UR Community Cares

How can you support an adult with a disability with independence?

By Kathleen M. Dormody, K.D. Content & Copy, LLC, UR Community Cares, Marketing Chair Executive Committee Member

The Importance of Independence in Adults with Disabilities

Independence has a multilayered definition including the ability to take care of oneself and his/her own needs, being responsible for one’s own life, the mastery of essential life skills, and self-advocacy.

Handling self-care is one of the main ways a person with a disability can maintain their independence; they must learn multiple ways of addressing their self-care needs.

Knowing and teaching multiple ways of addressing one’s needs to an adult with a disability is important because each individual is different as is their disability and their capabilities so the same technique will not work for everyone.

“According to the UN Convention on the Rights of People With a Disability, key elements of independence include autonomy, involvement in decision-making processes, and having opportunities to be involved in social and cultural events.” (https://www.abilities.com/community/independence.html). Some of the best ways a caretaker can promote autonomy in adults with disabilities is to ensure they are working in a fulfilling career and staying healthy and social.

What causes lack of independence in adults with disabilities?

Adults with disabilities lack independence because they do not get to choose where they live, whether at home or in a nursing facility. Research shows that nursing facilities tend to be more restrictive settings than one’s home. “Not only do adults usually enjoy greater choice when they live in their own homes relative to individuals living in congregate care or group home settings but independent and semi-independent settings are also associated with better outcomes.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711747/).

Another major cause of lack of independence in adults with disabilities is attributed to a lack of participation in society, whether social or otherwise; this is contributed to several barriers including attitudinal, communication, physical, policy, programmatic, social, and transportation. The Centers for Disease Control in Common Barriers to Participation Experienced by People with Disabilities (https://www.cdc.gov/ncbddd/disabilityandhealth/disability-barriers.html) explain how these barriers limit functioning and create disability:

physical environment is not accessible
lack of relevant assistive technology
negative attitudes of people towards disability
services, systems, and policies that are either nonexistent or that hinder the involvement of all people with a health condition in all areas of life
- World Health Organization, International classification of functioning, disability, and health. Geneva:2001, WHO. p. 214.

How can you support an adult with a disability who lacks independence?

The most effective way to support an adult with a disability who lacks independence is to empower them by involving them in all decision-making and celebrating their small improvements and accomplishments.

Take a comprehensive approach to working with adults with disabilities that consists of the following four tiers:

Support
Confident and Control
Education
Training and Skills

Within the Support Tier, it is important to not control what the individual does; they need autonomy. Do not judge the individual if they make a mistake; show them positivity. Build their confidence by respecting their identities rather than labelling them. Above all else, remember, you both have things to learn from one another.

Within the Confidence and Control Tier, be patient with them and start slowly with their daily tasks; it will take them time to learn. Give them choices and allow them to make their own decisions. Encourage them to interact with others by getting them involved in social activities, not only with other groups of individuals with disabilities but also with mainstream society.

Within the Education Tier, teach and encourage your community to embrace diversity and adversity. Show them how to live a healthy lifestyle by living a healthy lifestyle yourself. And talk to them about getting involved in learning activities, employment, and volunteer activities.

Within the Training and Skills Tier, help them build a learning and career plan and help them improve the skills required for independence. Teach them daily living skills including cooking, washing, ironing, social skills, money handling, technology, and interview skills. Most importantly, help them to establish daily routines and habits through repetitive training.

RESOURCES

Promoting Independence in Adults with a Disability