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Ms. Margaret Culliton, APT Development Officer How practice develops from a research based needs assessment for persons with an Acquired Brain Injury Margaret.

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Presentation on theme: "Ms. Margaret Culliton, APT Development Officer How practice develops from a research based needs assessment for persons with an Acquired Brain Injury Margaret."— Presentation transcript:

1 Ms. Margaret Culliton, APT Development Officer How practice develops from a research based needs assessment for persons with an Acquired Brain Injury Margaret Culliton Development Officer APT, HSE Dublin Mid Leinster Area

2 Ms. Margaret Culliton, APT Development Officer Background: BRÍ & HSE BRÍ & HSE Response by HSE – Needs Assessment & service Development Plan for persons with an ABI 2004 (Dr. Regina Kiernan) Response by HSE – Needs Assessment & service Development Plan for persons with an ABI 2004 (Dr. Regina Kiernan) Project team established – service users/providers Project team established – service users/providers Survey of: Survey of: clients and families (qualitative information) clients and families (qualitative information) service providers (qualitative and quantitative information) service providers (qualitative and quantitative information) information contained on databases E.g. PSDD in Midland area information contained on databases E.g. PSDD in Midland area

3 Ms. Margaret Culliton, APT Development Officer Head Injury in Midlands (every year) 600 cases of Mild Injuries 600 cases of Mild Injuries 40 cases of Moderate Injuries 40 cases of Moderate Injuries 18 cases of Severe Injuries 18 cases of Severe Injuries Approx 5 – 10% of those hospitalised will die Approx 5 – 10% of those hospitalised will die An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004 Identified from a recent Report from HSE Midlands Identified from a recent Report from HSE Midlands An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004 An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

4 Ms. Margaret Culliton, APT Development Officer Location HSE Dublin Mid Leinster area HSE Dublin Mid Leinster area –4 counties: Laois/Offaly Longford/Westmeath –Population of approx 251,000 APT – Aontacht Phobail Teoranta – (Community with agreed purpose) APT – Aontacht Phobail Teoranta – (Community with agreed purpose) –Subsidiary company of HSE Dublin Mid Leinster –RT, EBT, Shops, other projects

5 Ms. Margaret Culliton, APT Development Officer Some Facts from the Midland Area The average age of those admitted to Midlands Regional Hosp with ABI (under 65 years) The average age of those admitted to Midlands Regional Hosp with ABI (under 65 years) –TBI was 28 years –CVE was 55.5 years –Brain tumour was 35 years –Infection was 17 years –Anoxia (<1 and 8 years) 78% were discharged home and 14% transferred to other hospitals, 5 -10% did not survive 78% were discharged home and 14% transferred to other hospitals, 5 -10% did not survive An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

6 Ms. Margaret Culliton, APT Development Officer Client Survey (main points) Main consequences of ABI: Main consequences of ABI: – difficulties with ADLs, concentration & memory problems, mood swings, anxiety and depression …….. Social problems in nearly 60% cases Social problems in nearly 60% cases –Worse finances > 40% –< 20% returned to work –40% carers did not return to work An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

7 Ms. Margaret Culliton, APT Development Officer Client Survey (main points) Services required by individuals Services required by individuals –Physiotherapy, OT, & SLT –Peer support –Financial assistance –PA/Home help services –Counselling & Psychology –Respite care, Day care and Residential care An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

8 Ms. Margaret Culliton, APT Development Officer Client Survey (main points) Barriers to accessing existing services: Barriers to accessing existing services: –Nearly 75% stated lack of information –71% lack of service co-ordination & lack of a single contact person An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

9 Ms. Margaret Culliton, APT Development Officer Quotes – "No body cares you're just a number and its just a job that gives them money. They don't have the interest or care in your special needs. – There simply is no one I know with any understanding about my injury. It can be very frustrating. – No one will do anything when you tell them what you have had to put up with.... It like no one cares too many committees meetings etc we cant see any difference."

10 Ms. Margaret Culliton, APT Development Officer Service Provider (Survey ) main points: Nearly 1/3 rd individuals with ABI self sufficient Nearly 1/3 rd individuals with ABI self sufficient Almost ½ of individuals cared for at home with regular/occasional HSE support Almost ½ of individuals cared for at home with regular/occasional HSE support Individuals who are inappropriately placed Individuals who are inappropriately placed Need for more education for staff re. ABI Need for more education for staff re. ABI An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

11 Ms. Margaret Culliton, APT Development Officer Quotes (from service providers) – The current services for people with an Acquired Brain Injury are totally inadequate. Their needs are not met. – Very unsatisfactory from my (health professionals) point of view… There is no one giving family support or counseling for this family An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004 An Needs Assessment & Service Development Plan for persons with an Acquired Brain Injury 2004

12 Ms. Margaret Culliton, APT Development Officer Needs Assessment & Service Development Plan for persons with an ABI 2004 (Dr. Regina Kiernan) Many recommendations…..about service delivery Many recommendations…..about service delivery Development Officer ABI – central to service development for this group of individuals Development Officer ABI – central to service development for this group of individuals –Address issues identified in Kiernan Report

13 Ms. Margaret Culliton, APT Development Officer Pilot Project APT commissioned to undertake pilot project APT commissioned to undertake pilot project Pilot Project - commenced May 04 & ran for 2 years Pilot Project - commenced May 04 & ran for 2 years Development Officer ABI (employed by APT) Development Officer ABI (employed by APT) Project funded by HSE Midland Area Project funded by HSE Midland Area –Collaboration with Disability Services & service providers in area

14 Ms. Margaret Culliton, APT Development Officer Role of Development Officer ABI Provision of advice, information & support for persons with ABI/ Families Provision of advice, information & support for persons with ABI/ Families Liaison – hospitals, NRH, community services, & other voluntary agencies Liaison – hospitals, NRH, community services, & other voluntary agencies Co-ordination supports involved Co-ordination supports involved Development of peer support groups Development of peer support groups –BRÍ Education/Awareness Education/Awareness

15 Ms. Margaret Culliton, APT Development Officer Role of Development Officer ABI Prioritise service delivery needs & identify service gaps Prioritise service delivery needs & identify service gaps Support new developments in ABI within Midlands in co-operation with service providers Support new developments in ABI within Midlands in co-operation with service providers –Influence current service provision

16 Ms. Margaret Culliton, APT Development Officer Starting Point: Where are these individuals & their families? Where are these individuals & their families? No single register of clients No single register of clients BRÍ BRÍ P&SDD – letter sent from HSE P&SDD – letter sent from HSE Arranged meetings: Arranged meetings: –community service providers in Midlands –rehabilitation services (NRH) –acute services (hospitals)

17 Ms. Margaret Culliton, APT Development Officer Initial phase: All referrals with ABI < 65years All referrals with ABI < 65years Rapid increase of referrals Rapid increase of referrals Priority to Priority to –new cases with ABI –Individuals in hospital –Individuals in NRH –Subsequent cases then prioritised

18 Ms. Margaret Culliton, APT Development Officer Case History: John 15year old John 15year old TBI – following sports injury at school TBI – following sports injury at school Family – lives with parents and 1 older sister (18yrs) Family – lives with parents and 1 older sister (18yrs) Hospital Admissions: Hospital Admissions: –Acute Neuro Unit –Transferred to NRH for rehab Initial meeting with mother in NRH Initial meeting with mother in NRH

19 Ms. Margaret Culliton, APT Development Officer Case History Cont. Liaison with NRH – periodically Liaison with NRH – periodically Preparation for discharge Preparation for discharge –Video case conference organised with all relevant service providers – HSE, voluntary agencies, & school with all relevant service providers – HSE, voluntary agencies, & school Care package agreed prior to discharge Care package agreed prior to discharge 2nd video case conference - Pre discharge 2nd video case conference - Pre discharge –to assess progress & confirm that supports in place –discharge date agreed

20 Ms. Margaret Culliton, APT Development Officer Case History Cont. Ongoing contact (by DO) with John &/family Crucial!!! Ongoing contact (by DO) with John &/family Crucial!!! Responsible for co-ordination care package & reviews Responsible for co-ordination care package & reviews 3 rd case conference held (locally) after discharge 3 rd case conference held (locally) after discharge Outcomes: Outcomes: –John & family: satisfied with current supports (therapies, phn, pa, school/sna) satisfied with current supports (therapies, phn, pa, school/sna) had access to necessary information as they needed to know it had access to necessary information as they needed to know it –Service provision – co-ordinated approach A SEAMLESS SERVICE A SEAMLESS SERVICE

21 Ms. Margaret Culliton, APT Development Officer Other cases: Families requiring information: Families requiring information: –Preparation for discharge ….home or otherwise –entitlements/benefits –counselling services –peer support Individuals (ABI) Individuals (ABI) –Referrals for therapy/NRH/counselling –Information BRI meetings BRI meetings hospital visits – transport, directions or format of opd hospital visits – transport, directions or format of opd employment/further training employment/further training GMS cards GMS cards

22 Ms. Margaret Culliton, APT Development Officer Benefits of ABI project- for persons with ABI & families Continued contact person for individual with ABI & family Continued contact person for individual with ABI & family –hospital transfer home/NRH/Residential placement More timely & co-ordinated response by community supports More timely & co-ordinated response by community supports

23 Ms. Margaret Culliton, APT Development Officer Benefits of ABI project- for persons with ABI & families anxiety/fear/isolation anxiety/fear/isolation –concerns addressed –improved information about: services that can help services that can help roles of various people involved in supporting them roles of various people involved in supporting them what to expect? E.g.. Returning home what to expect? E.g.. Returning home assistance to work out what is needed & how to get it assistance to work out what is needed & how to get it Development of peer support Development of peer support

24 Ms. Margaret Culliton, APT Development Officer Benefits of ABI project- for service provision communication with service providers (within/outside HSE Midland Area) communication with service providers (within/outside HSE Midland Area) – phone calls, interim reports, discharge summaries co-ordination of support services co-ordination of support services Swift response of services for urgent cases Swift response of services for urgent cases Staff networking and supporting each other Staff networking and supporting each other Improved education/training for service providers Improved education/training for service providers –Education seminars/targeted workshops

25 Ms. Margaret Culliton, APT Development Officer Benefits of ABI project - for service provision Strategically Strategically –Gaps in services clearly identified & –Plan how we would address those needs –Commitment by HSE to address prioritised needs through service planning ABI Project completed in May 2006 ABI Project completed in May 2006 –Approx 100 persons with ABI & families identified & supported to various degrees

26 Ms. Margaret Culliton, APT Development Officer Developments : Main recommendations made by project to HSE Main recommendations made by project to HSE –More resources –Community outreach service for individuals & their families to be prioritised HSE commissioned Peter Bradley Foundation services HSE commissioned Peter Bradley Foundation services –Community Outreach Service –ABI support team

27 Ms. Margaret Culliton, APT Development Officer Margaret Culliton Development Officer APT Killcruttin Centre Tullamore Co. Offaly Telephone


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