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using this information create powerpoint slides. Summary table: (Sample Critical reflection) Introduction Significant systemic shortcomings in Australia’s disability support services have been brought to light by the tragic death of Kyah Lucas, a young Indigenous woman with numerous disabilities who was receiving care from LiveBetter, a provider under the National Disability Insurance Scheme (NDIS). The organization committed a criminal breach of duty of care in February 2022 when poorly educated LiveBetter employees tragically burned Kyah during a bathing session. Significant problems with the medical and social treatment of individuals with disabilities, systemic ableism, occupational injustice, and the lack of person-centered care are brought to light by this case, which Andrew Hedgman extensively covered in 2025. In this reflection, I critically examine this situation through four key disability theories models of disability, ableism, occupational injustice, and person-centred care and discuss how these insights will influence my future occupational therapy practice. (1) Models of Disability: Medical vs Social The contrasting medical and social models of disability provide crucial frameworks for understanding the failures that contributed to Kyah Lucas’s death. The medical model traditionally locates disability within the individual, framing it as a problem to be fixed or managed through medical or therapeutic intervention. LiveBetter’s approach appears to have been dominated by this model, as it focused on addressing Kyah’s disabilities in a narrow, clinical sense without adequately addressing environmental or systemic factors. Their failure to conduct formal risk assessments or implement safety checks such as temperature audits reflects a clinical focus that neglected the broader context of Kyah’s lived experience. The social model of disability, on the other hand, places more emphasis on how institutional, social, and environmental impediments handicap people than only their physical limitations. The tragic injury was directly caused by a number of glaring social and institutional hurdles, including inadequate staff training, a lack of organizational control, and a failure to provide safe bathing conditions. This approach emphasizes that Kyah’s death was caused by debilitating circumstances and careless systems rather than just an unlucky accident. Adopting the social model in disability services necessitates proactively removing obstacles and modifying settings to promote safety and participation. The risks of disregarding this viewpoint are glaringly demonstrated by the LiveBetter instance. By critically reflecting through the social model, occupational therapists can better understand that disability arises from the interaction between a person and an unaccommodating environment. This insight underscores the importance of designing supports that address environmental factors and prevent harm, not just treat impairments. (2) Systemic Ableism The systemic neglect and poor practices that led to Kyah Lucas’s death reflect pervasive ableism within disability services. Ableism, as a form of systemic discrimination, devalues people with disabilities and normalizes practices and structures that marginalize them. In this case, ableism manifested in multiple ways: the organization’s failure to implement basic safety measures like temperature checks, the reliance on minimal staff training through online quizzes rather than comprehensive hands-on education, and the overall organizational culture that allowed such neglect to occur. This ableist system not only undermined Kyah’s right to safe and dignified care but also perpetuated a broader societal attitude that disabled lives are less valued or deserving of rigorous protection. The fact that LiveBetter had provided services to Kyah for over a decade yet did not properly assess her risks or adapt their practices accordingly reveals an institutional disregard for her well-being. Ableism, therefore, is not just attitudinal but embedded in organizational policies and training practices. For occupational therapists, understanding ableism is critical to identifying and challenging discriminatory practices within health and social care systems. It calls for advocacy to dismantle ableist norms, promote equity, and ensure that disabled people receive care that respects their humanity and complexity. (3) Occupational Injustice: Occupational Marginalisation Kyah’s death also highlights the concept of occupational injustice, specifically occupational marginalisation. Occupational marginalisation occurs when people are excluded or restricted from meaningful participation in daily activities due to structural or systemic barriers. Bathing, an essential daily occupation, was the setting of the fatal injury. Rather than being supported to engage in this occupation safely, Kyah was exposed to a hazardous environment caused by organizational failure. This situation represents a grave occupational injustice: not only was Kyah denied safe participation in a fundamental activity, but the service meant to support her actively endangered her life. The lack of proper risk assessment, inadequate training of support workers, and absence of effective safety protocols marginalized Kyah’s occupation to the point of fatal harm. This case emphasizes the responsibility of occupational therapists to advocate for environments and services that promote safe, meaningful engagement in occupations. It also stresses the importance of recognizing how systemic neglect can manifest as occupational marginalisation, stripping individuals of dignity and wellbeing. (4) Person-Centred Care and Facilitating Participation The tragedy profoundly reflects a failure of person-centered care, a foundational principle in occupational therapy and disability support. Person-centered care involves tailoring services to the unique preferences, needs, and safety of the individual, ensuring their active participation and respecting their autonomy. Kyah’s profound intellectual disabilities, inability to communicate verbally, and difficulty regulating body temperature necessitated individualized, cautious care and vigilant safety measures. LiveBetter’s failure to conduct a formal risk assessment of her home and bathing routines, inadequate staff training, and poor incident response reveal a system that was not attuned to Kyah’s specific needs. True person-centered care would have involved comprehensive risk assessments, customized care plans addressing Kyah’s vulnerabilities, and a safety-first approach in training and supervision. Instead, LiveBetter’s generic, insufficient procedures showed a lack of respect for Kyah’s individuality and dignity. For occupational therapists, this case reinforces the imperative to embed person-centeredness in all aspects of care, from assessment to intervention and risk management. It stresses the need for advocacy to ensure organizations prioritize individualized, safe, and dignified care for people with disabilities.
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