Lecture 9 disability
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The document discusses disability as an interaction between impairment and environment. It defines disability according to the WHO and explores theoretical perspectives on disability, including the biomedical, economic, sociopolitical, and normalization models. Barriers to disability services are also examined, such as funding, rigid rules, linking to income, and attitudes. The experience of living with disability is discussed in terms of onset, course, outcome, limitations, and visibility/invisibility of disabilities. The key message is that disability is a difference that results from the mismatch between impairment and an unsupportive environment.
Lecture 9 disability
- 1. Disability As A Difference
- 2. WHO-Definition of Disability • Disability is defined as: the unsuccessful interaction between a person with an impairment and an unsupportive environment Environment has four dimensions: – Physical – Social – Financial – Political
- 3. Disability as a social construct Differently Abled
- 4. Theoretical Perspectives 1. Biomedical: emphasis on impairment & abnormality Patient is sick and society has an obligation to provide basic level of health care 2. Economic Model: emphasis on the economics of disability How does impairment affect capacity consequently limiting ability to be productive
- 5. Theoretical Perspectives (Continued) 3. Sociopolitical Model: represents current trends • Disability is a form of social injustice due to stigma, discrimination and marginalization 4. Normalization Theory: right to live life normally • Explains de-institutionalization/integration for people living with developmental & psychiatric diagnosis e.g. group homes, independent living, etc
- 6. The Future • Number of people living with disability will increase because: 1. population is aging 2. medical technology is improving 3. increasing # of infants survive with chronic impairments
- 7. Barriers to Services 1. Funding Barriers: Inequality amoung people with disabilities – varies greatly depending upon their source of income 2. Rigid Rule Barriers: – Programs tend to require the consumer to adapt or adjust to its requirements instead of being flexible based upon individual needs
- 8. Barriers to Services (continued) 3. Linking Services to Income: – Some people living with disability seem to have access to major funding however, we forget how much it costs to be disabled and how much are spent on care needs 4. Administrative Barriers: – Access to services can be a complicated process or has long waiting lists
- 9. Barriers to Services (continued) 5. Attitudinal Barriers: – Occurs within the community re: integration – E.g. not in my backyard mentality
- 10. Understanding the Disability Experience Onset, Course & Outcome
- 11. Onset of the disability • Way in which person becomes disabled has a major effect on self-perception – Disability at birth or early on – person never knows themselves without the disability – Acquiring a disability suddenly/traumatically – Gradual onset
- 12. Course of the Disability • Progressive – Disability progresses to greater levels of impairment e.g., ALS • Chronic – Once the adjustment to the disability is made there is reasonable levels of stability • Relapsing – Exacerbation-remission cycle e.g., MS & Lupus
- 13. Outcome • Outcome looks at the changes in lifespan changes – Some disabilities may shorten life. Others shorten it slightly, while other reduce life expectancy dramatically. – We live in a society that avoids thinking of death
- 14. Understanding the Experience of Disability Living with the limitations & stereotypes
- 15. Types of Disabilities • Limitations on mobility & energy • Sensory limitations • Limitations in communications • Limitations in reasoning ability and mental functioning Note: many disabilities are impairments only because of the social context and the built environment
- 16. Mobility Limitations – things to consider • Independent Wheelchair Mobility – Necessary to look up to make eye contact – Counters often too high – Harder to use many public facilities – Public transit – not all bus routes equipped – Wheelchair accessible bathroom stales often the furthest away – Shopping hard to manage – Accessible entrances not always where you think they are – Our bodies are not designed for sitting all the time – Textures of floor coverings
- 17. Mobility Limitations – things to consider • Dependent Wheelchair Mobility – Greater dependency on others to care for them e.g., eating, bathing, toileting
- 18. Limitations due to Energy Levels • Often having a condition or disability or being treated for it can use up enormous energy – Medications can weaken, – Receiving chemotherapy. • Certain types of disabilities are particularly associated with losses in energy – Chronic fatigue, Fibromyalgia, diseases related to lung capacity
- 19. Sensory Limitations – Vision & Hearing • Limitation can be complete or a partial absence • Blindness – Vision our favourite sensory – A social construct • Visual impairment – Easier to navigate – Takes enormous energy
- 20. Sensory Limitations – Vision & Hearing • Deafness & Hearing Limitations – Strong social component – Deaf culture – Has all the distinguishing marks for culture – a language, terminology & expressions, criteria for admittance and an established way of interacting – Deafness as a social construct – ability to learn other languages
- 21. Sensory Limitations – Vision & Hearing • Hearing Impairments – Rarely identify with deaf culture – Assistive devices have gotten significantly better
- 22. Limitations in Communications • Expressive Aphasia & Other Limitations in Speech – Expressive Aphasia • Individual unable to use the proper words or to form words to communicate • Often seen with cerebral damage and head trauma • Limiting – often only the most basic needs that are communicated due to effort involved in communicating
- 23. Limitations in Communications • Receptive Aphasia – Seen with some types of learning disorders • The person has difficulty in processing verbal and / written communication • What reaches the brain is not comprehensible • Difficulty individual facing is often not noticeable
- 24. Limits in Reasoning Ability & Mental Functioning • A very broad group including: – Developmental disabilities – Mental illness – Alzheimer’s disease – Senile dementias – Brain injuries
- 25. Cognitive Limitations: Developmental Disabilities • Constant state of dependency results in high levels of abuse – 80% • Compliance is a learned social behaviour • Very vulnerable out in the community • Sexuality and sexual identity often discouraged
- 26. Limitation in Cognitive Functioning: Alzheimer’s & Senile Dementia • Different from Developmental disabilities in that they occur later in life • Person experiences changes in – personality and behavioral, and reasoning ability and perception • Wide variation in the experiences – some become anxious, agitated, aggressive, confrontational, other become peaceful, happy and pleasant • Very difficult on the families as relationships change
- 27. Limitation in Cognitive Functioning: Mental Illness • Mental illness as social construct – something that society has created to explain behavior that is outside the norm • One of the most negatively judged limitations in society
- 28. Visibility: Special Challenge • When people with disabilities interact with others in society, the disability itself becomes one of the factors of the interaction, often determining the quality and quantity of relationships. • Some disabilities are visible and recognizable and others are not
- 29. Invisible Disabilities • Sharing is voluntary much of the time. • Sharing makes the invisible visible – it identifies you as having a difference from others • When do you share?
- 30. Disability As A Difference Disability is not the issue. The issue is the fit of disability with the social, attitudinal, medical, architectural, economic & political environment!