We are born into our ethnicity, race, gender, and culture. They are a part of who we are when we enter this world. One of the few diversities that may be acquired later on in our lives is disability. All of us, regardless of where we come from, what we believe, or who we are, can be afflicted with some form of disability in our life time through disease, accident, or other conditions that render us incapable of caring for ourselves in the same way that was possible before. This knowledge creates fear and is one of the primary reasons for the prejudice and stigma our society places on the disabled. The process of recognizing this fear, becoming knowledgeable, and culturally aware, is the ideal for individuals moving towards cultural competence, However; for those who are able to move past these prejudices, other biases await them. The well-meaning who overcompensate by solicitous and over protecting behaviors may be just as harmful as those whose bias creates prejudice.
I was working at the Mental Health Center in Los Angeles soon after receiving my license in nursing. A 36 year old Hispanic woman was admitted for depression and suicidal ideation. She was from an educated, upper middle class, Catholic, family, and had been raised in Los Angeles. One month previous to her admission, she was in a near fatal car accident that left her paralyzed from the waist down. She was having difficulty adjusting to her disability and her dependence on the wheelchair. I was assigned to be her nurse during her hospitalization. Every morning I would help her into her chair, assist her with her ADLs, and anything else I thought she needed. Throughout the day, I was cognizant of where she was in case she required my assistance or needed support. She was passively participating in her treatment but was also resistive to taking her medications and preferred to isolate in her room. Frequently during my shift, I would attempt to coax her into socialization with other patients and her treatment
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regimen. In essence, I created a dependency that incapacitated her based on my personal biases about individuals with disabilities.
Disabled individuals are emotionally fragmented, dependent, and need more support and assistance than the average person. They are less capable of understanding the extent of their health care and emotional needs and require significantly greater education, intervention, and assistance throughout the process of their healthcare.
Disability does not predispose an individual to weakness, dependence, decreased mental capacity, or inability to understand and provide for one’s own healthcare. Promoting independence, education, and knowledge provides a disabled person with the tools to live their lives fully within the limits of their disability. This also includes their right to accept or deny treatment.
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