After spending nine long years in a mental health unit of a Sydney hospital, Petra* is finally set to move into supported housing in the community, where she can begin to improve her quality of life.
The 44-year-old’s prospects began to take a turn for the better last year, after she engaged with Ability Action Australia through the NDIS, and our Senior Occupational Therapist, Rachel Ownsworth.
Since childhood, Petra has lived with schizophrenia, a complex brain disorder that affects about 1 in 100 Australians and causes psychotic symptoms such as delusions and hallucinations.
In Petra’s case, she’s required a high level of support within the hospital’s psychiatric unit for extreme behavioural challenges, including physical and verbal aggression, and violent outbursts.
Unfortunately, her condition hasn’t responded to treatments such as medication, so she’s unable to perform simple everyday tasks, like dressing, on her own.
“Petra’s been in a hospital setting for far too long, so her quality of life hasn’t been great. After so long, the hospital wanted to explore alternative accommodation options for her,” Rachel says.
“We all wanted to get her out of hospital and living a life with more normality.”
Needs assessment
Working closely with the hospital’s social worker, and with a security guard close by to defuse a situation if necessary, Rachel met with Petra several times to assess her care requirements for living independently, including how many live-in support staff she’d need.
They also performed a specialist disability accommodation assessment to determine an appropriate home for Petra, given her circumstances.
With Petra unable to identify her own therapy goals, Rachel spoke to the hospital staff who have known her for many years, to identify the types of things she may enjoy doing.
The first meeting with Petra lasted just five minutes, due to the verbal and physical aggression. However, during the next few meetings she was cooperative.
“She was actually really good with me,” Rachel says. “The hospital staff said this is the best she’ll ever present.”
Recommendations
Following the assessments, Rachel made several recommendations in her report, including that Petra live alone to avoid harming others, with the assistance of two support workers at all times.
Petra should live in a house free of any breakables, for her own safety and that of others, and have access to a group facility to increase her social skills over time, Rachel proposed.
And prior to any move, Petra should engage with a behavioural support specialist who would develop a support plan, as an alternative to restrictive practices such as sedation.
A positive behaviour support plan addresses the needs of the person with complex behaviours of concern, and is jointly prepared with the person with disability, their family, carers, and other support people to create personalised positive behaviour support strategies.
Positive behaviour support strategies yield a fantastic result for Petra
After submitting her recommendations to the NDIA, Rachel hoped for a positive response, even though her recommendations were costly.
“We were asking for significant supports and funding for Petra, but without them she’d be at risk of remaining in hospital for the rest of her life, which would cost even more,” she explains.
“One of the main goals we’ve set for Petra is to perform daily tasks, such as meal preparation, and that isn’t possible in hospital.”
After six months, Rachel received word from the NDIA that all of her recommendations for Petra had been approved, and that they’d found a suitable home for her.
The accommodation is in familiar territory for Petra, both close to where her mother lives and the well-known area around the hospital.
Now, Rachel will undertake further assessments to ensure the new home contains everything Petra needs to do things more easily or safely, using the right assistive technology equipment.
Petra is already receiving positive behaviour support strategies to reduce her challenging behaviours and improve her quality of life.
Because the move will be a big change for Petra, she will transition gradually into her new home, starting with viewing the property, and then staying over for one night, then for longer periods.
Community-based care
Rachel says she’s “so happy with this outcome”.
“Unable to participate in any meaningful activities in hospital, Petra wasn’t able to enjoy her life,” she says.
“But she’ll now start her journey transitioning out of the hospital setting where she’s been for way too long, and into supported housing with appropriate support needs.
“With the right support, she can now start to develop her own routine and work towards the goals in her plan.”
*Name changed to protect privacy
