Experimentation and Planning in Community Care

The dominant ideology in services for people with learning disabilities is clearly normalisation, or social role valorisation, as it has recently been termed. The emphasis is on the role that a person has within society. However, in Western society, what seems to be valued is power, individualism, enterprise, wealth, beauty and so on. It is not yet clear how we will be able to help people with learning disabilities to achieve such valued social roles. An alternative may be to consider whether we can design communities which value co-operation, affection and interdependence (rather than independence) and I shall describe first a fictional community which has such ideals, and then a real (albeit small) community, in Mexico, where conditions are arranged such that these ideals may be realised. I will then go on to outline some aspects of the philosophy which underpins these communities and which might be relevant to designing co-operative communities. These include the importance of setting objectives; the valuing of human diversity; the importance of viewing a person as a function of her or his social relations; acknowledging the complexity of human behaviour; and the distinction between rule-governed and contingency-shaped behaviour.     

Independence: What It Means to Six Disabled People Living in the Community

The hypothesis in this study asserted that independence is an infinitely variable self concept, unique to the individual which concerns control and choice rather than any absolute measure of competence. The study involved interviewing six disabled people who had lived in institutional care for at least three years and had lived in the community for a minimum of one year. The comparative data between life in an institution and living in the community was explored in relation to the concept of independence. The interviewees were able to determine, quite precisely, what independence in the community meant to them. Independence involved choice, control and power in, and over, the management of their lives and the environment in which they lived.     

Disabled People and the Politics of Difference

Whilst the Disabled People's Movement has necessarily evolved from a consciousness of disability as central to its participants' identities, and a critique of disablism as endemic to institutional discrimination, academics and activists in various civil rights movements are increasingly perturbed by the personal and political dangers generated by an adherence to 'identity politics' simpliciter. The actual complexities of social life-in particular, the multiple dimensions of identities and the matrices of interlocking discriminationshave propelled us towards a politics of difference. Since a shift of premises and even paradigms is the prerequisite of such a politics, it will inevitably encounter resistance from some sections of our respective movements. This article addresses some aspects of this emerging politics of difference with reference to the self-organised groups in UNISON, the UK's public sector trade union, where the disabled members' group co-exists with groups for women, black people and lesbians and gay men, so that the politics of identity is always already entwined with the politics of difference. Three main themes are pursued-the attempts to transform occasional inter-group collaborations into sustainable inter-group coalitions; the mobilisation of differences across groups in the service of enhancing democracy within groups; and the struggles to accommodate to a burgeoning intra-group diversity.     

Managing Risk in Community Care of Older People: Perspectives from the Frontline

Abstract

Since the mid-1980s, Australian governments have focused on expanding community and home-based services for older people. This has led to increased levels of dependency, vulnerability, and complexity to be managed in the community. Consequently, aged care services have had to develop mechanisms for regulating and managing these increased risks, and risk management has become more central to the practices of professional workers in this field. This paper reports on some findings from a large-scale study that explores the way risk management policies have been translated into practice by community-based services in Victoria, Australia. Drawing on interviews with 18 frontline and management professionals employed in community aged care, we found that these workers were wrestling with a diverse and new range of institutional risks beyond those encountered in the actual delivery of frontline care. We found that these workers experienced “risk” in four different contexts, which often created demands for contradictory or conflicting responses. Here we examine these “contexts of risk practice”: professional workers' relationships with their clients, relationships with other service providers, the unregulated nature of the home as a work environment, and community expectations about the management of risk. Despite tensions that frequently arose, workers expressed strong professional commitments to their clients and were motivated to find positive resolutions amid competing interests. We conclude that tensions experienced by workers were embedded in the structural dimensions of institutional relationships and the systematic absence of shared understandings of “acceptable” risks in the community care of older people, rather than in the failure of professional agency.     

Medicine and the Aesthetic Invalidation of Disabled People

Contemporary disability discourse is marked by a struggle between medical and social meanings and models. The latter reflects the aspirations and youthful radicalism of the disability movement, while the former regards itself as the legitimate voice of truth in all matters associated with bodily function and process. This paper argues that the battle lines between these two camps need not be redrawn. Despite hints to the contrary, the proposed extension of the social model to accommodate a sociology of impairment does not involve a rapprochement with the medical model. On the contrary, a sociological account of impairment seeks to augment the armoury of the social model by developing one of its weaknesses, namely the cultural critique of medicine. This paper examines some of the ways in which medicine has been involved in the 'aesthetic invalidation' of disabled people and proposes that 'geneticization' is an important current contributor to this form of disability discrimination.     

Impact of the National Minimum Wage on Disabled People

The survey reported here found disparities in the impact of the introduction of the National Minimum Wage on disabled people. These were associated with age, gender, impairment and type of employment setting. The main determinant of whether individuals gained from the NMW was their status as claimants of welfare benefits. We also found evidence that paid hours had been reduced to implement the NMW with no net increase in earnings, possibly to enable people to retain benefits entitlements. We make recommendations about how the anomalies can be tackled. It may be unrealistic to expect the Act to have been implemented fully so soon after it became law and some of the anomalies found may eventually disappear. However, many of the inequalities uncovered by this survey are not addressed by the NMW, specifically those inequalities associated with impairment and gender.     

Official Development Assistance to Disabled People in Ghana

Research was conducted in Ghana to (1) determine the extent to which the 1994–95 Official Development Assistance (ODA) donors to Ghana subscribed to inclusionary disability policies or mandates, (2) determine the extent to which disabled people were included in their mainstream development activities, (3) estimate the proportion of Ghana's 1994–95 ODA that went to activities specifically intended to benefit disabled people, and (4) estimate the proportion of those activities that were designed to foster the inclusion and empowerment of disabled people. In 1994–95, only two of the 16 donors examined subscribed to disability policies or mandates, and none took affirmative steps to include disabled people in their mainstream programmes and projects. Only 0.1282% of the total ODA examined for the entire 2-year period went to disability related activities, of which only 44.12% went to inclusionary and empowering activities.     

Key Worker Services for Disabled Children: the Views of Parents

This study reports the findings from 68 interviews with parents of disabled children who are users of seven key worker schemes in England and Wales. The interviews which lasted for one hour each, were tape‐recorded, transcribed and analysed according to both a priori and emerging themes. The findings from this study have implications for policy and practice, for example, the necessity of protected time for key workers, the necessity of conveying clear information about the key worker's role, the importance of access to training and information for the key worker, the need for key workers to be proactive, and for their involvement in care plan and review meetings. Copyright © 2006 The Author(s). Journal compilation © 2006 National Children's Bureau     

A Question of Friendship: Community Care and the Relationships of People with Learning Difficulties

There is evidence that a number of people with learning difficulties living in the community do not enjoy a range of satisfactory social relationships. This paper will examine the way that the issue of the apparent loneliness of people with learning difficulties has been approached in the community care literature. I will argue that there is a clear assumption in much of the literature that friendships between disabled and non-disabled people are of greater value than those relationships between disabled people. The low value accorded to friendships between disabled people is very damaging to their individual self-esteem, as well as to the possibility of political action based on a sense of solidarity. The paper will point also to the constraints that many people with learning difficulties face which render it difficult for them to form friendships and, therefore, reinforce their isolation.     

Government Policies and Disabled People in American Indian Communities

Although services and resources for disabled people in the United States have improved greatly as a result of legislation and advocacy efforts, many of the disabled in American Indian communities have yet to benefit from these advances. Inaccessibility to services is often complicated by problems and debates over which agency, state or federal, is responsible or has jurisdiction to provide the services. Meanwhile, Indian communities struggle to accomplish what they can with limited resources.     

Disability, Dependency and the New Deal for Disabled People

The emergence of the 'New Deal' and its attendant claim to be part of a new political and social future based on the 'third way' seems to offer formerly excluded people new horizons for social inclusion. This paper provides a critical exploration of the likely impact of the 'New Deal' for disabled people. The paper contextualises the 'New Deal' in the wider ideology and rhetoric of 'Welfare to Work'. In doing so, it highlights similarities between 'New Deal', 'Welfare to Work' and the victim blaming ideas which characterised discussions of a growing 'social underclass' in the 1980s. By looking at the way the disability problem is framed within the 'New Deal' and 'Welfare to Work', it will be argued that it is unlikely to address the nature of employment barriers, indeed risks seriously misrepresenting the causes of disabled people's economic and social exclusion. In this way, its ideological underpinnings may simply reaffirm disabled people's economic and social dependency.     

Aging,Disability, and Disabled Older People in India

Summary

India is witnessing a demographic revolution, leading to a considerable increase in the proportion of older people in the population. Similarly, life expectancy of both the mentally and physically disabled has improved considerably. About 5% of Indian older people have problems with physical mobility. Aging has become a gender issue in India not only because more women are surviving into old age; they are also vulnerable and disadvantaged in many ways. In most cases they are the only caregivers available for the old and disabled. Older Indians are considered a high-risk group for multiple morbidity. It is estimated that nearly four million Indians suffer from mental problems. India has around 12 million people designated as “handicapped.” However, little information is available about disabled people who grow older. The National Policy on Older Persons, which has been recently formulated, aims at providing an improved quality of life for millions of older Indians. However, the concerns of older disabled and of the disabled who grow old are still treated separately in both policy and practice.     

The Effect of Long-Term Care Insurance on Home Care Use Among the Disabled Elders

Using the 1998?C2004 Health and Retirement Study, this study uses Cox??s model to explore the effects of private long-term care insurance ownership on first home care use among the disabled elderly. Results show that long-term care insurance ownership and Medicaid eligibility did not significantly increase the likelihood of using home care services, while income and homeownership lowered this likelihood. Functional limitation was the key determinant of home care use and those who lived with children were less likely to use home care services. Based on the findings, this study provides foundations for long-term care policies and long-term care planning programs.     

Community Care in Taiwan

SUMMARY

This article explores the policy definitions and the funder roles of central and local governments in community care in Taiwan. The notion of community care has been adopted in Taiwan following the model of Hong Kong but the main question of the article is whether this has resulted in actual service provisions at the community level, forming an alternative to institutional care. The data has been collected from several sources: policy documents, official statistics, surveys, general reports, funding provision reports, and empirical studies. The results show that neither central nor local authorities are seriously involved in caring for elderly people or persons with disabilities in Taiwan's communities. In Taiwan, community care for these groups of people still means, in practice, informal care provided by female family members without any support from public policies.     

第十二届中国残疾人事业发展论坛综述

2018年12月22至230,在改革开放40周年、中国残联成立30周年之际,由中国残疾人联合会、深圳大学、残疾人事业发展研究会共同主办的第十二届中国残疾人事业发展论坛在改革开放的前沿深圳市举行。本届论坛的主题是“改革开放与残疾人事业发展”。     

Couples' Views about Planning Fertility in the Philippines*

Abstract This research examines Filipino couples' attitudes toward the occurrence and timing of their most recent pregnancies. Differences between processes operating in rural and urban areas are highlighted. Specific topics include the role of couples' fertility preferences in predicting the intention status of pregnancies, the effect of personal agency in decision making about contraception and childbearing, and whether women who are better able to communicate with their husbands about sex and related matters are more able than other women to avoid unintended births. These topics are explored through survey data and in‐depth interviews.     

第十三届中国残疾人事业发展论坛综述(上)

2019年11月30日到12月1日,由中国残疾人联合会、四川大学、残疾人事业发展研究会共同举办的第十三届残疾人事业发展论坛在四川大学举行。来自北京大学、中国人民大学、四川大学等50多所高校、研究机构的专家学者,以及全国各地的残疾人和残疾人工作者代表共约260人齐聚四川大学,围绕“新时代与残疾人美好生活”的主题,就中国特色残疾人事业制度建设和残障社群治理展开深入研讨,为制定好“十四五”规划、谋划好新时代残疾人事业现代化发展提供理论支持和智力支撑。