel safe here?, do you like your dinners? Do you know who to report staff who mistreat you to? Do you know who your key worker is? and do you like them or you want them changed? Having such closed ended questions only satisfies the staff tick box, on the contrary, it’s actually unfortunate that although this questions are being asked to residents ( Williams 2009: P111) sites appalling statistics of adults with learning disability who have witnessed physical abuse, a percentage of them verbal abuse and bullying ( statistics on learning disabilities, www. Learningdisabilities .org.uk) also most learning disability clients may well have other needs such as loss of hearing and eyesight (Levy 1997 cited in Williams 2009:p,39) that 60 percent of them will have sensory impairment, roughly 20 percent have eye problems let alone direct eye avoidance syndrome. So this meetings and questions are not how the learning disability client wants to communicate how they feel as in most times they communicate with action. (Caldwell 2015b, cited in williams 2009 p.39) that they require intensive interaction which involves close observation which truly represents the BASW 2017 and application of domain 3; Recognising Diversity and inclusion.
Max was a 69 year old who was leaving in a care home setting under the (Care Act 2014 and the Health and Social care Act 2008) He loved doing things, loveS routine and haS a preferred way of doing things, he clapped his hands indicating that he wanted to use the toilet, he would cry. Max really struggles and has no experience in negotiating or ask for a change, when a conflict arises because of change of routine he would find it difficult to cope and will instead go for a atantrum where by he will need help to calm down.
For example,one morning we left the residential home with Max and travelled to the day centre using specially adapted bus.
Max, enjoyed the activities there and at the end of the day we got ready to go back to the residential home. Normally, we would wait in a lounge at the day centre for the bus to arrive. This would usually be at around 4 oclock in the afternoon. The bus would usually be on time. On this day however, I got a call from the driver who said that the specially adapted bus had broken down and he could not make it to pick us up on time. I therefore decided to make alternative transportation arrangement using a taxi that is adapted to take a wheelchair. In the spirit of keeping the service user informed, my trainee colleague informed the service user of the changes. This was whilst I was on the phone to the taxi company. Upon hearing the change of plans, Max became extremely distressed, agitated, and anxious, and began crying and making sounds. He started to hit his head backwards against the chair, bit his hands because he was accustomed to taking the bus and did not like changes to routine. Knowing Max, I knew that he was trying to communicate to us with his behaviour and my colleague was not understanding him because she had just started working. Max appeared really agitated and irate. I was able to calm him down by explaining, reassuringly, that all would be okay and that I was working out an alternative way get us back home. He listened to me and quieted down, stopped biting his hand and rocking back and forth, and waited.
I remember having mixed feelings all through the incident. I think that although i persuaded M to calm down, i struggled to intervene be