Disability and Handicap
Disability is a present when a tissue, organ, or system
cannot function adequately. A handicap exists when disability interferes with a
patient’s daily activities or social/occupational performance. A marked
disability does not necessarily cause a handicap. Conversely, minor disability
may produce a major handicap. Both conditions require separate assessment.
Patients’ perception of their problems will be molded by their adaptation to
the depreciated tissue as well as their aspirations for recovery.
An aid in assessing the more important aspects of disability
is the PILS mnemonic, which considers four issues:
1.
P
Preventable causes of disability (e.g., falls, direct trauma)
2.
I
Independence (e.g., self-care)
3.
L Lifestyle
(roles, goals)
4.
S
Social factors (e.g., family, friends, shelter)
Functional Assessment
A complete functional assessment includes evaluation of the
following:
1.
Self-care:
ability to wash, bath, attend to toilet needs, dress, cook, and feed oneself
2.
Mobility:
ability to stand, transfer, walk, negotiate stairs, drive, and use public
transportation
3.
Lifestyle:
nature of occupation, work capacity, and Social Security benefits
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