The problems with disability policy based on medical model

When disability policy was developed, disability was viewed in the medical model.  The understanding was that the person had a medical problem that was in need of fixing and that, until that medical problem could be fixed, that person was unable to work.  If the medical problem could not be fixed, the person would be considered totally and permanently disabled. 

We put physicians and other medical providers in charge of whether or not a person could work, whether or not a person receives various disability benefits and what services and accommodations a person with a disability needs. 

While we are inundating medical providers with paperwork to attest to these things, no one seems to take into consideration that they are not the ones with all the answers. 

While most disabilities have a physiological beginning, that doesn’t necessarily mean they need or will respond to medical interventions.  For example, if a person is in an accident and incurs a brain injury, the disability can be permanent.  However, the time for effective medical therapy is only for a short period after the injury.  If the person still has the disability after 20 years, what do we expect a physician to do? 

Some disabilities are the result of medical conditions that need ongoing treatment, but many do not need medical intervention.  Yet, we put them all in the same category and require that there be medical documentation of all kinds of things related to disability. 

In the meantime, since most medical providers have the same view of disability as the average population, they are responding with the viewpoint that they are supposed to be able to decide major life issues for these people.  Should the person work?  What are the person’s transportation needs?  Does a person need a roll-in shower?  What about a parking pass?  Should the person be in a nursing home?  If so, can we keep the person out with appropriate services?  What services?  (Read the last three again to note the irony.)

Removing disability issues from the medical establishment could benefit persons with disabilities, ease the burden on medical providers and reduce costs for society.  Since the medical model is now recognized as not appropriate for determining disability, let’s next consider what the basis for disability needs to be.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

The Roles of Design, Attitude and Quality Control

Comments from Niall 3

This is the third of a series of Comments from Niall. It is designed as part of a series that will hopefully raise awareness of the contribution that people with disabilities can make to the community

Design

This is the starting point to achieve accessibility and therefore inclusivity. Architects, interior designers, construction engineers etc.... These are the people that will create our future environments. Yet, how many of them are fully informed of the needs of people with disabilities?

I am certain that the vast majority of them want to get the best result that they could but lack of awareness about accessibility is the main barrier to their achieving a fully inclusive environment.

Attitude

To physically create a fully inclusive environment means little if the people that work in it, or the people that buy or live in it, are not committed to the belief that everybody is welcome. This need for a positive and indeed, creative attitude also extends to people with disabilities. Their awareness of the possible limitations to achieving a fully inclusive environment is vital if a truly harmonious outcome is to be reached.

Quality Control

This may seem obvious but there are many examples, that I have actually seen, where the best intentions of people trying to achieve inclusivity, have failed. The initial design was good, the building appeared to be broadly accessible but the actual building work was altered (due to perceived construction necessities) so as to render the final result of little use to people with disabilities. When the builders move in they are focussed on the main issues: will it stay up, are all the electrics and plumbing in the right place and will it pass the inspections to allow it to open. The needs of people with disabilities are sometimes not their first priority. And, yet, if the concept of a fully inclusive working, selling or living environment were accepted then accessibility would become automatic. Rather than be treated as an additional worry, the building would meet the needs of as wide a range of people as possible. Inclusivity would be part of the Mainstream.

How to Maintain that Inclusivity

Having achieved an inclusive environment it is then all too easy to lose it. For example, extra desks and display stands for products etc. spread onto clear routes and accessibility is then lost.

The next Comment from Niall will cover the ways to maintain Inclusivity and then promote it to all potential users.

Niall can be contacted at tarrell@btinternet.com

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Who Benefits from Inclusivity

Comment from Niall 2

This is the second of a series of Comments from Niall. It is designed as part of a series that will hopefully raise awareness of the contribution that people with disabilities can make to the community

Who benefits from Inclusivity?

First, who are these people who will benefit? The immediate answer is people with disabilities. And yet there are so many more people involved in every interaction in our modern society. What about all the family, the friends, even the representatives (such as lawyers) of those people with disabilities? All of them will also hope and indeed, expect to be able to enjoy life or work together in a fully inclusive environment.

And yet, there are also the owners and people that work in every business. In an inclusive environment everybody benefits. The service or workplace environment is available to all and then everybody is happy, or at least they all share the same experience.  This allows people with disabilities to be an expected and valuable part of the community.

Meeting the needs of people with disabilities

This is often easier than it may at first appear. Most people with disabilities are very aware of what they need to be part of the community and are therefore a main source of information. There is also a wide range of design guides available to assist when building or renovating a building. But the most important thing is common sense. Speak and listen to people that have experience in this area. Best practice and good examples are so much more effective than trying to just achieve compliance with the law.

How to achieve inclusivity – an introduction

This will be covered in more detail in the next Comment from Niall but broadly includes: Design (of a building or a space), Attitude (of builders, managers, staff and users) and Quality Control (are access elements in an environment effective and truly meet the needs of people with disabilities).

The next Comment from Niall will expand on the various ways to achieve as much inclusivity as possible. Followed by an introduction on how to maintain that inclusivity.

Niall can be contacted at niall@btinternet.com

 www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude

Gong on Disability No Panacea

Social Security Disability, Supplemental Security Income, Medicare and Medicaid are all in jeopardy.  The growth in recipients cannot be sustained.  However, the standards for receiving Social Security Disability and SSI have eased.  At one time, the standard was that the recipient could not engage in any substantial employment at all.  Now there are television lawyers who promise people that they are entitled to these benefits and that they will help them receive them.

What most people do not realize is that “going on disability” is not finding a pot of gold at the end of the rainbow.  In general, it means living in poverty.  Having nothing to do and no money to do it with it is a common complaint from people who are on disability.  Which brings us to the fact that working is a quality-of-life issue at least as much as a need-to-work-to-pay-my-bills issue.

At this time, people legitimately receive disability benefits for three reasons:  1)  They really and truly cannot work (this is a small percentage of recipients); 2) They are unemployed due to discrimination because of their disability (ADA needs more enforcement); and 3) They need to be on disability to receive essential services that are not available unless someone is on disability.

Clearly, we need to address how disability policy works in this country so that people are not forced to live in poverty simply because they have a disability.

Annette Bourbonniere

www.accessing-ability.com

401-846-1960

Fax:  401-846-1944

Twitter:  @AccessInclude