Use Plan B in emergencies

The first thing that is important to understand is people have a social and moral responsibility to reach their full potential in what they are able to achieve, especially within a rehabilitation setting. This core medical model concept  is key to the assessment and allocation of services and resources, because no one is going to pay to help people to do something they can do themselves. As someone who is now learning to walk again, I now see this more clearly.

However, it is simply not that simple. If someone has the ability on paper to walk to work, does this mean they must? Of course not. Factors of time, energy and the allocation of other resources need to be considered - this is where a social model or outcome approach is needed. This means assessments need to balance function within a wider picture.

So while I may regain the ability to walk which will have enormous benefi ts in an indoor setting, especially for toileting, it may still be effective to use a wheelchair or scooter outdoors for issues of time and energy.

The key here is therefore options, it is always useful to have the ability to do something even if it is not effective to use it all the time. So if the car breaks down, then walking to work makes sense and this is where my concept of "plan B" comes in. Even when someone has very limited ability it is important for them to have a good understanding of their maximum ability for emergencies, like gaps in their personal assistance, even if it is just the ability to contact someone who can arrange cover, and shows the importance of appropriate assisting technology. This is also key in providing a sense of independence and control even when circumstances are not at their best.

Simon Stevens is an independent disability trainer and consultant