In a previous post, I introduced the idea of functional limitations in the context of disaster preparedness. This came from some research I did while working on community wide disaster planning in San Luis Obispo and Santa Barbara Counties.
Yesterday, I came across a question on the differences between functional limitations, disabilities and impairment and thought I'd attempt to clarify it here. It was a good question and triggered my consideration of the answer.
From my prior blog post, the inability to walk, run, see, drive, read, hear, speak and quickly understand and respond to instructions and alerts can be limitations in functioning. More specifically, someone with arthritis might find that the following common daily activities are “very difficult” or that they “cannot do” them."
- grasp small objects.
- reach above one’s head.
- sit more than 2 hours.
- lift or carry 10 pounds.
- climb a flight of stairs.
- push a heavy object.
- walk a 1/4 mile.
- stand more than 2 hours.
- stoop, bend, or kneel.
Every individual and their response to a any condition may be different.
The World Health Organization describes disabilities as an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives.
To me, disability is more of a legal or policy term, such as when qualifying for State or Federal disability benefits. Or when being evaluated for military fitness for duty and/or Veteran benefits. Just because a person is in a wheelchair, doesn't make them disabled and they don't necessarily like being referred to as disabled. The key is whether they can perform their job functions as an accountant, a professor, construction worker or a Marine given their functional limitations. In some cases, as with a professor or accountant, accommodations can be made. In others, even with accommodations some individuals still can't perform their necessary job functions.
Impairment, on the other hand, can be acute (short term) or chronic (long term). A physician who is impaired from drug abuse probably can't safely perform their job functions. At some point, this could become a disability. The same goes for someone who is depressed or has psychosis. If they receive treatment for the impairment/condition, they may never become disabled nor have long lasting functional impairments. A doctor who shows up at work with a hangover is functionally impaired and limited in their abilities, but not disabled.
So, how did I do? Does this make sense? If not, leave a comment and let me know what you think the delineation should be for each of the terms.