Val Lougheed
Northern Lights Canada
Real Work * Real People * Real
Results
Paradigms, Policies,
Systems and Outcomes
The R...
The Medical Model
1600’s – Rene Descartes (philosopher)
Disease
“pathology of a part that
is identified by objective
criteria”
(Barbour, 1995, p. 10)
Impairment
• “a loss of, or loss of the use
of….any body part, system or
function”
• relates to a specific function
(Zabro...
Disability
• “loss of capacity to meet
personal, social or occupational
demands”
• relates to a specific role
(Zabrodski, ...
Handicap
• result of an impairment or
disability that limits or prevents
the fulfillment of one or several
roles regarded ...
Impairment
Predicts
Disability
Person and their
Disability
Health Care & Rehab
►
Fix The Person
Disability Policy Objectives
-Art and Science
• Rehabilitation Services
• Financial
Compensation
Disability Policy Objectives
-Art and Science
Rehabilitation Services
“empower and enable
consumers to act effectively in
...
Disability Policy Objectives
-Art and Science
Financial Compensation
…ensures that you continue to
be able to “meet your d...
Combining Art and
Science
“twin but potentially
contradictory goals”
“how to reconcile these twin
goals has yet to be reso...
Disability Benefits
System
1. Measure impairment
2. Translate impairment into
disability
3. Compensate for loss -- $$
4. F...
Rehabilitation and Return
to Work
1. Directed by physician
2. Rehab – facility-based
3. RTW – ‘Fitness to Work”
statement ...
George Engel
The Need for a New
Medical Model: A
Challenge for
Biomedicine
(Engel, 1977)
Biopsychosocial Model
The Medical Model “assumes
disease to be fully accounted for
by deviations from the norm of
measurab...
New Definition -- Disease
“pathology of a part that
is identified by objective
criteria”
(Barbour, 1995, p. 10)
New Definition --
Impairment
• “a loss of, or loss of the use
of….any body part, system or
function”
• relates to a specif...
New Definition -- Disability
“a complex phenomenon,
reflecting the interaction beween
features of a person’s body and
feat...
New Definition -- Handicap
a condition that “creates
obstacles to accomplishing life’s
basic activities and if these
obsta...
Nordenfeldt (2003) says…
• Disease and Impairment ►
Medicine and Health
• Disability and Handicap ►
Action Theory and Soci...
Disability and Handicap
Only have meaning when
associated with action and placed
in context
► doing something, somewhere
►...
Impairment
does not
Predict
Disability
Focus ►
Disabling Factors not Disability
1. Person
2. Environment
3. System
Disability Policy
Objectives Redefined
Rehabilitation Services
BPS Model “captures factors
that more directly relate to
fu...
Disability Policy
Objectives Redefined
Financial Compensation
“The vast majority of people…who take up
disability benefits...
Another New Definition –
Work Disability
“preventable absence or
withdrawal from work [which is]
disruptive, potentially h...
Disability
Benefits System
SAW/RT
W
Rehabilitation and Return
to Work
Holistic Problem Solving
1. Person
2. Environment
3. System
Person
Impairment plus
•Personal circumstances
•Social supports
Environment
• Lack of modifications or
accommodations
• Psychological (fears, anxiety,
depression, distress)
• Social (per...
System
“benefits system
itself has a
disabling effect on
people”
(OECD, 2009, p. 17)
Iatrogenesis
VIDEO CLIP
Viktor Frankl video
http://www.youtube.com/watc
15 to the end
Rehabilitation Strategies
in a BPS System
S.P.I.C.E.
IT
UP!
Simplicity
Proximity
Immediacy
Centrality
Expectanc
y
Trr re organization of disability benefits system
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Trr re organization of disability benefits system

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Val's presentation at the University of Calgary -- Social Construction of Disability and Health Course; Paradigms, Policies, Systems and Outcomes

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  • Northern Lights Vocational Services www.nlvs.ca 1-800-361-4642
  • Northern Lights Vocational Services www.nlvs.ca 1-800-361-4642
  • Trr re organization of disability benefits system

    1. 1. Val Lougheed Northern Lights Canada Real Work * Real People * Real Results Paradigms, Policies, Systems and Outcomes The Re-Organization of the Disability Benefits System 1-800-361-4642 * www.northernlightscanada.ca * vlougheed@northernlightscanada.ca
    2. 2. The Medical Model 1600’s – Rene Descartes (philosopher)
    3. 3. Disease “pathology of a part that is identified by objective criteria” (Barbour, 1995, p. 10)
    4. 4. Impairment • “a loss of, or loss of the use of….any body part, system or function” • relates to a specific function (Zabrodski, 1999, pp. 49 & 52)
    5. 5. Disability • “loss of capacity to meet personal, social or occupational demands” • relates to a specific role (Zabrodski, 1999, pp. 51 & 52)
    6. 6. Handicap • result of an impairment or disability that limits or prevents the fulfillment of one or several roles regarded as normal • activity limitation; participation restriction (WHO, 1980; ICF, 2001)
    7. 7. Impairment Predicts Disability
    8. 8. Person and their Disability Health Care & Rehab ► Fix The Person
    9. 9. Disability Policy Objectives -Art and Science • Rehabilitation Services • Financial Compensation
    10. 10. Disability Policy Objectives -Art and Science Rehabilitation Services “empower and enable consumers to act effectively in a spirit of self-reliance” (Hope, Timmel and Hodzi, 1985)
    11. 11. Disability Policy Objectives -Art and Science Financial Compensation …ensures that you continue to be able to “meet your daily financial needs” (Great-West Life, 2010)
    12. 12. Combining Art and Science “twin but potentially contradictory goals” “how to reconcile these twin goals has yet to be resolved” (OECD, 2004, p. 3)
    13. 13. Disability Benefits System 1. Measure impairment 2. Translate impairment into disability 3. Compensate for loss -- $$ 4. Fix person so they can work again
    14. 14. Rehabilitation and Return to Work 1. Directed by physician 2. Rehab – facility-based 3. RTW – ‘Fitness to Work” statement by physician
    15. 15. George Engel The Need for a New Medical Model: A Challenge for Biomedicine (Engel, 1977)
    16. 16. Biopsychosocial Model The Medical Model “assumes disease to be fully accounted for by deviations from the norm of measurable biological (somatic) variance. It leaves no room…for the social, psychological and behavioural dimensions of life”. (Engel, 1977. p. 130)
    17. 17. New Definition -- Disease “pathology of a part that is identified by objective criteria” (Barbour, 1995, p. 10)
    18. 18. New Definition -- Impairment • “a loss of, or loss of the use of….any body part, system or function” • relates to a specific function (Zabrodski, 1999, pp. 49 & 52)
    19. 19. New Definition -- Disability “a complex phenomenon, reflecting the interaction beween features of a person’s body and features of the society in which he or she lives” (http://www.who.int/topics/disabilities/en/)
    20. 20. New Definition -- Handicap a condition that “creates obstacles to accomplishing life’s basic activities and if these obstacles can be overcome only by compensating in some way for the effects of the impairment” (Zabrodske, 1999, p. 52)
    21. 21. Nordenfeldt (2003) says… • Disease and Impairment ► Medicine and Health • Disability and Handicap ► Action Theory and Social Science
    22. 22. Disability and Handicap Only have meaning when associated with action and placed in context ► doing something, somewhere ► must understand the something and the somewhere (Nordenfeldt, 2003)
    23. 23. Impairment does not Predict Disability
    24. 24. Focus ► Disabling Factors not Disability 1. Person 2. Environment 3. System
    25. 25. Disability Policy Objectives Redefined Rehabilitation Services BPS Model “captures factors that more directly relate to functional recovery”. (Loisel, 2009, p. 97)
    26. 26. Disability Policy Objectives Redefined Financial Compensation “The vast majority of people…who take up disability benefits never return to work.” (OECD, 2009, p. 19) •Disability does not equate with ‘unable to work’ •Financial compensation should support RTW efforts
    27. 27. Another New Definition – Work Disability “preventable absence or withdrawal from work [which is] disruptive, potentially harmful and costly both to the employee and the employer” (ACOEM – Ontario Summit to Prevent Work Disability, 2010, p. 5)
    28. 28. Disability Benefits System SAW/RT W
    29. 29. Rehabilitation and Return to Work Holistic Problem Solving 1. Person 2. Environment 3. System
    30. 30. Person Impairment plus •Personal circumstances •Social supports
    31. 31. Environment • Lack of modifications or accommodations • Psychological (fears, anxiety, depression, distress) • Social (perceived demands, perceptions of co-workers) • Discrepancy between demands of the work and capabilities of the worker (Loisel, 2009, p. 97)
    32. 32. System “benefits system itself has a disabling effect on people” (OECD, 2009, p. 17)
    33. 33. Iatrogenesis
    34. 34. VIDEO CLIP Viktor Frankl video http://www.youtube.com/watc 15 to the end
    35. 35. Rehabilitation Strategies in a BPS System S.P.I.C.E. IT UP!
    36. 36. Simplicity
    37. 37. Proximity
    38. 38. Immediacy
    39. 39. Centrality
    40. 40. Expectanc y

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