Define the term “physical disability” Physical disability pertains to total or partial loss of a person’s bodily functions (e.g. walking, gross motor skills, bladder control etc) and total or partial loss of a part of the body (e.g. a person with an amputation). Simply stated, a physical disability is any type of physical condition that significantly impacts one or more major life activities. That is a pretty broad definition, but the types of physical disabilities, their causes, and the manner in which they impact a person’s life are wide-ranging and virtually limitless. Any impairment which limits the physical function of limbs, fine bones, or gross motor ability is a physical impairment, not necessarily a physical disability.
The social model of disability defines physical disability as manifest when impairment meets a non-universal design or program, e.g. a person who cannot climb stairs may have a physical impairment of the knees when putting stress on them from an elevated position such as with climbing or descending stairs. If a lift was provided, or a building had services on the first floor, this impairment would not become a disability. Other physical disabilities include impairments which limit other activities of daily living, such as severe sleep disorders. 2.2 Describe the following terminology used in relation to physical disability: – congenital – acquired – neurological
A congenital disability is a medical condition which you are born with. Congenital disorders are caused by development problems with the foetus before birth, congenital disorders are also genetic and can be passed down from one or both parents. Examples of congenital disabilities:
• Cerebral palsy
• Cystic fibrosis
• Spina bifida
• Congenital heart conditions
• Muscular dystrophy
• Congenital hip disorder
An acquired disability is a medical condition that you get later on in life they can develop following e.g. accidents (such as a road traffic accident), illness or working conditions that expose a person to an unhealthy environment. Examples of acquired disabilities:
• Arthritis • Rheumatism • Cardiac conditions
• Pulmonary conditions from an unhealthy working environment
A neurological disability is a disorder within the body’s nervous system including the brain and spinal cord; there are many different causes for neurological disabilities such as heart attacks, infections, genetic disorders, and lack of oxygen to the brain. Having a neurological disability can affect a person’s capacity to move. Examples of neurological disabilities:
• Multiple sclerosis • Parkinson’s disease
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2.3 Compare a congenital disability with a neurological disability, including causes Those with congenital disabilities have always had the disability so know no difference and have become used to them – it’s normal to them. Those with progressive disabilities have to become used to being disabled and learn to adapt both physically and emotionally.
Those with progressive disabilities had the opportunity for some development to take place. Those with congenital disabilities did not. For example, someone who has always been blind has no experience of sight for reference but someone with progressive blindness knows what the world looks like e.g. what colours things should be, light, faces etc look like and this can be useful.
2.4 Explain the emotional impact of a progressive disability on the individual Life satisfaction is influenced by marital status. For many people with disabilities, singlehood is not a purposely chosen status. Desolation, isolation, and a general lack of social support can engender feelings of loneliness. One of the benefits that marriage can bring is emotional support. Those who have never married are less likely than married or divorced individuals to have a confidant, as the frequency of interpersonal interactions in the social realm decreases substantially in later adulthood (Barrett, 1999).
Women with disabilities are happier than men. The rise of the human rights movement in recent decades, particularly for women, individuals from ethnic and minority groups, and persons with disabilities, has changed the landscape of the power structure in society. Perhaps women are more satisfied than men with the progress made in education, careers, intimate relationships and social status.
The length of time since the onset of the disability has been found to correlate positively with life satisfaction in individuals with “stable” disabilities such as spinal cord injury (Crewe, 2000).
Individuals with high hope enjoy high life satisfaction. Hope symbolises “the light at the end of the tunnel”, for many individuals who have been scarred physically and emotionally following the occurrence of a disability. The positive effects of spiritual well-being on the level of life satisfaction reinforces that the contemplation of priorities in life is indeed a cognitively learned process.
Spiritual practice and/or organised religion often provide psychological relief to those who are experiencing internal mental anguish.
Learned helplessness (a lack of hope) contributes to low self-esteem and lack of assertiveness, and is prevalent in people with disabilities, who tend to perceive themselves as powerless. Such a psychological impasse usually stems from the belief that their efforts to take command of life events will be ineffective.
People with disabilities perceived uncertainty about the unpredictable progression of their disability may instill in them a strong urgency to accomplish personal and vocational goals at a relatively fast rate compared to people without progressive disabilities.
Health, in both physical and mental forms, affects the quality of life in people with disabilities, as well as their ability to search and maintain gainful employment.
2.5 Compare the different impacts on individuals that congenital and progressive disabilities can have Children who are born with a disability do not realize immediately that they are different from anyone else. Generally, children start to become aware of physical differences in human bodies, such as differences in hair and skin color, body size and shape, and gender, by their second year of life. Over time, children with disabilities realize that they are in some way different from most other people. At first this difference is neither good nor bad to them. Since congenitally disabled people may have never lived in a nondisabled body, they often feel complete, intact, and “okay” with the disability, even though the outside world may view them as different. Children, whose parents accept them, support them, show pride in them and their abilities, and communicate factually and directly about the disability are more likely to develop good self-image and self-esteem.
When parents of children with disabilities encourage them to change and act more like “normal” people, hide their limitations, or dwell on things that they cannot do, the children may feel frustrated, unaccepted, and disappointed at not living up to their parents’ expectations. When they are faced repeatedly with other people’s negative reactions to their limitations, people with disabilities may come to view themselves negatively and develop a poor self-image. The conflict between “owning” a disability and making it part of oneself versus trying to get rid of the disability to become more like other people can be seen in the current debate in the deaf community about cochlear implants. When these devices are installed surgically in a deaf person’s inner ear, they allow some deaf people to hear, but not like “congenitally hearing” people do. On one side of the debate are people who were born deaf and who are comfortable with their deafness.
They see deafness and deaf culture as part of their identity, and they do not want to change. On the other side are those deaf people who believe that it is in their best interest to enter the mainstream of hearing people, if that is possible. People who acquire disabilities later in life have a different experience from those who are born with a disability. These people have lost something that has played a part in the development of their self-image, whether it is an arm or leg or the ability to perform a particular activity. People with acquired disabilities tend to go through a grieving process similar to the grieving process for any other major life loss. Their emotions usually follow these stages: grief, denial, anger, depression, working out a new way to live, and acceptance of the disability. Unfortunately, some people get stuck on one or more of these steps and may never reach the last two steps. Chronic illness is a special kind of “disability.”
There are different kinds of chronic illnesses. Some illnesses, like diabetes, often can be managed by the family doctor without hospitalisation or pain. Others, such as back or neck injuries, can severely limit activities and may require treatment for pain with medications that may have some undesirable side effects. Progressive chronic illnesses, such as muscular dystrophy or Alzheimer’s disease, get worse with time and eventually can lead to death earlier than expected. Some people with chronic illness may go through repeated periods of anger, sadness, and depression. They may become frustrated and angry. Most physicians and mental health practitioners agree that there is a connection between mental health and physical well-being. In general, the better a person’s self-image and self-esteem, the more able a person is to cope with life’s ups and downs and the better a person feels both mentally and physically.
Many studies have found that people with disabilities experience psychological problems (especially depression and anxiety) and behaviour problems at about twice the rate of the non-disabled population. Family members of people with disabilities are also more likely to experience emotional problems brought on by the extra responsibilities, financial burdens, and limitations of caring for someone with a disability. Though chronic illness and disability include the risk of psychological problems, most individuals and families learn to cope with these conditions.
Risk factors that increase the likelihood of psychological problems include: chronic illnesses that are painful, unpredictable (like seizures), or embarrassing “invisible” disabilities (because people may feel stressed by wondering if they should tell others about their limitations) disabilities that require a schedule of time-sensitive special treatments poor social skills and a rigid personality failure of loved ones and professionals to talk honestly with the person about the disability failure of parents to address sexuality in teens with disabilities allowing the disability to become the focus of family life fighting between the parents or break-up of the parents’ marriage Over protectiveness on the part of parents or caregivers.
Factors that decrease the likelihood of psychological problems include: family acceptance of the disability strong bonds within the family that help the family work together open and direct communication about the nature of the disability and what to expect balancing of family needs with the needs of the disabled person good social skills and plenty of social interaction appropriate expectations of accomplishments a strong support network in the community.