Microsoft powerpoint - yacds presentation [read-only]
Young Adult Complex Disability Service
Dr Genevieve Kennedy, Director Rehabilitation Medicine
Barbara Scoullar, Occupational Therapist

Transition in Victoria –from children’s to adult health services
Many young adults with complex disabilities have continued to receive health care at the Royal Children’s Hospital (RCH)

DHS - Paediatric Transition Process Project 2005
“Complex disabled patients appeared to be in limbo”
(Paediatric Review – DHS Victoria 2002)
– To facilitate the routine transition of young adults from the RCH
– Young adults with complex medical needs and/or
developmental disabilities have a right to receive appropriate care within the adult public hospital system
– Care to be funded through the standard funding streams

DHS - Paediatric Transition Process Project 2005
– Successfully transitioned 11 young adults from RCH to SVH
Sub-acute service environment most appropriate for long term, episodic medical care
Sustainable clinics developed at SVH and the RMH

– Is a well recognised neuro developmental condition beginning
in early childhood and persisting through the lifespan
– Bax, 1964 –
A disorder of movement and posture due to a
defect or lesion of the immature brain

Cerebral Palsy – a quick medical refresher
Epilepsy Hearing problems Visual problems Cognitive deficits

–
70% of young people with cerebral palsy will survive to
–
Suggests to young people and their families that living into
adulthood is a realistic expectation
–
Encourages self responsibility of the young adult in managing
Stevenson et al Dev Med Child Neurol 1997

– To assist young adults with complex medical/physical needs,
and their families, to navigate and integrate into the adult health care system
Ongoing contact with clients to be maintained Provide specialist assessment for young adults who have
not accessed the health care system for a period of time

Initial assessment on average takes 1.5 hours

Must have physical component Exclusion, mental health/intellectual disability only
Medical and physical Exclusion, behavioral/psychosocial complexity only Exclusion, people currently receiving Intrathecal Baclofen

St Vincent’s YACDS – number of patients and referral source
Number of patients = 47 ( as at March 2007)
80% diagnosis cerebral palsy 92% aged between 16 – 25 Trend towards self referral

St Vincent’s YACDS – functional status
MOBILITY – largest group is wheelchair dependent
Walking indep
Walking + WC indep
Walking with assist
WC depend

St Vincent’s YACDS – functional status
SELF CARE – largest group are dependent

St Vincent’s YACDS – functional status

St Vincent’s YACDS – functional status
Continent
Incontinent

St Vincent’s YACDS – living arrangements
Home with parents
Home with guardian
Home alone
Homeless

St Vincent’s YACDS – vocational status
Nil program
Day program
Paid employment
Tertiary study
Special school
Unemployed

St Vincent’s YACDS – presentation of associated conditions

Cerebral Palsy –Health & Social Issues in Adulthood
–
Use of, and exposure to, health and social services markedly
–
Carer anxiety regarding provision of services, and frustration in
–
Communication poor between agencies providing care and between
the agencies and the young person or carer
Stevenson et al. Dev Med Child Neurol. 1997 May;39(5):336-42
Ng et al. J Orthop Surg (Hong Kong) 2003 Jun;11(1):80-89Cathels et al. Med J Aust. 1993 Oct 4;159(7):444-6

Issues surrounding complex disabled patients
– Unfamiliar conditions and presentations

– Future services and staffing implications
Wheelchairs and seating Carer support Orthopaedic surgery Intrathecal baclofen Support of GP’s Sexuality
Source: http://proceedings.com.au/nahc/presentations%20(pdf)/weds_phipps.pdf
FOR IMMEDIATE RELEASE October 2011 Sasha Ali, Exhibitions Coordinator 323.937.4230 x25 / [email protected] Máximo González: Playful CAFAM presents the first solo exhibition in Los Angeles of Mexico City-based artist Máximo González January 28 – May 6, 2012 LOS ANGELES, CA — Máximo González: Playful is the first major solo exhibition in Los Angeles of Mexico C
Shakedown? Epilepsy Drug Lobby Gave Lawmakers Fits • Industry- Funded Non-Profit Pushed To Limit Generic Substitutes. acing huge revenue losses as a result of expiring The Journal reported that when the foundation’s San patents for anti-seizure pills, drug makers teamed Antonio and Houston chapters decided to make such a F up with the industry-funded Epilepsy Foundation