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• Screening tests and vaccines

Medical care and rehabilitation

• Tips for getting the best possible health care
• Rehabilitation and types of therapy
• Choosing a rehabilitation program
• Clinical trials
• More information on medical care and rehabilitation

Women with disabilities have many of the same health concerns and needs as all women — such as needing routine Pap tests or treatment for the flu or an infection. They also might have special health concerns related to their disabilities or illnesses.

Yet people with disabilities often face barriers to receiving good overall health care. Part of the problem is that some doctors have had limited experience treating patients with disabilities, both during their medical training and in their practice. As a result, a doctor might focus on the patient's disability rather than on the health problem that brought the patient to the doctor in the first place. The doctor also might not know to check for health conditions that are more common among people with disabilities, such as depression or pressure sores.

Another issue is physical barriers at health care facilities. Although the Americans with Disabilities Act requires that all public buildings, including health care facilities, be accessible to people with disabilities, problems still remain. For instance, many doctors do not have exam tables that can be lowered for easy access by patients in wheelchairs. As a result, the doctor may do a pelvic exam on a woman while she is seated in her wheelchair. This set-up does not allow for a thorough exam. A health problem, such as a vaginal infection, is easy to overlook.

More and more, doctors and others who provide health care are becoming aware of the barriers faced by people with disabilities and are working to address them. But if you have a disability, you need to look out for yourself to ensure that you get the best possible health care. This is important for all people, but even more so for people with disabilities.

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Tips for getting the best possible health care

If you are disabled, you can take steps to be sure you are getting the best possible health care:

• Find out who the best doctors are in your area to meet your needs. When shopping around, call the doctor's offices to find out if the doctor has experience treating patients with similar issues.
• Check to be sure that you can physically get into your doctor's office. For instance, are there ramps for people who use wheelchairs?
• Check to be sure that the doctor has the staff and equipment you need.
• Know your body — how you feel when you're well and when you're not. This will help you to know when to see your doctor and how to describe any problems or concerns that you have. Don't assume that any new pain, fatigue, weakness, or other problems are part of your disability and normal.
• Think through your concerns before you visit your doctor. Make a list of topics you want to bring up.
• Ask for a long appointment so that you have enough time for an exam and to discuss all your concerns.
• Bring your health records with you.
• Talk openly with your doctor about your concerns.
• Show the doctor the most comfortable position for you during an exam.
• Tell your doctor about all the medicines you use, both prescription medicines and medicines that you can buy without a prescription. Don't forget to mention any vitamins or herbal supplements you use.
• Bring a family member or friend with you, if you're concerned you might not remember all your questions and all the answers.
• Get it in writing. Write down, or have someone write down for you, what the doctor says.
• Ask for help finding more information. Ask about books, brochures, or reliable websites on the Internet.
• If you feel that your doctor is not giving you the care that you need, find another doctor.

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Rehabilitation and types of therapy

Recovery from a serious injury or illness can take a lot of time. If you have been hurt or sick, you may need to regain your strength, relearn skills, or find new ways of doing things you did before. This process is called rehabilitation. Many types of therapies can be used in rehabilitation. These therapies can also be useful for people who are born with certain disabilities.

To start a rehabilitation program, your doctor will refer you to a rehabilitation center or to a specific type of therapist. Here are some types of therapies used in rehabilitation programs:

• Physical therapy
• Occupational therapy
• Speech-language therapy
• Vocational therapy
• Recreational therapy
• Psychological services

Physical therapy

Physical therapy aims to improve:

• Joint movements
• Muscle strength
• Coordination
• Balance
• Walking

A physical therapist may give you certain physical activities to do to improve your ability to move or to strengthen your muscles. For instance, the parallel bars can help if you are having problems keeping your balance or walking. You hold onto the bars as you relearn how to stand up straight or to walk. The physical therapist may also give you certain activities to do to help improve your overall physical fitness. Being physically fit is important for preventing diseases such as heart disease and osteoporosis.

Occupational therapy

An occupational therapist helps people do activities of daily living that are made difficult by a disorder or injury. These could be activities at home, on the job, or at school. They include activities such as dressing, feeding yourself, bathing, writing, using a computer mouse, paying attention, and remembering things. Occupational therapists also can help some children with autism learn how to interact with others.

First, an occupational therapist will evaluate how well you do something that you're having a problem with. Then he or she may suggest a different way of doing it. For instance, an occupational therapist may help a person with a paralyzed arm learn new ways to dress and fasten buttons. An occupational therapist also might recommend helpful devices. For instance, for a person with impaired hearing, the therapist might recommend a telephone that has a flashing light instead of a ring.

Speech-language therapy

The therapist who helps people with speech and language disorders is called a speech-language pathologist. A speech-language pathologist might:

• Help you learn how to say speech sounds correctly
• Help you overcome a stuttering problem
• Help you improve the quality of your voice
• Relearn how to use spoken and written language if you've lost this ability because of a stroke or other type of brain injury
• Help children with language disorders with skills such as grammar, vocabulary, conversation, and story-telling
• Recommend an alternative communication device for someone who cannot speak. One example is a speech generating device that "speaks" words that you type on a keyboard.

Vocational therapy

Vocational therapists help people with disabilities get jobs. They can help people with disabilities identify job strengths and develop résumés that highlight those strengths. They also can help in job searches and educate people with disabilities about their legal rights regarding employment.

Recreational therapy

Recreational therapists help people with disabilities use their free time to improve health, sense of self and body image, independence, and quality of life. For instance, children who are mildly impaired by cerebral palsy are sometimes taught to ride horses. Besides helping them learn to move better, the therapy often improves their mood and boosts self-esteem.

Psychological services

As part of your rehabilitation, you may see a psychotherapist, such as a counselor, clinical psychologist, or psychiatrist. A psychotherapist can help people with disabilities cope with depression and other emotional problems.

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Choosing a rehabilitation program

A rehabilitation program can be:

• A hospital dedicated to just rehabilitation
• A unit in a regular hospital
• In an outpatient clinic that is either part of a hospital or a separate business
• Part of a nursing home

Depending on your needs, you may also be able to get rehabilitation services at home. When choosing a rehabilitation program, find out about the quality of the program that you are considering. One way to do this is to check to see if the program is accredited. Accreditation is like a "seal of approval" given to hospitals and other health care facilities. Accredited programs meet high standards of excellence in service and quality. Two accrediting groups that look at how well rehabilitation programs perform are:

• The Joint Commission – Find a Joint Commission accredited program in your area.

• Commission on Accreditation of Rehabilitation Facilities (CARF) – Find a CARF-accredited rehabilitation program in your state.

Another way to judge the quality of a rehabilitation program is to contact the program and ask questions, including:

• Does the program provide rehabilitation services for a wide range of conditions (such as brain injury, multiple sclerosis, and hip replacement)? Or does it offer expert care for only one condition (such as spinal cord injury)? You may want to choose a program that specializes in the care that you need. If one is not available in your area, you might want to consider going to another area or state for rehabilitation.
• Does the program ask patients to fill out a satisfaction survey and to rate their care? If so, what are the results?
• What percentage of patients are able to return to their own homes after rehabilitation rather than to nursing homes? Are people who are able to return home functioning well enough on their own to not need help with daily living?

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Clinical trials

Clinical trials are studies aimed at finding ways to prevent or treat illness or disability.

If you have an illness or disability, you can help yourself and others by taking part in clinical trials. Find out more about clinical trials at http://www.clinicaltrials.gov.

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More information on medical care and rehabilitation

Explore other publications and websites

• Animal-Assisted Activities/Therapy 101 (Copyright © Delta Society) — This publication explains the different ways animals can be used in therapy, and also describes the difference between therapy animals and service animals.
  http://www.deltasociety.org/Page.aspx?pid=317
• Ask a Physical Therapist (Copyright © American Physical Therapy Association) — This website links to information about physical therapy and physical therapists from the American Physical Therapy Association.
  http://www.moveforwardpt.com/askpt/default.aspx
• Consumers Page (Copyright © American Occupational Therapy Association) — this web page links to information about occupational therapy for consumers from the American Occupational Therapy Association.
  http://www.aota.org/Consumers.aspx
• Health Insurance and Physical Therapy (Copyright © American Physical Therapy Association) — This website features links that help explain the complexities of health insurance and allow you to find the best care.
  http://www.moveforwardpt.com/Resources/Insurance.aspx
• Psychotherapy: Definition (Copyright © Mayo Foundation) — This publication describes psychotherapy, why it is used, how to prepare for it, and what to expect.
  http://www.mayoclinic.com/health/psychotherapy/MY00186
• Rehabilitation — This publication gives an overview of the many different types of rehabilitation. It also includes several links to helpful resources.
  http://www.nlm.nih.gov/medlineplus/rehabilitation.html
• Understanding Physical Therapy (Copyright © Easter Seals) — This fact sheet describes physical therapy, what it is used for, and how a physical therapist can help develop individualized treatment objectives that are realistic and consistent with the individual’s needs.
  http://www.easterseals.com/site/PageServer?pagename=ntl_understand_pt
• Vocational Rehabilitation Agencies (Copyright © Job Accommodation Network) — This site lists local vocational rehabilitation agencies, which provide a wealth of resources related to employment options for people with disabilities.
  http://askjan.org/cgi-win/TypeQuery.exe?902

Connect with other organizations

• American Academy of Physical Medicine and Rehabilitation
  http://www.aapmr.org/
• American Art Therapy Association, Inc.
  http://www.arttherapy.org/
• American Dance Therapy Association
  http://www.adta.org/
• American Music Therapy Association, Inc.
  http://www.musictherapy.org/
• American Occupational Therapy Association, Inc.
  http://www.aota.org/
• American Physical Therapy Association
  http://www.apta.org//AM/Template.cfm?Section=Home
• American Speech-Language-Hearing Association
  http://www.asha.org/default.htm
• Delta Society
  http://www.deltasociety.org/
• National Center for Medical Rehabilitation Research, NICHD, NIH, HHS
  http://www.nichd.nih.gov/about/org/ncmrr/
• National Rehabilitation Association
  http://www.nationalrehab.org/
• National Rehabilitation Information Center, NIDRR, ED
  http://www.naric.com/public

Content last updated September 22, 2009.

Resources last updated September 22, 2009.

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