Learning Plan for Adult Patients with Stroke
Adults suffering from stroke or those surviving after a stroke are left with serious brain damages that leave them with weaknesses on certain body parts, which impair movement, talking, or thinking. As such, there is a reduced blood flow to the brain normally caused by blocked blood vessels or the blood vessels become too narrow to allow blood vessels to flow or at times the blood vessels burst making blood to cause damage to the brain through leakage. In turn, the brain cells in the affected areas die because of limited oxygen supply. Strokes are common in older people especially those who are over 60 years of age. Disabilities after stroke cover a range of activities that surround normal daily activities, which they could have easily undertaken before they succumbed to the effects of stroke. These activities of daily living (ADLs) include normal tasks such as eating, dressing, bathing in addition to undertaking more complex that entail instrumental activities of daily living (IADLs) that include writing, driving, and using the telephone among others (Cook et al, 2006).
Stroke patients normally suffer from mental retardation, which makes them incapable of learning new activities and teaching such patients is not only difficult but also challenging. However, successful teaching for stroke patients calls for the development of focused lesson plans that involve tasks that are easily learned rather than being easy to watch.
Description and Assessment of the learner
A 64-year old male college professor suffered an acute stroke after losing his family in plane crash. He managed to survive the stroke but suffered from serious effects from the stroke that affected the body, mind, and feelings. First, he is suffering from weaknesses or paralysis on the right arm. This might have been caused by the injury brought to the left side of the brain, which in turn affected or paralyzed the right arm. Second, the professor is having problems with balance and coordination because he is having difficulties in walking, writing, and/or holding things. Third, the professor seemed to be suffering from dysarthria because he is having language problems in that he seems to understand the right words but encounters difficulties spelling or saying them clearly. Last, the professor seems to be having a lot of difficulty in mental activities (cognitive problems) such as those problems to do with memory, attention, thinking, and/or learning. Furthermore, the professor is still saddened by the effects brought about by the stroke and thusly, he suffers from physical and psychological symptoms.
Special Learning needs
Since the patient suffers from stroke, his special learning needs must be focused around concrete tasks that are easily learned through doing activities rather than those learning activities that involve watching. Therefore, the learning program for such a patient must involve the creation of a learning plan involving doing simple things. In such a situation, a variety of items can be used for rehabilitating the patient back to learn the things that he used to perform before he succumbed the stroke (Cook et al, 2006). The items to be included in his needs must include those items that can be easily grasped by the patient and assessment must be done in order to estimate the level of progress. For instance, immediate feedback must be given to the patient as soon as he undertakes an activity efficiently. Same activity must be done if the patient fails to perform the activity correctly. For language problems, the most effective type of language to be used in such a situation is the simplest form of language that can be easily understood.
His psychological inadequacies make him to be aware of his cognitive problems and therefore, he needs an environment that can increase his self-confidence and capabilities. This includes an environment where he would feel supported and safe, a typical environment where his uniqueness and needs will be honored. In such an environment, his intellectual freedom will be fostered and in turn foster creativity and experimentation (Royal College of Physicians, 2007). The environment will involve the professor being admitted to a hospital program where he would be assisted by an organized team of professionals who would be responsible for providing therapy. In such a facility, more effort will be required from the side of the patient, thereby enabling him to be rehabilitated faster. Later in the program, the Professor will be admitted to an outpatient program whereby he would be allowed to stay at his home but under the condition, that the full range of services will be provided once the patients visits the outpatient department of the hospital or the hospital rehabilitation facility (Cook et al, 2006). Family members will be very helpful during the last stages of this program given that they would be spending most of their times with the patient at home during the recovery phase. It must be noted that family members will be included in this learning plan from where they will be educated on how they will help the patients once they released from the hospital rehabilitation program to the outpatient rehabilitation program (Royal College of Physicians, 2007).
Upon completion of the planned activities, the professor must be in a position of doing on his own activities on a daily basis as well as instrumental activities on a daily basis. Simply put, the professor must be able to coordinate and perform tasks such as writing using his right arm that had suffered from paralysis, describe things he understands using the right language and finally yet importantly, solve the difficulties associated with cognitive issues and mental activities such as those problems to do with memory, attention, thinking, and/or learning. This will enable him to reduce the sadness associated with the loss of his family members and plan the life that his ahead of him.
The Professor will be assisted through demonstration to undertake the normal daily activities such as coordination and balance in order to assist him use the right arm to perform tasks and this will include assisting him to read and write as he usually did before he succumbed to the stroke. Provide audio-visuals instruments that would enable him to develop his language and pronouncing inadequacies. Additionally, this will include the provision of handouts and descriptive signs that relate to language needs (Kim, and Axelrod, 2005).
This program is developed based on learning theories in the sense that the theories will be used to provide the conceptual frameworks to guide the professor in interpreting the examples of activities taught to him during therapeutic activities in addition to suggesting to him the practical solutions that must be employed to solve his practical inadequacies. Even though the theories will not provide complete solutions to the problems that are currently suffered by the professor, they are adequate for directing his attention towards those variables that will enable him to recover quickly (Kim, and Axelrod, 2005).
The learning theories that are utilized in this learning program are constructivism, behaviorism, and cognitivism. Cognitivism theory is essential in ensuring that the professor is capable of looking beyond the activities associated with brain-based activities and as such, he would be able to find solutions to his cognitive inadequacies. Constructivism entails the development of new activities and this theory will be helpful in the sense that professor will construct or develop new ideas that will enable him survive the stroke. Last, behaviorism theory entails the focus of only the objective things that are observable through learning aspects. In light of the objective things, the professor will be able to progress through the change in behavior that will be shaped by the environment. Consequently, the professor would be able to learn new things by acquiring new behavior based on the subjected condition.
Past plans developed by the use of the behaviorism, constructivism, and cognitivism theories have been successful in enabling patients who have suffered different types of stroke. The three theories are very effective in the sense that they cover a wide range of aspects ranging from behavior to mental cognition and practical activities and as such, this learning program would be able to allow the professor cure from the inadequacies and/or disabilities associated with the stroke (Potter, and Perry, 2009).
Critiques of the current plan
The current learning or rehabilitation program for stroke patients suffers from a number of shortcomings that must be improved in order to bring efficacy and efficiency to patients suffering from stroke. First, the program is not patient-centered given that patients are not given the chance to view themselves as the most important individuals in the program. As such, they do not have an upper hand in determining or making decisions relating to their care (that is if they are in a position of doing so) but instead they are just left to sit back and wait for whatever will happen to them (Tooth, and Hoffmann, 2004). They are also not allowed to see their medical records and air their opinions and wishes regarding matters that affect them. Family members can come in handy in such situations because they can assist patients when making decisions relating to rehabilitation. Second, the current program does not involve family members in efforts aimed at rehabilitating stroke survivors when they are released from the hospital rehabilitation program to the outpatient or home program. Family members will be helpful when assisting the patient to relax, communicate, or perform tasks at home. Additionally, the discharge planning in the current program fails transfer the benefits of the rehabilitation to the outpatient program. They feel the goals have fulfilled and therefore, family members have little roles to play (Belciug, 2006). Finally yet importantly, the current program does not decide the care, special equipment, and assistance that must be offered to patients after they are discharged. This makes it difficult for them to practice the activities that have been learned during the rehabilitation process thereby undermining the goals of the recovery process.
Revision Areas and Areas that need improvement
Acute setting calls for the delivery of the necessary secondary health care and all facilities must be provided to ensure that the patient recovers in the shortest period possible. All learning activities in the acute setting must be developed in such a way that the rehabilitation process can be continued as soon as the patient is released or discharged from the facility to continue with the recovery at home (Wilma, Hopman, and Verner, 2003). However, this learning program will ensure that the patient will be discharged after his condition has been proven stable and healthy.
Given the shortcomings of the current learning program in the acute setting, this learning program has identified certain areas that need an improvement. First, is the issue of making the program to be patient-centered whereby patients would be allowed to air their opinions and wishes on matters that affecting them. Even though they might not be in a position to decide what is right for them, they must be given a chance, which will involve allowing family members to assist them in making decisions (Royal College of Physicians, 2007). It will also include giving them a right to their medical records even though they are in a disadvantaged position.
Second, this plan will involve close family members who will be taught various ways that they can use to rehabilitate the patients to their new environment. The roles that will be played by family members will include assisting the stroke patients to undertake activities of daily learning as well as those instrumental activities (Belciug, 2006). They would also ensure that the patients would have a safe place to recover after they are discharged. The last improvement in this learning program will be making the acute hospital program to decide the type of care, special equipment, or assistance that will be needed by patients once they are discharged. Consequently, the acute hospital setting will determine the individuals who will work the patient to enable them access the right daily care and assistance as they recover. The evaluation of this teaching plan will be monitored depending on the speed of recovery on the affected patients.
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