Lecture Disability week 8 EH2 Dr Paul Chapman- student PDF

“There is no greater disability in society than the inability to see a person as more” Health of Special Populations: People with Disability DR PAUL CHAPMAN [email protected] Expected Learning outcomes this week: 1 - Define the terms disability, handicap, impairment 2 - Describe t...

“There is no greater disability in society than the inability to see a person as more” Health of Special Populations: People with Disability DR PAUL CHAPMAN [email protected] Expected Learning outcomes this week: 1 - Define the terms disability, handicap, impairment 2 - Describe the categories of disabilities and the application of appropriate terminologies 3 - Explain the concept of normalisation 4 - Explore the lived experiences of a person living with disability 5 - Analyse environmental and social constraints of having a disability 6 - Develop appropriate communication strategies for use with people with disabilities 7 - Describe changes in policy and perception of disability across the years. Having a disability is just one way that someone can be different. u People with a disability are people first, with the same variety of desires, interests, problems, talents and faults as any other member of the community. Topics u u Disability u What it means u Types/Classification u Impacts on patients Terminology u Disability u Impairment u Handicap Topics u History/Social Changes in the area of disability u Legislation- Disability Discrimination Act (1992) u NDIS u Tips for interaction with patients in the medical setting Disability-What is it? u “any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them” u CDC Types of Disability u Physical u Intellectual u Mental Health u Sensory u Neurological Disability u Disability is Common u 1 in 6 (4.4 million) Australians have a disability u 1 in 3 of those (1.4 million) are severe. u Rate increases as people age u More common in regional areas u You will treat people with disability! u You may have or may acquire one yourself! Disability Impact u 47% of adults with disability have experienced violence after the age of 15 (36% without disability) u 24% of adults with disability experience very good or good health (65% without disability) u 48% of working age people with disability are employed (80% without disability) u 32% of adults with disability experience high/very high psychological distress (8% without disability) History of Disability u 18 & 19 century: People with disabilities were segregated u 20th century: Impact of advances in medical treatment, health, increased longevity, living conditions u u Surgery u Infectious diseases u Spinal Cord Injury 1948 UN Declaration of Human Rights History of Disability u 1958 Bank-Mikelson & Nirje– principle of normalisation u 1981 UN International Year of Disabled Persons u 1992 Commonwealth Disability Discrimination Act u 2012 Commonwealth National Disability Insurance Scheme Act u 2013 National Disability Insurance Scheme http://www.ndis.gov.au/ u 2017 Implementation of NDIS Prominent people with Disability u u “Just because a man lacks the use of his eyes doesn’t mean he lacks vision.” Stevie Wonder Types of Disability and Classification Types of Disability u Physical u Intellectual u Mental Health u Sensory u Neurological Historical Terminology Disability is a social construction. Previous language used to describe people with disabilities included: u mentally retarded u mentally deficient u handicapped u subnormal u crippled Disability Terminology u Impairment u Disability u Handicap Definition of terms Impairment: u The loss or an abnormality of psychological, physiological or anatomical structure or functions. Disability: u is the resulting functional impact of impairment on performance that is any restriction or lack of ability to perform an activity in the typical manner eg intellectual, physical, sensory, cognitive, psychiatric. It refers to impairments, activity limitations, participation restrictions. Handicap: u is a disadvantage for a given individual resulting from impairment or disability that the limits or prevents the fulfilment of the role that is typical for that individual Disability Terminology u Impairment u Disability u Handicap Think about these words….. Impairment Disability Handicap Think about these words….. Impairment Disability Handicap ICF u International Classification of Functioning, Disability and Health u Internationally Recognized way of describing the impacts or health, environmental and personal factors on an individuals ability to function and participate in activities. ICF Example ICF Example ICF Example ICF Personal Affects of Disability Disabilities affect different people in different ways depending on § § § § § § § § § Age of onset Cause of impairment Severity of impairment Attitude and awareness Family and other supports Background Opportunity Adjustment to new impairments Personal values. u “Equality is the public recognition, effectively expressed in institutions and manners, of the principle that an equal degree of attention is due to the needs of all human beings.” Rights and Legislation Rights – enforced by legislation in Australia The Commonwealth Disability Discrimination Act 1992 http://www.austlii.edu.au/au/legis/cth/consol_act/dda1992264 Disability Discrimination Act 1992 u Why was it written? Normalisation u The belief that people with a disability should enjoy the same rights, privileges, opportunities, and access to services and facilities as those who do not have a disability. Major Aims of Disability Discrimination Act u Eliminate discrimination against people with disabilities u Promote community acceptance of the principle that people with disabilities have the same fundamental rights as all members of the community u Ensure as far as practicable that people with disabilities have the same rights to equality before the law as other people in the community. NDIS NDIS u National Disability Insurance Scheme Act 2013 www.legislation.gov.au/Details/C2013A00020 Disability today: National Disability Insurance Scheme u Provides support to Australians with a disability + their families and carers u Necessary supports to enjoy an ordinary life u Helps people with a disability achieve their goals, independence, community involvement, education, employment, health and well being. u Provides information and referrals to existing support services in community Disability today…focus on normalisation u Focus on provision of services for quality of life for person with disability u Funding individualised support and care u Choice and control u Assistive technology, equipment, home modifications u Inclusion u Lifetime approach u Age Birth – 64 years u Person-Centred Plan Developing a profile of individuals, identifying individual support and housing needs u Identification of standards of service provision to facilitate a quality of life in the community u Consideration of cultural background, geographic location, age, history u Involvement of informal supports – family, friends, advocates, community networks u PCP funded by NDIS Reasonable and necessary supports u For independence u Achieve goals u Participate in social activities u Participate in work u Activities in the community u Personal care activities Reasonable and Necessary Supports u Therapeutic support u Help with household jobs u Aids or equipment for independence u Home modifications u Mobility equipment u Vehicle modifications It does not cover… u Day to day living costs u Health Related Costs u Rehabilitative Therapy NDIS Questions u Is access fair? u Is the service equitable? u Is it doing what we had hoped it would? u Can we afford the ongoing costs? Practice Points Rehabilitation Medicine 101 Think about how you would access the community if you had- u Impaired mobility? u Vision impairment? u Cognitive impairment? u Neurological impairment? How do you feel when interacting with patients with Disability? How do you feel? u Uncertain u Scared u Ill equipped u Frustrated u Sorry u Pity Consider what language you use in interacting with people Some Positive Attitudes for the Inclusive Doctor As a medical practitioner remember that: A patient with a disability has needs like all others Speak to them as you would to any other patient. u u Place the person first, rather than the disability or disorder; u Recognise the individual rather than the disability or difference. u You will treat people with disability! You may have or may acquire one yourself! u BUT you may have to: § § § § § § § simplify your language speak more slowly face the person directly use adaptive devices take more time use a carer or other support person additional information but…….. remember who is the patient for Things to Remember Normalisation u The belief that people with a disability should enjoy the same rights, privileges, opportunities, and access to services and facilities as those who do not have a disability. Terms u Impairment: the loss of some capacity u Disability: a restriction resulting from an impairment u Handicap: a disadvantage resulting from an impairment or disability NDIS u What it covers… u And what it doesn’t Aims of the disability Discrimination Act (1992) u 3 aims u Eliminate discrimination u Promote community acceptance u Ensure that people with disabilities have the same rights to equality Strategies for treating patients with disability How will you practice? § § § § § § § simplify your language speak more slowly face the person directly use adaptive devices take more time use a carer or other support person for additional information but…….. remember who is the patient “Know me for my abilities, not my disability.” ROBERT M. HENSEL