Disability Contexts Flashcards
Discuss the implications in word choices such as “client”, “patient”, and “customer”.
Word choice can create/diminish rapport with people and can alter the power relationship between therapist and the person receiving therapy.
“Patient”- conveys a sense of ethical responsibility on therapist, but conveys passivity and dependence on those receiving care (can create an imbalance of power by creating a context in which a person is being acted upon by the therapist.
“Client” or “customer”- creates an economic relationship of mutual interaction in which the person has hired the therapist to perform a service for them, and the consumer is in a position of greater control.
What is “liminality”? How does it impact the life of a person with a disability? What can you do about it as a therapist?
Liminality-quality of ambiguity/disorientation (“Limbo”) that occurs after a person acquires a disability, when they no longer identify with a lack of disability but haven’t begun the transition to an identity in a life with a disability
→ Can result in a person feeling as if they don’t “belong” in the world anymore; may see(or perceive that others see) their disability as diminishing their status of being human; but can also be a time/opportunity to make radical changes in one’s life
→ Therapists can use person-first language to empower, encourage persons with disabilities to develop a sense of pride in their lives, and help them integrate into a supportive community
What does this describe? an obstacle/barrier a person with a disability may encounter in the environment (created by context/environment)
Handicap
What does this describe? a condition (implies a person can’t do something or that they must do something differently)
Disability
What does “disability is contextual” mean? What does that mean for your practice as an OT?
→ a person with a disability is not handicapped in all environments (ex. a person w/a wheelchair is not handicapped in an environment with no steps)
→ Example, Olympians like Oscar Pistorius & Alan Oliviera are not disabled in the context of running track, in fact athletes without the speed conferred by flex-foot prosthetics are the ones with a disability.
What are the four stages of the Disability Adjustment (medical model).
- Vigilance
- Disruption
- Enduring the self
- Striving to regain self
What stage of the disability adjustment model does this describe? feeling a separation of subjective and objective body at point of intense crisis, contrast b/w state of internal calmness and external distress
Vigilance
What stage of the disability adjustment model does this describe? “time out” or disruption of reality, confusion/disorientation in the world
Disruption
What stage of the disability adjustment model does this describe? confronting and regrouping, physical limitation/implications of injury are realized, but still hope to regain full abilities
Enduring the Self
What stage of the disability adjustment model does this describe? merging old and new reality, frustration in attempting to regain previously taken-for-granted tasks and changes in routines, need to reformulate goals.
Striving to Regain Self
Pedretti discusses the impact of “narrative experience” in building co-relationships with our clients. How does that work?
Narrative process for discovery of the individual: client-centered exploration into person’s perspective of their life; can include discussing the meaning of core categories including illness, independence, self-caring & respect→ leads to insight about client’s feelings and attitudes.
Allows client to be an active constructor of their own identity and may allow client & therapist to discover unique disability experience= Collaborative problem solving.
How does the setting where ADL is performed affect its meaning to a person with disability?
ADLs and IADLs performed within the context of the person (eg their home rather than the rehab kitchen/gym/etc.) are much more meaningful to the client. Additionally, the environment can be a limiting factor for a person with a disability and can actually create the “disability” by introducing barriers (ie social model of disability).
Explain how “Self-care” may mean different things to a person with disability, to her/his caregiver and to a therapist.
Self-care could be defined physically, emotionally, mentally, spiritually; and across multiple types of occupations (ex: ADLs, IADLs, leisure, etc.)
