Upload
jacob-small
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
ALABAMA VETERANS CONFERENCE
MAY 2012
DISABILITIES & CASE MANAGEMENT
Profile of Today’s Soldiers
All VolunteerAll Volunteer
Average Age 27 – 28
Many Married With Families
High Number of Guard and Reservists
More Women in CombatMore Women in Combat
More Than One DeploymentMore Than One Deployment
Technology Improvements On & Off The FieldTechnology Improvements On & Off The Field
Profile of Today’s Soldiers
High Number of Survivors
WWII 1 soldier killed = 1.6 wounded
Viet Nam 1 soldier killed = 2.6 wounded
OIF/OEF 1 soldier killed = 16 wounded
Better care on the field & better armor
High Number of Survivors
Transport field to U.S. Hospitals
Viet Nam 35 – 40 days
OIF/OEF 35 – 40 hours
QUOTE
"In the history of the Republic, never has so much been placed on the shoulders of so few for so long," said Brigadier General Loree K. Sutton, director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, "We have no reference population to compare with the addiction and mental-health problems facing today's military personnel.”
Frequent Types of Disabilities
AmputationsHearing LossVisual Impairments Mental or Emotional Disorders
~ Anxiety Disorders -including PTSD~ Depression
Traumatic Brain InjuryBurns
Amputations
High tech prosthetics
Above the knee/elbow compared to Below the joint
Most have multiple prosthetics
In demand by employers
Never assume limitations without discussion
Hearing Loss
Technology getting better
Many hearing aides only amplify sound
Communication adds to frustration
May be more difficult to place on a job
May interfere with retention
Visual Impairment
s
Common problem with soldiers
May be associated with other issues
Many devices/agencies to
help
JAN would be a good resource for
placement issues
Mental /Emotional
• Anxiety disorders, including PTSD
• Depression
• Could be in combination
Anxiety
Unlike the relative mild, brief anxiety caused by
such a stressful event such as business presentations
or a first date, anxiety disorders are chronic,
relentless and can grow progressively worse, if
untreated. Included: Panic, obsessive-compulsive,
PTSD, phobia’s, & generalized anxiety
disorder.
Depression
An illness that involves the body, mood and
thoughts, that affects the way a person eats
and sleeps, the way one feels about oneself, and
the way one thinks about things. Without treatment, symptoms
can last for weeks, months or years.
Depression Symptoms
Loss of interest in activities
Weight loss or gain
Poor concentration/memory
Social withdrawalUnusual fatigue
Feelings of worthlessness, sadFlat affect
Post Traumatic Stress Disorder
Exposure to an event that causes intense horror,
terror, or fear of death.
After the event, the person: persistently re-experiences the
event, attempts to avoid memory or images of the
event, and suffers distress or impairment.
PTSD
Many do not seek help-they do not want to be seen as “weak”
May feel great guilt, just for surviving
Do not recognize own symptoms for a long time
Often a major event will bring it to surface
A Whole body-mind disorder
PTSD Symptoms
Sleep Problems
Restlessness
Overly watchful or hyper vigilant
Social withdrawalHeadaches or unexplained personality
changes
Anger outbursts-out of character
Risk taking behavior
PTSD Symptoms
Distrust of authority
Socially disconnected/emotionally numb
Depressed/anxious
Problems with memory, attention, follow through
Poor frustration tolerances
Traumatic Brain Injury or Concussive Blast Injury
Estimates of over 30% from OIF/OEF have TBI
Most resolved in 90 days
60% of bomb blast victims have TBI
80% with TBI also have PTSD
Many avoid screening and do not disclose
TBI Common Symptoms
Symptoms depends on part of the brain injured
Fatigue
Headaches
Alertness/concentration
Lack of Self Awareness
TBI/PTSDShare
many
symptoms
•Sleep problems•Depression•Anger/irritability•Concentration•Memory•Planning•Attention•Poor frustration
tolerance
What to Do?Listen carefully
Don’t try and diagnose
Be consistentAsk what would help-memory
aides are important
Be PatientMake appropriate referral if they are
undiagnosed and you suspect an issue
COPING
Denial/IsolationAngerDepressionAcceptanceHope
USING THE SERVICE DELIVERY STRATEGIES TO PLACE WITH WARRIORS
CASE MANAGEMENT
J
Assessment
Red Flags
Strategies
Elements of Case Management
AssessmentCase Notes Develop and Document a PlanCase NotesReferral to Support ServicesCase NotesFollow up and ModificationCase NotesFacilitate Job Placement
Definition:Case Man-age-ment
Case Management , as the framework for Intensive Services is the facilitation and coordination of services at the community level. The purpose of case management is to provide an individual with specific resources to take control of his / her life. It requires the case manager to focus on the long and short term goals an individual has and empower him / her to make educated decisions about his or her future.
1. Comprehensive and client centered2. The service provider and the client are
partners3. There is mutual respect between
clients and service provider.4. A client has only one IDP
Nine Key ConceptsNine Key Concepts
5. Relates the client’s actions to outcomes6. Involves creative problem-solving7. Relies on a network of services and
support8. The service provider and the system are
accountable9. Requires partnership at the systems
level
Nine Key ConceptsNine Key Concepts
(Continued)
INITIAL ASSESSMENT
Gather Relevant Information
Establish Rapport
Use Whole Person Concept
Analyze Information
Identify Barriers to Employment
One on One facilitation skills
Body LanguageReflectionOpen-Ended QuestionsClosed-Ended QuestionsActive listeningNon JudgementalPara-PhrasingTaking Effective Case Notes
SOCIAL &
ECONOMICFACTORS
INTERESTS
POTENTIALSKILLS
LEISURE TIMEACTIVITIES
PHYSICALCAPACITIES
PERSONAL
TRAITS
TRANSFERABLE
SKILLS
EDUCATION& TRAINING
Case NotesCase NotesS DATE anything you writeS QUOTE exactly as statedS Recognize PERTINENT informationS Write in SPECIFIC, OBSERVABLE and
MEASURABLE termsS If your OPINION, say so
Writing The Individual Plan
Determine Employment Barriers to Address
Set Goals
Establish Plan as a Team
Review
Implement
Monitor
Modify If Needed
Criteria For GoalsCriteria For Goals
Specific
Measurable Attainable
Realistic
Trackable
S-M-A-R-T
1. Change problem statements into goal statements
2. Brainstorm solutions and options
3. Balance options with reality; Choosing one or more options
4. Sequence and assign responsibility on the IDP
FACILITATING JOB PLACEMENT
Establishing Business Relationships
Through the Business Services TeamThrough the Local Veterans Employment RepresentativeOn Your Own
Critical when placing individuals who have been in Case Management
Critical when working with someone who has a disability needing accommodations
COMMENTS FROM BUSINESSES
Veterans may need more time after returning homeAwareness of the needed mental and physical skills
of a jobBe there after the hireNew challenges may arise for the veteranBe willing to educate my staff and/or supervisorsAre absent from work for on-going treatment, not
disclosed
*INSTITUTE ON REHABILITATIVE ISSUES
Concern
All
companies
Small
(5–14)
Medium
(15–249)
Large
(250 or more )
% Rank % Rank % Rank % Rank
It costs more to employ workers with disabilities 58.1 1 64.0 1 54.4 1 39.7 5
Workers with disabilities lack the skills and experience to do our jobs 49.4 2 52.1 2 47.6 2 41.5 4
People with disabilities may not be as safe and productive as other workers 45.7 3 49.9 3 42.7 4 35.0 6
Supervisors are not sure how to take disciplinary action 44.3 4 44.4 4 43.6 3 47.6 1
Supervisors are not sure how to evaluate 40.7 5 39.8 5 41.3 5 43.1 3
Table 12. Percent of companies citing hiring strategies that would be helpful in hiring people with disabilities, by company size
Strategy
All
companies
Small
(5–14)
Medium
(15–249)
Large
(250 or more)
% Rank % Rank % Rank % Rank
Employer tax credits and incentives 69.2 1 66.8 1 70.5 1 77.1 5
Disability awareness training 64.3 2 59.1 5 66.9 2 82.8 3
Visible top management commitment 64.2 3 59.4 4 65.8 3 84.9 1
Mentoring 63.4 4 60.7 2 62.3 4 84.3 2
Assistive technology 61.1 5 59.1 5 59.7 6 80.3 4
Using a specialized recruiting source 60.8 6 57.3 7 61.8 5 76.6 6
Flexible work schedule 60.0 7 59.7 3 58.1 7 71.8 12
Training existing staff 57.9 8 54.7 8 58.0 8 76.1 7
On-site consultation or technical assistance 57.1 9 54.5 9 57.0 9 73.1 9
Disability targeted internship program 55.4 10 53.0 10 54.4 11 74.3 8
Short-term on the job assistance with job coach 54.3 11 50.5 11 55.2 10 72.4 10
Alternative Job Development Techniques
Mentors
Supported Employment
On the Job Training
Specialized Programs
Creating Jobs
Mentors
Mentors are normally from inside the organization
Become the go to person for the veteran
Meetings are held regularly, maybe daily in the beginning
then less and less
Supported Employment
Using employment coaches
The coach learns the job
The coach coordinates with the supervisor
The coach teaches the veteran the job
They work side by side as needed
A contract often defines the roles
Possible Coaches
Retirees
Graduate Students in Counseling or Rehabilitation
Disability Navigators
Through VR&E or State Rehabilitation programs
On the Job Training
A contract is established with the employer, the veteran
and the placement specialist
Time frames are established along with expected
knowledge to be gained
Normally pay increases at each step of the process
Specialized Community Organizations
Placement is in a controlled environment
Supervisors work for the agency
Work is carried on at the agency or in the field under agency supervision
Many communities have these organizations: Goodwill, Compensated
Work Therapy, etc.
Alternative Job Development Technique
Business Perspective
Connecting with the Business Community
Being Aware
Creating a Job
Developing Proposals
The Business Proposal
Identify problem /
issue withina business
Explain howthis
could be addressed
Provide a description of
someoneyou know
who could fill the proposed
position
Provide a description of
someoneyou know
who could fill the proposed
position
Enclosea list
of references
ContactInformation
POSSIBLE ACCOMMODATIONS
Several Apps for the PhoneReduce Distractions Provide Private SpaceLightingDivide Work into Smaller TasksWork from HomeAllow for Flex TimeDisability Awareness Training to Co-Workers
What is Your Role?
Recognize possible problems, if un-diagnosed and make referrals
Know the resources and options for employment in your area
Help research accommodations Understand the frustrations Be creative when thinking employment
QUESTIONS?
SUGGESTIONS?
IDEAS?
RESOURCES?