Oxfordshire Skills and Learning Service

Introductory awareness of models of disability 4200-223; SS OP 2.1; 4222-25 ; 35!5-014 "nowled#e $or%boo%

Learner name: Learner signature: Date completed: Assessor name: Recommended GLHS: 3 &'e (ur(ose of t'is unit is to (ro)ide t'e learner wit' introductory %nowled#e about t'e medical and social models of disability. In t'is assi#nment* you will demonstrate your understandin# of t'e social and medical models of disability. +ou will loo% at 'ow t'ese models 'a)e de)elo(ed o)er time and are reflected in ser)ice deli)ery. +ou will also consider 'ow your own (ractice s'ould (romote inclusion. &'ere are two tas%s to t'is assi#nment set by ,-./ 0/ 1odels of disability 2/ 3eflecti)e account Pa#e ! of !"

&'is (a#e is blan%

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$andidate Assessment Record %nter &nit 'um(er according to )ualification taking: &nit *itle: +ntroductor, a-areness of models of disa(ilit, Date .ork(ook su(mitted: !st 4444444444.. #nd 4444444444.. 0ssessment 0ssessor 5eedbac% 1st Submission 2nd Submission ,riteria Outcome Outcome Pass63efer Pass63efer 1.1

1.2

1.3

1.4

2.1

2.2 a b c d 2.3

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0ssessor comments to 7earner

&ar#et date and action (lan for resubmission 8if a((licable9

Outcome of second submission

I confirm t'at t'is assessment 'as been com(leted to t'e re:uired standard and meets t'e re:uirements for )alidity* currency* aut'enticity and sufficiency 0ssessor Si#nature/ ;ate/

I confirm t'at t'e assi#nment wor% to w'ic' t'is result relates* is all my own wor% 7earner Si#nature/ Internal <erifiers Si#nature/ ;ate/ ;ate/

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&'e ,are =uality ,ommission 8,=,9 www.c:c.or#.u% is t'e inde(endent re#ulator of 'ealt' and social care in >n#land. &'e ;e(artment for >ducation www.education.#o).u% is res(onsible for education and c'ildren?s ser)ices. &'e ;e(artment of @ealt' www.d'.#o).u% is res(onsible for leadin# on 'ealt' and social care. 1y 'ome life aims to celebrate eAistin# best (ractice in care 'omes and (romote care 'omes as a (ositi)e o(tion for older (eo(le. www.my'omelife.or#.u% Bational ,entre for Inde(endent 7i)in# www.ncil.or#.u% is a resource on direct (ayments* inde(endent li)in# and indi)idual bud#ets Bational Institute for @ealt' and ,linical >Acellence 8BI,>9 www.nice.or#.u% is t'e inde(endent or#anisation res(onsible for (ro)idin# national #uidance on t'e (romotion of #ood 'ealt' and t'e (re)ention and treatment of ill 'ealt'. S%ills for ,are www.s%illsforcare.or#.u% is t'e em(loyer-led aut'ority on t'e trainin# standards and de)elo(ment needs of social care staff in >n#land. Social ,are Institute for >Acellence 8S,I>9 www.scie.or#.u% was establis'ed to identify and (romote t'e dissemination of %nowled#e about w'at wor%s in social care* and t'e de)elo(ment of best (ractice #uidelines.

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0ssessment ,riteria 1.1/ t'e medical model of disability 0ssessment ,riteria 1.2/ t'e social model of disability 0ssessment ,riteria 1.3/ 'ow eac' of t'e models 'as de)elo(ed and e)ol)ed o)er time *he 0edical 0odel 1 Cnder t'e 1edical 1odel* disabled (eo(le are defined by t'eir illness or medical condition. &'e 1edical 1odel re#ards disability as an indi)idual (roblem. It (romotes t'e )iew of a disabled (erson as de(endent and needin# to be cured or cared for* and Dustifies t'e way in w'ic' disabled (eo(le 'a)e been systematically eAcluded from society. &'e disabled (erson is t'e (roblem* not society. ,ontrol resides firmly wit' (rofessionals; c'oices for t'e indi)idual are limited to t'e o(tions (ro)ided and a((ro)ed by t'e E'el(in#E eA(ert. &'e 1edical 1odel is best summarised by referrin# to t'e International ,lassification of Im(airments* ;isabilities and @andica(s de)elo(ed by t'e $orld @ealt' Or#anisation in 1 F0. &'e classification ma%es t'e followin# distinctions/ Im(airment is Gany loss or abnormality of (syc'olo#ical* ('ysiolo#ical or anatomical structure or function?. ;isability is Gany restriction or lac% 8resultin# from an im(airment9 of ability to (erform an acti)ity in t'e manner or wit'in t'e ran#e considered normal for a 'uman bein#? &'e 1edical 1odel focuses on w'at a (erson can?t do/ Im(airment ;isability 0 w'eelc'air user cannot climb t'e stairs or wal% to t'e s'o(s 0 (artially si#'ted (erson cannot read information in Gstandard? siHe (rint 0 (erson wit' an ac:uired brain inDury cannot s(ea% as :uic%ly as ot'er (eo(le

Peo(le wit' disabilities 'a)e #enerally reDected t'is model. &'ey say it 'as led to t'eir low self-esteem* unde)elo(ed life s%ills* (oor education and conse:uent 'i#' unem(loyment le)els. 0bo)e all* t'ey 'a)e reco#nised t'at t'e 1edical 1odel re:uires t'e brea%in# of natural relations'i(s wit' t'eir families* communities and society as a w'ole. ;urin# t'e 1 !0?s and 1 I0?s newly formed #rou(s of disabled (eo(le started to c'allen#e t'e way in w'ic' t'ey were treated and re#arded wit'in society.

'tt(/66u%.ettad.eu6Cnderstandin#J20;isabilityJ20-J20#uideJ20toJ20#oodJ20(ractice.(df

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&'e medical model is based on t'e (at'olo#y of t'e indi)idual. It em('asises on 'ow t'e body?s functions are im(aired by disability and 'ow medical6sur#ical inter)ention can reduce or correct t'e im(airment. &'e focus is t'erefore on in)estin# in 'ealt' care and related resources to researc'* identify* dia#nose* cure* mana#e* alter and control illness. It does not account for social and en)ironmental influences w'ic' contribute to an indi)idualEs le)el of EdisabilityE. Bow* medical (ractitioners reco#nise t'e need to include indi)iduals in decision ma%in#. 0lternati)e definitions of im(airment and disability were de)elo(ed and formed t'e basis of w'at is %nown as t'e Social 0odel. Im(airment is t'e functional limitation wit'in t'e indi)idual caused by ('ysical* mental or sensory im(airment. ;isability is t'e loss or limitation of o((ortunities to ta%e (art in t'e normal life of t'e community on an e:ual le)el wit' ot'ers due to ('ysical and social barriers. 82arnes* 1 4/29 ;isability is no lon#er seen as an indi)idual (roblem but as a social issue caused by (olicies* (ractices* attitudes and6or t'e en)ironment. 5or eAam(le* a w'eelc'air user may 'a)e a ('ysical im(airment but it is t'e absence of a ram( t'at (re)ents t'em from accessin# a buildin#. In ot'er words* t'e disablin# factor is t'e inaccessible en)ironment. &'e disabled (eo(leEs mo)ement belie)es t'e EcureE to t'e (roblem of disability lies in t'e restructurin# of society. Cnli%e medically based EcuresE* t'at focus on indi)iduals and t'eir im(airment* t'is is an ac'ie)able #oal and to t'e benefit of e)eryone. &'is a((roac' su##ests t'at disabled (eo(leEs indi)idual and collecti)e disad)anta#e is due to a com(leA form of institutional discrimination as fundamental to our society as seAism* racism or 'omo('obia. &'e social model focuses on riddin# society of barriers* rat'er t'an relyin# on Gcurin#? (eo(le w'o 'a)e im(airments. &'e social model is based on t'e )iew t'at t'e en)ironment and attitude of ot'ers limits t'e indi)idual?s (artici(ation in society. 0lt'ou#' it c'allen#es t'e medical model* many (eo(le now mer#e t'e two w'ere (ossible* ta%in# t'e best from eac'.

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0edical 0odel ;isability is a G(ersonal tra#edy? ;isability is a (ersonal (roblem 1edicalisation is t'e Gcure? Professional dominance >A(ertise is 'eld by t'e 8:ualified9 (rofessionals &'e disabled (erson must adDust G&'e ;isabled? 'a)e an indi)idual identity ;isabled (eo(le need care Professionals are in control ;isability is a (olicy issue Indi)idual ada(tations

Social 0odel ;isability is t'e eA(erience of social o((ression ;isability is a social (roblem Self-'el( #rou(s and systems benefit disabled (eo(le enormously Indi)idual and collecti)e res(onsibility >A(ertise is t'e eA(erience of disabled (eo(le &'e disabled (erson s'ould recei)e affirmation ;isabled (eo(le 'a)e a collecti)e identity ;isabled (eo(le need ri#'ts ;isabled (eo(le s'ould ma%e t'eir own c'oices ;isability is a (olitical issue Social c'an#e

3s,cho4Social 0odel of Disa(ilit, >ri% >ri%son used t'e ('rase K(syc'o-socialL to describe sta#es of 'uman de)elo(ment. It combines t'e de)elo(ment of t'e mind wit' t'e social circumstances or relations'i(s of an indi)idual. It is sometimes referred to as a bio-(syc'o-social model addin# biolo#ical as(ects. .eor#e >n#el considered t'at t'e idea of mind* body and circumstances to be fundamental to 'ow (eo(le reacted to ill 'ealt' and disability. &'e model 'as been used in mental 'ealt' for se)eral years. It deals wit' all as(ects of t'e (erson* in (articular t'eir ability to adDust to ac:uired im(airment. It considers 'ow for eAam(le* culture and (o)erty* can interact wit' (ersonality and beliefs to affect t'e way a (erson eA(eriences or mana#es t'eir illness or im(airment. &'e model reco#nises t'at (eo(le will react differently to t'eir situation and condition and concentrates on ado(tin# an indi)idualised a((roac' to identifyin# and meetin# t'e needs of (eo(le 8for eAam(le a (erson wit' dementia9. &'ere is a need to be fleAible and (erson-centred. @ow indi)iduals are described can cause offence e.#. Kt'ey are dementedL or Kare ;own?s syndromeL. It is im(ortant to consider t'e indi)idual and 'ow t'ey mi#'t be Pa#e 5 of !"

affected if t'ose around t'em ado(t a (articular a((roac' based on t'e different models of care. Social care (olicy and (ractice 'as mo)ed from institutionalisation to inde(endent li)in# o)er t'e (ast century. Personalisation 'as e)ol)ed o)er many years and 'as been stron#ly influenced by (eo(le w'o use ser)ices. Personalisation was officially introduced in #o)ernment (olicy in ;ecember 200I w'en t'e Puttin# Peo(le 5irst concordat 8official a#reement9 was (ublis'ed. &'is outlined t'e reforms for social care. Personalisation is about #i)in# (eo(le more c'oice and control o)er t'eir li)es in all social care settin#s. Personalisation means startin# wit' t'e indi)idual as a (erson wit' stren#t's and (references. It is about startin# wit' t'e (erson not t'e ser)ice. It is wider t'an sim(ly #i)in# (ersonal bud#ets to (eo(le eli#ible for council fundin# and a((lies to (eo(le w'o (ay in full for t'eir care needs to be met. &'e 'istorical timeline #i)es a clear (icture of 'ow society is mo)in# slowly towards acce(tin# disabled (eo(le* (eo(le wit' learnin# disabilities* (eo(le wit' mental 'ealt' (roblems and older (eo(le as e:ual citiHens and im(ortant members of t'e community. $'ere (eo(le were once 'eld in 'os(itals and institutions* t'ey are now bein# su((orted to li)e inde(endent li)es in t'e community. &'e idea of t'e Esocial modelE of disability was a crucial (art of t'is c'an#e. 0ssessment ,riteria 1.4/ eAam(les of w'ere eac' model of disability may be used in ser)ice deli)ery. 0ssessment ,riteria 2.1/ 'ow t'e (rinci(les of eac' model are reflected in ser)ice deli)ery &'in#s to consider are/ @ow mi#'t t'e indi)iduals see t'emsel)es if t'e carers and ot'ers ado(t a w'olly medical model* social model or (syc'o-social modelM Practical day to day factors/ @ow mi#'t t'eir li)es be affected in e)eryday matters suc' as self-care* eatin# and drin%in#* wor%in#* trans(ort* educationM ,ontrol and self-determination/ &o w'at de#ree may t'e indi)idual be in control o)er t'eir own lifeM Self-esteem and confidence/ @ow mi#'t t'e different a((roac'es affect t'e confidence of t'e indi)idual and t'e way t'ey see t'emsel)es in relation to ot'ersM

&'e 1edical 1odel of ,are/ Pa#e " of !"

,an lead to a lac% of (artners'i( wor%in# as t'e (rofessional is seen as t'e eA(ert ,an lead to treatment w'ic' see%s to KnormaliseL an indi)idual 8e.#. coc'lea im(lants to Kcure Kdeafness* (rost'etic limbs w'ic' are desi#ned to loo% KnormalL rat'er t'an to function effecti)ely and efficiently &as% centred rat'er t'an (erson centred 'ome care 8w'ere ('ysical needs are more im(ortant t'an 'olistic needs9 ,are 'omes desi#ned to meet stereoty(ical and #rou( needs rat'er t'an indi)idualised care 0utomatic care (roceedin#s w'en a c'ild is born to (arents wit' a learnin# disability.

&'e Social 1odel of ,are/ See%s to c'an#e attitudes and encoura#es inte#ration In)ol)es (eo(le wit' disabilities in de)isin# and de)elo(in# le#islation and (olicy Increased use of assisti)e tec'nolo#y ;isability ;iscrimination 0ct 8in terms of re:uirements not for t'e definition it uses9 Influenced t'e <aluin# Peo(le 8<aluin# Peo(le Bow9 0lterations to en)ironments suc' as re(lacin# ste(s wit' ram(s ,losure of s(ecialist 'os(itals w'ic' mo)ed (eo(le wit' disabilities away from society Inte#ration of c'ildren wit' disabilities into main stream sc'ools Influenced Our @ealt' Our ,are Our Say Cse of direct (ayments and indi)idualised bud#ets for care (ro)ision Promoted 7earnin# ;isability Partners'i( 2oards &'e Psyc'o-social 1odel of ,are/ 7eads to indi)idualised care. 7oo%s at t'e w'ole (erson and all t'e factors t'at im(act on t'eir eA(erience of im(airment. ,'an#es to en)ironments in treatment centre suc' as 'os(itals to include suc' t'in#s as #ardens* 'airdressin# etc. Inter)entions aimed at t'e wider social conteAt of t'e indi)idual* suc' as wor%* education* family ;ementia ,are w'ic' offers a (erson centred a((roac' 1ental 'ealt' care w'ic' offers a combination of t'era(ies $@O International ,lassification of 5unctionin# and ;isability 8I,59 ;ementia Strate#y Suitable s'ort brea% (ro)ision

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0ssessment ,riteria 2.2/ 'ow eac' of t'e models of disability im(acts on t'e a9 inclusion b9 ri#'ts c9 autonomy d9 needs of indi)iduals &'e followin# statements are eAtracts from t'e e-learnin# resource t'at you can access on t'e followin# website lin%/ 'tt(/66www.scie.or#.u%6(ublications6elearnin#6(erson6(erson016resource6indeA.'tml Disa(ilit, is a personal traged, ;isability6illness is often described as a tra#edy. Oli)er 81 09 su##ests t'at if disability is re(resented as a tra#edy* disabled (eo(le will be (ercei)ed as )ictims of some tra#ic 'a((enin#6circumstance and social (olicies are t'en de)elo(ed to com(ensate for t'is. If we see disability as a result of social o((ression t'en disabled (eo(le will be )iewed as collecti)e )ictims of an uncarin#* i#norant society. Social (olicies would be more li%ely aimed at rectifyin# and redressin# social inDustices. Disa(ilit, is the experience of social oppression Social o((ression is seen as t'e (rimary factor leadin# to t'e eAclusion of disabled (eo(le. ,am(ai#nin# for e:ual ri#'ts 'as t'erefore been central to disability (olitics.

Disa(ilit, is a personal pro(lem Illness or disability is t'e result of a ('ysical condition* is intrinsic to t'e indi)idual 8it is (art of t'at indi)idualEs own body9.

Disa(ilit, is a social pro(lem 0 %ey conce(t of t'e social model is t'at society disables (eo(le. @ow we or#anise t'in#s in our culture often limits w'at some of its members can do. In t'is sense disability is )iewed as a social construct.

+t is al-a,s important to diagnose all illness and disa(ilit, &'e medical model )iews dia#nosis as a startin# (oint to dealin# wit' illness and disability. &'e im(ortance of understandin# t'e cause of someoneEs illness or disability (ro)ides t'e %ey to wor% towards a cure* control or mana#ement.

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%xpertise is held (, the )ualified professionals >A(ertise is assumed t'rou#' :ualification* (rofessional eA(erience and researc'. It is usually e)idence based and t'erefore robust. %xpertise is the experience of disa(led people &'e social model insists t'at t'e (erson wit' t'e #reatest eA(ertise is t'e (erson eA(eriencin# t'e issue. It is u( to (rofessionals to listen and res(ond to t'eir eA(erience not to dominate it *he disa(led person must ad7ust &'e medical modelEs focus is towards cure w'ere)er (ossible. $'ere t'is is not (ossible resources are tar#eted at mana#in# and controllin# t'e illness and disability to allow t'e (erson to adDust. 5or eAam(le a deaf (erson may be offered t'e latest and most tec'nolo#ically ad)anced 'earin# aid so t'ey can adDust to a E'earin# worldE.

+ndividual Adaptations &'e medical model assumes t'at indi)iduals s'ould be (ro)ided wit' ada(tations w'ere)er (ossible to enable t'em to reac' t'eir (otential in society.

Social $hange &'e social model doesnEt always see indi)idual (olicies* ada(tations and cure as t'e (rimary focus. It reco#nises disability as a (olitical issue w'ic' 'as to be addressed by t'e w'ole of society not Dust disabled (eo(le.

0ssessment ,riteria 2.3/ 'ow own (ractice (romotes t'e (rinci(le of inclusion
2

Or#anisations must 'a)e a strate#y and a clear (olicy to in)ol)e (eo(le w'o use ser)ices and carers in ways w'ic' are meanin#ful and acce(table. &'is (ro)ides a way of s'owin# accountability and met'ods of usin# t'e eA(ertise of (eo(le w'o use ser)ices to de)elo( #ood (ractice. &'e im(ortance of in)ol)ement at all le)els* and in a ran#e of different functions and acti)ities* needs to be reco#nised. 5eedbac% about an indi)idual?s own care and6or feedbac% about a ser)ice s'ould influence or#anisational (lannin# and im(ro)ements and contribute to t'e de)elo(ment and learnin# for em(loyees.
3

8arriers to inclusion
'tt(/66www.scie.or#.u%6(ublications6#uides6#uide3F6files6#uide3F.(df 'tt(/66www.scie.or#.u%6(ublications6#uides6#uide356files6#uide35.(df

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N N N N

Po)erty* disability* mobility* sensory and communication (roblems* (oor ('ysical and mental 'ealt'* unsuitable accommodation and lac% of trans(ort can all contribute to t'e eAclusion of older (eo(le. 0#eist attitudes and assum(tions* low eA(ectations and limited as(irations may be s'ared by (rofessionals* families and some older (eo(le t'emsel)es. &'e )oices and )iews of disabled older (eo(le* includin# t'ose wit' multi(le and com(leA needs* are often un'eard* discounted or outwei#'ed by ot'ers. .rou(s w'ere a#e is combined wit' ot'er discriminatory factors* includin# disability* et'nicity* #ender and6or seAuality* (articularly ris% eAclusion. &ranslator* si#nin# and ot'er communication ser)ices may be restricted.

Negative language is a factor. Older people are conscious of talk about the problem of old age, the plague of an ageing population. They are referred to as a burden for the young to carry. There is also a widespread fear of old age fear of l!heimer"s disease, fear of becoming helpless and dependent, fear of isolation and the loss of mobility, fear of having to go into a home, fear of dwindling resources ... Transport is a fundamental problem in rural areas# unless you are rich you can"t get about if you"re a person who doesn"t drive. Older (eo(le ta%in# (art in a consultation. $n residential homes, a variety of issues around access to information can lead to e%clusion. One home had various policies printed in miniscule font and pinned high up on the wall in the home"s reception area. &any homes offer no access for residents to daily newspapers, maga!ines, 'ournals or phone calls. newly admitted resident was an%ious and tearful because her daughter was undergoing surgery for an aggressive cancer, and wanted to phone the hospital to find out how the operation had gone. (he was denied access to a phone, and told a member of staff would ring the hospital later in the day. Obser)ations from )isits to 'omes Overcoming (arriers to older people9s inclusion Positi)e ste(s s'ould be ta%en to desi#n and de)elo( inclusi)e forms of su((ort and care for older (eo(le ;isabled and older (eo(le s'ould 'a)e a wide ran#e of access (oints and o((ortunities to influence and s'a(e t'eir su((ort ser)ices. 1easures to alle)iate a#e-related (o)erty and increase (eo(le?s access to t'e widest ran#e of resources s'ould recei)e 'i#'er (riority. &'e ;i#nity and 3es(ect (ro#rammes s'ould be stron#ly (romoted as measures to encoura#e older (eo(le?s social inclusion and em(owerment. 0cti)e media and (ublic education strate#ies s'ould illustrate wide-ran#in# and inno)ati)e o((ortunities for includin# disabled and older (eo(le. Inter-#enerational (roDects 'a)e demonstrated creati)e ways in w'ic' youn# and older (eo(le can benefit from in)ol)ement wit' eac' ot'er.

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&'ere are many ways of (romotin# and (ro)idin# an enablin# en)ironment. 7istenin# to t'e indi)idual Pro)idin# information in accessible format 1a%in# sure you use lan#ua#e and words t'ey understand Positi)e re(resentation of (eo(le wit' disabilities 3aisin# awareness and education ,'allen#in# attitudes ,'allen#in# discriminatory actions or (ractice wit'in or outside t'e ser)ice

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*ask A 0odels of disa(ilit, ,om(lete t'e table in relation to t'e medical and social models of disability. 8minimum 50 words for eac' (art9 80ssessment ,riteria 1.1; 1.29 O)er)iew of t'e medical model of disability O)er)iew of t'e social model of disability

&'e main features of t'is model

&'e main features of t'is model

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;escribe 'ow eac' of t'e models 'as de)elo(ed o)er time 8minimum 50 words9 80ssessment ,riteria 1.39 If you 'a)e internet access clic% on t'is lin% to find out more about t'e timeline of c'an#e O select Section &wo 'tt(/66www.scie.or#.u%6(ublications6elearnin#6(erson6(erson016resource6indeA.'tml 1edical model

Social model

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5or eac' of t'e models #i)e one eAam(le to s'ow 'ow t'e a((roac' mi#'t affect eac' of t'e followin# as(ects of an indi)idual?s life. 80ssessment ,riteria 1.49 1edical model
.i)e one eAam(le to s'ow 'ow eac' a((roac' mi#'t affect eac' of t'e followin# as(ects

Social model

Inclusion of t'e indi)idual bein# su((orted in society

&'e reco#nition and (romotion of t'eir ri#'ts

>nablin# t'em to ta%e or resume control o)er t'eir li)es; t'is may re:uire informed consent and s'ared decision ma%in# 80utonomy9

3eco#nisin# and meetin# t'e needs of indi)iduals

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*ask 8 3eflecti)e account ,'oose a ser)ice t'at is (ro)ided for (eo(le wit' a disability. &'is may be t'e ser)ice you wor% for or any ot'er local ser)ice t'at you 'a)e %nowled#e of. 80ssessment ,riteria 2.1; 2.29 1. Outline t'e ser)ice (ro)ided by t'e or#anisation. $'o recei)es su((ort and for w'at disabilitiesM

2. Pro)ide eAam(les of t'is ser)ice deli)ery t'at demonstrates t'e social model of disability.

3. Pro)ide eAam(les of t'is ser)ice deli)ery t'at demonstrates t'e medical model of disability.

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4. Pro)ide at least 5 eAam(les of 'ow your own (ractice (romotes inclusion. 80ssessment ,riteria 2.39

Once com(lete (lease ma%e sure t'at your details are on t'e front of t'e wor%boo% and t'en return it to your assessor/ OAfords'ire S%ills and 7earnin# Ser)ice Cni(art @ouse .arsin#ton 3oad ,owley OP4 2.=

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