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Understanding Physical Disabilities

Physical Disability can be acquired through diseases, accidents or unknown factors. It can affect your closest friends or loved ones and even you at any time. The following information provides some basic knowledge about different types of physical disabilities and tips for those or their family members who have just acquired a physical disability.

 

 

General Information on Physical Disabilities

Introduction

A person with a physical disability is constrained by his physical ability to perform an activity independently such as walking, bathing, toiletting, etc. A person can be physically disabled due to two reasons: Congenital/Hereditary - the person has physical disability since birth or the disability developed at a later stage due to genetic problems, problems with muscle cells or injury during birth. Acquired - the person acquired the physical disability through road or industrial accidents, infections such as polio or diseases and disorders such as stroke or cancer.

Types of Physical Disabilities

There are two major categories under the Physical Disability Group, they are:

  1. Musculo Skeletal Disability
    It is defined as the inability to carry out distinctive activities associated with movements of the body parts due to muscular or bony deformities, diseases or degeneration. The disabilities grouped under musculo skeletal disability are:
    • Loss or Deformity of Limbs
    • Osteogensis Imperfecta
    • Muscular Dystrophy
  2. Neuro Musculo Disability
    It is defined as the inability to perform controlled movements of affected body parts due to diseases, degeneration or disorder of the nervous system. The categories are:
    • Cerebral Palsy
    • Spina Bifida
    • Poliomyelitis
    • Stroke
    • Head Injury
    • Spinal Cord Injury

Details of Musculo Skeletal Disability

  • Loss or Deformity of Limbs
    This may be due to birth defect or may occur due to diseases or accidents. The person may require an artificial limb to compensate the functional loss of activities.
  • Osteogensis Imperfecta
    A defective development of the connective tissues at the growing age that leads to softening of bones and the affected person experiences deformed posture. The person is usually small built with brittle bones. The cause of this condition is unknown but there is a strong hereditary link to it. Such persons are usually active though may require a wheelchair or crutches for mobility.
  • Muscular Dystrophy
    Progressive loss of muscle strength due to a group of hereditary disorders. Muscles around the neck, shoulders and hips are usually more affected than the other muscle groups. Muscles of the respiratory system are also affected at a later stage. With time the affected person's functional and mobility status deteriorates and may require a wheelchair for mobility.

Details of Neuro Musculo Disability

  • Cerebral Palsy
    A group of non-progressive disorders occurring in young children in which damage of the brain causes impairment of motor function. It is caused by birth injury, jaundice and infection. A person with Cerebral Palsy usually has movement and co-ordination problems. The person may have other associated disabilities such as intellectual, behavioral, visual, speech etc. He may need different adaptive equipment and external support for the day to day activities.
  • Spina Bifida
    It is due to development defect of the spinal canal, characterised by incomplete closure of the bony encasement of the spinal cord. It may cause paralysis of the lower part of the body depending on the level and extent of the lesion. The person may loose bowel and bladder control and may have sensory loss at the affected side. This person may require a pair of crutches or wheelchair to move around.
  • Poliomyelitis
    It is an infectious virus disease affecting the lower motor-neuron system. It is caused by the poliovirus and can affect children and adults. It causes weakness in the body and both legs. The person may require mobility aids and external limb supports for the day to day activities. Recently it has been found that many victims of poliomyelitis experience a second decline of their physical and functional status when they reach around the age of forty.
  • Stroke
    It is caused by the interruption of blood supply of the central nervous system or due to hemorrhage inside the brain. The affected person experiences a sudden impairment of the sensory motor functioning of one side of his body. This condition may also associate with other disorders like loss of vision, hearing, speech or intellectual functioning. The person may require a walking stick or wheelchair for mobility.
  • Head Injury
    The extend of this disability depends on the part of the brain involved and the severity of the injury. In most cases it leads to a condition called hemiplegia where the sensory and the motor functions of one side of the body are impaired. It may also be associated with other disabling conditions like impairment of vision, hearing, speech or intellectual functioning.
  • Spinal Cord Injury - two types of disabilities:
    1. Paraplegia:
      Total or partial impairment of the sensory and motor functions in the lower part of the body and lower limbs. In most cases the affected person looses bowel and bladder control and in some occasions experience poor postural control. Depending on the level of injury the affected person may require a crutch, external limb supports or wheelchair for mobility.
    2. Tetraplegia:
      Total or partial impairment of the sensory and motor functions of the body including all four limbs. The person looses control over bowel and bladder functions, posture and even in few cases respiratory functioning. The affected person may require different assistive devices to perform daily activities independently.

Treatment For Physical Disabilities

Improvement of the disabling condition depends on the cause, type, extend of the disease, disorder or injury. However, in most cases the physical improvement is seen only in the initial few years of disability. There are few conditions that are progressive type and the treatment goal is to maintain their condition. Rehabilitation programmes are planned to help individuals to overcome initial unstable conditions and prevent deterioration of the medical condition. The person should also be more conscious with his diet to avoid further deterioration of his medical condition and recurrent of diseases. More importantly, people with disabilities will learn, through rehabilitation programme, to manage their disabilities confidently. Some of the programmes include:

  1. Occupational Therapy is a specialised treatment programme that prepares the clients to live successfully in his/her own family and society. Through the practice and training of purposeful and goal directed activities and exercises, this treatment programme tries to improve client's functional abilities and independent living skills.
  2. Physiotherapy is a rehabilitative treatment programme, through the use of physical means such as exercises and electrotherapy that are planned and customised according to the individual client's need. Examples of the treatment are maintaining and improving the power of the target muscle group, preventing occurrence and progression of contractures and deformities.
  3. Speech Therapy is a specialised treatment and training programme that treats and trains clients to communicate effectively.
  4. Medication/Vaccination

    5. may be prescribed by doctor to avoid further deterioration of the physical condition and structural deformities. Vaccination against common virus is an effective way to prevent disabling diseases.

Life of a Disabled

Having a physical impairment is not the end of the world. Many people with disabilities live their lives just like any other able-bodied. They enjoy sports, movies, shopping and do a lot of other activities as well. They work as hard as the able-bodied and earn a decent income to support themselves and their families. Some do get married and have children of their own. However, they do need support from their families, friends, members of the public, the community to help them to integrate into the mainstream society by accepting who they are. Giving them opportunities at work and treating them like any able-bodied are some of the ways that can help them to live life to the fullest.

 

 

Information for the Newly Disabled and/or Family Members

The Effects of Physical Disabilities

The extent of impact on the person depends on the type and severity of the disability condition, the person's educational level and personality, peers and family support, and financial condition. The impact faced by people with acquired disabilities and people with congenital disability can be described as follows:

  1. PEOPLE WITH ACQUIRED DISABILITY
    In general, people with acquired disabilities usually go through a difficult emotional adjustment process, along with their bodily adjustments to the treatment and continual care process. It starts with shock over sudden disability, which later develops into anger, denial and grief over the lost function, body part and image. Self-esteem is usually shattered and needs to be rebuilt, along with the change in body image and condition. They get into lots of worries, fears and anxieties of their future. Over time, they can ultimately overcome their adjustment periods and advance to acceptance and coping of their disabilities with guidance and care. Some will strive towards greater independence physically and financially, if possible. For some who do not make it, they will become frustrated and depressed as time goes by.
  2. PEOPLE WITH CONGENITAL DISABILITY
    This disability group usually adjusts to their condition physically and emotionally during their growing period. In general, some have low self-esteem especially in a neglected situation at home. Those with severe condition but with good mind may see themselves as a burden to their family. Some are very positive with supportive family members. The situation is different for those staying in an institutional home, they may feel rejected if their family members do not visit and contact them regularly. On the other hand, they may just live day to day as their basic needs are being taken care of even better than when they are at their own home. In conclusion, people with disabilities (for both congenital and acquired type) (for both congenital and acquired type) face lots of social challenges such as educational opportunity, independence level, employment and marriage opportunities due to their disabilities. They require assistance from the family, peers, society and government to help them to cope with their disabilities and move towards independence.

Counselling Information that We Provide

Here are the various aspects of counselling information that we provide:

  • MEDICAL & REHABILITATION
    Consult your doctors and therapists on:
    1. your medical condition and treatments
    2. medical condition and special diet if any
    3. management and prevention of incontinence, sore, pain, wounds, spasms, etc
    4. independent living skills (e.g. dressing, using the bathroom, transfer, overcoming steps, etc.)
    5. follow-up therapy after discharge. This is available at HWA.
    6. recommendations of suitable aids like wheelchair, commode, cushion, etc, before buying or loaning. Loan is available at HWA.
    7. recommendation of bed, grab bars for toilet, ramp, etc, for your home before any alteration work begins
  • GOING HOME
    Preparations needed! Weekends' home leave from hospital is a good start, if possible.
    1. Transport If you need a taxi or an ambulance, book it early. HWA has this service but without attendant. Booking is at 2543006. St John Ambulance has attendant service but only takes in standard types of wheelchairs and during office hours. Booking is at 2980300
    2. Inaccessibility of House for Wheelchair Users If your house is not on lift-landing level, you may want to consider other alternatives like changing house (but need to consider your finance) or apply for hostel (for working people)
    3. Check-ups Observe these closely for your health's sake
  • SOCIAL
    1. This is likely your main worry. It's natural, but do something about it
    2. Check if claims are available from personal insurance, dependent protection schemes provided by the CPF, company, Housing Protection Insurance (for owner's of HDB flats) or the courts (traffic accident cases, if applicable). These will take time
    3. Explore employment opportunities for yourself or your family members
    4. Financial assistance can be explored with Social Workers in hospitals or at HWA.
  • FINANCE
    1. This is likely your main worry. It's natural, but do something about it.
    2. Check if claims are available from personal insurance, dependent protection schemes provided by the CPF, company, Housing Protection Insurance (for owner's of HDB flats) or the courts (traffic accident cases, if applicable). These will take time.
    3. Explore employment opportunities for yourself or your family members.
    4. Financial assistance can be explored with Social Workers in hospitals or at HWA.
  • EDUCATION
    1. HWA has programmes like BEST, WISE and also offers computer lessons
    2. HWA also provides education subsidies, bursaries and scholarships
  • WORK
    1. Work on the possibility of going back to your former job, or maybe even at other places
    2. Bizlink Centre, the job agency for disabled people, provides vocational assessment and placements. TEL : 4402633
    3. Jobs are sometimes available from HWA. Members can register through the circulars
  • YOUR FUTURE
    1. Strive towards greater independence and happiness
    2. You too can contribute to the society like many other members at HWA
    3. Give yourself a chance and be patient with yourself

 

 

How to Help a Wheelchair User?

Why people depend on wheelchairs

Why people depend on wheelchair .....because of injury, illness or disability, they require the wheelchair to provide them with mobility so that they can

  1. Live an independent life
  2. Work or go to school
  3. Move around on their own (where possible)

It's time to learn if you don't know about the proper wheelchair handling techniques.....

Parts of a wheelchair as shown:

Parts of a wheelchair

How to Fold and Unfold a Wheelchair

  • To unfold most wheelchairs.....
    1. Push down on both sides of the seat, keeping fingers inwards.
    2. Don't force open the chair and never put your fingers between the frame and seat in case they get trapped.

    Unfold and fold a wheelchair

  • To fold most wheelchairs....
    1. Remove cushion (if any)
    2. Adjust the footrest, rotate them out or remove them.
    3. Hold the midpoint of the seat at the font and back, pull upwards.

How to tilt a wheelchair backwards

Tilt a wheelchair

  1. Always warn the occupant of your intention
  2. Push down the tipping lever with your foot and the same time, pull back and down on the handles

Getting up & down the kerbs safely

  • Getting up kerbs safely
      Kerbs safety
    1. Position the wheelchair so that the front wheels almost touch the kerb
    2. Inform the occupant of your intention
    3. Grip handles firmly, tilt the wheelchair backwards and balance the wheelchair on its rear wheels
    4. Place the front wheels onto the pavement
    5. Push the wheelchair until it reaches the kerb
    6. Lift the wheelchair onto the pavement
  • Getting down the kerbs safely
    1. Position the wheelchair on top of the kerb
    2. Tilt the wheelchair and balance the wheelchair on its rear wheels and move backward
    3. Lower the rear wheels against the kerb while supporting some of the chair's weight
    4. Make sure both rear wheels touch the ground gently and at the same time
    5. Gently lower the front wheels

Getting up & down the Stairs Safely

  • Getting up stairs safely
    Getting up stairs safely ...use a lift or ramp if one is available, do not go up single-handedly unless you must
    1. Back the wheelchair to the first step
    2. Grip handles firmly and tilt the wheelchair back
    3. Place one foot on the first step and the other one above
    4. Lean back, taking the weight of the chair and gently pull chair up the first step
    5. Always keep your weight and the wheelchair in balance as you move up the stairs
  • Going down stairs safely
     Going down stairs safely ...again, look for a ramp. If a ramp is not available
    1. Take the wheelchair in a frontward manner down the steps
    2. Grip the handles firmly and tilt the wheelchair, balancing on the rear wheels
    3. Move the wheelchair to the top of the first step
    4. Use your body as brake while gently lowering the wheelchair
    5. Control the descend with your body, keeping the rear wheels tight against the stair edge and roll the wheelchair forward and down the step
    6. Don't let the chair drop unevenly or too quickly

Going down a steep but short slope or ramp

If it is a short but steep slope, it may be advisable to go down backward to prevent the person in the wheelchair from tipping out.

  1. Make sure the path of travel is clear
  2. Grip the handles firmly to prevent the wheelchair from sliding backwards
  3. Take steps backwards one step at a time
  4. Control the descend and ensure that the wheelchair does not roll down too quickly as you will loose control of it

Keeping the wheelchair in a Car Boot

  • Remove cushions, armrest, footrest and other removable parts
  • Fold the wheelchair and engage brakes to prevent wheels from spinning
  • Position folded wheelchair parallel to the boot
  • Bend your knees keeping your back straight
  • Grip the wheelchair by the frame
  • Lift the wheelchair and balance it on the boot edge (your legs may be used to raise the wheelchair)
  • Slide the wheelchair into the boot

Keeping a wheelchair in car boot

Think Safely and Comfort when Assisting

  • Ask the wheelchair user how she or he prefers to be moved, lifted, etc
  • Aim for smooth gentle moves, avoid rushing and rough handling
  • Always ask for help if you have doubts about your abilities

What You Can Do

  • Ask how you can help
  • Talk to a person in a wheelchair at the same eye level
  • Do inform the person in the wheelchair of your intention e.g. when tilting the wheelchair
  • Make sure the seat belt (if any) if fastened before moving off
  • Apply the brakes when the wheelchair is stationary, when transferring and when leaving the wheelchair unattended
  • Ask the person in the wheelchair if they are comfortable especially if they have been transferred
  • Always maintain at least one wheelchair length behind another "pusher"
  • Ask for assistance if you cannot overcome an obstacle
  • Look ahead to avoid sudden changes in level and other hazards
  • Look out for drain gratings and approach in a diagonal manner
  • Push wheelchair on the walkway rather than on the main road (if possible)

What You Should Not Do

  1. Don't talk to a disabled person through a third person
  2. Don't race when you are with a wheelchair user
  3. Don't force a wheelchair to move if it is stuck - see what the problem is and try to correct it
  4. Don't use the escalator when you are with a wheelchair user if you are not sure how to handle it
  5. Never lift a wheelchair by the armrest, wheels or any detachable or movable parts
  6. Don't go down a steep slope in a forward manner
  7. Never tip the wheelchair forward or too far back
  8. Don't go down a short steep slope in a forward manner