Neglect

I've had several trainings or sessions with coworkers and have been thinking about disability this week.

One national leader, talking about transportation, mentioned that a person might get a particular diagnosis, and then went on to say that it depends on how that person intends to "wear" their diagnosis. In other words, if you're a person who enjoys having services, having something that makes you special or gives you an entitlement, you may wear your diagnosis differently from someone else, who might prefer to have independence, to enjoy being the same as everyone else, to continue doing the things one did before diagnosis.

What does your diagnosis of diabetes mean to you?

Does a diagnosis alone mean that you can claim a disability? I don't think so. There is some language in the law that talks about limitations on the activities of daily living. For many diabetics, the disease does not significantly limit their ability to perform the activities of daily living. For others, the disease, or its complications, does produce limitations and changes to one's ability to do the things one once did.

I was doing some reading on the American Diabetes Association website, after the mother of a 10-year-old child, three years post IDDM diagnosis, informed me that they had certified that her child had a disability, and the ADA does use the term 'disability' with regards to minors in an educational setting, and the disability or diagnosis providing some protection against discrimination. But I don't think that the ADA has the authority to determine that a particular person has a disability. That's not the business they're in. (That being said, I recognize that a minor, in an educational setting, still needs access to the best possible diabetes care. I applaud the ADA in their role in gaining rights for persons with diabetes, including in schools.)

I want to be the healthiest diabetic that I can be, with the resources and health choices that I make today. I want to be the healthiest diabetic that I can be, on any given day, regardless of where, on the continuum of disability, I place myself. Or perhaps, regardless of the progression of my disease, and where, on the continuum of disability, it has placed me.

I want to be mentally healthy, no matter what my physical health does. I want to be physically healthy, too. I'm not giving up.

At one of the training sessions, a county worker was talking about elder abuse. She introduced the topic of neglect as abuse, certainly true, and included the idea of self-neglect as abuse. Her two examples of self-neglect were 1) a person whose living space was so messy that you only had pathways to move around from the couch to the kitchen to the bathroom and back again, or 2) a person whose home was clean, but who only had breakfast sausage and oreo cookie ice cream to eat, when they had diabetes.

She went on to say that, in most cases, adults have a certain amount of control over their own lives. Adults are, for the most part, allowed to make really bad decisions about their own lives. And she agreed that there is a balance point between imposing some order and care on a person, and allowing them to have their own independence and control and live with the results of their own (bad) decisions.

So, how true is that in my life? If I have an idea about how best to live healthfully with a diagnosis of diabetes, then it becomes an issue of how close or far I am from that ideal on any particular day. If I am very far away from the ideal diet, the ideal exercise plan, when does it become neglectful to me? When does it become self abuse? And how do I stop the abuse?

And how does it play out when there is a pair of diabetics in the home?

Just asking a lot of questions right now.

PS. Work has been very busy. I love having projects, but it may mean that I don't post as much.