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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 ƒ “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 ƒ Epilepsyƒ Hearing problemsƒ Visual problemsƒ 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 ƒ Ongoing contact with clients to be maintainedƒ Provide specialist assessment for young adults who have not accessed the health care system for a period of time ƒ Initial assessment on average takes 1.5 hours ƒ Must have physical componentƒ Exclusion, mental health/intellectual disability only ƒ Medical and physicalƒ Exclusion, behavioral/psychosocial complexity onlyƒ Exclusion, people currently receiving Intrathecal Baclofen St Vincent’s YACDS – number of patients and referral source Number of patients = 47 ( as at March 2007) ƒ 80% diagnosis cerebral palsyƒ 92% aged between 16 – 25ƒ 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 ƒ Wheelchairs and seatingƒ Carer supportƒ Orthopaedic surgeryƒ Intrathecal baclofenƒ Support of GP’sƒ Sexuality

Source: http://proceedings.com.au/nahc/presentations%20(pdf)/weds_phipps.pdf