Suggests that there is a difference between ‘impairment’ (such as sensory or physical impairment or learning disability) and ‘disability’
Looks beyond the individual impairment or disability to examine the social, political, educational and environmental causes of disability
It is society that causes and imposes disability on the individual due to its ignorance, stereotyping and the erection of structural, physical, environmental and attitudinal barriers that prevent full engagement, inclusion and participation of the individual with a disability or impairment within society
A positive disability identity and a pride in having a disability develops out of a greater control by those with a disability of both their own lives and the services that are provided for them
An aspect of this greater control by those with a disability is independent living supported with assistance when needed, rather than communal and dependent living.
CONCLUSION
Hanif has been exposed to a number of different meanings and perspectives of learning disability. As a result, he has acquired a basic understanding of what learning disability is. The meaning and understanding of learning disability is very much multi-dimensional in nature; differences in meaning and hence understanding arise from light being shone on learning disability from a variety of different angles, from a variety of different perspectives. Again, the meaning and understanding of learning disability has changed over time and will continue to do so. This is normal!
KEY POINTS
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There is no single definition of ‘learning disability’. |
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The ways in which learning disability and its attendant health issues can affect a person are manifold. |
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It is important to know a basic history of learning disability before the current situation can be understood and to prevent historical mistakes being repeated. |
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There are different theoretical models of care, the main ones being ‘social’ and ‘bio-medical’. |
REFERENCES
Barber, C. (2011) Understanding learning disabilities: an introduction. British Journal of Health Care Assistants, 05:04; 169–170.
British Dyslexia Association (2012) What are Specific Learning Difficulties? Available at: www.bdadyslexia.org.uk/about-dyslexia/schools-colleges-and-universities/what-are-specific-learning-difficulties.html (last accessed 16 October 2014)
Department of Health (DH) (2001) Valuing People: a new strategy for learning disabilities for the 21st Century. HMSO, London.
Garvey, F. & Vincent, J. (2006) The bio-physical aspects of learning disabilities. In Peate, I. & Fearns, D. (2006) Caring for People with Learning Disabilities. Chichester, Wiley.
Gilbert, T. (2009) From the workhouse to citizenship: four ages of learning disability. In Jukes, M. (ed.) (2009) Learning Disability Nursing Practice. London, Quay Books.
Hallawell, B. (2009) Challenges for the curriculum in learning disability nursing. In Jukes, M. (ed.) (2009) Learning Disability Nursing Practice. London, Quay Books.
Heuser, S. (2012) The human condition as seen from the cross: Luther and disability. In Brock, B. & Swinton, J. (2012) Disability in the Christian Tradition. Cambridge, Eerdmans.
Jukes, M. (ed.) (2009) Learning Disability Nursing Practice. London, Quay Books.
Mencap (2011) Shaping our Future: Mencap strategy 2011–2016. Available at: www.mencap.org.uk/sites/default/files/documents/Mencap%20Strategy%202011_2016.pdf (last accessed 16 October 2014)
Newcastle University (2011) Definition and Classification of Learning Disability. Available at: http://tinyurl.com/BJHCAlearning1 (last accessed 16 October 2014)
New Scientist (2009) A rational alternative to testing IQ (editorial). New Scientist, 2 November. Available at: http://tinyurl.com/BJHCAlearning3 (last accessed 16 October 2014)
Office for National Statistics (ONS) (2011) www.ons.gov.uk/ons/taxonomy/index.html?nscl=Population (last accessed 16 October 2014)
Romero, M. (2012) Aquinas on the corporis infirmitas: broken flesh and the grammar of grace. In Brock, B. & Swinton, J. (2012) Disability in the Christian Tradition. Cambridge, Eerdmans.
03
NURSING SUPPORT FOR THOSE WITH PROFOUND AND MULTIPLE LEARNING DISABILITIES
AIMS AND LEARNING OUTCOMES:
The aims of this chapter are:
To explore what profound and multiple learning disability (PMLD) is
To highlight the areas of care that a person who has a PMLD is likely to express, experience and need meeting.
By the end of this chapter, the reader will be able to:
Understand and discuss what PMLD is
Have a basic understanding of the ‘twelve activities of daily living’ model of care
Have a basic understanding of how these twelve activities of daily living could be applied when working with a person who has a PMLD.
INTRODUCTION
Chapter 2 highlighted a number of possible definitions and meanings of learning disability and suggested that the various meanings of learning disability are intimately bound up with the use of language and that as language changes, so does our understanding of those with a learning disability. It was suggested also that learning disability is a spectrum of conditions ranging from ‘borderline’ to ‘profound’.
This chapter will highlight the needs and care of Thomas, a 65-year-old gentleman with a profound and multiple learning disability (PMLD) who has recently had a heart attack. Although Thomas lives in a small care home, he was admitted to an intensive care ward and then transferred to a medical ward of his local general hospital. Whilst set against the backdrop of a busy medical ward, the contents of this chapter will have value for those working in other hospital-based clinical areas, community services and care and nursing homes, as those with a PMLD are also likely to access these services or clinical areas.
This chapter will provide a simple ‘definition’ of what PMLD is, briefly explain one model of holistic care and then explore how this model of care can be applied to those with a PMLD.
SCENARIO 3.1
Thomas is a 65-year-old gentleman who lives within a social care home and has a profound and multiple learning disability (PMLD) with additional needs in the following areas:
Severe mobility problems; is unable to sit without assistance and mobilise without the use