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Services and Assistance: Support for people with a disability
People with disabilities were also less likely to have non-school qualifications or to be employed and, consequently, more likely to be economically disadvantaged than people without disabilities. In 2002, 71% of adults without disabilities lived in middle to high income households, compared with 48% of those with disabilities and 33% of those with a profound or severe core activity limitation.
Appropriate and adequate support for people with disabilities, and their carers, is essential if they are to overcome the associated disadvantages and realise their full potential as individuals, family members and participants in the economic, social and cultural life of the broader community. The amount and type of support needed varies greatly depending on the type and severity of the limitations or restrictions experienced, and on the personal, family and economic circumstances of each individual.
ASSISTANCE WITH DAY TO DAY LIVING
The ABS 1998 Survey of Disability, Ageing and Carers found that of the 3.4 million people of all ages with a disability, and living in private households, over half (55%) received help with one or more activities such as property maintenance, housework, health care, transport, mobility, self-care, etc. The vast majority (90%) received assistance from informal carers such as family members, friends or neighbours while about a half (49%) made use of one or more formal providers including government, private nonprofit, and private profit making organisations.(SEE ENDNOTE 2)
In 1998, three out of four people identified as the primary carer of a person with a disability (i.e. the person providing the most ongoing informal assistance with one or more of the core activities of self-care, mobility or communication) were family members living with the recipient, most commonly a partner or parent.(SEE ENDNOTE 2) While the bulk of informal day to day care is provided by co-resident family members, the ability to ask for help from people beyond their own household can have both practical and social benefits for people with disabilities, particularly those who live alone (17% of all adults with disabilities in 2002).
ABLE TO ASK OTHERS(a) FOR SMALL FAVOURS: Proportion of population(b) by disability(c) status - 2002
In 2002, the vast majority of adults with a disability (93% of those living alone and 92% of those living with others) felt they were able to ask someone not living with them for a small favour such as collecting mail, looking after pets, house or garden while away from home; minding a child for a brief period; help with moving or lifting objects; borrowing equipment, etc. Among people with disabilities who lived alone, the proportion able to ask for small favours increased as the severity of limitations or restrictions increased. The reverse was reported for people with disabilities who lived with others, possibly because they had less need or less opportunity to ask for help from people outside their own household.
SUPPORT IN TIMES OF CRISIS
In 2002, the majority of adults with a disability (92%) felt that they could ask for support in a time of crisis (e.g. advice or emotional support; emergency money, food or accommodation; help with family or work responsibilities, etc.) from someone not living with them. Overall, the proportion of people with one or more external sources of crisis support decreased as the severity of limitations or restrictions increased. However, among people who lived alone, those with a profound or severe core activity were the most likely to have crisis support. Even so, 4% of people with a profound or severe core activity limitation, and living alone, said they had no one they could turn to in a time of crisis.
By far the most common external sources of crisis support were family members living elsewhere (nominated by 80% of adults with disabilities), friends (59%) and neighbours (36%). The proportion of people with disabilities who could call on friends in a time of crisis declined with age, from 71% of those aged 18-34 years to 42% of those aged 65 years and over. In contrast, the proportion who felt they could call on their neighbours for support in a crisis increased with age, from 26% of 18-34 year olds to 40% of people aged 65 years and over.
RECEIVING A GOVERNMENT CASH PENSION OR ALLOWANCE: Proportion of population(a) by disability(b) status - 2002
The sources of crisis support reported in 2002 were fairly similar across disability status groups. However, there were some clear differences. For example, people with disabilities, particularly those with a profound or severe core activity limitation, were less likely than those without disabilities to seek help from friends or work colleagues in a time of crisis.
Formal sources of crisis support such as community, charity or religious organisations; local council or other government services; and health, legal or financial professionals were much less commonly nominated than family, friends or neighbours in all disability status groups.
A key role of the Australian Government in supporting people with disabilities, and their carers, is the provision of income support or supplementation through a range of pensions and allowances. Among adults living in private households in 2002, more than half (53%) of those with disabilities were receiving a government cash pension or allowance. For the most part, this was their principal source of income. The proportion of people with a disability receiving a government pension or allowance increased with severity and age, to 78% of all adults with a profound or severe core activity limitation, 84% of all older people (aged 65 years and over) with a disability, and 88% of older people with a profound or severe core activity limitation. In comparison, 74% of older people without a disability received a government pension or allowance.
Of those 18-64 year olds with disabilities who were receiving a government cash pension or allowance in 2002, 33% were receiving the Disability Support Pension, 17% were receiving an employment-related allowance (e.g. Newstart or Youth Allowance) and 23% received the Parenting Payment. The majority (79%) of older people with disabilities who were receiving a government pension or benefit were receiving the Age Pension while a further 13% were receiving a Veterans' Service Pension.
DISABILITY SUPPORT SERVICES
In addition to Commonwealth funded income support and supplementation, the Australian and state and territory governments provide a wide range of specialist services for people with disabilities. Many of these services are either funded or directly provided under the Commonwealth-State/Territory Disability Agreement, most recently signed in 2003 and previously known as the Commonwealth/State Disability Agreement (CSDA). Total expenditure by governments on CSDA services during the 2001-02 financial year was $2.66 billion.
On the snapshot day in 2002, an estimated 65,800 people with disabilities received 77,400 CSDA-funded services from a total of 8,142 outlets. Half of these outlets were run by charitable organisations, a further 24% were run by other non-government organisations, and the remainder were run by government agencies.
On the snapshot day:
People with an intellectual disability were the main users of CSDA services. On the snapshot day, 61% of service recipients reported an intellectual disability as their primary disability. The types of services most commonly used by this group were: accommodation support, just over half of which was group homes; employment services, mainly in supported employment environments; and community access, mainly learning and life skills development.
People whose primary disability was physical formed the second largest group (12%) of people using CSDA services on the snapshot day. Compared to most other primary disability groups, a relatively high proportion of people whose primary disability was physical used therapy support (14%) and respite services (8%) on the snapshot day.
The Commonwealth-State/Territory Disability Agreement also funds various ‘generic’ support services where there may be little or no direct contact with individual consumers. These include advocacy, information and referral, print disability services, peak bodies, research and evaluation.
UNMET NEED FOR DISABILITY SUPPORT SERVICES
In 1998, over half (57%) of all people with disabilities living in private households needed assistance with one or more aspects of day to day living. A similar proportion (58%) of primary carers needed help in providing care to someone with a disability. In both cases, the majority (64% of people with a disability and 57% of primary carers) received all the assistance they needed. However, some of those who needed help received less than they needed - 32% of people with a disability and 27% of primary carers. In addition, some received no help at all - 4% of people with a disability and 16% of primary carers.(SEE ENDNOTE 2)
In recognition of unmet need for disability support services, additional funding was made available by the Australian and state and territory governments, totalling $519 million over the two years 2000-01 and 2001-02. This funding has been continued in the current Commonwealth-State/Territory Disability Agreement. A key priority area for unmet need funding is the provision of additional services which would enable people with disabilities who have ageing carers to remain supported within their families in their local communities.(SEE ENDNOTE 3)
As people get older the likelihood of having a disability increases. The chance of becoming the primary carer of someone with a disability, usually a partner or other family member, also increases with age, peaking in the 55-74 years age group. In 1998, one in five primary carers were aged 65 years and over, and most (56%) of them also had a disability.(SEE ENDNOTE 4)
1 Basser, LA and Jones, M 2002, ‘The Disability Discrimination Act 1992 (Cwlth): A three-dimensional approach to operationalising human rights’, Melbourne University Law Review, vol. 26.
2 Australian Bureau of Statistics 1998, Disability, Ageing and Carers: Summary of Findings, Australia, 1998, cat. no. 4430.0, ABS, Canberra.
3 Australian Institute of Health and Welfare 2002, ‘Unmet need for disability services: effectiveness of funding and remaining shortfalls’, Disability Data Briefing, no. 22.
4 Australian Bureau of Statistics 2000, Caring in the Community, Australia, 1998, cat. no. 4436.0, ABS, Canberra.