Lecture 5 Flashcards
What is Third-Party Disability?
The ‘study of disability and functioning of family members due to the health condition of significant others’
What is meant by ‘Primary Handicap’?
The activity limitations and participation restrictions that occur to the third party (i.e. the spouse) as a DIRECT result of the partner’s hearing impairment.
E.g. Spouses’ annoyance due to the loud volume of the television, and the reduced quality and quantity of social interactions are primary third-party disability.
What is meant by ‘Secondary Handicap’?
The activity limitations and participation restrictions that result from having to ADJUST to the partner’s disability.
E.g. the spouse’s difficulty having to repeat things for a partner and act as an interpreter are seen as secondary disabilities, resulting from the adjustment to disability.
What activity limitations are reported by people with hearing impairment?
- Understanding speech, especially in noisy environments 2. Problems listening to the television and radio
What participation restrictions are reported by people with hearing impairment?
Older people frequently report that they often feel left out of group conversations and may therefore be inclined to avoid social situations altogether
What is the prevalence of hearing loss in the elderly?
As many as 40–60% of people over the age of 65 experience hearing difficulties and this percentage increases with age.
What are some adaptations made by spouses of people with hearing impairments in terms of:
Activities and Participation - Communication domain
- General difficulty communicating with his/her partner
- Difficulties INITIATING conversation
- Difficulties MAINTAINING conversation (need to repeat and interpret)
- Conversing with a GROUP of people - partner felt like they needed to listen in/interpret/repeat partners’ conversation, to ensure that the group knew what the hearing impaired partner was saying.
- Use of communication TECHNIQUES to aid their partner’s communication - e.g. positioning, only face-to-face communication, increasing their volume.
What are some adaptations made by spouses of people with hearing impairments in terms of:
Activities and Participation - Domestic life domain
- Organise additional social activities to accommodate their partners’ hearing loss
- Explain the hearing loss to others to maintain friendships
- Found it difficult having to encourage their partners to attend audiology appointments and receive hearing aids.
What are some adaptations made by spouses of people with hearing impairments in terms of:
Activities and Participation - Interpersonal interactions and relationships domain
- Negative effects on the spousal relationship - “conversations” were more often like arguments.
- Negative effects on sexual relationship - compounded by feelings of irritation
- Experienced difficulty having to assist their partners maintain friendships.
- Participants reported concerns about what others thought of them - i.e. when interpreting/cueing partner during croup conversation, would they be perceived as being intrusive?
What are some adaptations made by spouses of people with hearing impairments in terms of:
Activities and Participation - Community, social and civic life domain
- Reduced socialisation with family and friends
- Reduction in visits to the movies and/or theatre due to their partner’s hearing difficulties
- “Don’t go along to our seniors group anymore”
- Avoidance of situations that involve multiple people
What are some adaptations made by spouses of people with hearing impairments in terms of:
Environmental factors - Products and technology domain
Hearing aids - can either be an environmental FACILITATOR (if worn, contribute to improved communication and quality of life) or an environmental BARRIER (barrier to communication and therefore contributed negatively to their third-party disability).
What are some adaptations made by spouses of people with hearing impairments in terms of:
Environmental factors - Natural environment and human made changes to environment domain.
- Loud volume of the television (spouse becomes aggravated/annoyed).
- Presence of background noise in restaurants and social gatherings provided a barrier to effective communication for BOTH the spouse and the hearing impaired partner.
What are some adaptations made by spouses of people with hearing impairments in terms of:
Environmental factors - Support and relationships domain.
- Imbalance (between the couple) of adjustment to the hearing impairment. Due to a lack of support from their partners to adapt to their hearing impairment, the non hearing impaired spouse had been responsible for most of the adaptation.
- Lack of support provided by specialist medical officers in terms of acknowledging the effect of the partners’ hearing difficulties on the spouses’ lives
What are some adaptations made by spouses of people with hearing impairments in terms of:
Environmental factors - Attitudes domain
- Attitude of the person with the hearing impairment - if they had ACCEPTED the impairment, their attitude was an environmental FACILITATOR. If they had DENIED the impairment, their attitude was an environmental BARRIER.
- Attitudes of family members - tendency to make jokes about the hearing impairment can be either a facilitator OR a barrier.
- Attitude of health professionals towards hearing loss and the psychosocial effects was also coded as an environmental barrier - health professionals did not realise the full extent of the impact of hearing loss upon the spouse especially.
What is the benefit of using the conceptual framework of the ICF to describe third-party disability?
Although an individual may not have a health condition, their functioning may be affected simply due to environmental factors, such as the presence of a hearing impairment in their partner.
Use of consistent terminology to describe third party disability.
Ability to map which concepts are most affected, and therefore focus on them in assessment / creation of goals.
