Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T21:28:25.440Z Has data issue: false hasContentIssue false
  • English
  • Français

The Lived Experience of Interdependence: Support Worker Relationships and Implications for Wider Rehabilitation

Published online by Cambridge University Press:  15 November 2021

John A. Bourke Open the ORCID record for John A. Bourke [Opens in a new window]
John A. Bourke*
Affiliation:
Burwood Academy Trust, Christchurch, New Zealand Menzies Health Institute, Griffith University, Southport, Queensland, Australia Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
*
Email: johnny.bourke@burwood.org.nz
Get access

Abstract

Engaging in a meaningful life where one can exercise autonomy has been proposed as a key aim of rehabilitation. Influenced by a neoliberal worldview, this has traditionally been characterised by a pursuit towards individual functional independence in which one completes tasks and activities unassisted. However for many persons, individual functional independence may not be a realistic, prioritised or beneficial goal. Many individuals must learn to work with support workers to exercise choice and control. Such relationships extend beyond a transactional nature and involve many subtle characteristics. In this article, I draw on my lived experience of partnering with support workers to illustrate the complexity of such relationships and how they can enable interdependence to serve as a vehicle to self-determination. I finish with some ideas about what rehabilitation can do to recognise the important role human connections play in facilitating interdependence. Understanding the nature of these relationships is necessary to provide services which value interdependence, supporting people to pursue a meaningful life following impairment.

Keywords

Interdependencelived experiencesupport worker relationshipsautonomyrehabilitation
Type
Clinical Practice: Current Opinion
Information
Brain Impairment , Volume 23 , Special Issue 1: Humanising Connections: Bringing people together in rehabilitation , March 2022 , pp. 118 - 124
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ballan, M. S., & Freyer, M. (2021). Addressing intimate partner violence with female patients with chronic physical disabilities: The role of physical therapists. Disability and Rehabilitation, 43(10), 1404–1409. doi: 10.1080/09638288.2019.1664648 CrossRefGoogle ScholarPubMed
Bourke, J. A., Nunnerley, J. L., Sullivan, M., & Derrett, S. (2019). Relationships and the transition from spinal units to community for people with a first spinal cord injury: A new zealand qualitative study. Disability and Health Journal, 12(2), 257–262. doi: 10.1016/j.dhjo.2018.09.001, doi:https://doi.org/10.1016/j.dhjo.2018.09.001 CrossRefGoogle ScholarPubMed
Cardol, M., De Jong, B. A., & Ward, C. D. (2002). On autonomy and participation in rehabilitation. Disability and Rehabilitation, 24(18), 970–974. doi: 10.1080/09638280210151996 CrossRefGoogle ScholarPubMed
Clapton, J., & Kendall, E. (2002). Autonomy and participation in rehabilitation: Time for a new paradigm? Disability and Rehabilitation, 24(18), 987–991. doi: 10.1080/09638280210152058 CrossRefGoogle Scholar
Davy, L. (2019). Between an ethic of care and an ethic of autonomy: Negotiating relational autonomy, disability, and dependency. Angelaki: Journal of the Theoretical Humanities, 24(3), 101–114.CrossRefGoogle Scholar
Dickson, A., O’Brian, G., Ward, C., Allan, D., & O’Carroll, R. (2010). The impact of assuming the primary caregiver role following traumatic spinal cord injury: An interpretative phenomenological analysis of the spouse’s experience. Psychology and Health, 25(9), 1101–1120.CrossRefGoogle Scholar
Dickson, A., O’Brian, G., Ward, R., Flowers, P., Allan, D., & O’Carroll, R. (2011). Adjustment and coping in spousal caregivegivers following a traumatic spinal cord injury: An interpretative phenomenological analysis. Journal of Health Psychology, 17(2), 247–257.10.1177/1359105311411115CrossRefGoogle ScholarPubMed
Dove, E. S., Kelly, S. E., Lucivero, F., Machirori, M., Dheensa, S., & Prainsack, B. (2017). Beyond individualism: Is there a place for relational autonomy in clinical practice and research? Clinical Ethics, 12(3), 150–165. doi: 10.1177/1477750917704156 CrossRefGoogle Scholar
Finkelstein, A., & Marcus, E. (2018). Realizing autonomy: The phenomenology of independence and interdependence while living with duchenne muscular dystrophy. Disability & Society, 33(3), 433–453. doi: 10.1080/09687599.2018.1427049 CrossRefGoogle Scholar
Gibson, B. E. (2014). Parallels and problems of normalization in rehabilitation and universal design: Enabling connectivities. Disability and Rehabilitation, 36(16), 1328–1333. doi: 10.3109/09638288.2014.891661 CrossRefGoogle ScholarPubMed
Hammell, K. W. (2006). Perspectives on disability and rehabilitation. Contesting assumptions; challenging practice. Edinburgh: Churchill Livingstone.Google Scholar
Hunt, M. R., & Ells, C. (2011). Partners towards autonomy: Risky choices and relational autonomy in rehabilitation care. Disability and Rehabilitation, 33(11), 961–967. doi: 10.3109/09638288.2010.515703 CrossRefGoogle ScholarPubMed
Leplège, A., Barral, C., & McPherson, K. (2015). Conceptualising disability to inform rehabilitation: Historical and epistemological perspectives. In McPherson, K., Gibson, B. & Leplège, A. (Eds.), Rethinking rehabilitation: Theory & practice. Boca Raton: CRC Press, Taylor & Francis Group.Google Scholar
Leplège, A., Gzil, F., Cammelli, M., Lefeve, C., Pachoud, B., & Ville, I. (2007). Person-centeredness: Conceptual and historical perspectives. Disability and Rehabilitation, 29(20-21), 1555–1565.CrossRefGoogle Scholar
Malihi, Z. A., Fanslow, J. L., Hashemi, L., Gulliver, P. J., & McIntosh, T. K. D. (2021). Prevalence of nonpartner physical and sexual violence against people with disabilities. American Journal of Preventive Medicine, 61(3), 329–337. doi: 10.1016/j.amepre.2021.03.016 CrossRefGoogle ScholarPubMed
McClure, J., & Leah, C. (2020). Is independence enough? Rehabilitation should include autonomy and social engagement to achieve quality of life. Clinical Rehabilitation, 35(1), 3–12. doi: 10.1177/0269215520954344 CrossRefGoogle ScholarPubMed
McKinney, E. L. (2018). Two’s company, three’s a crowd: Disabled people, their carers and their partners. Disability & Society, 33(2), 272–284. doi: 10.1080/09687599.2017.1399106 CrossRefGoogle Scholar
McPherson, K., Gibson, B., & Leplège, A. (2015). Rethinking rehabilitation: Theory, practice, history - and the future. In McPherson, K., Gibson, B. & Leplège, A. (Eds.), Rethinking rehabilitation: Theory & practice. Boca Raton, FL: CRC Press, Taylor & Francis Group.CrossRefGoogle Scholar
Reindal, S. M. (1999). Independence, dependence, interdependence: Some reflections on the subject and personal autonomy. Disability & Society, 14(3), 353–367. doi: 10.1080/09687599926190 CrossRefGoogle Scholar
Trajkovski, S., Schmied, V., Vickers, M., & Jackson, D. (2013). Using appreciative inquiry to transform health care. Contemporary Nurse, 45(1), 95–100. doi: 10.5172/conu.2013.45.1.95 CrossRefGoogle ScholarPubMed