I have worked as a Midwife specializing in maternity care of women living with a disability for 16 years and I am speaking from years of experience of delivering care to women with disabilities in a multi cultral society and a major city hospital environment amongst multidisciplinary health professionals and administrative staff. I have witnessed first hand and listened to the experiences of women accessing services or the lack of services and the barriers faced by people with disabilities accessing support within a hospital and broader community. Amongst professionals I have seen a keeness to understand disability and best practice however and also some apathy. For health professionals working in the maternity arena there’s so much training to be kept upto date with to remain abreast of the latest medical and nursing knowledge, and allied health advances and mandatory training modules to maintain a level of professional competancy ensuring registration requirements are met, that to be honest, best practice training when facing a woman with a disability is not high on the priority list for many professionals.
Topics of violence against women has become mandated as well as training to introduce electronic records, moving away from an antiquated system of paper medical records. There is only so much time in a day to clinically care for patients and recieve training in the myriad of areas that constantly need updating and informing on.
It’s not to say that women with disabilities accessing health care are not important or a priority, they absolutely are and something I feel passionate about. The question is, how do we educated health care workers on this topic amongst every other topic they need continually training on.
How do we deliver information around disability to better provide quality health care. I believe that busting some myths about disability is a start. My hope in doing this that people with disabilities that are marginalised and seen more on the periphery are instead seen more as mainstream. Education tools for training professionals needs to be a interesting and delivered in a quick and susinct manner in text or visually. It needs to capture the attention and curiosity to know more about living with a disability.
I recently listened to an interview of by Richard Fidler with Professor Ron McCallum who is a law Professor at Sydney University Australia. Being born in the late 1940’s, he believes he was born at the right time. Being blind from a newborn due to complictions of prematurity he relayed that war helped prevent him from being on the margins of society. Instead of society seeing these men as disabled thus on the periphery and not able to function, they were seen as men who had been active members of mainstream society who were now having difficulty coping with everyday tasks so solutions were created to assist them to continue to live as independantly as possilbe as they were prior to being injured at war. The Germans realising many of their soldiers who were virile and educated pre war and and now blind invented the guide dog, Dr Richard Hoover in America 1945 invented the long cane for returned service personal. Societal attitude and how people with disability are seen within it, is about perception and our attitude to them.
As members of society we are very visual assessors. We have pre-conceived ideas around appearance and where a person fits in our world. We discount or accept people at face value by their appearance and at times their ability to articulate. If we believe someone has something of value to say we listen more intently. I think this is across all areas of society. Best practice in interaction and caring for a person with a disabilty is looking past the appearance. Looking past the wheel chair, the slurred speech or dysmorphic features in some cases. Looking past the disability. Seeing the person before you as you would any other person you interact with when providing care. Poor articulation, a less groomed appearance and dysmorphic feature does not mean lack of interlect necessarily. The waiter or waitress in a cafe can often be presumed less intelligent by some because of her choice of occupation however many of these workers are university students or even graduates. The first thing we need to remind ourselves as professionals is to resist our pre-concieved ideas of a person by occupation or lack of , or by appearance.
Be mindful that they like many other people you care for do not understand your jargon. Speak to the person you are caring for in a manner they can understand. If they have poor speech, remembering this does not make them deaf. They do not need to be spoken to in a slow loud voice. Use your perceptive skills to help guide you as to whether they are understanding you, not your pre-concieved ideas. This is not something just for best practice with disability its is best practice full stop. Check for understanding, ensure the patient is understanding you.
Best practice in caring for someone with a disability is often general best practice. Because someone is disabled and appearance may cause you to judge, remember general best practice first and upmost.
Its important to remember that no one asks to have a disability and that life generally is harder because of it. Catching public transport, gathering goods off a supermarket shelf, filling the car up with petrol if they drive and just to get to your appointment. I once cared for a women whose abled husband would once a month take himself to the supermarker in her wheelchair to remind himself of the barriers she faced. Understand the barriers face by people with disabilities. Treat them with the same dignity and respect as you would want a member of your family to be treated
Once you have looked past the disability decided how you will approach your interaction. Ask the patient if there is anything specific they require to assist in there care, especially if you need to examine them. They live with this disability everyday. They know what does and doesn’t work for them. Ask if they require any assistance and what with. Ensure for future appointments equipment is pre- organised and present if required to save time, fustration allowing a more seamless interaction and where possible prior to there very first appointment.
I believe best practice is looking past the disability and more so how can you make this interaction more effective and a better experience for you and the patient. People can sense insincerity. Take a general interest in the person. Over 16 years of working as a health professional and looking past the disability, building on strengths and problem solving difficulties in an approach that enables the patient, I have been inspired by people for their reslience and individuality. I enjoy interacting with ‘the person’ as an individiual like any other person.
Love Lucy x