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Individuals may need to work on their skills for life for various reasons. It could be long term institutionalisation, they may never had the chance to learn these skills, damage, difficulty or loss of motivation due to their condition or they never had to do these things because of the attitude of family or carers.
There reasons for loss of skills can be mental health, physical health, frailty or acquired disability. Whatever the reason is, usually they are many fold.
Some service users are moved to live independently in the community after spending long years, even decades in institutions like hospital, residential care or prison. Their ability to exercise their independence skills in these settings is limited. Meal times are set, access to the kitchen is limited. Laundry and cleaning is done by staff. There are no bills like electricity or TV licence, as they are part of the service. While in hospital, individuals do not receive their full benefit, all their limited income can be spent impulsively and there would be no consequences, therefore budgeting is not a necessary part of life. Many of our service users developed mental health conditions when they were adults, so there is a possibility that they once had the skills. Developing problems late in life is actually a protective factor, as regaining skills tend to be is easier than developing them. The way to regain skills is to remember the skills and life they had before the onset of the illness and re-learn the routines. People who spent their lives in institutions prior to adulthood may have never had the chance to develop their skills. The best time in my opinion is childhood or adolescence. Early onset schizophrenia can happen as early as young adolescence. When it does, natural development of skills is disrupted. To learn the skills not learned as a teenager in someone’s 30s requires a different approach from from helping to regain skills as memory does not support the process.
Some conditions like ASD are life-long, meaning the person had it as a child as well. ASD can disrupt family life and therefore skills are meant to learned as a child are not obtained. Due to the condition learning a skill can be difficult. With the lead of the client, client and staff working together can figure out the best route. It could be a picture guide, a flow chart or staff prompting the client to pay attention to different areas.
Some mental health conditions, like schizophrenia damage the cognitive abilities and therefore the skills once possessed are lost. Other negative symptoms, like depression, lack of concentration, lack of motivation can be a barrier as well. Finding to root of the problem can help tackle it. Assessing the attention span of the client can determine what tasks they are able to do. When confidence is gained in some areas, new goals can be set and new skills can be learned. During an episode some skills are lost. When back in the community, clients face the daunting task of relearning those skills over and over again. It is very disheartening. Support needed is often acceptance and encouragement, as service users first need to regain their self-esteem before they can work on their skills.
In mental health, as service users often say, there is no stability. Most placements last for only a couple of years and they are moved on. When moved on, they feel uprooted, motivation plummets. Staff support is needed for clients to find relearn some skills, like the knowledge of local area.
Lack of stress tolerance is often a problem with mental illness. Stress levels have to be minimised but kept at a level where the person does not lose their ability to cope with stress. A good balance is hard to achieve.
Physical health issues can be barriers to maintaining or learning new skills. Many of the medication associated with mental health cause massive weight gain. As a consequence, self-esteem suffers and carrying out tasks become more difficult.
In some cases families can be the reason why individuals have not developed everyday life skills. Parents can be very involved in care when the service user is an adult, taking over tasks that the individual would otherwise be capable of doing.
Carrying out tasks can cause discomfort, pain and may be exhausting. Breaking down chores to achievable tasks and prioritising can be helpful.
When life skills are assessed, it is important to know the history as well to give the person the best support possible in the way it is the most effective.


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