Caring for Caregivers in Retirement: Social Security Works for Direct Care Workers

Social Security provides the basic foundation for the economic security of retired workers, workers who become disabled before retiring, and the children and spouses of workers who die or become disabled. Social Security is particularly important for workers, such as most direct care workers, who received modest compensation for the work they did during their working years. This issue brief looks at the importance of Social Security and how proposed cuts to the program would hurt direct care workers

Access and utilisation of maternity care for disabled women who experience domestic abuse:a systematic review

BACKGROUND: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. METHODS: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. RESULTS: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. CONCLUSIONS: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base

Farming for Health: Aspects from Germany

Until now, the term ‘Farming for Health’ is unknown in Germany but it would cover a wide spectrum of different kinds of social agriculture already existing in Germany, such as farms that integrate disabled people or drug therapy into their farming system, or farms that integrate children, pupils or older people. Relevant work in Germany is done in ‘Sheltered Workshops’, where supporting and healing powers of farming and gardening are used for disabled people with a diversity of work possibilities. Relevant activities also take place in work-therapy departments using horticultural therapy and in animalassisted therapy. There are an estimated number of 1000 different projects for mentally ill, disabled and elderly people in hospitals, Sheltered Workshops, on farms and other projects in Germany with a multitude of individual work places. The upcoming idea of Farming for Health may be met by the term ‘multifunctionality’ as one of the future goals of agriculture: to combine the production of cash crops with social functions, like providing space for recreation, care for landscapes and care for disabled people. Research showed that farms that work together with clients in their farming system have more time and financial support to integrate aims like caring for biotopes and landscape measures into their work schedule

“Disabled people are sexual citizens too”: supporting sexual identity, well-being, and safety for disabled young people

Disabled young people are sexual beings, and deserve equal rights and opportunities to have control over, choices about and access to their sexuality, sexual expression and fulfilling relationships throughout their lives. This is critical to their overall physical, emotional and social health and wellbeing. However, societal misconceptions of disabled bodies being non-normative, Other or deviant has somewhat shaped how the sexuality of disabled people has been constructed as problematic under the public gaze. The pervasive belief that disabled people are asexual creates barriers to sexual citizenship for disabled young people, causing them to have lower levels of sexual knowledge and inadequate sex education compared to their non-disabled peers. As a consequence they are more vulnerable to ‘bad sex’ - relationships which are considered to be exploitative and disempowering in different ways. Access to good sex and relationships education (SRE) for disabled young people is, therefore, not only important for them to learn about sexual rights, sexual identity and sexual expression, but also about how to ensure their sexual safety. In so doing it will contribute to the empowerment and societal recognition of disabled people as sexual beings, and also help them resist and report sexual violence. Therefore, it is critical that parents, educationalists and health and social care professionals are aware and appropriately equipped with knowledge and resources to formally educate disabled young people about sexuality and wellbeing on par to their non-disabled peers

Disabled patients in acute hospital wards: the limitations of role theory for understanding the problems of patients and nurses

This study explores the care provided for physically disabled people who are admitted to acute hospital wards for the treatment of short -term illness. Two groups of 75 disabled and 75 non - disabled patients were recruited for the study on a matched pair basis, and a survey of 205 nurses was undertaken. The study involved an assessment of how well disabled patients could manage eight activities of daily life at home and in hospital. The experiences of disabled and non -disabled patients in acute hospital wards were compared by assessing patient satisfaction with six different aspects of care. The views of nurses about caring for disabled patients in acute hospital wards, their experience and training in the care of disabled patients are also explored.The study demonstrates no difference in the levels of satis- faction with care experienced by disabled and non- disabled patients. Patient satisfaction with all aspects of care was found to be associated with satisfaction with the communication of information, a factor shown to be equally important for both disabled and non -disabled patients.It was hoped that the theory of social roles would provide a theoretical framework for understanding the position of the disabled patient on an acute hospital ward. However, in the event, role theory proved not to be entirely adequate for this purpose. An alternative model is developed which takes into account the attitudes and experiences of nurses as well as the experiences of disabled patients on acute hospital wards. This is used to suggest ways in which improvements could be made in the care of disabled patients

Medicaid Expansions for the Working Age Disabled: Revisiting the Crowd-out of Private Health Insurance

Disabled individuals under 65 years old account for 15% of Medicaid recipients but half of all Medicaid spending. Despite their large cost, few studies have investigated the effects of Medicaid expansions for disabled individuals on insurance coverage and crowd-out of private insurance. Using an eligibility expansion that allowed states to provide Medicaid to disabled individuals with incomes less than 100% of the federal poverty level, I address these issues. Crowd-out estimates range from 49% using an ordinary least squares procedure to 100% using two-stage least-squares analysis. This potentially large degree of crowd-out could have fiscal implications for the Affordable Care Act which has greatly expanded Medicaid eligibility in 2014

Purchasing Strategies to Improve Care Management for Complex Populations: A National Scan of State Purchasers

Explores cost-effective alternatives to fee-for-service plans and full-risk managed care for Medicaid's aged, blind, and disabled or Supplementary Security Income beneficiaries. Includes summaries of systems being implemented in twelve states

Survey of Rehabilitation and Return-to-Work Practices Among U.S. Disability Carriers

[Excerpt] Disability insurance provides financial protection for workers who become disabled and are unable to perform their occupations. It is beneficial to both disabled employees and their employers to have their employees return to work as soon as they are able to do so. For disabled employees, benefits are typically 60% to 66 2/3% of their pre-disability income. For employers, an employee’s indefinite absence due to a disability involves the loss of productivity and the extra cost of training a new employee. In addition, the disabled employee often has on-the-job knowledge that may take a new employee many years to acquire. Many employees who receive disability benefits subsequently recover and return to work. Frequently, the cause of disablement is successfully treated with appropriate medical care, and the employees are able to return to their jobs with no additional assistance. However, for some claimants, the nature of their disability is severe enough to require extra support to facilitate their return

The Impact of Managed Care Payer Contracts on the Subspecialty Medical Provider: Policy Implications that Impact on the Care of Disabled Children

This Note explores the impact of current managed care contractual practices on the subspecialty provider\u27s ability to deliver health care to chronically ill and disabled children. In doing so, it delves into the historical events giving rise to the development of health care reform. It then reviews various physician agreements with several managed care organizations ( MCOs ) to demonstrate how contract conditions affect compensation for pediatric neurosurgical services. This Note then details the impact of managed care on the management of the chronic health problems of such children and proposes alternative solutions for affordable health care delivery systems for poor, medically fragile groups with complex health problems