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Disabled and Their Needs

   Disability is usually defined as “a loss or restriction of functional ability or activity as a result of body or mind”. (Oxford English Dictionary) As a result of a definition like this disability is seen as a problem.

   It has been widely accepted that disabled people generally have fewer opportunities and a lower quality of life than non-disabled people. Any action taken to remove the disadvantage suffered by disabled people depends on what is believed to be the cause.
There are two main ideas of what causes the disadvantage namely:
  • the medical (or individual) model of disability,
  • the social model of disability.

   The medical model sees the inability of disabled people to join in society as a direct result of the impairment and not the result of the features of our society which can be changed. When individuals such as managers think in this way they concentrate on ‘compensating’ them for what is ‘wrong’ with their bodies.

   According to this model the role of the professional is to assess the individual and help them function as near normal as is possible for them, to help them adapt psychologically and physically, to help them by treatment and rehabilitation to achieve the level of physical and intellectual functioning they are capable of. It also sees the professional as the expert. This model also controversially agrees with screening and termination of pregnancy to prevent a disabled child being born.
The social model of disability makes the crucial distinction between ‘impairment’ and ‘disability’.

   The social model sees disability as a result of the social and physical environment which creates unequal outcomes for people with impairments compared to able bodied people. The negative attitudes of professionals towards disabled people has led to discrimination and internalised oppression.
The social model has been developed by disabled people who feel that the individual model does not provide an adequate explanation for their exclusion from mainstream society. Within the social model the key definitions are:
Impairment – an injury, illness or congenital condition that causes or is likely to cause a long term effect on physical appearance and/or limitation of function within the individual that differs from the common place.
Disability – the loss or limitation of opportunities to take part in society on an equal level with others due to social and environmental barriers.
The medical model of disability encourages explanations in terms of the features of the body’s limitations whereas, the social model encourages explanations in terms of the characteristics of society.

   There are two unintended consequences that as a result of using the medical model of disability. Firstly the medical model says that the person’s disability effects their day-to-day activities but it doesn’t take into account how social factors effect their daily routine i.e. ability to walk has an impact and is recognised by this model but so does inaccessible transport which is not recognised by this model. Secondly the medical model appears to state that it is ‘normal’ to see, speak and hear but by omitting activities such as British Sign Language and Braille it theoretically labels them as ‘abnormal’.

   Disability quite often becomes a taboo subject because people are not sure how to act or what to say when a person with a disability is present. Quite often people just ignore the issue and talk to anyone but the person with the disability. Such attitudes are not the result of deliberate unkindness. They are more likely to be based on feelings of ‘sympathy’, when a child is disabled the feelings of sympathy are directed not only at the child but at the parents. This results in the child being marginalised as second best rather than being treated as equal.

   Psychologist and sociologist research has quite often pointed out that these attitudes come about from stories old and new. (Disability: a psychologist’s view) We all know the story of King Arthur, Camelot and the Knights of the Round Table. One seat remained unfilled at the table which was the perilous seat in which it was fatal for any man to sit except for the perfect knight. When a perfectly formed knight came, Lancelot dubbed him immediately as his bodily perfection would be matched by his spiritual perfection. He sat in the chair unharmed and the rest is irrelevant. The point is that his perfect body was the key to his acceptance. We might also note in passing that the perfect knight was also white, and male, and young. The same pattern continues with heroes and villains. By contrast pirates in long john silver and captain hook had missing limbs.
The association is deeply ingrained: Caliban, the Ugly Sisters, The Cyclops, and even today children continue to make that link.
There are different types of barriers. The barriers which disable people with impairments can be:
  • Prejudice and stereotypes
  • Inflexible organisational procedures and practices
  • Inaccessible information
  • Inaccessible buildings; and,
  • Inaccessible transport

   It is worth understanding that language also forms a barrier. Fears of the able-bodied about ‘getting it wrong’ are increased by the fact that language is a dynamic process, and what was considered all right a few years ago such as the term ‘the handicapped’ is no longer acceptable. Yet such a term however is acceptable if it applies to the successful, dominant section of society; ‘the rich’ doesn’t get changed to ‘people who have riches’
Disabling barriers experienced in the past can continue to have an adverse effect today. An example of this may be those people that attended segregated schools who may have gained lower academic qualifications than their non-disabled peers, simply because their ‘special’ school failed to provide them with a mainstream curriculum. These barriers have nothing to do with the disabled people’s restrictions; they are put there by people and can therefore be removed. You can take a social approach to disability by identifying and correcting those barriers in place that are within your control.

1. Discrimination may mean that individuals spend their life struggling with low self esteem and unmet safety needs. Discrimination may deny individuals the opportunity to self-actualise.
2. Devaluing, false assumptions, exclusion, negative non-verbal responses from others can influence an individual to develop an inferior sense of self-worth.
3. Exclusion, avoidance and devaluing can mean that a person comes to believe that they do not belong.
4. The threat of attack or verbal abuse, and the threat of devaluation and exclusion can mean that a person does not feel safe.
5. People can be physically damaged as a result of assault. Physical health can suffer if a person is stressed, has poor physical resources or restricted opportunities to access jobs and social activities.
(Maslow’s Hierarchy of needs)

Discrimination can occur in different ways. It can be:
  • Physical assault of those who appear to be different,
  • Verbal abuse towards those who appear to be different,
  • Excluding people from activities and opportunities,
  • Avoiding people who appear to be different,
  • Negative non-verbal communication,
  • Making assumptions and devaluing people

   Disabled people are shouldn’t need to fight for equality, but they do. As a result of this they have managed to bring about a fundamental challenge to the ways they have been thought about. The main achievement was a public recognition that disability is a matter of discrimination not just of sympathy and care which was written into legislation: the Disability Discrimination Act 1995. There is less segregation of disabled people from mainstream society. Voluntary organisations for disabled people now actually led by disabled people. Disabled people are now able to choose their own care by professionally prescribed packages. Radical changes have also been made to the way health and social care professionals are taught in relation to disability. All these changes have come about as a result of the strength of disabled people.

   There are two Acts of Parliament which introduce and provide a means of enforcing rights preventing discrimination against disabled people: - The Disability Discrimination Act 1995 and The Disability Rights Commission (DRC) Act 1999.
The Disability Discrimination Act (DDA) aims to end the discrimination which disabled people face.

This Act gives disabled people rights in the areas of:
  • employment
  • access to goods, facilities and services
  • buying or renting land or property.

   Special Educational Needs and Disability Act 2001 (SENDA 2001) – This act covers all disabled students. It introduces the right for disabled students not to be discriminated against in education, training and any services provided wholly or mainly for students. It covers students enrolled on courses that are run by responsible bodies, this includes further and higher education and sixth form colleges.
The act covers both educational and non-educational services such as examinations and assessments, field trips, arrangements for work placements, short courses, and libraries and learning resources. (www.ukcle.ac.uk).
As Healthcare professionals it is important to remember to listen to the people who really know the most about their illness or disability, the patients. When dealing with children realise that parents can feel deskilled by so called experts who don’t listen or contradict what they say. It is impossible to describe what disabled people want from healthcare professionals as each person is an individual with different wants and needs. The only way to find out what is wanted from us is to ask our patients and not make assumptions.

Reflection
This unit has involved us looking at welfare, health, and inequalities. Within this unit we have looked at areas which involve people being disadvantaged within society. The areas we have covered have been power and oppression, racism, stereotyping, ageism, poverty, disability and gender.
This unit has really changed the way I view things. I had thought of myself as a very open-minded person anyway but it was good to hear other people’s opinions on such topical issues. The videos really stand out clearly in my mind. The blue eyes, brown eyes video (A Class Divided) was really good. It makes you realise that with a little bit of education and experience, children can learn how it feels to be discriminated against and it is likely to discourage them from such behaviour. I was previously nursery nurse and from my experience I believe that by doing activities like this it could stop a lot of the bullying that goes on in today’s society. It may be a controversial method but in my opinion it would be very effective.

   The video about poverty (Kelly and her sisters) caused mixed reactions in discussions in and out of the lecture. A lot of people immediately felt sympathy for the girls which I can relate to. I could never imagine living in such poor conditions. Yet, I couldn’t help thinking that the mother of the children needed to get her act together. She could have tidied that house and made it comfortable to live in and she didn’t seem to make any effort to get herself out of that situation. If she doesn’t show that she wants things to change, who is going to help her?
I didn’t agree with the fact that she smoked. I know that she had a really hard time and that it may have helped her to cope with it all but if she were as desperate as she said for it all to change, then surely that extra money would have made a significant difference. However after having these lectures I realise that people deal with things in different ways.

   The video about disability (‘Talk’) was also effective. I already had a lot of experience of this issue. I had a severely disabled sister who was in a wheelchair. We had to think very carefully about where to go and what to do because there were limitations. The video helped a lot of people understand a bit of how it felt to ‘not fit into the norm’ and to spend your time being singled out.
Elderly people are singled out because of age. Ageism can stem across all ages but the people who feel the full impact of this in my opinion are the elderly. I have worked as a care assistant for the elderly. They are stereotyped as slow, frail people who are a nuisance. They are referred to bed-blockers who eat away at the tax payer’s money. It is attitudes like this that nearly saw one of the kindest ladies you have ever met die. She suffered a heart attack in the middle of the night and although she had an emergency cord she did not press it and lay there all night so not to be a nuisance. So much for a society in which all are treated as equal and are respected. The lecture highlighted how people lose out on opportunities because of naпve attitudes.

   Welfare, health and inequalities is an imperative unit. I believe that to be successful in dealing with the public you need to be able to understand problem and often be able to identify them. This unit has shown me that people don’t always put themselves in a situation and that they sometimes need someone to talk to.
Women are said to be inferior to men. As a woman I have never experienced this area of discrimination and in my opinion I don’t think that it is prominent in today’s society. Stereotypes cause more of a problem. Stereotypically men are seen as strong and dominant. Women are seen as weak and the view is that they should stay at home, do the housework and look after the children. In my opinion these stereotypes don’t really exist. Women have changed the way in which they are seen by becoming more career minded.
This unit is invaluable. It has taught me to be aware of stereotypes and discrimination. It taught me not to judge people. An example of this would be if an alcoholic came in as an emergency than I would feel that it is his own fault. Now I realise that there may be an underlying cause for the drinking.

   This unit has led me into thinking that a lot of these topics are usually caused by personal moral failings. We are all responsible for attitudes that have been created and continue to be passed on. If we stopped discriminating, and promoted equality for all then it wouldn’t be a problem in a couple of years because our children would not be brought up with these views. By educating the children in school we may be able to teach them to be respectful.
Overall I have enjoyed this unit. It was easy to stay focussed because the teaching methods were varied. In my opinion this unit has been interesting, and I would have enjoyed being given the chance to research into some of the other topics. It has made me more aware of other people’s thoughts and feelings. I look forward to studying more units on this course and hope they will all be as interesting as this has been and start as much thought and self reflection.

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