Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.
This article describes the social networks of four individuals with aphasia and their perception of their social interactions and social integration within their network. Four male participants, who were aphasic as a result of a single left hemisphere stroke, were interviewed with their sigruficant other. The age of the participants ranged from 29 to 65 years and they were between 9 and 25 months poststroke. The Interview Schedule of Social Interaction (ISSI) (Henderson, Byrne, & Duncan-Jones, 1981) was used to measure the perception of social support. Several aphasia-related variables and contextual factors were assessed for their impact on the maintenance of social networks using a standardised language assessment and a range of questionnaires.A descriptive analysis of results revealed that social support networks were altered following the onset of aphasia, with extended network relationships being most affected. Several factors were identified that potentially shaped the networks of the four participants. These factors fell into two broad categories: aphasia-related and contextual factors. Aphasia-related factors included severity of aphasia, time post onset, and inherent disease characteristics. Contextual factors included degree of distress exhibited by the recipient, age at onset, life cycle stage, quality and type of relationship, social network characteristics, and family constellation. Finally, limitations of the study and directions for future research are discussed.In recent years, the societal participation of people with disability has become a public goal of health policy (World Health Organisation, 1998). According to the World Health Organisation (WHO) model of
In December 1999, Greener, Enderby and Whurr reported the findings of their Cochrane review to assess the effects of formal speech and language therapy for people with aphasia following stroke. They concluded that aphasia therapy had not been shown to be “clearly effective or clearly ineffective within a randomised controlled trial (RCT)” (p. 1). Their conclusion led to much discussion among speech pathologists with some expressing grave concern that the outcome of the review would undermine the provision of services for people with aphasia and their carers. In this paper, evidence for the effectiveness of aphasia therapy that has been provided by published systematic reviews is critically explored. Clearly, challenges remain with respect to provision of evidence-based aphasia therapy. However, the weight of evidence accumulated over the years and synthesised in systematic reviews supports the broad conclusion that aphasia therapy is effective.
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