Corporal Gibbs Hypothetical Client - Report Example

Corporal Gibbs Hypothetical Client 0 Introduction This study is about Corporal Gibbs Hypothetical Client. As a Corporal in the military, the physical injury and psychological trauma that Gibbs went through has made him so depressed. Currently, he is struggling to overcome lost hope, low energy; depressed mood and sleeping problems in the fight recover. In fact, his concentration has significantly changed. What is really weighing him down is the problem of depression because he is inert and most of the time sleeping or seated on a chair without getting engaged in any productive work. The condition of Gibbs will be explored based on an empathic understanding while linking to other conditions for essential client centered therapy. Proper contact with clients, as well as, establishing an efficient therapeutic environment are among the main issues that should be enhanced in supporting Corporal Gibbs under his condition. The next section in this paper will have a comprehensive coverage of Gibbs background information which includes his childhood life and career aspirations to serve in the military. Other areas to be explored include challenges faced while service in the army which includes injuries suffered in the Helicopter crash, medical condition at Darnell Army Hospital and Miami Veteran Hospital. The study will also explore impact of TBI on Gibbs, medical orders, important needs of Gibbs, therapy plans and finally, treatment modification methods relevant to his condition. 1.1Client Background 1.1.1 Jason Gibbs Background Early life of Corporal Gibbs showed that he was very interested in joining the military since High School life. In fact, in an effort to express his interest, he relayed the information to his parents about joining the military in several occasions. The dream came true in the September 2001, when Corporal Gibbs finally decided to join the army. In the initial period, the unit where he was attached to was 75th Ranger Battalion and was enlisted for a period of 6 years. After joining the army, Gibbs has two tours. The first one took place in Iraq where things were difficulty because of insecurity. However, he was lucky to escape various attacks during the period of visit. The second place was in Afghanistan where he experienced the same problems, but suffered a blow after being caught in a helicopter crash. During his Iraq tour, Corporal Gibbs squad was ambushed in 2004 and he was shot twice in the arm. Three Combat Distinguished Valor awards, the Purple Heart, and more than 30 other military medals — said the termination forced him to re-enlist in the Army National Guard and eventually serve in Afghanistan in order to generate income to support his three daughters. On the other hand, in his Afghanistan tour, Corporal Gibbs helicopter crash in province valley. The platoon succumbed severe injuries such as broken ribs, neck, leg, arm, and some minor burns. However, Corporal Gibbs suffered most injuries in the crash. To give an overview of his scale of injuries, he suffered from broken ribs, broken nose from his severe head injury on helicopter crash. In addition, he had a severe closed head injury with right side paralysis requiring neurosurgery. Neurological surgery is a medical condition that requires a special diagnosis and treatment for those who suffers from peripheral nerve injuries, brain or spine injuries. Depending on the nature of illness or injury, a neurological surgeon may propose a number of treatment methods either non surgical or surgical care. Corporal Gibbs suffered a severe injury on the head and this might have caused spine, brain or nerve problems. Given the condition, it was important to establish a timely and early diagnosis of the problem followed by a comprehensive treatment, as well as, postoperative rehabilitation of Corporal Gibbs. He was subjected to a neurosurgical care through application of a computerized microscope and an advanced technical support in various operational phases. Some of these support employed include robotic laser systems, endoscopic technique and cryogenic technologic. Basically, the above accident made him to be in a coma for a period of 2 months at Darnell Army Hospital. During this time, a comprehensive diagnosis and treatment approach was employed, but no significant improvement was observed in him. In fact, further treatments were found necessary, particularly, on spines, skull, and bony structures including the central nervous system. This was a serious issue to the neurosurgeons and family members. Despite the treatment not being successful at Darnell Army Hospital, the decision was reached after a period of another one month to have Corporal Gibbs discharged and transferred to Miami Veteran Hospital. There was hope that by transferring him to MVH, an appropriate neurosurgery process would be applied to reverse the condition. The next part in this paper will look at sections and bulletins with regards to impacts of Gibbs TBI, therapy plans and various treatment modifications for Corporal Gibbs. Section 2: The Miami Veteran Hospital Name of Agency: The Miami Veteran Hospital What population does the agency serve? Our agency mainly serves veterans, spouses and children. What services does the agency provide? VA medical facilities and Vet Centers are run by the Veterans Health Administration of the United States Department of Veterans Affairs, while community-based outpatient clinics are run by civilian medical practitioners within a community and serve the veterans of those communities in partnership with the VA. Vet Centers focus on post-war adjustment, counseling and outreach services for veterans and their families. Facilities types (level of care types) are listed in table below as: Network System Headquarters (HQ) Network Health Care System (HCS) VA medical centers (VAMC) Division (Inpatient/Outpatient) (DIVIO) Domiciliary Care (DOM) Outpatient Clinic (OPC) Community Based Outpatient Clinic (CBOC) VA Independent Outpatient Clinic (IOC) VA/DoD Joint Venture Site (VADOD) Vet Center (VC) Mobile Vet Center (MVC) VA Outreach Clinic (ORC) VA Rehabilitation Center (REHAB) Community Service Program (CSP) What are the eligibility criteria for services? A veteran must have more than 10% disability and honorable discharge on his military record. All services are free to all veterans and their families. What are agency’s sources of funding? Well, Veteran Affairs are federally funded. How many and what kind of human services workers are employed by the agency? There are about five thousand VA health care professionals working only for Dade County. The amount does vary from counties and states. Most of professionals have at least a master degree in psychology, clinical psychology, psychotherapy etc. We also have psychiatrists that work 24/7 at each VA facilities. Corporal Gibbs got ambushed and involved on helicopter crash that caused a severe closed head injury with right side paralysis requiring neurosurgery. Coma for 2 months Discharged from Darnell Army Hospital a month later Section 3: 3.1. Impact of TBI on Corporal Gibbs PCS Symptom Increase after Mild TBI Gibbs became nonverbal. He was primarily nonvocal to consistent sound response When called by his name, he attempted to localize speaker Gross gestures and Grasps are limited to his left side however; the right side was completely non-functional He has insufficient Swallowing for saliva management, as well as safe oral intake Right eye had a better visual perception however; left neglect was still present after TBI 3.2 Medical orders: The use of PEG tube feeding system Lower extremities casting to prevent any contractures Intense therapy on physical, occupational and speech 4.0 Treatment Goals and Objectives: 4.1 Most Important Needs To establish consistent social response approach to people in the surrounding environment To develop functional means of expression To create oral intake To establish a long-term educational goals 4.2 Therapy Plan Goal 1.0: To consistently increase sound response to 60% Objective 1.1: Under a multimodal cues for approximately 5 consecutive sessions, Gibbs should respond to a minimum of 3 out of 5 attempts Objective 1.2: Under verbal and auditory cues, he should localize sounds with an estimated consistency is 60% Goal 2: To increase social response with approximately 60 percent consistency Objective 2.1: In multimodalic cue with an estimated consistency of 60 percent, Gibbs should comfortably establish eye contact with those in his environment. Objective 2.2: In 7 out of 10 cases, he should gesture hello and goodbye during entry or exit of a person from the surrounding environment Goal 3.0: The goal is to increase functionality of swallowing reflex for oral intake and Saliva management consistently by 50%. Objective 3.1: To develop a safe swallowing routine, as well as, a minimal stimulation consistently by 50%. Objective 3.2- To improve ability for safe oral intake by engaging in a swallowing exercise consistently by 50%. Objective 3.3: To perform at least 2 oral mechanism exercises for approximately one minute each of which should have 50% consistency. 4.3 Gibbss Treatment Modifications Given that Gibbs’s visual perception is better, especially, in the right eye, clinician will mainly use right eye for contact purposes: Objective 1.1 and 2.1. Similarly, Gibbs’s gross gestures and grasp on the left side are very limited, but completely non-functional when it comes to the right side. In the objective 2.2 clinician may assist client in performing gestures. Oral intake and swallowing need to be closely monitored. Work Cited Brain Injury Association of America. Web. 6 April 2013. . Creative Mesh. Neurology Channel. Web. 6 April 2013.. Johnson. G. About Brain Injury: Rancho Los Amigos Scale/The Levels of Coma, 2002. Web. 6 April 2013 McAfee, J, and Shipley, K. Assessment in Speech-Language Pathology. A Resource Manual, third edition 2004. Print. National Dissemination Center for Children with Disabilities. Traumatic Brain Injury, 2002. Web. 6 April 2013. < http://www.nichcy.org/pubs/factshe/fs18txt.htm>. National Institute on Deafness and Other Communication Disorders. Traumatic Brain Injury: Cognitive and Communication Disorders, 2005. Web. 6 April 2013. . Traumatic Brain Injury. 2004. Web. 6 April 2013. < http://nichcy.org/pubs/factshe/fs18txt.htm>. Read More