Four models of disability with barriers and assessing them.

Unit 26 – Caring for individuals with additional needs

In this assignment I am going to describe four models of disability; Social, Medical, Normalisation and the Holistic approach. I shall include barriers and explain how and why they occur and give examples. Finally I am going to assess different barrier which exist for people with additional needs.

The term ‘additional needs’ is used by health and care professionals and it means that some children and adults may need other things to help them; it could be that their first language isn’t English so they need an interpretator, or it might be that they can’t walk very far so they need a wheelchair. It is a wide range of things and it doesn’t make anyone different- we all have additional needs, some are more needed than others.

The social model of disability was created by disabled people themselves; it was a first response to how society reacts to them being ‘different’, but also of how doctors and those in the health care profession treat them because they have a disability.

The model says that society is the problem, those with disabilities aren’t the sufferer, the person is capable to look after themselves and make decisions and that they are equal to those without disabilities. For example; (using the case study of Hannah), from the social model’s point of view Hannah isn’t a disabled person; it is the environment that makes her life difficult as it doesn’t always provide what she needs to live a ‘normal’ life. She might not be able to live in a house that she wants to live in due to it not being adapted to her needs; lower sinks, baths, hand rails, stair lifts, living in a bungalow may be too expensive, she may need more care- badly designed buildings may also be a factor. The social model accepts that these are all problems as to why Hannah can’t live in a ‘normal’ house and having to get the house adapted to her needs may cause problems.

The social model allows people with disabilities look at themselves in a positive way; the model aims to increase self-esteem and independence. It ignores that they have a disability and regardless of this, it helps reinforce that everyone should have equal opportunities.

There are advantages and disadvantages of the social model, advantages are; - it makes the person more independent, it looks at the person and their needs not their disability, their medical needs are overlooked- the fact that they are in a wheelchair etc isn’t a problem in the social model, the person isn’t the problem- society is and the way society runs. The model tries to change the environment and factors around them, not the person and their disability to suit the environment. Another advantage is that it is cost effective putting stair lifts in, lower sinks, hand rails- if the person decides to move, they could sell/rent the property out to an elderly person, this would help them greatly or even to another person with a disability, it lasts a long time and replacements won’t have to be made. The model also tells people about disability and how people do feel singled out- this can help people understand and gain more knowledge. The social model also says that the person can do that if they change the environment, not that they can’t do it because they have a disability, it shows that even if you have a disability you can still do things.

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Disadvantages of the model are that it is expensive- it may help the person to change the environment, putting stair lifts and getting those carers etc but this can be expensive for the person and for the government, agencies and organisations. It can be time consuming and time that the person may not have spare due to other commitments, or not being able to get to and from the house that they want to live in- this can also be costly. Finding care can be hard, and finding someone to fit the requirements that would help the person, also moving someone from a care home or from their parents’ house to their own house can be stressful not on the family but also on the family. In addition to this, the family may have to care for the person who can be time consuming and relationships within the family itself may be strained.

The Medical model is the second model of disability. This model says that the problem is that they are disabled, and that only medicine and science can treat them. That the person will have to adapt to society, and they will be labelled- learning disabled, paraplegic, autistic, partially deaf, deaf, blind etc. The doctors have all the knowledge and power over you, and you are not equal. The medical model is regarded as an approach that doesn’t give people power if they have a disability whether it is severe or not despite advances in science and medicine that have improved the lives of people who have disabilities.

From the point of view of the medical model; Hannah (case study), is a disabled person who needs looking after due to her disability, not because she is an actual human being who has needs. She may need round the clock care, agencies will have to work together to help her condition – not to help her, she may need treatment from doctors, and tests doing to her. She may not want this doing- but doctors see this as an advantage to science and their knowledge if something does help her (like a treatment), they can then use this to help others in similar situations. The medical model doesn’t see Hannah as having needs, they see her as someone with a disability, and this is all they focus on. If she gets care, it will primarily help her condition not her as a person and her life.

There are advantages and disadvantages to the medical model; advantages are- advances in science and medicine will help the person’s condition, this can have a great impact on their life (in a good way), the medical model can help them lead a ‘normal’ life, or as close to a normal life as possible; if they get given a wheelchair to move about, they can still get around and do things for themselves and adapt to society without changing society. Disadvantages of the model are; that the model doesn’t see the person for their needs, it focuses on their disability first and then their needs. It says that the person should adapt to the environment, however sometimes this isn’t always possible. A disadvantage could be that tests, medicine etc is expensive and the person may not be able to afford it if the NHS won’t fund it for them anymore, e.g. if their wheelchair keeps breaking, they may have to keep paying for replacements. It labels those with disabilities, most people don’t like to have a label, and they want to be seen as a person not as someone who has something wrong with them – that is usually not their fault.

Normalisation involves the acceptance of those with disabilities, offering them the same conditions you would offer everyone else without a disability – making sure you treat them equal. The model was developed as a reaction to policies that were dehumanising- meaning that some policies degraded those with disabilities. People with additional needs and disabilities want to live a normal live and not get judged by it, or have a label like they would in the medical model.

The model is about making those with disabilities equal and trying to get them to have a life that is as normal as possible; it is giving people with disabilities the same choices and opportunities as everyone else. The model stresses that those without disabilities or additional needs to be accepted and valued, it also strongly believes that those without disabilities should let those with disabilities to what they can do, not saying that they can’t do something because they are in a wheelchair etc. Normalisation played a key role in movements both for education and for empowerment meaning that those with disabilities are in charge of what they do within education- whether they go to a special school or a main stream school.

The medical model attracted much criticism from disabled rights groups who claimed it oppresses those with disabilities, because of this, people started to think differently about disability and a new model emerged this is called the Social Model. The social model says that society puts up barriers that prevent disabled people from participating; this links into the Normalisation model because the social model wants to provide a normal life for those with disabilities and the social model wants social acceptance from society for those who have disabilities.

There are several advantages and disadvantages of Normalisation. Advantages are that the model wants everyone to be ‘normal’ and no one to be better than another, due to a disability. The model emphasises the importance of equality, they want to make sure that people aren’t just having a normal as possible life, but making sure they are treated equal as well. The people who believe in Normalisation, can work with those who believe in the social model and work together and they could together make points stronger and ensure people aren’t labelled etc. Disadvantages are that some people are happy with their life and living it their way, they may not want someone coming in and making them fit this ‘normal’ category that is seen as the best way to live. A major disadvantage is that the model was developed as a reaction to the policies that degraded those with disabilities, not because people wanted those with disabilities to live a ‘normal’ life and to be treated equal.

The holistic approach is an approach that helps those who are dealing with people with disabilities have the care basically all about them, it is person centred care. Holistic care is care that considers the physical, emotional, and social needs of the disabled person.

Holistic care focuses on all aspects of the person’s life, not just the disability. For example; using Hannah (case study), she may feel lonely and confused about her disability, she may wonder why it is her that has the disability. Her care workers may offer her counselling to deal with emotional stress and problems that she may have, she may need support off her family and friends and this may include seeing them (social), this could make her feel better about herself. However, to see them this may require special arrangements, like transport or a care worker; this may take assessing and this may also take time and money- this may make her feel angry and annoyed that she is in a wheelchair/disabled etc; however staff should make this happen as it what she wants and her needs.

Holistic care is important for those with disabilities, as like the normalisation and social model, it focuses on the person’s needs and what they want. It puts the persons needs first and then their disability.

Advantages of the model are that it focuses on the person and their needs; it focuses on all aspects of their life; this may lead the person to feel valued and wanted, despite their disability they have some purpose in life. Disadvantages is that person centred care/holistic care can be expensive because staff members that work at the care home may have to make extra time to ensure that everyone has holistic care that helps their needs and makes them feel wanted etc.

There are several barriers that those with disabilities and additional needs may come across. A barrier basically means something that restricts a person from doing something.

Discrimination includes stereotyping and labelling, this links in with the medical model. The Disability discrimination act 1995, amended in 2005, is a piece of legislation that empowers those with additional needs to have equal opportunities as everyone else. Mr Blunkett was a member of parliament who was blind. The social model backs up the right that he should still be able to work and do his job even though he is blind, reasonable adjustments should be made when he is at work so he can do his job. This could include giving him a stick to get around, putting Braille on doors so he knows where they are, putting notes from meeting etc on a tape so he can listen to them and in Braille if necessary.

Employment is another barrier that people may face; the employer may feel like they are a barrier to employment and that the person who wants to become their employee thinks that can’t do the job because of the person’s disability. The employer may make up excuses as to why the person won’t be getting the job- all revolved around their disability, for example- it may cost more to get the disability person insured on their insurance, the company may not want to spend more money on someone, the place of work were the person with the disability wants to work- it may not have sufficient ramps, lifts, lower desks, bathrooms that are big enough for the person to go into with the wheelchair. The person shouldn’t be getting a job due to their disability, it should be due to the person in general- they might not have enough qualifications etc, there should be reasons that don’t relate to their disability.

All people disabled or not, should have opportunities. For example; if a person is disabled and their school tutor group is going on holiday, and they get told they can’t go because of their disability as they are in a wheelchair, this would be illegal as the Equal Opportunities Act 2010 (replaced by the 1999 Equal opportunities act), it means that under this act, everyone should have equal opportunities. In addition to this; reasonable adjustments should be made for the person to be able to go on holiday. Barriers could be that insurance is too high, health and safety is an issue, more staff might be needed and it could also be costly. This links into the holistic model as the care needed for the person to go on holiday will be centred on them and their needs. It also links with the normalisation model as going on holiday is a ‘normal’ thing to do.

Cultural barriers are ones that are against the person for a certain reason, it could be due to the colour of their skin, or the foods they eat due to coming from a certain background. For example; if a disabled person is from Pakistan and they are living in a residential home and the other people who they are with are having pizza for tea, and the person who is from Pakistan doesn’t like pizza, then the care workers should have something else for them to eat, something they like, the person shouldn’t put this on their disability. This relates to the holistic model as the care should be relating to their needs and what they like and dislike.

Physical access for a disabled person may mean being able to use a lift, however- if there isn’t a lift to use then this would be a barrier. There should be other ways for the person to access, like stair lifts. For example, if a person who is in a wheelchair wants to do a night course at a college and because it is a old building, it hasn’t been updated with a lift or stair lifts, the person who wants to do the night course can’t do it because of this barrier, however the class should be moved to the ground floor so that the person can still attend the night course and it won’t cost the college any money in putting lifts in. This is allowing physical access for the person. This is normalisation for the person as it is allowing the person to lead a normal life and go to college, and also the social model- it allows them to socialise.

The medical model relates to the attitudes that are displayed towards those with disabilities and additional needs, this could be stereotyping towards someone because they are in a wheelchair, patronising them and making them feel like they are a child because they aren’t ‘normal’, just focusing on their disability and what the disability means they can’t do, rather focusing on what they can do. People’s attitudes against disability are rather one sided, like the medical models labels people, but the social model says that society is the problem- society needs to adapt to those with disabilities.

A barrier that those with additional needs or a disability could face is communication. A barrier to communication could be that they don’t speak English or know limited English; they might need to get a translator in to help with this. If someone has Autism, they will need to use PECs, (picture exchange communication system), this is a non-verbal way of communicating and is effective for those who have autism, this is overcoming a barrier to communication.

Financial barriers could be that the person who is in a wheelchair, can’t afford to pay for a ramp outside their house themselves so they may need help of the local council, they might not have the chance to go on holiday as it could be expensive. Rest bite care could mean that the family will get a break from having to look after them and they could go on trips and have choice. Lack of choice could mean that they can’t do everything that they want to do, say if they want to go shopping and the place doesn’t have public access for them this would mean they can’t go there.