Disability and Handicap

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.

Assessing Disability

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