These labels can be very confusing if you are not familiar with the jargon of disability world. They are not only quite different but are not treated equal under the law. The definition of service animal was changed July 23, 2010 defining only dogs and miniature horses as a category for service animals. People are always surprised to see that miniature horses were approved as a service animal. While not common, they have earned a reputation as an alternative to traditional service dogs. They can be house broken, a requirement for service animals under the ADA and their life span of 30 years is a much longer working life span than dogs. Typically, people using dogs as service animals must find a new dog every 10 years as their service dog ages. For many reasons this can become an emotional trying experience. The miniature horse must be a docile, intelligent temperament even in the hectic urban environments just like the dogs are expected to be.
To be considered a service dog they are required to perform a “task” to qualify such as fetching a cell phone, opening or closing doors, taking garbage out, pull a wheel chair up an incline, etc. The task performed is based on the individual needs but they must perform one to qualify as a service dog.
Emotional support dogs assist people with mental impairments. They are not protected under the Americans with Disabilities Act. Needing glasses would be an impairment not able to see it all is the disability. This distinction is why a person using an emotional service dog is not protected under the ADA since the most important criteria is that the person has to have a disability according to the ADA definitions. However, there are provisions under the Fair Housing Act that allows them in HUD housing if proper paperwork is filed.
Psychiatric service dogs on the other hand can be taught to do tasks similar to mobility service dogs. Examples would be retrieving things dropped because on certain medication bending over would cause dizziness to the person, reminding or redirecting people with OCD to stop behaviors, alerting to smoke alarms, door bells, tornado warnings. They are a huge help for social phobias and much more so you can see how psychiatric service dogs would qualify because of the “task” they perform and the person’s status of disabled.
To clarify there is NO certification required by law. There are many organizations that are very good at training service dogs to accomplish tasks but it is not required. However keep in mind a service dog must act like a service dog. They should be socially trained to not only perform tasks but know their place in all situations so that’s the great benefit of the organization that knows their stuff and can instill that training in the service dog. An average training process for these dogs is typically 18 to 24 months, a huge investment of time and money.
If a service dog is not socially trained and barks and bites or growls or disturbs other people the business you are visiting can ask you to leave and not bring your dog in again and it would b their complete right to do so. These service animals’ open doors of freedom for people with disabilities that were once closed. They fill many roles such as companion, helper and unconditional love but they are also a tool when working and must follow regulations in order to have access to all the places a person wants to go. For more information visit the website http://www.swcil.org a nonprofit Center for Independent living and request an advocate to assist you with the current laws and compliance in your state. .
To start off the beginning of this year I wanted to share my favorite poem from Carl Sandberg. Poetry is a personal contact with its author. When you read poetry you are taking the same breath, the same rhythm as the creator that wrote it. In this particular piece it is not only inspirational but if understood deeply, also ethereal. May this new year bring many soft and velvet days of introspection.
And it won’t help any, it won’t get us anywhere
it won’t wipe away what has been
nor hold off what is to be
if you hear me saying
love is a little white bird
and the flight of it so fast
you can’t see it
and you know it’s there
only by the faint whirr of its wings
and a hush song coming so low to your ears
you fear it might be silence
and you listen keen and you listen long
and you know it’s more than silence
for you get the hush song so lovely
it hurts and it cuts into your heart
and what you want is to give more than you get
and you’d like to write it but it can’t be written
and you’d like to sing it but you don’t dare try
because the little white bird sings it better than you can
so you listen and while you listen you pray
and one day it’s as though a great slow wind
had washed you clean and strong inside and out
and the little white bird’s hush song
is telling you nothing can harm you,
the days to come can weave in and weave out
and spin their fabrics and designs for you
and nothing can harm you–
unless you change yourself into a thing of harm
nothing can harm you.
I give you the little white bird–
and my thanks for you hearing me–
and my prayers for you, my deep silent prayers.
“little word, little white bird”
I love to cook! But, I have difficulty keeping my balance because of neurological damage. It especially bothers me if I try to bend down to look into cabinets or do too much walking back and forth in the kitchen. So, I adapted my kitchen area to accommodate my limitations. I wanted to share some ideas that have worked very well for me. These changes would actually work well for anyone.
- Add A Pantry
I bought these outdoor units from Walmart. They are intended for garage storage but they work perfectly in my kitchen. I relocated my pots, pans, baking sheets, etc. so that I did not have to stoop to the lower dark cabinets and dig these items out. They are neutral in color so they went with all of my decor. I actually bought three because I have one for baking and cooking supplies another for my pots and pans and one for food storage. They were around $77 each. I just bought one at a time.
- Add a small 4 drawer chest
I bought this same style and color in a four drawer chest to house my big utensils, foil, zip lock bags, plastic storage containers and other attachments I don’t use every day. Also found at Walmart for $59. Although my kitchen has a good amount of floor space it only had two small drawers for utensils and the drawers would stick. This little chest has drawers that slide out very smoothly and the drawers are very deep.
- Add a crate under your sink
I have a milk crate under my sink with all the cleaning supplies I use in the kitchen. I can easily slide it out to get what I want without getting on my hands and knees to find something in that dark space.
- Refrigerator organization
I organize my refrigerator so that breakfast things are together, left overs are on their own shelf and heavy milk and juice containers are on the top shelf. This keeps me from stooping and pushing things around to find the butter hiding behind a big leftover dish that has to be moved out first before I can find it.
- Utility cart
The utility cart can hold my heavy appliances like the KitchenAid mixer, the bread machine and food processor. Not only does it open up counter space but keeps me from lifting items that are too heavy. All I have to do is roll it over to the outlets and I’m in business. I found this one at Lowe’s.
- An office chair
I use an inexpensive armless office chair and wheel around to gather ingredients for recipes. It works great for going from pantry to refrigerator to the working areas. It also works great for cleaning out those low refrigerator shelves and for cleaning the oven.
- The garbage bowl
I learned this little trick from watching “30 Minute Meals”’ on the Food Network channel. Using a garbage bowl sounds trivial but believe me saving your time and energy walking back and forth to the garbage 20 times during meal prep is well worth the effort!
- A good spice rack
I bought a spice rack that fits flush against the wall and sits on my counter. It saves reaching and looking for spices I use the most and it keeps things in order. There’s nothing worse than trying to find a certain spice in a cupboard full of 50 or more that have fallen over or rolled to the back of a cabinet you can barely reach.
- And finally the two things I could not live without
I could not function at all without my two sets of cheap kitchen scissors. I use them to open up packages boxes snack bags you name it. They are my extra set of hands. The second thing is the simple wooden clothespin. I use these to fasten snack bags, bread, brown sugar bags and anything else that needs a closure. They are cheap and easy to use and not near as frustrating as those little twist ties.
Diagnosis and prognosis are very different concepts based on different criteria. Diagnosis refers to identifying the nature or cause of the condition. Prognosis refers to the future of the condition based on previous case histories. People very often get these terms confused and link them together as a predetermined outcome of their injury or their illness. In other words, the prognosis is the likelihood of the person’s future with their condition based on other cases. It is a subjective not an objective conclusion but remember there are no two humans exactly alike physically, mentally, with beliefs or inner strength and ability. So really, how much credibility does that really give a prognosis?
In my long career as a disability advocate I’ve seen hundreds of people come for help as victims and helplessness because some doctor told them that they would never be able to do this or that and their future would be pretty bleak. Negative prognosis is more dangerous than the diagnosis itself because it fosters an attitude of giving up and giving in.
Why do doctors continue to make these negative diagnosis? I think there are two main reasons. One is that they are trained to look at facts based on previous outcomes and not to give patients “false hope” (how I hate those two words). Another reason is they are medically and scientifically trained and are not invested in transitioning their patients into the world after the hospital or diagnosis. In summary, they do not know the almost unlimited options living with disability.
They rely on a rehabilitation facility to do that but the rehabilitation staff is bound by doctor’s orders and his prognosis. Our whole medical system is based on specialists who are all under the control of the doctors. But guess who has the control over the doctors? You and only you. That’s right, you have the last say, you decide your own prognosis. You empower yourself by digging out the options, learning what is possible. You are a unique human with your own brand of determination and courage. Only you know what you’re capable of. Don’t let the medical field take away your self-determination by telling you what you can’t do.
The life journey is not about the destination but the process of every day and how you live that process is totally up to you. If you or someone you know needs a peer support or options in technology or just a place you can see people who have beat the odds and are living life on their own terms take a look at the website www.swcil.org it could possibly change your life. There is also a blog where you can ask questions and find resources.
The doctor’s role as an authority figure is very much deeply ingrained in the American culture. In addition, no one wants to be perceived as a difficult patient. It’s fine to follow your doctor’s orders if it is based on shared medical decision-making. However, when you’re in a room with a paper on the exam table crinkling under your bare bottom you may not feel so empowered. That being said, you cannot afford to be intimidated by your doctor and be a passive bystander. You need to keep focused on what is being ordered for tests and medications. Do not make rash decisions at that moment but rather go home and research it and look at other options if they are available. I would disregard those doctors who tell you everything on the Internet is incorrect. You must be careful when researching of course but there are very reliable nonprofit organizations that provide sound guidance like the Mayo Clinic and the Cleveland clinic. Dig for the facts and not someone’s recommendations because they had a similar medication or similar test. Ask a lot of questions, make sure you know the tests are justifiable and medications are not in conflict with what you are ready taking or the side effects that could be dangerous to your particular condition. We would not dream of buying a weed-eater let alone a car on someone’s recommendation without looking at facts and figures and comparisons first.
Be careful and be precise when you explain a symptom to your doctor. Many unnecessary x-rays, MRIs, and other procedures are commonly ordered because doctors do not want to be sued for not screening properly, for instance, if the patient has a heart attack or some other unknown known event after the appointment. Doctors are often paid a fee for these procedures and have a “better safe than sorry” justification. The same goes for referrals to specialists. They are invaluable in diagnosing a problem but need to be terminated when their expertise is no longer needed and a primary care physician can take over.
Make sure your communication is open with your doctor.
- Ask questions such as “what does that mean”? Most doctors just assume that you understand their medical terminology that they use every day. They are under incredible time pressure and if you do not bring a list of complaints to them you will probably get rushed out before you have all of your answers and concerns addressed.
- Don’t be afraid to tell your doctor that you’ve considered other hypotheses about your health based on your own observations.
- Avoid “on the way out the door” complaints. Those are things you suddenly remember like “oh and by the way I’m having pain in my back or trouble swallowing”. At that point the doctor can’t really do anything so they tell you to make another appointment or go to the emergency room. By then your 15 minute allotted appointment is up.
- Be honest when talking to your doctor about your out-of-pocket costs. Most people are shy about bringing up financial concerns even thinking they might get substandard care if they mention money is an object. But the fact is that in almost all cases physicians have good options available. They may know about free prescription drug samples or programs from the pharmaceutical companies that could pay for your medications.
Putting these suggestions in place may be difficult at first but it will empower you as a patient. After all it is your body and your life. Too many times miscommunication or lack of communication between patient and doctor ends up with serious consequences. There are no old-time general doctors anymore that know your family and have the time to sit down and have a conversation with you. The old practice of physicians using critical questioning to get a better knowledge of what’s really going on with the patient has been replaced by scheduling as many patients in 15 min. increments as possible. Never forget the medical field is a huge business and as such you are the customer. You are the profit and the loss on their financial sheet but that also gives you enormous power because without your insurance and money they would not exist as the huge corporation that they are. You are the customer, you are the product and you have a right to accept or decline medications, tests or procedures. If you have a doctor that is very uncomfortable with that you need to look around and find a doctor that became one for the right reason.
Have a relationship with a rich man
But don’t stay until you get hard
Have a relationship with a poor man
But don’t stay until you are soft
Don’t misunderstand love as weakness
Don’t misunderstand weakness as love
Honor your dreams regardless of
What people say
Don’t crush another’s dreams for
The sake of reality
Never take hope away from another
It may be all they have
Never hope more than you are
Willing to work
Remember the Cheetah that lives in your heart
But know that it is there only to save you
Remember the Dove that lives in your Soul
But know it will not protect you