Care for People with Disabilities
Authors: Colline Wong, Christopher Steele MD MPH
Introduction
In the United States, about 1 in 4 people live with a disability. Disabilities—including mobility, cognitive, hearing, and vision disabilities—affect the way people interact with their surroundings and society as a whole. Disabilities may affect a person’s ability to live independently; in fact, 6.8% of adults with a disability have difficulty doing errands alone and 3.6% have difficulty with self-care such as dressing or bathing.1 Furthermore, people with disabilities are more likely to have poorer health outcomes than their typical counterparts. They have high rates of obesity, cigarette use, heart disease, and diabetes. They are also more likely to have see multiple health care providers, have an unmet health care need because of cost, and to not receive a routine annual exam.1
The goal of this module is to provide a better understanding of how disabilities affect health care, a physician's role in caring for patients with disabilities, and how to get the resources and services that disabled patients need.
Learning Objectives
By the end of the session, learners will be able to:
- Describe the epidemiology of people living with disabilities in the United States.
- Describe the disparities in health and access to health care for people with disabilities in the United States.
- Describe how to apply for disability and the disability benefits available through federal programs.
- Explain the physician role in eligibility assessments for Social Security disability.
- Describe the issues raised by lower extremity mobility, vision, hearing, and intellectual disability and the appropriate assistive devices for different types of disabilities.
Required Assignments
- Wong C. Introduction to Care for Patients with Disabilities: https://youtu.be/0GO88MVvw0s
- Peacock, G., Iezzoni, L., & Harkin, T. (2015, September 3). Health Care for Americans with Disabilities--25 Years after the ADA. Retrieved September 26, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/26225616 https://drive.google.com/file/d/1YIY9TOi60n3WoTIpvwOwRZ7gS-AHfJ3O/view?usp=sharing
- Mello, M. M., Persad, G., & White, D. B. (2020). Respecting Disability Rights — Toward Improved Crisis Standards of Care. New England Journal of Medicine, 383(5). doi:10.1056/nejmp2011997https://drive.google.com/file/d/1YIY9TOi60n3WoTIpvwOwRZ7gS-AHfJ3O/view?usp=sharing
- Disability Impacts All of Us .Center for Disease Control. (2020, September 16). https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Information and Resources to apply for disability:
- Disability evaluation under social security (bluebook): https://www.ssa.gov/disability/professionals/bluebook/
- Adult disability starter kit: https://www.ssa.gov/disability/disability_starter_kits_adult_eng.htm
- Disability Determination Process: https://www.ssa.gov/disability/disability_starter_kits_adult_eng.htm
- What You Need to Know When You Get Social Security Disability Benefits: https://www.ssa.gov/pubs/EN-05-10153.pdf
- Benefits for people with disability: https://www.ssa.gov/disability/
- Federal and local disability programs: https://www.usa.gov/disability-programs
Forms to apply for disability:
- Social security disability report-adult: https://www.ssa.gov/forms/ssa-3368-bk.pdf
- Social security physical residual capacity: https://secure.ssa.gov/apps10/poms/images/SSA4/G-SSA-4734-U8-1.pdf
- Social security application for insurance benefits: https://www.ssa.gov/forms/ssa-16-bk.pdf
Resources for Blindness and Low Visions:
- American Foundation for the Blind’s Resources for Adults New to Vision Loss: https://www.afb.org/blindness-and-low-vision/visionaware
- American Academy of Ophthalmology’s Resources and Links for People with Low Vision: https://www.aao.org/eye-health/diseases/low-vision-resources
- National Federation of the Blind’s Resources: https://nfb.org/resources
- Future in Sight Support, Training, and Tools for Independent Living : https://futureinsight.org/adult-services-for-visually-impaired/
Resources for deafness and hard hearing:
- National Association of the Deaf’s Resources: https://www.nad.org/resources/
- American Speech-Language-Hearing List of Hearing Loss Organizations and associations: https://www.asha.org/public/hearing/hearing-loss-organizations-and-associations/
- National Deaf Center’s Resources: https://www.nationaldeafcenter.org/resources
- Hearing Health Foundation Resources: https://hearinghealthfoundation.org/resources
- My Deaf Child Org’s Resources: https://www.mydeafchild.org/resources
Works Cited
- Disability Impacts All of Us .Center for Disease Control. (2020, September 16). Retrieved September 26, 2020, from https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Application Exercise
The purpose of this application exercise is to practice finding resources for patients who are newly disabled and may need support adjusting to life with the new disability. Please complete Part A and Part B below.
Part A: Mr. A, a 70 year old male, has a history of hearing loss. At his most recent appointment with his audiologist, Mr. A learned that he is now considered deaf. Today, Mr. A is presenting for his annual physical exam and communicates primarily by reading/writing written English. Mr. A indicates that he would like to learn American Sign Language and asks for help locating resources that can help with this goal. Please list a few community resources in your area and online resources that can help Mr. A. learn ASL.
Part B: Ms. B is a 56 year old female who has advanced type 2 diabetes. Over the past 5 years, Ms. B has experienced diabetes related vision changes. Today, Ms. B has 2/100 vision in both eyes with corrective lenses. Ms. B is worried that she may become legally blind soon and asks you to recommend resources she can look into for help adjusting. Please list 3 resources, either online or community based resources, that would benefit Ms. B. as she is adjusting to her vision disability.