HEALTH AND LIFELONG DISABILITY

INTRODUCTION

This 3000-word case study task is worth 45% of your total grade for the unit of study. It has both a theoretical,
research-driven focus, and a professional practice focus.

You will be asked to analyse a case of your choice from a range of three that are available. All of these cases
focus on the experience of living with disability as a result of traumatic brain injury (TBI). The task builds on the
skills that were required in the mid-semester essay, and takes them one step further in asking you to apply those
skills to a specific, complex case.

LEARNING OBJECTIVES

This case study task relates to a number of learning objectives detailed in the Unit of Study Outline. For this task,
you will be marked in particular on how well you:

(1)  Define the nature and incidence of TBI with reference to the International Classification of Functioning,
Disability and Health (ICF) model, and to data published by the Australian Bureau of Statistics.

(2)  Define the scope of practice for health professions working with persons with TBI, including common
models of service delivery.

(3)  Recognise and communicate the rationale for inter-professional learning and workplace practice in
supporting persons with TBI and their families, including possible implications for client safety.

(4)  Interpret and integrate research evidence, the lived experience, and the preferences of clients and
caregivers in considering broad intervention goals for clients with TBI.

(5)  Search for, identify, critically evaluate, summarise, and report the research evidence for rehabilitation
interventions in the field of TBI, with reference to methodological rigour and ethical practice.

MARKING CRITERIA

A marking criteria document is available for this task (see the last six pages of this document). It is strongly
recommended that you follow this document when writing out your response to the case study.

When reading and interpreting the case of your choice, and when planning and developing your submission, the
best approach to take would be to align your writing with what is specified in the marking criteria, and to ensure
that your response effectively demonstrates your meeting of the learning objectives listed above.

INSTRUCTIONS AND QUESTIONS

Choose ONE (1) case from the three (3) that are available for download. Each case is situated at a different
point of the lifespan, and presents its own set of unique key issues in the lived experience as a factor that
informs healthcare and support practices.

Your response to the case study should be 3000 words (with a 10% lee-way either side of the limit available),
and should incorporate answers to the following questions:

(1)  With reference to relevant scientific literature on use of the ICF with individuals who have experienced
TBI, what are the main impairments, activity limitations and participation restrictions associated with this
health condition, and how are these recognisable in the case you have selected?

HSBH3010 Health and Lifelong Disability (Semester 2, 2014)

(2)  Drawing on your discussion of impairments, activity limitations and participation restrictions, and with
reference to scientific evidence, what are the main care needs that arise for people who have
experienced TBI? How are these illustrated in your selected case? Based on the scientific evidence,
how can these care-related needs be met?

For Questions 3, and 4, imagine that you are a case manager working with the individual in your chosen case.
Choose an allied health profession that, in your opinion, would be best suited to providing support for your client.

(3)  What are the goals and guiding principles that underpin this profession? List two main TBI-specific
interventions that can be administered by this profession to help your client. How do these interventions
work? What is the scientific evidence base that shows the effectiveness of these interventions? How
would these interventions relate to your chosen case?

(4)  Consider how this profession sits within a multidisciplinary healthcare team that seeks to support your
client. How do you, as a case manager, work with this profession? List the other types of health
professionals that you think are relevant for this case. Explain how you think such professions work
together within the multidisciplinary team. What kind of scientific evidence supports this idea of inter-professional collaboration as specific to TBI rehabilitation and care?

Question 5 should be treated as the conclusion for your case study response. It continues the professional focus
required from Questions 3 and 4. It is encouraged that you be as reflective and constructive as possible in
writing this particular component of the submission.

(5)  Provide a summary of the main issues for both clients with TBI and relevant health professionals with
respect to the case you selected, as well as the ethical and policy implications you have recognised
within the case study. What do you think are the implications of all of this new knowledge for your future
career in the health sector?

To complete this case study, we strongly encourage you to take into account evidence-based practice guidelines
relevant to rehabilitation and support for TBI. A key example of these would be Traumatic Brain Injury:
Diagnosis, Acute Management and Rehabilitation (The New Zealand Guidelines Group [NZGG], 2006).

In particular, consult pages 69-118 (Rehabilitation) and pages 129-136 (Follow-Up) for relevant information.

The full document of these guidelines can be downloaded and perused at the following web link:
http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_communications/documents/guide/wim2_059414.pdf

WORD COUNT DIVISION

Ideally, you should devote approximately the following amount of words to each section of the task:

Questions 1 and 2  Questions 3 and 4  Question 5
1000 words altogether  1500 words altogether  500 words

EVIDENCE BASE AND REFERENCES

You should include at least 12 references of good quality and scientific rigour for your submission. Evidence
must, wherever possible, be peer-reviewed and scientific in nature (for example, journal articles, book chapters,
or relevant policy documents from international health organisations and the Australian government).

All references should also be recent (i.e., published within the last 10 years). We highly recommend seeking
resources through the University of Sydney’s Library website (http://library.usyd.edu.au/) for this task wherever
possible.

Note that non-government websites (for example, Better Health Channel, Wikipedia, and community
organisations focused on specific disabilities) will NOT be counted as scientific, and thus will NOT be counted in
the minimum number of references.
HSBH3010 Health and Lifelong Disability (Semester 2, 2014)

FORMATTING GUIDELINES

The submission you make must adhere to the below guidelines for formatting; this will make the process of
marking all submissions easier.

  Please remember to include an Assignment Coversheet; if this is not included, your submission will
simply not be marked until one is included.

  All submissions MUST be typed in size 12 Times New Roman font and double-spaced.

  Margins no more and no less than 2.54cm (1 inch) must be specified on ALL sides of the document.

  Use of headings and sub-headings is optional – it is up to you as the student. If you do decide to use
them, please do not simply type out the questions as headings; be creative in writing them. It also
means you do not eat as much into your word count if you develop creative headings.

  You may choose to write in first-person, third-person, or a combination of both for this task, depending
on what you consider to be most comfortable and appropriate.

HSBH3010 HEALTH AND LIFELONG DISABILITY

MARKING CRITERIA FOR END-OF-SEMESTER CASE STUDY

QUESTION 1: With reference to relevant scientific literature on use of the ICF with individuals who have experienced TBI, what are the main impairments,
activity limitations and participation restrictions associated with this health condition, and how are these recognisable in the case you have selected?

QUESTION 2: Drawing on your discussion of impairments, activity limitations and participation restrictions, and with reference to scientific evidence, what are
the main care needs that arise for people who have experienced TBI? How are these illustrated in your selected case? Based on the scientific evidence, how
can these care-related needs be met?

QUESTION 3: What are the goals and guiding principles that underpin this profession? List two main TBI-specific interventions that can be administered by
this profession to help your client. How do these interventions work? What is the scientific evidence base that shows the effectiveness of these interventions?
How would these interventions relate to your chosen case?

QUESTION 4: Consider how this profession sits within a multidisciplinary healthcare team that seeks to support your client. How do you, as a case manager,
work with this profession? List the other types of health professionals that you think are relevant for this case. Explain how you think such professions work
together within the multidisciplinary team. What kind of scientific evidence supports this idea of inter-professional collaboration as specific to TBI rehabilitation
and care?

QUESTION 5: Provide a summary of the main issues for both clients with TBI and relevant health professionals with respect to the case you selected, as well
as the ethical and policy implications you have recognised within the case study. What do you think are the implications of all of this new knowledge for your
future career in the health sector?

Case study summary   – Ravi
Stage 1    2 years after the injury
Ravi has only just been referred to you for case management.
Ravi is a 15 year old boy who sustained a traumatic brain injury 2 years ago. As a result of the brain
injury, he has ongoing impairments.
He lives with his mother, father and two younger sisters in a rented single storey home. The family
receives a 255 subsidy rent from Department of Housing. Both his parents have lost their jobs prior
to the injury. The family migrated from India when Ravi was 3 years old. Both his sisters were born in
Australia.
Ravi has a left hemiplegia with dystonia, and a hemianopia in his left eye, cognitive impairments. He
is naturally left handed. He is learning to use his right hand for manipulation tasks e.g buttons and
zippers, with his left hand assisting.   Ravi has no limitations with
–  his communication in Hindi nor English
–  Moving around – In shoes with his orthotic device he does not need support. When wearing
bear feet, he walks with a limp. His balance is poor and he overbalances when he attempts
to run or jog.
–  Self care- dressing, showering or personal hygiene.
He has difficulties with
–  Learning new information but once he it is more familiar to him, he retains it and
remembers things well
–  he becomes stressed when there are multiple tasks
–  in the morning before school, he finds it difficult working out and planning what he needs.
His mother helps to organise him.
He does not do any domestic tasks except putting out the rubbish. This is consistent with his pre
injury domestic responsibilities. His two sisters were required to do more domestic tasks. His mother
and two sisters share the domestic responsibilities – cooking, cleaning, washing and shopping.  The
family are Hindu and their diet is vegetarian. The language spoken at home is Hindi, although all the
family are fluent in spoken and written English.
Prior to the injury Ravi took the bus to school as both his parents worked. Both his mother and
father drive. Prior to the injury he attended a local high school. He did not receive any learning
support. His favourite subjects were the technical subjects. At school, he played football (soccer) in
winter and cricket in summer. He was an average student. Before he was injured, he took the bus to
school with his friends. This was an important to him. Now he is driven to and from school by one of
his parents.

Ravi has a close network of a few friends at school whose friendship he continues to maintain. His
family and particularly his mother are very supportive although sometimes is overprotective and
tends to ‘hover’ around if one of his friends visit him at home. He has extended family close by with
two male cousins of similar age. Ravi has good computer skills, plays computer games and enjoys
woodwork.
Ravi is developing some behaviours where he becomes annoyed at his mother and sisters. One day
after his mother picked him up from school, he became angry and was verbally aggressive towards
his mother. His father did not respond or get involved. Ravi went to his room and threw one of his
sports trophies which left a hole in the wall.
There is no paid attendant care or other formal supports.
Ravi is very keen to take the bus to and from school, but his parents have concerns about his safety.
He no longer plays with his football team on the weekend.
Stage 2   4-5 years after the injury
Ravi continues to live in the family home. He has just turned 17 and recently finished school. He is
due to complete year 12 in six months. At school he has achieved a reasonable pass in the subjects
of computer science, general maths, English, Information processes and technology. He did not do
well in society and culture. He spends most of his spare time at home in his room playing games on
his computer.
Ravi does not know what he wants to do after school.

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