What is a Physical Disability?
A physical disability is one that affects the person's mobility or dexterity. The Australian Bureau of Statistics (ABS) estimates that at least 6% of Australians over the age of 5 years have mobility disabilities.
Physical disabilities can be permanent, intermittent or temporary. Physical disabilities can be caused by:
- congenital factors
- trauma
- infection
- degeneration
- disease
- chronic medical conditions.
Mobility impairments vary from person to person. Difficulties may include problems with balance, gait and co-ordination; dizziness and weakness; pain and paralysis. Aids such as crutches, a walking stick or a wheelchair may be used. Sometimes, people with physical disabilities may have involuntary movement of the muscles. Some conditions may go into remission; others may come and go with no particular pattern, or there may be gradual deterioration.
Among the most common permanent disorders are partial or total paralysis, amputation, severe spinal injury, types of arthritis, cerebral palsy, motor neurone disease, multiple sclerosis, muscular dystrophy, post-polio syndrome and spina bifida. Additionally, some respiratory and cardiac diseases may affect mobility. Any of these conditions may also impair strength, speed, endurance, coordination and dexterity.
Attendants to assist with personal care may be organised by the employee with the disability.
Arthritis is Australia's major cause of disability and chronic pain. It affects an estimated 3.1 million people (as at June 2000) or approximately 16.5% of Australians. Almost 60% of all people with arthritis are of working age (15-64 years). Nearly 5% of Australians are taking medication for arthritis.
Although the term literally means joint inflammation, arthritis really refers to a group of more than 100 rheumatic diseases and conditions that can cause pain, stiffness and swelling in the joints. Certain conditions may affect other parts of the body - such as the muscles, bones, and some internal organs - and can result in debilitating, and sometimes life-threatening, complications. If left undiagnosed and untreated, arthritis can cause irreversible damage to the joints. The two most common forms of the disease, osteoarthritis and rheumatoid arthritis, have the greatest public health implications.
For further information, refer to: Arthritis Australia (2006) What is Arthritis?
Cerebral palsy is a general term for a group of disabling conditions caused by damage to the brain which may have occurred before, during or shortly after birth. The major types of disability associated with cerebral palsy can occur in combination and are:
- Spasticity - muscular contractions of the limb muscles
- Athetosis - involuntary movements of the limbs, trunk and face
- Ataxia - lack of coordination with a clumsy gait and poor balance
- Atonia - muscle weakness causing difficulty in movement.
Individuals will therefore vary widely in the effects of the disability which may include involuntary muscle contractions, rigidity, spasms, poor coordination, poor balance or poor spatial relations, vision, auditory, speech, hand-function and mobility problems.
Those severely affected may need to use a wheelchair, while those mildly affected may have no physical manifestations at all.
For further information refer to: The Spastic Centre, About Cerebral Palsy
Motor Neurone Disease (MND) is the name given to a group of diseases in which the nerve cells (neurones) controlling the muscles that enable us to move around, speak, breathe and swallow fail to work normally. With no nerves to activate them, muscles gradually weaken and waste. The patterns of weakness vary from person to person. Early symptoms are mild, and include stumbling due to weakness of the leg muscles, difficulty of holding objects due to weakness of hand muscles, slurring of speech or swallowing difficulties due to weakness of the tongue and throat muscles. The effect of MND varies enormously in respect of initial symptoms, rate and pattern of progression, and survival time after diagnosis.
For further information refer to: The Motor Neurone Disease Association of NSW.
Multiple sclerosis (MS) is a chronic, often disabling disease that randomly attacks the central nervous system (brain and spinal cord). The progress, severity and specific symptoms of the disease cannot be predicted. Symptoms may range from tingling and numbness to paralysis and blindness.
Twice as many women as men have MS, with the onset of symptoms occurring most often between the ages of 20 and 40. In 2001 there were approximately 15,000 Australians with MS. Studies indicate that genetic factors may make certain individuals more susceptible to the disease, but there is no evidence that MS is directly inherited. It occurs more commonly among Caucasians, especially those of northern European ancestry, but people of African, Asian and Hispanic backgrounds are not immune.
Symptoms of MS are unpredictable and vary greatly from person to person and from time to time in the same person. They may include: extreme tiredness (fatigue), impaired vision, problems with temperature control loss of balance and muscle coordination, slurred speech, tremors, stiffness, bladder and bowel problems, difficulty walking, short-term memory loss, mood swings and, in severe cases, partial or complete paralysis.
For further information refer to: MS Society website.
Muscular dystrophy refers to a group of generally hereditary progressive disorders that most often emerge in young people, producing degeneration of voluntary muscles. The atrophy of the muscles results in chronic weakness and fatigue and may cause respiratory or cardiac problems. Walking, if possible at all, may be slow and appear uncoordinated.
No treatment has yet been found to correct the underlying pathology or to stop the progression of the disease. Nonetheless, assistive aids are available and comfort, functional capacity, and even life expectancy can be significantly increased through early diagnosis and proper therapy.
For further information refer to: Muscular Dystrophy Australia website.
Polio (poliomyelitis or infantile paralysis) is a viral infection that was common in the Western world until the early 1960s. Most cases of polio developed only mild symptoms while others were more severe and progressed to a paralytic form.
It is estimated that a minimum of 20,000 - 40,000 people had paralytic polio in Australia between 1930s and 1960s. Actual figures for the number of people infected with the virus are up to a hundred times greater: 2 - 4 million Australians.
While polio no longer threatens Australian society today, it is not forgotten. Thousands of Australians are now experiencing what is known as the late effects of polio or post-polio syndrome (PPS), a set of unexpected new symptoms occurring some 30 - 40 years after the initial infection.
Commonly reported symptoms include unaccustomed fatigue (either muscle fatigue or a feeling of total exhaustion); new muscle weakness (including muscles apparently unaffected at the time of the initial polio infection); joint and/or muscle pain; sleeping, breathing or swallowing difficulties; increased sensitivity to cold temperatures; and a decline in the ability to perform basic daily activities.
The cause of these symptoms is as yet unknown, but research suggests there are a number of possibilities of which the "overuse of polio-weakened muscles" is the most common theory.
Energy conservation and pacing of activities appear to be quite successful in managing the symptoms of the late effects of polio.
For further information refer to: Post-polio Network NSW, Fact Sheet.
Spina bifida comes from the word for 'split spine' in Latin. It is one of a class of serious birth defects, called neural tube defects (NTDs), which involve damage to the bony spine and the nervous tissue of the spinal cord. Some vertebrae of the spine don't close properly during development and the spinal cord's nerves don't develop normally. Nerve signals to most parts of the body located below the level of the 'split spine' are damaged and a wide range of muscles, organs and bodily functions are affected.
The effects of spina bifida vary according to the type, location and severity of the condition. Generally, defects higher on the spine produce a greater risk of paralysis and other debilitating complications. Problems associated with spina bifida typically include:
- reduced sensation in the lower body, legs and feet
- a degree of paralysis of the lower body and legs
- degrees and types of incontinence
- learning difficulties
- abnormal joints
- deformities of the spine - commonly scoliosis, where the spine bends into an 'S' shape
- cord tethering, where the spinal cord 'sticks' to the area of the original lesion and becomes stretched.
Depending on the severity of disability, age and the opportunities to socialise and mature, in most cases the child will be able to grow up and live an independent adult life in the community. More and more people with spina bifida are seeking and gaining employment in a wide range of areas in the workforce. Advances in the surgical and medical treatment of spina bifida and more effective methods of controlling hydrocephalus have dramatically improved life expectancy in the last 30 years.
For further information refer to: Spina Bifida and Hydrocephalus Association, Fact Sheets.
Severe short stature can represent a major physical disability in terms of the ability to drive, reach for objects, and perform ordinary daily tasks that the person of average height takes for granted. It is not appropriate to use terms such as "dwarf" or "midget" when referring to people of short stature.
People of short stature may experience difficulty in reaching day to day objects such as door handles, light switches, wash basins, banking facilities, seating on public transport, supermarket and library shelves, reading noticeboards or whiteboards, workplace resources and equipment.
Social or public situations involving crowds may be very difficult and threatening for people of short stature.
When speaking to someone of short stature, keep in mind the person's likely age - people of short stature are often inappropriately addressed as much younger than they are.
Myths and Realities of Physical Disabilities
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Interacting with a person with a disability, including a person with a physical disability, should be characterised by respect for their rights to dignity, confidentiality and equity.
- Do not assume people with a physical disability cannot comprehend because of any different outward physical appearance.
- Respect the person's personal space which includes their wheelchair.
- Do not use the term 'wheelchair bound'. A wheelchair is an enabling device not a restriction.
- Where possible, position yourself at the same level as the person when communicating.
- Look at the person directly.
- If you think the person may require some assistance, ask first and be willing to accept 'No' for an answer. If the person says "yes", ask what kind of help would be best and provide it.
- If waiting is necessary, ask if the person requires a chair.
- If a food tray is to be carried, offer to bring the tray with the food to the table.
- If you are in a lift when a person with a physical disability is entering or leaving, hold the door open to ensure the person's safety.
People who use wheelchairs have varying degrees of difficulty with mobility. Some may use their arms to propel the chair; others may use a motorised wheelchair which is usually heavier and cannot be easily lifted or folded into a car.
- Check with the person before rushing to assist and accept it if they refuse your help.
- Do not assume that a person can manage without checking first.
- Look at the person when speaking to them.
- Be aware that heavy doors can be awkward for a person in a wheelchair. If necessary, hold open lift doors to ensure that a person in a wheelchair has sufficient time to enter or leave.
- Offer to reach things on high shelves.
- If possible and appropriate, sit down to speak with a person in a wheelchair so that you are at the same eye level.
- Use of a wheelchair usually means that it takes longer to get from one place to another - so bear this in mind if the person is late for a meeting.
- People who are dependent on taxis to get around may need to book the cab by phone, or be advised when the cab arrives.
- If the person carries their pads, notebooks and pens in a bag hung over the back of the chair they might appreciate an offer of assistance to get them out or put them away.
- Most people using wheelchairs are able to push themselves or have motorised wheelchairs. However, if assistance is needed always ask the person what they require. When pushing a wheelchair, talk to the person and do not move too quickly.
- To negotiate a step or gutter while pushing a wheelchair, you should reverse the chair down the step then ease the front wheels to the ground level once down. To go up a step, you may need to tilt the chair backwards enough to land the front wheels on the higher level, then lift the rest. Never tilt a wheelchair forwards or backwards without the occupant's knowledge or consent.
Lifting and Assisting in Wheelchair Occupant Transfer
The situation may arise when someone with a physical disability asks for help to transfer from their wheelchair to some other seating arrangement. Many people will be able to transfer themselves or need minimal help, but sometimes they may require total lifting. Ask the person how they need to be lifted and or assisted.
Physical access is a key concern for those who use wheelchairs, callipers, crutches, canes or prostheses, or who tire easily and find it difficult moving about.
- Consult with the employee about possible barriers and problems they may encounter, and consider their suggestions for solutions.
- With the employee plan physical access around office space, meeting room locations and general facilities. The Building Codes of Australia provides a guide to minimum standard specifications for access.
- Stand or sit clear of a wheelchair as it is often considered a part of the person's body space. Where possible put yourself in a position to maintain level eye contact; that is, sit down and talk.
- Ergonomic furniture may be required (e.g. adjustable desks and suitably designed chairs). Some employees may have difficulty sitting at a conventional desk.
- Absence or lateness for work may be caused by transportation problems, weather conditions, waiting for lifts, lift or wheelchair breakdown.
- Provide a car space for an employee with a disability whose primary source of transport is a car.
- Flexibility of job role, job hours and location may be considered to accommodate an employee with a physical disability.
- Assistive technology and other devices may be required for an employee with a physical disability; e.g. voice or speech recognition programs, page turning devices, document holders, adjustable tables.
Remember: Access deemed suitable for people with disabilities tends to benefit all employees and often helps address occupational health and safety requirements as well.
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