The lived experience of disability

In this paper I reflect upon my personal experience of chronic progressive multiple sclerosis in order to provide a phenomenological account of the human experience of disability. In particular, I argue that the phenomenological notion of lived body provides important insights into the profound disruptions of space and time that are an integral element of changed physical capacities such as loss of mobility. In addition, phenomenology discloses the emotional dimension of physical disorder. The lived body disruption engendered by loss of mobility includes a change in the character of surrounding space, an alteration in one's taken-for-granted awareness of (and interaction with) objects, the disruption of corporeal identity, a disturbance in one's relations with others, and a change in the character of temporal experience. The loss of upright posture is of particular significance since it not only concretely diminishes autonomy but affects the way one is treated by others. Such a change in posture is, therefore, particularly disruptive in the social world of everyday life. An understanding of the lived body disruption engendered by disability has important applications for the clinical context in devising effective therapies, as well as for the social arena in determining how best to resolve the various challenges posed by chronic disabling disorders.I should like to thank Frances Chaput Waksler for her helpful comments on my work.     

Social approval and helping

An experiment was conducted to examine the role played by social approval as an incentive for helping behavior. After filling out the Marlowe-Crowne Social Desirability Scale, 95 female undergraduates were asked to make donations to a research fund under either public or private conditions. The following predictions, derived from social learning theory, were supported: (a) more money is donated under public conditions than under private conditions (p < .01), (b) more money is donated by individuals high in need for approval than those low in need for approval (p < .05), and (c) the effect of need for approval on donating is greater under public conditions than under private conditions (p < .05).     

Learning of a serial task by different age groups

In a serial learning task given to subjects whose ages ranged from twenty to seventy, a decline in performance showed itself as a loss of speed in the thirties, a loss of accuracy in the forties, and a marked loss of both speed and accuracy in the fifties and sixties. Experiments on recall and reorganization of material verified that older subjects were forgetting more quickly than younger, but that one of their main difficulties was an inability to substitute new reponses in an already mentally formed sequence.

Older subjects were not introducing new learning features but accentuating normal tendencies, such as the repetition of the same error at the same serial position. In so far as subjects learned their repeated errors, final learning involved unlearning, with the often observable phenomenon of the previously learned error serving as the cue for the more recently learned correct response. In terms of schematic concepts of mental functions, serial learning difficulty was not so much the formation of a general “scheme” but its subsequent amendment. Preformed habits influenced both the learning procedure and its results, particularly in the constraints and expectancies which the making of one serial response had upon another.     

Reduction of caregiver burden in Alzheimer's disease by treatment with galantamine

Alzheimer's disease is a progressive condition characterized by a loss of cognition, altered behavior, and a loss of functional ability, such as bathing, dressing, toileting, and organizing finances. Family and friends provide nearly three quarters of all care for patients with Alzheimer's disease. This informal care results in significant burden to caregivers. Caregiver burden is the set of physical, psychological or emotional, social, and financial problems that family members may experience when caring for impaired older adults. Caregivers of Alzheimer's disease patients report higher rates of physical symptoms, mortality, depression, and fatigue, as well as adverse effects on employment compared with those who are not caregivers for Alzheimer's disease patients. In many cases, the same family members are responsible for both out-of-pocket expenditures and caregiving duties. For this article, a MEDLINE search using the key words "caregiver and Alzheimer's disease" and "cost and Alzheimer's disease" was performed. The purpose of this article is to review the literature on caregiver burden, the components of caregiver burden, effects of caregiving on the health of caregivers, the cost of Alzheimer's disease on the caregiver and society, and the benefits attainable with treatment.