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Biomedical subjects

C Horwood

Publications and source records attributed to C Horwood.

3 recordsLinked to original sources

The organically handicapped child. How can the family physician help?

The better his understanding of some of the ways in which an organic deficit might affect normal development of the handicapped child, the more able the family physician will be to offer guidance to the family aimed at preventing the development of secondary problems. He can thus be instrumental in helping a child achieve his maximal potential.First, it is important to take into account how the parents' emotional and intellectual responses to having a defective child may interfere markedly in normal parent-child relationship. Second, ways in which each deficit will limit a child's exposure to stimuli must not be over-looked. Third, one must consider how a deficit may indirectly distort the normal learning patterns when parents do not make age appropriate demands. Fourth, it is important to understand how specific interference in the area of language skills may cause further developmental retardation. Fifth, one must be aware of special problems that an organically handicapped child must face in the society outside of the family. Last of all, in an older child, one must consider the need for a full scale evaluation to sort out primary and secondary factors in the picture.

Blindness

The assessment of disability in patients on an acute medical ward for elderly people.

The level of independence in self-care was monitored weekly in 212 patients admitted over 6 months to an acute medical ward for elderly people, and documented on discharge using a standard assessment, the Barthel Index. At discharge from the admitting ward, 39% of patients were independent (Barthel score of 20), 36% were mildly dependent (Barthel 15-19), 15% were moderately dependent (Barthel 10-14), 4% severely dependent (Barthel 5-9) and 6% very severely dependent (Barthel 0-4). Approximately 80% were able to transfer, walk, were continent of urine and could wash their top half, but one-third were unable to dress or use the toilet independently. Over half were unable to bath themselves or climb stairs unaided. It is feasible to assess disability in a busy acute service this way. Information can be provided both to community services on discharge of individual patients, and to managers responsible for planning services for elderly people.

Activities of Daily Living