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Beyond 50.03: A Report to the Nation on Independent Living and Disability: Executive Summary

What Do We Mean by Disability?

Disability has multiple meanings that cannot be captured in one definition. There are huge differences in the causes of disabilities, the age of onset and pace of progression, and the degree of activity limitations that may result. Disabilities may occur at birth suddenly, as a result of an accident, or slowly, as a chronic condition progresses. They may be sensory, cognitive, physical, or emotional. They may be visible or hidden.

Researchers find varying rates of disability based on the definition of disability they use as well as other factors. But despite the complexity of defining and measuring the number of people with various types of disabilities, some points are universal. Disability usually involves difficulty conducting daily activities, such as bathing, cooking, or shopping, or getting around our communities. And almost all of us need some help with these activities at some point in our adult lives, especially as we grow older.

What do we mean by "activities of daily living"? Surveys typically distinguish between two types of disabilities: limitations in activities of daily living (ADLs) and limitations in instrumental activities of daily living (IADLs). ADLs refer to basic personal activities required for daily life and typically include bathing, dressing, getting in or out of bed or a chair, using the toilet, eating, and getting around inside the home. IADLs refer to activities related to being able to manage one's affairs independently and typically include grocery shopping, housework, preparing meals, managing money, using the telephone, taking medications, and getting around outside the home.

 

Does This Report Include Long-Term Care?

Yes, although the term "long-term care" is used only occasionally. Long-term care has been defined by gerontologists Rosalie Kane and Robert Kane as "personal care and assistance that an individual might receive on a long-term basis because of a disability or chronic illness that limits his or her ability to function."1 It includes not only nursing homes, but also the services received while living in many other settings, including private homes and apartments.

"Long-term supportive services" is the preferred term among many people with disabilities because the term "care" may imply dependence and convey paternalism

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