What are activities of daily living?
- everyday tasks and functional activities that are an essential part of life
- can be categorised as: personal, locomotion, domestic/work, leisure
- can be assessed and monitored
What is the ICDH/WHO definition of impairment?
Any temporary or permanent loss or abnormality of a body structure or function whether physiological, psychological. An impairment is a disturbance affecting functions.
What is the ICDH/WHO definition of disability?
Restriction or lack of ability to perform an activity in the manner or within a range considered normal mostly resulting from impairment.
What is the ICDH/WHO definition of handicap?
A disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal for that individual.
What is the DPI definition of impairment?
Is the functional limitation within the individual caused by: physical, mental or sensory impairment.
What is the DPI definition of disability?
Is the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers.
Who cares for people with lack of ADLs?
- the individual
- their family and friends
- employed carers
- their GP and primary care team
- hospital specialists
- social services
- voluntary services
- allied health professionals
Name allied health professionals who might be involved in the care of someone with a lack of ADLs
- physiotherapist
- occupational therapist
- dieticians
- orthotists
- podiatrists
- radiographers
- speech and language therapists
- art therapists
How can ADLs be assessed?
- observation
- active listening
- asking carefully worded questions
- clinical examinations
- validated questionnaires
- specific lab tests (for specific conditions)
Give examples of generic/global outcome measures
- Barthel index
- Functional Assessment Measure
- SF-36
- Nottingham Health Profile
- Health Assessment Questionnaire
Describe the medical model of disability and it’s effects
- emphasised what was wrong/abnormal in the individual
- focussed on what they could not do
- led to separate education, employment and living situations - general exclusion from society
What are the criticisms of the medical model of disability?
- views disability as an individual tragedy and fails to account for social barriers
- positions disability between the doctor and the patients; if the doctor cannot ‘cure’ the disability they will try to ‘treat’ it and if treatment is ‘unsuccessful’ they have the power to remove need for treatment e.g. sign off sick
Describe the social model of disability
- states that disabled people do not face disadvantage because of impairments but experience discrimination because of the way that society is organised
- society fails to make activities accessible, remove barriers of assumption, stereotype and prejudice and outlaw unfair treatment
- lots of emphasis on poorly designed buildings, lack of awareness, prejudiced attitudes etc
What are the criticisms of the social model of disability?
- only thinks of white, middle class men with spinal injuries and doesn’t recognise the complexity of different disabled peoples lives
- unrealistic in suggesting that an idyllic society, where impairments cause individuals not problems, can exist
Describe the effects of the Disability Discrimination Act 1995
gives rights to people wit a physical, sensory or mental disability which makes it difficult to carry out normal day to day activities
Who is classified as disabled under the Equality Act 2010?
anyone with a physical or mental impairment which has a substantial and long-term negative effect on their ability to do normal daily activities
How many people experience disability globally?
> 1 billion (prevalence is rising)
What is the principle of justice?
treating people in a way that is fair and equitable
Outline a needs-based approach to healthcare distribution
the fairest or most equitable system of healthcare is one where health care is distributed according to those who need it most
Outline questions and objects to needs-based approaches of healthcare distribution
- How do we measure need?
- Who measures need?
- Whose needs count?
- Sometimes need is not the only thing that matters e.g. on a needs-based waiting list some people would need get to the top
- What should be done when patients are in equal need but there are not enough resources to provide for everyone?
Outline other criteria for healthcare distribution (other than need)
- quality adjusted life years (QALY) calculation
- place on the waiting list
- likelihood of compliance
- lifestyle-based assessment
What are rights?
- justified claims on others
- correlative duty on other to fulfil that right
- can be legal rights (e.g. right to vote), moral/natural rights (e.g. right to autonomy), human rights (combination of the two, e.g. right to life)
Explain types of rights
- positive rights (e.g. right to healthcare)
- negative rights (e.g. right not to be assaulted)
- active rights (e.g. right to strike)
Why are rights important?
- provide protective boundaries
- conducive to good
- provide minimum standards
- gives ideal directives
