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Evans R, Douglas J, Winkler D, Cubis L. Understanding the interaction between support and social participation for people with physical disabilities: a scoping review protocol. BMJ Open 2024; 14:e083102. [PMID: 38816056 PMCID: PMC11138261 DOI: 10.1136/bmjopen-2023-083102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Around the world, the disability rights movements and the social model of disability have placed emphasis on the importance of social participation for people with disability. People with physical disability who have high and complex support needs often need support to access their communities, however, very little is known about the interaction between support and social participation for this population of people. Therefore, the aim of this scoping review is to explore the literature related to the interaction between support and social participation for adults with disability and understand any existing gaps in the literature where further research may be required in order to maximise quality support and social participation. METHODS AND ANALYSIS This scoping review will be conducted and reported according to scoping review guidelines outlined by Arksey and O'Malley and later modified by Levac et al, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews. Thorough database searches will be conducted across MEDLINE, PsycINFO, CINAHL and Scopus. The search will be limited to papers published in English from 2013 onwards. Citations will be uploaded into Covidence and screened by two independent reviewers. Data extraction will extract data regarding participants, housing, support and study characteristics, as well as qualitative and quantitative data relevant to the research question. A narrative synthesis will be used to summarise findings. A minimum of three consultants with lived experience of disability will be engaged to review and contribute to the final scoping review paper. ETHICS AND DISSEMINATION It is anticipated that the findings of this scoping review will be made available in peer-reviewed publications and also in plain language formats to ensure accessibility to a wide range of audiences. Ethics will not be required for this scoping review.
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Affiliation(s)
- Rebecca Evans
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Di Winkler
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Lee Cubis
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Couples with intellectual disability where one partner has dementia – a scoping review exploring relationships in the context of dementia and intellectual disability. AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x22001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Relationships and marriages between couples with intellectual disability are to be celebrated, as is the longer life expectancy now enjoyed by many with intellectual disability. However, dementia disproportionately affects people with intellectual disability, especially people with Down's syndrome. Research into experiences of couples without intellectual disability who are affected by dementia suggests that a relational perspective provides health and social care professionals with information to support the wellbeing of both partners. This dyadic perspective is missing for couples with an intellectual disability where one partner has dementia. There is currently no evidence base informing how each partner may best be supported. This scoping review, with three separate searches, aims to address this gap. The first search sought to establish if any studies had explored the experiences of couples with intellectual disability where one partner has dementia. After determining that no studies have been published to date, the review explores what is known about relationships in the context of dementia (N = 8) and in the context of intellectual disability (N = 10), in second and third searches. Different ways to approach care and support in relationships among partners, staff and other family members were identified and it was evident that support could act as a facilitator as well as a barrier to people and their relationships. While the lives of couples affected by dementia appeared to remain largely private, couples with intellectual disability had a high involvement of staff and family members in their life. Potential implications for future research with couples with intellectual disability affected by dementia are discussed, highlighting the importance of exploring how couples navigate emotional complexities and changes in their relationship, while understanding that the context in which the lives of people with intellectual disability take place and relationships happen is different.
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Balancing Flexibility and Administrative Burden: Experiences of Family Managers Using Directly Funded Home Care in Manitoba, Canada. Can J Aging 2022; 41:593-604. [PMID: 35403593 DOI: 10.1017/s0714980821000660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Directly funded (DF) home care provides funding to home care recipients to coordinate their own care and supports, and is available across all Canadian provinces. Current research on DF home care focuses on the experiences of adults with disabilities self-directing their own care, but less is known about the experiences of family members managing services for adults 55 years of age and older. This article presents findings from a qualitative analysis of 24 semi-structured interviews with older adults and caregivers using the DF program in Manitoba, Canada, focusing on family manager experiences. We identify three themes in the interview data: (1) DF home care enhances choice and flexibility for older people and their caregivers, (2) choice and flexibility reduce caregiver strain, and (3) agency services reduce administrative burden. We discuss the importance of care relationships and the role of family managers. We recommend that traditional home care systems learn from DF, and that increased administrative support would reduce caregiver strain.
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O’Brien L, Randjelovic I. Intermediary Services to Assist People With Disabilities to Implement Individualized Funding Plans: A Rapid Systematic Review. JOURNAL OF DISABILITY POLICY STUDIES 2022. [DOI: 10.1177/10442073221130529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A systematic review was conducted to describe, and evaluate the effectiveness and cost-effectiveness of, intermediary services to support people with a disability to implement individualized funding plans. We included six records, including one subanalysis of randomized trial data, three qualitative studies, and two systematic reviews (reporting on 73 and 18 studies, respectively). No studies directly compared “consumer-directed plan plus intermediary services” to “consumer-directed plan with no/alternative intermediary,” so effectiveness of these interventions is uncertain. There is qualitative evidence from the perspective of disability planners and workers that intermediary interventions are important enablers of successful plan implementation. There is also qualitative evidence from consumer and family perspectives that external support is required to successfully navigate self-directed systems and that strong, trusting, and collaborative relationships with both paid and unpaid individuals in the person’s support network were facilitators of successful plan implementation. There was evidence of disabling practices and attitudes among some support agencies, resulting in coordinators being very risk averse in order to safeguard their clients. Suggestions for future research include carefully planned and ethically robust comparative trial designs, clear description and consistent delivery of interventions, and long-term evaluation of impact. The protocol was published on PROSPERO (CRD42020177607).
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Affiliation(s)
- Lisa O’Brien
- National Disability Insurance Agency, Melbourne, Victoria, Australia
- Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Ivana Randjelovic
- National Disability Insurance Agency, Melbourne, Victoria, Australia
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Kim KM, Meyer N, Hall-Lande J, Freeman R. Supervisory and administrative staff's perspectives of self-directed supports for people with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:480-487. [PMID: 34697876 DOI: 10.1111/jar.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 09/23/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-directed supports (SDS) are a model of disability service delivery that focuses on supporting increased decision-making authority and budget autonomy for people with disabilities and their families. This study identifies supervisory and administrative staff's perspectives within a self-directed, individualised budgeting programme for people with intellectual and developmental disabilities. METHOD Data were collected through 28 face-to-face interviews with supervisory and fiscal administrative staff in Minnesota, USA. RESULTS A qualitative analysis of these interviews resulted in four major themes: (1) the benefits of SDS, (2) the relationship between SDS and person-centred strategies, (3) the perception that a natural tension arises when balancing person-centred approaches with the need for consistent and fair state policy-including rules and regulations within state systems and (4) the unique challenges related to SDS benefits and challenges occurring across Minnesota. CONCLUSIONS The results indicate the importance of providing effective communication and training to all stakeholders.
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Affiliation(s)
- Kyung Mee Kim
- Department of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | | | - Jennifer Hall-Lande
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rachel Freeman
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota, USA
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Cherry E, Stancliffe RJ, Emerson E, Tichá R. Policy Implications, Eligibility, and Demographic Characteristics of People With Intellectual Disability Who Access Self-Directed Funding in the United States. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 59:123-140. [PMID: 33793785 DOI: 10.1352/1934-9556-59.2.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/17/2020] [Indexed: 06/12/2023]
Abstract
This study identifies factors (state of residence, personal characteristics, and living situation) associated with access to self-directed funding (SDF) for adults with intellectual disability in the United States. Data from 10,033 participants from 26 states in the 2012-2013 National Core Indicators Adult Consumer Survey were analyzed. We examined state, age group, residence type, disability diagnoses, mental health status, and type of disability support funding used. Availability of SDF for people with ID varied by state and aligned mostly with state-by-state policy data on SDF eligibility and availability. The results of a logistic regression analysis demonstrated that access to SDF was lower in older adults and higher for people who lived in their parents' or relatives' home, an independent home, and with certain personal characteristics. Potential influences from policy and practice, and approaches to increase access to SDF are discussed.
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Affiliation(s)
- Elizabeth Cherry
- Elizabeth Cherry and Roger J. Stancliffe, The University of Sydney, Centre for Disability Research and Policy, Faculty of Medicine and Health, AU
| | - Roger J Stancliffe
- Elizabeth Cherry and Roger J. Stancliffe, The University of Sydney, Centre for Disability Research and Policy, Faculty of Medicine and Health, AU
| | - Eric Emerson
- Eric Emerson, The University of Sydney, Centre for Disability Research and Policy, Faculty of Medicine and Health, AU; and Lancaster University, Centre for Disability Research, Faculty of Health and Medicine, UK; and
| | - Renata Tichá
- Renata Tichá, Research and Training Center on Community Living, Institute on Community Integration, University of Minnesota, US
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Smethurst G, Bourke-Taylor HM, Cotter C, Beauchamp F. Controlled choice, not choice and control: Families' reflections after one year using the National Disability Insurance Scheme. Aust Occup Ther J 2020; 68:205-216. [PMID: 33372302 DOI: 10.1111/1440-1630.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/22/2020] [Accepted: 12/12/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION At least 40 percent of children with cerebral palsy and their families rely on access to allied health services, assistive technology, and require funding and expertise to achieve skills and participate in daily life. Implementation of the National Disability Insurance Scheme (NDIS) has resulted in a shift to public funding and emphasis on choice and control of services, support and assistive technology to promote social and economic participation. Families of children with cerebral palsy are invested in scheme success and their subjective experiences require consideration if the NDIS is to meet participation targets. OBJECTIVE The aim of this research was to explore the experiences of families with a child with cerebral palsy, who have been in receipt of the NDIS for 12 months, comparisons to previous funding systems, and recommendations for the NDIS going forward. METHODS Purposive sampling was utilised within one specialised paediatric setting. All families received occupational therapy intervention for their child. A qualitative approach using semi structured interviews was employed. Braun and Clarke's six phases of thematic analysis was utilised to analyse the data and explore participants lived experiences. FINDINGS Eight (n = 8) mothers of children with cerebral palsy were interviewed. Three overarching themes were derived from the data: Equipment impacts on all areas of life; Frustration navigating the National Disability Insurance Scheme; and Gratitude, hope and suggestions. CONCLUSION Families reported challenges navigating the NDIS including administrative challenges and extensive wait times for assistive technology, as well as gratefulness for increased opportunities for support. Occupational therapists and other allied health professionals can assist by: being proactive in service delivery and advocating for the needs of individual families and children; and finding ways to increase the preparedness of the NDIS to better understand the needs of children with cerebral palsy and their families.
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Affiliation(s)
- Gabrielle Smethurst
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Helen M Bourke-Taylor
- Occupational Therapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Claire Cotter
- Cerebral Palsy Education Centre, Glen Waverley, VIC, Australia
| | - Fiona Beauchamp
- Cerebral Palsy Education Centre, Glen Waverley, VIC, Australia
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Pattyn E, Werbrouck A, Gemmel P, Trybou J. The impact of cash-for-care schemes on the uptake of community-based and residential care: A systematic review. Health Policy 2020; 125:363-374. [PMID: 33423802 DOI: 10.1016/j.healthpol.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/20/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Internationally, deinstitutionalization and the provision of community-based care are growing policy aims. Several developed countries have thus introduced cash-for-care schemes, which turn the traditional funding stream from the perspective of the care provider around, giving purchasing power to care users. This review explores whether cash-for-care schemes encourage the shift towards deinstitutionalization. METHODS Ten databases covering medical, nursing and social science journals were systematically screened up to July 10, 2020. Only peer-reviewed articles written in English or French and containing empirical evidence on the uptake of care services in a cash-for-care scheme were included. RESULTS The search resulted in 6,865 hits of which 27 articles were retained. Most studies took place in the United Kingdom or the United States. Overall, the search showed mixed results concerning the uptake of the different types of community-based care. CONCLUSION Evidence demonstrating a higher uptake of informal, respite or home care individually, is scarce and inconclusive. A reduction in residential care and an uptake of services in the community can, with caution, be noted. However, contextual and individual factors can affect the way deinstitutionalization takes place and which community-based services are chosen. Future research should therefore focus on the underlying processes and influencing factors, in order to obtain a clear view of the shift towards deinstitutionalization.
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Affiliation(s)
- Eva Pattyn
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Amber Werbrouck
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Paul Gemmel
- Department of Marketing, Innovation and Organization, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium.
| | - Jeroen Trybou
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
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Ordway A, Johnson KL, Kneale L, Amtmann D, Demiris G. The Experience of Home Care Providers and Beneficiaries With Enhanced Training Requirements in Washington State. J Aging Health 2019; 31:124S-144S. [PMID: 31267811 DOI: 10.1177/0898264319860298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Our objective was to understand the perceived impact of Washington State's upgraded training and certification requirements of long-term care workers providing personal care services from the perspectives of consumers and home care aides. Methods: We applied conventional qualitative content analysis to semi-structured interviews with 17 consumers and 10 certified home care aides. Results: We found that consumers in this study put a high premium on directing many aspects of their personal care services. We also found that while home care aides supported what consumers desired for their own care, some were unsure how to reconcile providing individualized services with the State's standardized, competency-based training and certification program. Discussion: State-based efforts, such as the one in Washington State, serve as an important starting point for building a broader effort toward the identification of competencies and associated training standards for the home care workforce.
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Houseworth J, Stancliffe RJ, Tichá R. Association of state-level and individual-level factors with choice making of individuals with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:77-90. [PMID: 30144747 DOI: 10.1016/j.ridd.2018.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/12/2018] [Accepted: 08/13/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND State-level factors have not been examined in research on choice, despite findings of between-state differences. AIMS To examine both individual and state-level factors associated with choice. METHODS AND PROCEDURES We used multilevel modeling to explore two choice scales, support-related and everyday choice, based on the National Core Indicators (NCI) data from 2013-14. OUTCOMES AND RESULTS At the individual level, milder ID, greater mobility, fewer problem behaviors, answering questions independently, communicating verbally, and living in a non-agency setting, particularly independent settings, were associated with more choice for both scales. State-level factors overall explained variance for both scales, but were more strongly associated with support-related choice. A higher proportion of people with IDD living independently within the state predicted more support-related choice. High cost of living within a state predicted less everyday choice. Higher proportion of people living with family and lower proportion being served within a state predicted more everyday choice. CONCLUSIONS AND IMPLICATIONS These findings suggest further study of choice in relation to policies that: (1) increase independent living for individuals with IDD, and (2) assist individuals/families living in high cost states. State differences on important QOL outcomes are likely to be associated with economic and system-based factorsbeyond individual differences.
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Affiliation(s)
- James Houseworth
- University of Minnesota, Institute on Community Integration, Minneapolis, MN, 55455, United States.
| | - Roger J Stancliffe
- University of Sydney, Centre for Disability Research and Policy, Sydney, Australia.
| | - Renáta Tichá
- University of Minnesota, Institute on Community Integration, Minneapolis, MN, 55455, United States.
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