Mary Egan, D. Rudman, C. Ceci, D. Kessler, C. McGrath, P. Gardner, J. King, M. Lanoix, and Ravi Malhotra
(2017) 39: 13 Disability & Rehabilitation, 1348-55.
Purpose: Conceptualizations of risk in seniors' rehabilitation emphasize potential physical injury, functional independence and cost containment, shifting rehabilitation from other considerations essential to promoting a satisfying life. In a two-day multidisciplinary planning meeting we critically examined and discussed alternatives to dominant conceptualizations.
Method: Invitees reflected on conceptualizations of risk in stroke rehabilitation and low vision rehabilitation, identified and explored positive and negative implications and generated alternative perspectives to support rehabilitation approaches related to living a good life.
Results: Current risk conceptualizations help focus rehabilitation teamwork and make this work publically recognizable and valued. However, they also lead to practice that is depersonalized, decontextualized and restrictive. Further research and practice development initiatives should include the voices of clinicians and seniors to more adequately support meaningfully living, and foster safe spaces for seniors and clinicians to speak candidly, comprehensively and respectfully about risk. To ensure that seniors' rehabilitation targets a satisfying life as defined by seniors, increased focus on the environment and more explicit examination of how cost containment concerns are driving services is also necessary.
Conclusion: This work reinforced current concerns about conceptualizations of risk in seniors' rehabilitation and generated ways forward that re-focus rehabilitation more on promoting a satisfying life. Implications for rehabilitation In seniors' rehabilitation, considerations of risk focus on physical injury, functional dependence and cost containment. Focus on provider-defined risk of physical injury limits examination of patient goals and patients' histories of judging and dealing with risk. Focus on functional dependence and cost containment may lead to practice that is depersonalized and decontextualized. Abandonment of ableist and ageist thinking and an explicit focus on person-centered definitions of risk and a satisfying life are recommended.
About the Author:
Ravi Malhotra’s primary research interests are in the areas of Labour and Employment Law, Human Rights, Globalization and Disability Rights Law. He has published widely in a number of journals including the Journal of Law & Equality, the Harvard International Law Journal, New Politics, the Washington University Journal of Law & Policy, the Manitoba Law Journal, the Ottawa Law Review, the Journal of Law & Social Policy, Socialism & Democracy, the Supreme Court Law Review, and the Alberta Law Review. He is the author of Exploring Disability Identity and Disability Rights through Narratives: Finding A Voice of Their Own (with Morgan Rowe) (Routledge) and editor of Disability Politics in a Global Economy: Essays in Honour of Marta Russell (Routledge). He is also writing a biography of double amputee and politician E.T. Kingsley, with Dr. Benjamin Isitt, under contract with University of British Columbia Press and is based on research funded through SSHRC.