For a few people, erb’s palsy and the restricted use of one upper limb will remain a lifetime disability. Here we look at the reality of living with erb’s palsy and what restrictions it places on day-to-day life, including bringing up your own children and achieving equal access to work.
What are the day-to-day restrictions of living with erb’s palsy?
The restrictions on daily activities for an adult or child with Erb’s palsy depend upon the extent of the nerve injury and whether or not the affected limb is their dominant arm.
It may be easier for people with mild Erb’s palsy to develop ways to bathe, dress and prepare meals without much difficulty. But having more severe Erb’s palsy can significantly impair day-to-day activities, such as:
- Washing hair
- Preparing meals
- Sport and hobbies.
Many of our clients are disabled to the extent that they require assistance to get dressed, particularly as children. As adults they may have adopted techniques enabling them to dress using only one arm, or acquired clothing that’s easy to pull on and off.
Washing and drying hair can also prove difficult and tiring, particularly for women and girls with longer hair. Most women complain that they are unable to style their own hair because they cannot hold a hairbrush and hairdryer at the same time.
Preparing meals can be difficult for people with erb’s palsy, as most food preparation requires the use of two hands. For example:
- Opening tins and packages
- Holding and cutting food
- Lifting heavy, hot trays out of the oven.
Driving a vehicle would be impossible without either using an automatic car or fitting adaptations to the car e.g. gear controls on the steering wheel or a specialist wheel that can be moved with only one limb.
For many people with erb’s palsy, access to sport is difficult. This can be especially upsetting for children who might feel left out during school sports, particularly sports that require the use of upper limbs such as basketball and netball. Riding a bike is also difficult with one arm.
All schools should be able to include children with disabilities in their sporting activities and encourage everyone’s participation in team sports.
All mainstream schools and colleges will have special educational needs coordinators (SENCOS) and equality coordinators who can help to secure the services and additional help your child needs, even if they are not assessed as having special educational needs.
How can occupational therapists and physiotherapists help?
Occupational therapists give practical help and advice on carrying out everyday tasks that people with Erb’s palsy might struggle with. The aim is to ensure as much independence as possible whether at home or in the community.
For example, an occupational therapist can examine your home and routines, and advise on adaptations and equipment that might help in the kitchen or bathroom. They will also teach special techniques that can improve your performance of everyday tasks, especially self-care tasks such as eating, washing and dressing.
Therapists can also help in work or school settings by suggesting improvements to aid access and inclusion, including access to sports and aids for typing etc.
This help is vital for your – or your child’s – sense of belonging, independence and self-esteem.
Can erb’s palsy impact on employment?
It is a sad reality that people with significant physical disability, like moderate or severe Erb’s palsy, are excluded from applying for some of the more physically demanding roles within the police force, emergency services or armed forces. There are also some civilian roles that cannot be performed adequately with an upper limb disability, including nursing, dentistry and manual labouring.
Many more jobs are, of course, possible with the right support from employers. Any office job, for example, would require your employer to undertake a careful ergonomic assessment of the desk and work area, and supply any special equipment required to assist with typing and using the phone etc.
Support in work
Employers are encouraged by the Government to ensure equal access to work and to support disabled job applicants and employees.
Under the Equality Act 2010, employers have a duty to ensure disabled people can overcome any substantial disadvantages they may have by making ‘reasonable adjustments’ to working conditions. If you feel that reasonable adjustments have not been made, then you have a right to take your employer to an employment tribunal.
You may be eligible for the Government’s Access to Work programme to help pay for the cost of support at work. This could include special aids and equipment, office adaptations and support workers. If you are eligible, the department will approach both you and your employer for more information.
You can find out more about the ‘reasonable adjustments’ that employers have a duty to make, and the Access to Work programme at the Department for Work and Pensions website (Work and disabled people).
A specialist citizens’ advice bureau, job centre or employment solicitor can provide you with more detailed advice and assistance.
Does erb’s palsy impact on caring for children?
Anyone who has cared for a child will appreciate what a physically demanding task it is. People with Erb’s palsy will find it even more difficult given the limited use of arm, especially as the child grows.
Women with Erb’s palsy who wish to breastfeed might struggle because they cannot hold the baby to the breast easily (or at all) with their disabled arm. They might also find it difficult to help the baby to latch on. This means that they’ll require assistance to feed their baby, at least until feeding is well established.
Carrying children with the remaining ‘good’ arm can strain one side of the body, causing neck and back problems. Many of our clients feel restricted in the amount of time they can carry their child before it causes pain and discomfort.
Treatment from an osteopath or chiropractor can help ease strains, and a physiotherapist and/or occupational therapist can advise you on techniques for lifting and carrying, as well as exercises to prevent injury.
Toddlers are well known for pushing boundaries and exploring. While manageable within the home, it can prove a real problem if the parent has difficulty in physically restraining or controlling their child in a wider environment. Many people with erb’s palsy report that they need help when out and about. For these reasons, we frequently allow for the costs of additional professional childcare when pursuing a claim for erb’s palsy.