Disability

Question 1

Why is disability important?

Answer 1

• Affects us all as we are all on a trajectory towards disability
• Disability is part of human condition (transcends geography, sex, ethnicity and socio-economic position)
• Numbers on the increase for patients and doctors
• Will treat them and the impact of how we do this is big on the person
• We must support disabled citizens to lead ordinary lives as active community members
• Must work within a legislative framework in terms of disability

Question 2

What are the 3 models of disability?

Answer 2

1. Medical
2. Social
3. Interactional/integrated

Question 3

What is the medical model of disability?

Answer 3

Disability is INTRINSIC to the individual and is attributed to physical of cognitive impairments and is treated by changing or curing the disabled person where medical professionals are central to this treatment

Question 4

What are the criticisms of the medical model of disability?

Answer 4

• Individualises issue of disability
• -ve/disempowered image (‘personal tragedy’)
• Medicine defines and controls disabled people inc. assess to treatment and in some cases right to life

Question 5

What is the social model of disability?

Answer 5

Disability is EXTRINSIC to individuals where social, attitudinal and physical barriers prevent disabled people from participating in society to the same extent as other people so the problem is primarily caused by the way society is organised so it is a public issue that needs socio-political responses

Question 6

What is the distinction between impairment and disability stated by the social model?

Answer 6

Impairment = bodily, mental or intellectual limitation or condition but this does not disable them

Disability = loss or of limitation of opportunities to take part in society on equal basis

Question 7

What are the advantages of the social model of disability?

Answer 7

• Disability is not seen as an inevitable consequence of living with impairment
• Emphasizes need to remove physical, attitudinal and social barriers to full participation
• Calls for social and political change rather than individual adaptation

Question 8

What are the disadvantages of the social model of disability?

Answer 8

Can fail to acknowledge the significance of impairments for individuals because its saying impairments aren’t disabling but the barriers are

Question 9

What is achrondroplasia?

Answer 9

A bone growth disorder in short limbs where disability results from lack of adjustments to the environment and due to social and attitudinal barriers but there can be some physical features that cause pain and distress such as spinal curvatures

Question 10

What is the interactional/integrated model of disability?

Answer 10

Disability is the outcome of complex interactions between impairments AND the social, environmental and cultural contexts

Question 11

Who adopts the interactional/integrated model of disability?

Answer 11

1. WHO’s International Classification of Functioning (ICF)

2. United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)

Question 12

What is the main role of policies and services for disabled people?

Answer 12

To enable them to lead ordinary lives and to participate in society to the same extent as non=disabled people

Question 13

What replaced the WHO’s International Classification of Impairments, Disabilities and Handicaps?

Answer 13

The International Classification of Functioning (ICF) addresses some of the difficulties with this previous classification system

Question 14

What is the aims of the International Classification of Functioning (ICF)?

Answer 14

1. Address difference of emphasis implicit in the medical and social models of disability
2. Establishes a common language for describing health and health-related states to improve communication between different users
3. Provides an international coding system for classifying coding and functioning

Question 15

What are tools that promote humans rights and equality?

Answer 15

International: UN Convention on Rights of Persons with Disabilities (UNCRPD) and other human rights conventions

National: UK Equalities Act for e.g.

Question 16

What is the human rights approach for the UN Convention on Rights of Persons with Disabilities (UNCRPD)?

Answer 16

1. Establishes that disabled people are not ‘other’ i.e. have the same right as others
2. Established a universal standard or benchmark which can be applied
3. If a disabled person experiences fall short of this universal standard, it is understood as a human rights violation

Question 17

What does the UK Equality Act demand?

Answer 17

Equal treatment in access to employment, private and public services, regardless of protected characteristics of age, disability, gender, reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation

Question 18

What are the health and social care services covered by the UK Equality Act laws?

Answer 18

• All NHS providers e.g. hospitals
• All NHS commissioners e.g. GP practice
• Those supporting elderly and disabled people in their homes
• Care in day centres and residential/nursing homes
• Those caring for children who cannot live with their parents

Question 19

What is the UK Equality Act’s definition of disability?

Answer 19

A person is disabled if s/he has a physical or mental impairment and the impairment has a substantial and long-term adverse effect on his/her ability to carry out normal day-to-day activities

Question 20

Why is human rights and equality legislation needed?

Answer 20

Disabled people experience social, economic and health inequality - as a group they have lower levels of participation in all aspects of life

Question 21

What are examples of inequality disabled people experience?

Answer 21

• Less education
• Less employment
• More poverty
• Poorer health outcomes
• More discrimination esp. in work place
• Lack of control/choice
• Difficulty accessing goods and services inc. health services

Question 22

What is the Accessible Information Standard?

Answer 22

Legal requirement that all organisations providing NHS or adult social care must follow aiming to make sure people who have a disability, impairment or sensory loss are provided with:

1. Information they can easily read or understand
2. Support so they can communicate effectively with health and social care services
   - covers clinical record keeping

Question 23

Why is disability relevant to doctors?

Answer 23

• How we think about it is likely to influence treatment and services provided
• Should see it as resulting from complex interactions (interactional/integrated model)
• Need to help people manage their impairments and conditions
• Clinical management should enhance participation in ways the person wants (person-centred approach)
• Important to recognise barriers to participation and QoL
• Must operate within international legislation (Equality Act and Human Rights)

Question 24

What words should be avoided?

Answer 24

Negative language:

• Person/people with disability
• Wheelchair bound
• Retard
• Albino
• ‘Suffering’

Question 25

What inclusive language should be used?

Answer 25

Positive language: - Disabled person/people - Wheelchair user - Challenged (physical or cognitive impairment) - People with albinism - 'Experiencing'

Question 26

What is inclusive language?

Answer 26

Language that avoids the use of certain expressions or words that might be considered to exclude particular groups of people e.g. disabled people