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.     

New Disability Services: The Critical Role of Staff in a Consumer-directed Empowerment Model of Service for Physically Disabled People

Australian disability services have undergone a major review. Initiated by the government and now enshrined in new legislation, this review has significant implications for non-government social welfare organisations as major service providers in that it demands a significant service delivery reorientation. This paper describes one demonstration project involving four physically disabled persons, one female and three males, located in one domiciliary unit which signposts this new service direction and identifies it as a consumer-directed and empowering model. This is contrasted with previous institutional and care models of service. It identifies the staff role as important in this client-empowering model of service and raises a range of critical issues in the consumer-staff interface which enhances such empowerment. The paper suggests that where these staffing features and empowerment processes are lacking deinstitutionalisation may well have occurred without consumer empowerment being achieved.     

'It Won't Change the World But it Turned my Life Around': participants' views on the Personal Advisor Scheme in the New Deal for Disabled People

This article is a response to the largely negative commentary on the New Deal for Disabled People, in this journal and other leading social policy journals. It draws on a recent qualitative study of disabled people who have re-entered the labour force with the assistance of the Personal Advisor Scheme. Whilst it is acknowledged that the New Deal has its limitations and shortcomings, it is argued that the positive aspects of the scheme deserve to be highlighted. Also, it is suggested that the importance of enabling individuals who have experienced the scheme to voice their opinions and perceptions cannot be understated. By listening to the views and attitudes of those who have first hand experience of the scheme, policies and practices can be developed and redefined in ways, which incorporate the needs and views of the users.     

Work and Work Alternatives for Disabled Young People

This paper presents results from a population based action research study in East Devon of the needs of 383 young people aged 16-25 years with a whole range of impairments and disabilities, and 152 able-bodied controls. A comparison between these two groups is made of their current and past experiences of work and work alternatives. The aspirations and expectations of the disabled young people are also compared with those of their families and service providers, and the preferred occupations of the young people, with various profiles of disability, are explored. Although the analysis pinpoints groups of disabled young people with particularly high levels of employment handicap, there is, throughout the study group, a need for progress out of static or unstable occupational paths. The handicapping features of employment services that impede this progress are discussed together with an examination of society's response to high levels of unemployment among disabled people. The research findings, set within this context, provide a basis for action research now being undertaken in local communities within East Devon to improve employment opportunities.     

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.     

Disabled People, Service Users, User Involvement and Representation

The issue of representation and representativeness has become central in debates about user involvement, disabled people and users of social care services. This article examines the emphasis of service agencies on the 'unrepresentativeness' of disabled people and service users; looks at how this is experienced by the latter and considers why the issue has gained such importance. It examines the different meanings attached to representation by recipients and providers of services. As well as looking at how the issue of representativeness is used to devalue, exclude and disempower disabled people and service users, the article explores its relation with the competing participatory and representative models and practices of democracy employed by disabled people and service providers.     

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.     

Charities, Authority and Disabled People: a qualitative study

Disabled people are greatly under-represented in positions of authority within traditional charities. Using qualitative data from original empirical research, this paper identifies some of the causes of their exclusion. The values, attitudes and beliefs of those who govern traditional charities accord largely with the 'personal tragedy' or medical model of disability, and a major consequence of this perspective is that disabled people are confined to roles in which they have little opportunity to exercise power in the traditional voluntary sector.     

Disability and Dependency: origins and futures of 'special needs' housing for disabled people

In this paper we analyse the provision of housing for disabled people in both its historical and ideological contexts. While the recent extension of part M of the Building Regulations to dwellings by the government represents a significant advance towards the inclusion of disabled people, we argue that the shift in funding of public housing from a 'bricks and mortar' subsidy to Housing Benefit potentially creates greater dependency. This amounts to a policy contradiction in which the government is punishing disabled people for being dependent whilst simultaneously being the cause of their dependency. If this issue is not addressed disabled people will continue to remain excluded, albeit within accessible dwellings.     

The Effectiveness of Adult Day Services for Disabled Older People

Abstract

Adult day care has attracted a considerable amount of attention among researchers, practitioners, and policymakers. However, there have been few efforts to synthesize empirical results. This paper reviews research that determines the effectiveness of adult day services in improving client functioning, alleviating caregiver stress, and delaying nursing home placement. In addition, the strengths and limitations of the research are considered. This paper concludes with a discussion of policy-relevant issues that must be addressed when determining the effectiveness of adult day services.     

Using Disability Law to expand Academic Freedom for Disabled Researchers in the United Kingdom

We consider the findings of a study of the experiences of Postgraduate Researchers with Disabilities and explore how this relates to academic freedom. Drawing upon the provisions of the Public Sector Equality Duty and Indirect Discrimination within the Equality Act (2010), we note that a range of existing public policy practices, such as the operation of the REF, are likely to be in breach of these obligations. We recommend revisions to existing practice that speak more widely to the general concern of academic freedom, suggesting that a consideration of anti-discrimination law – rather than a purely intellectually focussed agenda – represents a pragmatic means towards shaping the inclusivity of higher education policy going forwards.     

A Global Perspective on Social Security Programmes for Disabled People

By the mid-1990s, 163 countries had statutory general disability programmes. Most have adopted social insurance as their primary policy instrument, which restricts coverage to those in paid formal employment, makes benefit eligibility dependent upon the satisfying of specific minimum contribution period requirements and provides earnings-related pensions. Many countries also provide supplementary and special need benefits. Programme funding comes overwhelmingly from employer and employee contributions, with a majority of countries providing government subsidies. Using a methodology that assesses national statutory social security intentions, a ranking of these disability programmes reveals that Australia has the best designed one.     

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.     

Negotiating the Dependency/Nurturance Tightrope: Dilemmas of Motherhood and Disability*

La féminité normative place les mères dans une situation difficile, entre la dépendance et la tendance à se dévouer; d'un côté, les bonnes mères devraient être dépendantes dans une relation avec un mäle pourvoyeur. Inversement, elles devraient fournir de bons soins par un maternage actif, habile ainsi que par leur engagement. Cette condition pose des défis aux femmes ayant une incapacité et dont la dépendance à l'égard d'un partenaire masculin peut entrainer de la vulnérabilite par rapport à l'abus, alors que de la dépendance envers l'Etat peut découler de la pauvreté et de la surveillance. L'auteure explore les dilemmes que les mères handicapées rencontrent pour concilier leur position de dépendance par rapport aux besoins de leurs enfants d'etre maternés. Compliquant les conceptions négatives de la dépendance, plusieurs femmes ont décrit comment certaines relations de dépendance leur ont apporté, a elles et à leurs enfants, des réseaux positifs de soutien. Normative femininity offers mothers a tightrope of nurturance and dependency. On the one hand, good mothers should be dependent through a relationship with a male provider. Conversely, they should provide nurturance through active, involved and expert mothering. This tightrope poses challenges to women with disabilities whose dependency on male partners can bring vulnerability to abuse, while dependency on the state can result in poverty and surveillance. This article explores the dilemmas disabled mothers face, reconciling their position of dependency against their children's need for nurturance. Complicating negative conceptions of dependency, many women described how some relations of dependency provided them and their children with positive networks of support.     

Cultural Representation of Disabled People: Dustbins for Disavowal?

Impairment and imagery are neglected within the social model approaches to disability. This is connected to a neglect of representation. Comparing the experience of disabled people to that of women, I explore the prejudice underlying cultural representation, using a variety of theoretical models. I conclude by suggesting an explanation for popular prejudice against disabled people.     

Gay,Lesbian, Bisexual,and Transgendered People and Chemical Dependency: Exploring Successful Treatment

This exploratory and quantitative study presents a model of treatment success of the nation's oldest and largest chemical dependency treatment provider for the gay, lesbian, bisexual, and transgender (GLBT) population. The main purpose is to examine the potential ability of the predictor variables’ degree of affiliation with Alcoholics Anonymous (AA), the severity of chemical use, the strength of a higher power relationship, attitudes about sexual orientation, and length of time in treatment to predict length of time clean and sober.

The proposed model demonstrated the ability to explain 29% of the variance in time clean and sober. Results lend tentative support for culturally competent treatment and include specific intervention recommendations for professionals, including social workers, chemical dependency counselors, and therapists.     

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.     

Poverty and Disabled People: challenging dominant debates and policies

This article explores the relationship between poverty, disability and impairment in a global context. It challenges dominant critiques of poverty and disability, and explores the critiques, policy proposals and developments of the disabled people's movement to combat poverty. It offers an international perspective including the experience of both the North and South.     

Seeing the Invisible Children and Young People Affected by Disability

This paper presents a brief review of literature relating to children in families with a disabled member, including the 'young carers' and disability studies literature, and relevant works from the social psychology and sociology of childhood. Key themes identified in the literature are then illustrated by findings from two exploratory research studies that sought to explore the experiences and service needs of children in families with a disabled member, within two Scottish areas. The authors suggest that, although young people affected by disability in the family, including young carers, face significant problems, particularly in socially disadvantaged areas, there are other issues that need to be addressed. Alternative conceptual frameworks are proposed, which challenge the dominance of the young carers research paradigm.