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

Policy Implication: Encourage the use of independence-enhancing technologies. Assistive technologies should be more widely available and affordable. These technologies should be as readily available as other forms of support, and funding for them should be integrated into programs providing long-term supportive services. At the very least, "low-technology" devices, such as canes and wheelchairs, should be available to persons 50 and older with disabilities who need them. Because a high proportion of persons with disabilities use computers, new ways of using computers to help older persons with everyday activities, including online shopping for information and services, should be pursued.

(3) Many persons with disabilities, especially those with severe disabilities, have unmet needs for long-term supportive services and assistive equipment in their homes and communities. Some of these needs would be relatively simple to meet; others, such as providing more personal assistance services, would require significant resources and our collective will.

Only about half of persons 50 and older with disabilities report receiving any regular help with daily activities from one or more people. The vast majority of such help is the unpaid assistance of family or other informal caregivers. In addition, only one out of three uses any community-based service. Because there is no organized "system" for delivering services, many individuals do not know about sources of support or how to find them, or if they are eligible for any publicly funded services.

Our data indicate there are high levels of unmet need among persons 50 and older with disabilities:

  • Almost one-quarter report needing more help than they receive now with basic daily activities, such as bathing, cooking, or shopping.
  • One-half said they were not able to do something they needed or wanted to do in the past month because of their disability. These needs were very basic, such as doing household chores, getting some exercise, or getting out of the house.
  • More than one-third of homeowners would like to make home modifications that would make their lives easier, such as installing grab bars in the bathroom, but have not done so, largely because of cost.

Policy Implication: Reorient public funding to enable persons with disabilities to live independently in their communities. Medicaid is the major public benefit program funding long-term supportive services for older persons with disabilities. Federal and state funding for home and community-based services should be expanded through Medicaid, and the shift in current funding from institutional to community-based care in many states should continue. More emphasis also needs to be placed on recognizing the rights of older persons with disabilities to live in their communities and obtain services in the least restrictive environment possible.

Policy Implication: Develop navigation tools and a single point of entry in localities and states to enable consumers to learn more easily about the range and location of service options and to get assistance in determining their eligibility for public programs.

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