Identifying the individual’s needs
The first step to choosing the correct descriptor is to clearly identify what the individual is telling us in their ADP application form and/or supporting information about their ability to perform the activity.
The descriptors within an activity generally relate to a specific ability or difficulty. For example, throughout daily living component activity 1, the use of aids is most likely to relate to individuals who have a physical disability. The requirement for prompting would most likely apply to individuals with learning disabilities or mental health conditions. (See activities chapters for details of the descriptors.)
It is common for an individual applying for ADP to have a number of disabilities or health conditions.
Common symptoms
An individual can experience a range of symptoms that are unique to their lived experience and can vary in both duration and severity.
Common symptoms may include but are not limited to:
- pain
- shortness of breath
- fatigue
- lack of motivation
- loss of consciousness
- confusion
A clear picture of their needs
You should have a clear picture of the needs an individual has. If this is unclear, then the application form, supporting information and the Principles of Decision Making chapter should be reviewed to establish if further information is required.
Example: identify a person’s needs in relation to their mental health condition
Application form
Stephen reports that due to his bipolar disorder, he experiences low mood for seven months of the year and loses motivation to wash regularly. His partner has to persuade him to shower. Without this support he would not complete the activity.
Case manager actions
In the above example, we can identify that Stephen has a need for prompting in relation to this activity due to his mental health condition.
Example: identify the symptoms that cause the individual’s needs when one need relates to a mental health condition
Application form
Stephen reports that due to his bipolar disorder he experiences low mood for seven months of the year and loses motivation to wash regularly. His partner has to persuade him to shower. Without this support, he would not complete the activity.
Case manager actions
In the above example, we have already identified that Stephen has needs relating to a mental health condition. We can take the next step and identify that his mental health condition leads to a lack of motivation. It is this lack of motivation that we’ll make a decision on.
Example: identify an individual’s needs in relation to their physical abilities
Application form
Eli reports that following the loss of one of their legs in a car accident, while they are able to walk with a prosthetic leg, they can only walk twenty metres due to severe pain.
Case manager actions
In the above example, we can identify that Eli has needs relating to their physical abilities. Therefore, we only have to consider the descriptors that relate to physical abilities.
Once the individual’s needs are identified, we need to establish:
- what the symptoms are that cause the individual’s needs
- the severity of the symptoms
- the duration of the symptoms
Example: identify what symptoms cause the individual’s needs when one need relates to physical abilities
We have already identified that Eil has needs relating to physical abilities. We can now take the next step and identify that we will have to make a decision on their ability to walk with a prosthetic leg and their levels of pain.
Full example
Application form
Heather’s partner reports that she was diagnosed with severe autism at a young age and has a learning disability. Alongside this, Heather has depression and epilepsy. Her family reports that she is unable to cook safely as she cannot follow the steps of a recipe, due to her autism. Due to her depression and low mood, which happens for about a month every six months, the family must motivate her to cook. When cooking, there must be a member of the family present as she has daily seizures that lead to her collapsing to the floor and losing consciousness. She has had incidents in the past where she has fallen and burned herself.
Case manager actions
We begin by identifying the conditions that relate to Heather’s needs:
- severe autism and a learning disability – cognitive conditions
- depression – mental health condition
- epilepsy – neurological condition
We then consider the severity and duration of her symptoms, within these areas of challenge:
- severe autism and a learning disability – is unable to follow a recipe to cook, this is always present
- depression – lacks motivation to cook, this happens once for a month in every six months
- epilepsy – is unable to keep herself safe due to loss of consciousness, this risk is always present
The above symptoms, their severity and duration should be considered and explained when making a decision on the descriptors. By completing this step, we can take what appears to be a highly complex situation and make it clear.