What are some important issues to consider when working with people with a high degree of impairment?

Question

Imagine you are working in a state mental hospital with individuals diagnosed with severe and profound intellectual disability. Besides significant cognitive and adaptive skill limitations, many of these individuals may also have multiple physical and sensory impairments. Those most impaired are likely totally dependent upon others for their care. What are some important issues to consider when working with people with a high degree of impairment? What kinds of things do you need to consider to be sure you are respecting the dignity of those for whom you care?

Please and thank you.

Answer 1

The biggest thing in my mind when working with a client of any ability level is providing respect for their indivisibility, their preferences, their needs and wants, their desires and their culture. Even people that are significantly impacted by multiple disabilities still have the ability and the right to assent to anything that you are doing. Assent is going to look different based on communication skills, but it is something that I feel is required. You should never be doing things 'to' the client, you should be doing them with the client.

A great question to ask yourself when working with clients with limited communication skills is "Would I want someone doing this" or "How would I feel in their place". Empathy is really the cornerstone of the psychology field that had been forgotten in an era of quickness. If you can't wrap your own head around those questions, substitute a beloved family member.