When caring for someone with a physical disability, there may come a time when they develop another condition, through illness or injury. Whether they are related or two separate conditions, a second condition can lead to changes in their needs and make the caring role feel more complex. Whilst some secondary conditions simply cannot be prevented, there may be some things you can do to help reduce the risk or manage the impact should it arise.
Understanding the language
When thinking about managing the needs of someone with more than one diagnosis, it can be helpful to know the terminology which might be used to describe someone’s condition.
A primary condition is an illness or injury which directly affects aspects of a person’s health. In this context, the primary condition is likely to be the direct cause of an individual’s physical disability. Examples of primary conditions includes cerebral palsy and a spinal cord injury.
A secondary condition is an additional health issue or complication which arises as a result of a primary condition. They can be caused by the primary condition or indirectly related. Secondary conditions for someone with a physical disability can include pressure sores, urinary tract infections and muscle spasms due to limited mobility and osteoarthritis due to excessive wear and tear on the joints. Management of the primary condition can often help to manage the impact of the secondary condition.
Here we share some practical ideas to support you in managing a secondary condition or injury if you care for someone with a physical disability.
Understanding the change in their needs as a result of the secondary condition
An injury or secondary medical condition can lead to an increase or change in symptoms such as their pain levels or range of motion. An important first step for individuals experiencing this is to speak to their consultant, physiotherapist or a specialist to understand how to manage their symptoms most effectively. As a carer, you may be involved in encouraging them to access support and speaking to professionals about changes you have observed in their condition.
Understanding how a secondary condition can influence the caring role
As a carer for someone with a physical disability and secondary condition, you may be tasked with identifying how those changes affect a person’s care needs and coordinating their support network to ensure it continues to meet their needs. For example, if a secondary condition is causing increased pain or reduction in mobility, this can affect a person’s ability to complete day to day tasks and their level of independence. This may mean that the carer is required to take on additional tasks in order to meet the individual’s needs.
Planning ahead
Certain types of physical disabilities can come with an increased risk of a secondary condition. For example, individuals with a spinal cord injury or physical condition may be more likely to develop pressure sores if they are unable to stand or have limited mobility.
Planning ahead can help the individual to remain in good physical health for as long as possible and identify potential risks early. There are a range of ways an individual can plan ahead, many of which you may be involved in as a carer
If someone has a physical disability, they may have regular scheduled appointments with their doctors or a specialist. These checks can help to ensure that they are in the best physical health possible and that the symptoms of their physical condition are managed as best as they can be. As a carer, you may also go along to these appointments and speak to the professionals about any questions or concerns you have.
Whilst not all secondary conditions are preventable, there may be some things you can do as part of the caring role to reduce the risk or manage their impact. For example, maintaining a good hygiene routine for the person you care for can help to avoid infections. Other measures like a good diet, regular exercise and a skin care routine can all be useful too.
Falls can be particularly difficult to manage when supporting someone with a physical disability and unfortunately more likely. As a carer you may find that, as part of your caring role, you explore ways to reduce the risk of falls in the home including
- Installing or accessing equipment to help someone move around independently at home.
- Have a plan in place for if the individual falls onto the floor to minimise the amount of time they are on the ground.
- Undertake moving and handling training to help reduce the risk of falls whilst you are transferring them.
There may be some physical activities which an individual with a physical disability may not be able to do. That being said, being active with tasks and exercises they can do can help them to remain in the best physical condition possible which can help with their level of independence and physical resilience.
Staying active can also be hugely important when helping someone to look after their mental health and maintain the best quality of life possible. Encouraging the person you care for to engage in activities and hobbies they enjoy, maintain their independence and to connect with others outside the home will support them in feeling less isolated and more purposeful, boosting their self-esteem and general sense of wellbeing. You might also like our articles on Helping someone you care for to be independent and Supporting someone with a physical disability to get out and about.
As a carer, you may also be able to prevent secondary conditions from escalating or becoming unmanageable by identifying them early. For example, you may notice new symptoms or changes in their condition which indicate an infection or health concern. You may also notice a change in their behaviour or regular patterns which suggest that they may need to review their current treatment and medication to ensure the symptoms of their primary condition are well-managed. Their medical team will help you understand these factors, get clear on what to watch for and understand when it is the right time to seek extra help.
Development of a mental health condition or dependency
Sometimes, the impact of a physical disability can affect a person’s mental health and lead to the development of a mental health condition such as anxiety or depression. In more complex situations, individuals can also develop a dependency which they use a coping mechanism for the challenges they experience in their day to day lives. Everyone will experience this differently depending on the primary condition, its impact on their mental health, their life circumstances and the support they have available. This can make it a particularly difficult situation for carers to navigate but there is information and support available to help.
Firstly, whilst the primary physical condition resulted in the development of a mental health condition or dependency, the two are in fact separate. In some situations, having a physical condition and mental health condition is called a ‘Dual Diagnosis’ which means that the two conditions exist side by side.
This distinction is important in helping someone to get the support they need for both conditions. A useful first step is to speak to the health professionals supporting them with their primary condition to ensure that the impact of their mental wellbeing is not due to a physical cause or a side effect of medication. They can then refer the individual to a mental health or dependency specialist.
It can then be useful to speak to mental health and dependency specialists about how to support someone with this new emerging condition. Many organisations also have support for individuals, family members and friends who are affected by the condition including information, resources and access to peer support.