Bullen Ann, Luger Rosemary, Prudhomme Debbie, Geiger Martha
The Chaeli Campaign, Cape Town, South Africa.
Centre for Rehabilitation Studies, Stellenbosch University, South Africa.
Afr J Disabil. 2018 Jun 5;7:273. doi: 10.4102/ajod.v7i0.273. eCollection 2018.
The purpose of this article is to share some lessons learnt by an interdisciplinary therapy team working with persons with profound intellectual and multiple disabilities (PIMD), implemented in diverse, low-income contexts over a period of 8 years.
The objective of all the activities described here was to provide increased stimulation and development opportunities for persons with PIMD within different settings (day care centre, residential centre or family home).
We used an iterative action-learning approach where we applied existing evidence in the given context, reflected on and adapted strategies in collaboration with stakeholders on a cyclical basis. We focussed on achieving our objectives through ongoing hands-on training of the carers involved with the clients as we felt that by providing them with the knowledge and skills needed, plus ongoing support, these programmes would be more sustainable.
It took some time to put systems in place in care settings, but once they became part of the daily routine, they provided increased opportunities for learning for clients with PIMD. In addition, there were often marked changes in individual clients' communicative and physical functioning, which in turn encouraged carers to find new and different ways to interact with, and stimulate, the persons with PIMD in their care.
Our hope is that parents and carers or professionals working in the field of PIMD in low-income contexts elsewhere may find one, some or all of these simple ideas useful in providing opportunities for learning, development and enjoyment for persons with PIMD.
本文旨在分享一个跨学科治疗团队在8年时间里，在不同的低收入环境中与重度智力残疾和多重残疾患者（PIMD）合作所学到的一些经验教训。
这里描述的所有活动的目的是在不同环境（日托中心、住宿中心或家庭）中为PIMD患者提供更多的刺激和发展机会。
我们采用了迭代行动学习方法，即在给定背景下应用现有证据，与利益相关者合作，周期性地反思和调整策略。我们专注于通过对照顾客户的护理人员进行持续的实践培训来实现我们的目标，因为我们认为，通过为他们提供所需的知识和技能以及持续的支持，这些项目将更具可持续性。
在护理环境中建立系统需要一些时间，但一旦它们成为日常工作的一部分，就为PIMD患者提供了更多的学习机会。此外，个别患者的沟通和身体功能往往会有显著变化，这反过来又鼓励护理人员寻找新的、不同的方式与他们护理的PIMD患者互动和刺激他们。
我们希望其他低收入环境中从事PIMD领域工作的父母、护理人员或专业人员可能会发现这些简单想法中的一个、一些或全部，对为PIMD患者提供学习、发展和享受的机会有用。
