What does it really mean to experience an accident as a person with disability and does mainstream medicine really understand the impact on our ability to mobilise?

Written by Tammy Milne – PDA’s TAS Director

My own experience.

In 2022, and as a result of a poorly constructed council footpath, I fell from my mobility scooter and landed on the road.  Fortunately this accident occurred outside a repatriation hospital, so I was quickly attended to by nursing staff from the hospital. An ambulance was promptly called and I was taken to the local public hospital, where I was diagnosed with a broken finger and bruised ribs. 

Imagine how, as an able bodied person, you would cope with this sudden pain on your left side from bruised ribs and and sporting a splint on your hand. It’s painful, but you are still able to walk around, go to the toilet and for the most part go about your normal day to day living – in pain, but still able to move.

Now imagine the same scenario where you do not have the use of your legs. To move you need to use your arms to push, pull and lift your body around, BUT your ribs are so painful that doing so is excruciating. This also impacts on the injury’s rate of healing through constant movement and having to disturb those injured ribs and finger.

You beg the hospital for help. A rude nurse actually scoffs that you are in hospital for a broken finger. Your frustration at her lack of compassion and understanding is such that you whip the sheet from the bed back and proceed to lift up your legs with your unaffected arm, flopping them around to prove you are in fact “disabled” and in need of help.

You are discharged with no plan and no assistance on how to mobilise.

Two years later, you have another accident in a hostile built environment, due to a step that is not visibly defined with required signage or tactile markers. As a result, you now have a fractured clavicle (collarbone). After seeking medical treatment, you are given a sling – basically taking away your arm so you are no longer mobile – AND sent home again.

The sling is quickly discarded in the carpark because, with it on, you can not get back into the car to go home, get out at home, or basically move at all whilst wearing it.

This was my experience.

One of my friends who has no leg function, had a similar situation following surgery for Carpal Tunnel Syndrome, where she was sent home “to recover”. There is no way a person with a disability who is reliant on the usage of their upper body can simply stop using one arm and continue to function. Yet she was sent home to ‘cope’. Her pain was unimaginable and the success of the operation compromised as a result.

Three situations where the medical system has let people with disabilities down. Stories such as these are not uncommon. There are many more with people discharged from hospital with no duty of after care! 

Many studies, reports and information are provided to patients about discharge planning from a multitude of sources – including NDIS discharge planning, hospital planning and even academic publications like the CSIRO (2024) https://www.publish.csiro.au/IB/pdf/IB23088  which comprehensively highlight the real issues. A major one being the conflict between the needs of people with disabilities and the hospitals’ discharge of patients with disability without real planning or consideration of the needs of the person upon returning home.

How and why does this occur in a fully functioning health system?

Lack of knowledge at the ward level and the clinician level. There is a lack of knowledge about the level of complexity an injury or surgery has on the functionality of a person with disabilities. A desire to ‘move patients on’ and free up beds at the detriment of patient care. The lack of advocacy within the health system to assist people to have a voice around their care. The lack of experience at every level of staffing in the health system – including allied health working with and understanding the complexity of physical mobilisation of people who are wheelchair users. Clinicians are seemingly simply under so much pressure that they are unable to follow the logical threads of loss of limb function due to accident or surgery and how this may impact the person’s mobility. There seems to exist a real lack of understanding or expertise, and perhaps an unconscious incompetence or lack of capacity to train up to do better.

How do we address this?  More training. We need to seriously have more training for clinicians. This needs to be co-designed with people who have experienced the system failures and the malfunctions within. People with disability need to be involved in developing an education program for clinicians to avert failures in post-hospital discharge of people with disabilities when they are sent home in pain with no after care.  Such consideration would reduce longer healing times and permanent and ongoing injuries commonly experienced due to such lack of care and clinical resources at accidents and injury onset.

We have to stop giving wheelchair users slings and sending them home.

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