Print article: "Social Rehabilitation Project and a new life" Social Rehabilitation Project and the new life of medulloleso
Marco Vaccaro (Social Worker and member of the Scientific and Technical Committee dell'ASMS)
The wording of the decree of the Ministry of Health for "Spinal unit" means the operating units hospital, specifically, for ongoing support of quadriplegics and paraplegics, of traumatic origin and not, for the first cycle of treatment usually not exceeding 360 days to 180 days for quadriplegics and paraplegics and annual cycles of readmission average duration of not more than 30 days of the year. Given the complexity of treatments to practice, the establishment of spinal units requires the presence, multidisciplinary, in the Presidio of specialized functions, including urology, neurology, orthopedics, surgery (plastic surgery, neurosurgery general), gynecology, provided the necessary physical medicine rehabilitation. Given the importance that the quality of life assumes, in this particular type of unit operation, the organic base of structured transactions, it should be integrated with the presence of at least a social worker.
It should be noted, that the Sicilian Region, through a decree to transpose the directive said the national provision, too, the organization shape the social worker. The patient medulloleso needs from the first moment of a multidisciplinary medical team and nursing, given the complexity of the disease, which affects nearly every organ of the person and all vital organs.
The team must take responsibility for the patient, but also, where possible, his family or a part thereof, to the changed conditions of living, which will establish, in the case of survival of trauma. Consequently (as required by law) within the team will be social workers, who are able to assess situations in which the patient can be returned to the family and society.
In our region, the spinal units planned since 1995 and whose needs is reiterated in the Regional Health Plan 2000/2002, not yet exist, and attempts to become the only operational facility of continuity of care and rehabilitation "Villa of the Broom" existing in the city of Palermo (ongoing outpatient services).
the treatment of persons with spinal cord injury is the result, as mentioned above, a work team in order to arrive at a comprehensive rehabilitation program. Within this overall rehabilitation project, is part of the force to shape the social worker. The social worker acts as known within the following general principles:
1. respect for the individual;
2. solidarity;
3. responsibility;
4. participation;
5. coherence;
6. equality.
In keeping with the above principles, the social worker's professional activity, is expressed: •
in welcoming and user acceptance and recognition of the profound dignity of the person;
• confidence in the person and in his ability to undertake a change process;
• the need not to replace the person in the path of solving problems, but accompanying it with empathetic professional attitudes;
• contextualisation of the interventions in relation to specific geographical areas;
• collaboration and involvement constructive, not just the user, but also with all the stakeholders.
With the user is established a genuine process of aid, defined as the ability to activate in the face, problems and needs of medulloleso, paths articulated answers. This path can be schematically feasible, the following steps: 1
. identifying the problem and care;
2. analysis of the problem and available resources;
3. project development intervention;
4. implementation of the project
5. verification of the results obtained (in progress and final);
6. conclusion of the process of helping.
At this point, before continuing, in particular discussion of the social worker's intervention, it should explain that the medulloleso is "a person with spinal cord injury, the injury compromises which, more or less seriously, the functionality of the whole body, except for the view , hearing, speaking, swallowing and functions, so-called cortical (thinking, reasoning, remembering).
The most common causes of spinal cord injury are road accidents, work, military, sports, and, above all, diving into the sea in shallow water. The medulloleso not heal, if healing means returning to its previous state of the morbid event. It should be emphasized, however, that the clinical picture can be improved with appropriate drug treatment, rehabilitation, orthotic and behavior.
part of the intervention overall rehabilitation, specifically, the functions performed by the social benefit of medullolesi are:
A. SOCIAL SECRETARY;
B. DOOR GUIDANCE FOR WORK;
C. SOCIAL ACTION PROGRAMME operator following hospital discharge;
D. CARE DOMICILIIO;
E. Reiser SOCIAL AND FAMILY.
A. SECRETARIAT SOCIAL
The Secretariat provides a professional social space to listen, and filtering of information. The fornt office, carried out at the Hospital "Villa of the Broom" by association Sicilian medullolesi ganglia, can be carried and accompany the request for help by activating the network of local resources. The interview provides some guidance for the conduct of administrative procedures and practices relevant to the solution of problems, such as: • Ensuring
state disability civil
• The Right to Education;
• Purchase technologically advanced tools, aimed at the independence and medulloleso of autonomy.
B. DOOR GUIDANCE FOR WORK
The cash for work orientation has the function to take charge of the patient medulloleso, asking to be helped to integrate or reintegrate into the world of work. Through the knowledge of his life's path, the current situation of land resources and social work agencies, the social contract is shared for an appropriate response to the request for help.
C. SOCIAL PROGRAMME D'ACTION operator following hospital discharge
The main activities carried out and agreed upon with the patient with spinal cord injuries are: • Start
practices regarding disability and the provision of prostheses and aids;
• information and involvement of general practitioners;
• Preliminary contacts for activation assistance home;
• Preliminary contacts with educational institutions to ensure the right to study;
• Preliminary contacts with employers and employment agencies for vocational rehabilitation;
• Contacts with the various private social organizations operating in the territory, to provide additional support, both in terms of both welfare and paino psychological
• Contacts with friendship networks;
• Contact with relevant institutions to adapt living spaces and architectural barriers.
D. PERSONAL DELIVERY SERVICE MEDULLOLESA
Normative References
The National Law N.328 of 08/01/2000 laying down detailed rules for implementing the integrated system of social services and social, is the source of legislation, to which reference must be made for the rights to service at the person medullolesa. In particular should be highlighted, the following articles of the law: •
third paragraph of Article 2 recognizes the recipients of that access, giving priority to the rights those persons in poverty or with limited incomes or with total or partial inability to to meet their own needs, incapacity, of a physical and psychic
• Article 14 first paragraph and second paragraph provides that, to achieve full integration of people disabled, at the request of an individual project is prepared for the care and rehabilitation to the SSN;
• The third paragraph of Article 16 states that the provision of help and support at home, even with the economic benefits In particular, for families that take on tasks of reception and care of physically and mentally disabled;
• Article 22 sets out the essential level of social benefits, payable in the form of goods and services. The fourth paragraph, in particular, provides that, with appropriate regional laws must be provided for donations of the following services: professional social work and social secretariat, emergency service social intervention for emergency personal and family home care, residential facilities for people with fragile and semi-social day care centers or residential community character.
home care home care consists of medical, nursing, rehabilitation, essential assistance in this area is the integration with the municipal social services.
The goals of home care, are:
• Assistance for people with diseases treatable at home;
• Continuity of care for discharged from health facilities;
• Support for families;
• Recovery of capacity and autonomy of the report;
• Improving the quality of life.
The preconditions for access to care in the home are: • Terms of
term care;
• Adequate family support;
• Appropriate housing;
• Informed consent from the patient and his family;
• Taking charge by the practitioner. The
care in home care must, first, to provide an integrated multidimensional approach, including the following aspects are essential:
• Overall functional status, clinical and social patient
• Preparation PAI (individualized care plan);
• Approach care provided through a multidisciplinary team, which includes social workers;
• Regular monitoring of results and evaluation of outcomes.
E. FAMILY AND SOCIAL REINTEGRATION
The best answer to the existential crisis of the patients medullolesi is the ability for them to live, right from the start, a life of social relations in continuity with that which preceded the spinal cord injury. To do this we must provide the unity cord unipolar adequate space to encourage socialization. Must be prepared under the project total intervention by the social worker, in particular, the following operational programs: • Program
school for further study in conjunction with local schools;
• Support program for the promotion and establishment of trails vocational training and education in support of families;
• Cultural mediation program for non-Italian users, identification of the work situation, school, family and insurance in order to set the most appropriate social assistance for the person medullolesa and his family.
Finally, at the conclusion of this brief paper, I consider it necessary to emphasize the role of collaboration synergy and integration with public institutions, voluntary associations in favor of medullolesi. Particular attention should be paid to non-profit association Sicilian medullolesi cord, based in Palermo, in which it operates, as a social worker, founded in 1974, provides that under the total gratuity, or in agreement with local authorities (region , province and municipality), the following fundamental servants:
• scientific and medical advice;
• Legal advice;
• Advice service social
• Tax advice,
• Nursing care;
• Integrated Home Care;
• Service transport disabled
• listening center for the disabled and families;
• Laboratory pictorial
• Organization of excursions;
• Information campaigns, prevention and awareness;
• Organisation of cultural activities of importance to health.
Palermo, 12.10.2010 there
F.to
Rapporteur
Dr. Vaccaro