According to the World Health Organization, disability is a multifaceted concept that encompasses the interplay between personal attributes and environmental factors. Based on the social model, when appropriate modification and support is available, an individual with a different level of physical or psychological functioning may remain “functional,” if not highly “successful.”
When working with individuals with chronic or progressive health issues, other “team players” don’t always look at certain personal attributes the way we do. Particularly in the case of “mental disability,” we become the “annoyingly naive” people who are “wasting” our time and effort advocating for a “lost cause” sometimes.
I am sorry that despite years of treatment and supportive services, my otherwise non-psychotic, non-violent client who takes all of his psychotropic medications as prescribed remains initially “rude” and “sarcastic” whenever he deals with new faces and stressful situations. I, too, find it challenging to work with the resident who is very narcissistic and at times verbally hostile. But wouldn’t it be ethically and morally dubious if we gave up handing her the pills she needed just because she was “difficult” 90% of the time? What if she’s only difficult 75% of the time? Where do we draw the line, especially when she actually wants treatment?
As a society, we have made some progress in making “physical disability” a little less challenging in the past few decades. When it comes to “disability” sustained by cognitive, emotional, and personality issues, or the more “invisible” forms of disability, I am not sure if we have accomplished as much. Instead of attempting to change every single personal attribute that we don’t like, perhaps we ought to consider what healthcare providers could do to make things easier for the individual? I don’t want to justify anybody’s rude behavior but if we have already identified the situation or interpersonal style that usually triggers hostility, maybe we could at least try to better prepare ourselves mentally and behaviorally?