Disability

Objectives

1. Determine whether a specific decline in functioning (e.g., social, physical, emotional) is a disability for that specific patient.
2. Screen elderly patients for disability risks (e.g., falls, cognitive impairment, immobilization, decreased vision) on an ongoing basis.
3. In patients with chronic physical problems (e.g., arthritis, multiple sclerosis) or mental problems (e.g., depression), assess for and diagnose disability when it is present.
4. In a disabled patient, assess all spheres of function (emotional, physical, and social, the last of which includes finances, employment, and family).
5. For disabled patients, offer a multi-faceted approach (e.g., orthotics, lifestyle modification, time off work, community support) to minimize the impact of the disability and prevent further functional deterioration.
6. In patients at risk for disability (e.g., those who do manual labour, the elderly, those with mental illness), recommend primary prevention strategies (e.g., exercises, braces, counselling, work modification).
7. Do not limit treatment of disabling conditions to a short-term disability leave (i.e., time off is only part of the plan).