Do Words Matter?

Kate Sheehan

Director, The OT Service

The OT Service provides high quality advice, consultancy and training to manufacturers, retailers and service providers. It also provides occupational therapy clinical services in housing and equipment to case managers, solicitors and private individuals via its handpicked network of occupational therapists.

For more info email kate@theotservice.co.uk

client or their carer described them and the impact on their daily life. Deaf, blind – this is describing the impairment not the impact. We should write or talk about sensory impairments and the impacts they have on the clients’ chosen goals; someone is not defined by their medical diagnosis and should never be referred to by it.

Bed bound or confined to a bed

– a person may spend a significant portion of their time in a bed, but they are not bound or confined to only being in that bed, as there are always solutions to provide alternative options to being in bed. We may need to say that a client has no alternative options at present to not spend significant amounts of time in bed, or the client prefers to or chooses to be in bed as they feel comfortable and safe there.

Wheelchair bound or confined

to a wheelchair – again, a person is not confined or bound to their wheelchair. A wheelchair offers freedom, independence, empowerment, confidence, and choice, especially if it is the right one to meet their needs. In reports we need to indicate how the wheelchair supports function, choice, and control. Nappies – this term should only be used for children under four; above this age you should use the term continence pads and describe the impact of the client’s incontinence on their function. Special needs – we need to understand that some of our clients’ needs may be, but they need what we all need, which is to be able to carry out daily tasks to eat, to sleep, to live, to thrive, to engage in society. And finally, one on a more generic subject, which frustrates me daily - a hotel bedroom, a toilet, or a parking bay is not disabled, it is accessible. This is not a finite list and there should be a greater debate about what is acceptable, and a discussion with our clients on whether our use of words is acceptable to them, as ultimately the report is about them and their chosen goals.

DO WORDS MATTER?

During a recent conversation with a long-standing colleague, Dr Ruth Parker, we ended up discussing language used in reports, both verbal and written. We are both involved in reviewing documents daily or listening to colleagues’ feedback on their casework and are concerned about the use of certain words or phrases that can have a negative or condescending impact on our clients. Although we are often assessing and observing difficulties a person has, we should always phrase our reports more positively, expressing clearly what a client can do. For example: “Mrs Jones can independently walk around her home, but she needs a manual wheelchair for longer distances due to fatigue and poor balance, and is supported to use this by a family member or carer.” Or, for a child: “David can put his shoes on independently; he requires the assistance of a carer to tie his shoelaces.” I have highlighted some of the words and phrases that, in my opinion, we should not be using in either verbal or written reports. Nice, charming, good, lovely – these are subjective descriptions of a person and add nothing to a clinical report or give its reader clear information on a person. One person’s “lovely” person could be “grumpy” to another, it is therefore a meaningless descriptor. Fits – people have seizures. These need to be documented by how the

...someone is not defined by their medical diagnosis and should never be referred to by it