Feature Article - Disability, ageing and carers in Western Australia
This article was published in the June Quarter 2005 issue of Western Australian Statistical Indicators, ABS Catalogue Number 1367.5
There is growing interest about the prevalence and characteristics of disability in Australia. In particular, the ageing population makes disability a key social issue. Increasing numbers of people are surviving to their late eighties or beyond and most will experience a disability in their lifetime. Family members and friends are the main providers of care to people with disabilities and to the frail aged. While caring is often rewarding, it can also involve substantial personal and financial cost. Information about the circumstances of people with disabilities, the frail aged and carers is important to inform government policy and to determine the need for formal support and services.
The following article highlights selected findings from the 2003 Survey of Disability, Ageing and Carers (SDAC) for people living in Western Australia. The primary aim of the SDAC was to provide information about three population groups - people with a disability, persons aged 60 years and over, and their carers.
In 2003, there were 405,500 people with a disability in Western Australia representing 21% of the state population. This disability rate was similar to the national rate of 20%. Between 1998 and 2003 the number of people with a disability in Western Australia increased by 50,000 (14%). The number of carers who had provided informal assistance to people with disabilities or the frail aged rose by 32%, from to 187,400 to 246,800 over the same period. Meanwhile the number of primary carers rose by 11%. Primary carers are those who routinely provide the majority of informal help with activities of daily living.
A disability is defined as any limitation, restriction or impairment which has lasted or is likely to last for at least six months and restricts everyday activity. Some examples of disabilities include, loss of hearing, difficulty in learning, breathing difficulties, chronic or recurring pain, or nervous conditions.
Disability is further defined in terms of the area of life in which the restriction is experienced. Some people are restricted in ways that have a minor impact on their lives while others are restricted in the type of work they can do or in learning or schooling activities. Others may be restricted in performing activities that are more basic in terms of their wellbeing and independence. These latter activities are described as 'core activities' and comprise; self-care, mobility and communication.
The severity of these restrictions are further classified as profound, severe, moderate or mild dependent on the level and type of assistance required. People with profound and severe restrictions either always or sometimes require assistance with core activities. In 2003, over one quarter (28%) of Western Australians with a disability had a profound or severe core-activity limitation.
The main health conditions of 81% (329,800) of people with a disability in Western Australia in 2003 were of a physical nature. One in three (33%) people with a disability reported disorders of the musculo-skeletal system and connective tissue, which include arthritis, back problems, osteoporosis and rheumatism as their main health condition. Arthritis was the main health condition of 13% of people with a disability.
Almost one in five (75,700) people with a disability had a mental or behavioural disorder as their main health condition. Of these, one third (34%) had a psychosis or mood affective disorder such as dementia, schizophrenia and depression as their main health condition while about one quarter (27%) had an intellectual or behavioural disorder.
People with disabilities whose main health condition was a mental or behavioural disorder were more likely to be profoundly or severely restricted in core activities than those with physical conditions (39% compared to 26%). One half (50%) of those with intellectual and developmental disorders and 43% of people with psychoses and mood disorders had a profound or severe core-activity limitation.
DISABILITY STATUS - 2003
Profound or severe core-activity limitation(a)
All with reported disability(b)
Proportion of age group with a disability
|Age group (years)|
|85 and over|
|* estimate is subject to sampling variability too high for most practical purposes|
|(a) Core activities comprise communication, mobility and self-care.|
|(b) Includes persons with a disability who have mild and a moderate or mild core-activity limitation and those who do not have specific core-activity limitations or schooling or employment restrictions.|
|Disability, Ageing and Carers, Western Australia: Summary of findings, 2003, cat. no. 4430.5.40.001.|
AGE AND SEX
The likelihood of disability increases with age. Older people with a disability are also more likely to be restricted in their day to day lives. In 2003, 18% of people aged under 65 years had a disability. This rate rose to 47% of those aged 65-74 years and 84% of those aged 85 years or over. While fewer than 5% of people aged 65 years or less had a profound or severe core-activity limitation the rate rose to 10% of 65-74 year olds and 67% of those 85 years or over. There were three times more women with a profound or severe core-activity limitation as men aged 85 years or over corresponding to the higher number of women in this age group.
Of people under 65 years, children aged 5-14 years had the highest rates of disability (12%) and profound or severe core-activity limitation (7%). There were twice as many boys as girls with a disability in this age group. Likewise, three times more boys aged 5-14 years had a profound or severe core-activity limitation.
In 2003, fewer than 4% (14,600) of Western Australians with a disability lived in cared accommodation such as hospitals or nursing homes. Most (390,900) lived in households, either in private dwellings (99%) or in other types of accommodation such as caravan parks, boarding houses and self-care units in retirement villages.
Of people with a disability living in households, 60% required assistance from others to manage their health conditions or cope with everyday activities. The most common activities for which help was required were meal preparation, cognition or emotion, paperwork and property maintenance. While most people with a disability received some form of assistance, just over one quarter (26%) felt they needed more help than they already received. The proportion of those with an unmet need rose with the severity of disability. Almost a half (45%) of those with a profound or severe core-activity restriction felt their need for assistance was not fully met.
Of those needing assistance, 90% received help from informal carers such as family and friends. Most received help from either a partner or parent (71%). Similarly, 73% of those with a profound or severe core-activity restriction received assistance from a partner or parent.
In 2003, 60% of people with a disability who needed help had received assistance from formal providers. This figure rose to 66% of those with profound or severe core-activity limitations. Private commercial organisations (33%) and government organisations (33%) were the most common sources of formal assistance for all people with a disability. Government organisations (40%) were the most common formal providers to people with profound or severe core-activity restrictions.
PEOPLE AGED 60 YEARS OR OVER
In 2003, there were 299,000 people aged 60 years or over in Western Australia. Most (88%) lived in private homes and about 5% lived in aged care facilities. The remainder (7%) were living in other types of households, such as self care units in retirement villages.
Over one in three (38%) Western Australians aged 60 years or over required assistance with everyday activities because of disability or age. The need for assistance rose significantly with age to 47% of persons aged 75-84 years and to 90% of those aged 85 years or over. Almost two thirds (63%) of people aged 60 years or over who required assistance reported that their needs were fully met, while a third (37%) required more help. Three quarters of older people who needed assistance received help from family or friends.
Persons 60 years or over living in households (excluding aged care facilities) most commonly reported that they needed assistance with property maintenance and health care because of disability or age. Other common areas of need were transport, mobility, housework and self-care.
In 2003, there were 246,800 informal carers providing assistance to people with disabilities and the aged in Western Australia. Females were more likely to be carers than males. The peak caring ages for both males and females were between 35 and 54 years. There were 54,800 women and 41,200 men of these ages providing care to people with disabilities or older people. There were a higher number of female carers in all age groups under 65 years, excepting the 18-24 year age group where the numbers of male and female carers were similar. Of those aged 65 years or over, more men were providing care than women (22,900 and 17,000).
ALL PERSONS LIVING IN HOUSEHOLDS, Carers by age and sex - 2003
In 2003, one in six carers (38,800) in Western Australia was a primary carer. The primary caring role was much more likely to be undertaken by females than males. Almost three quarters (73%) of primary carers of people with disabilities were women. Primary carers were more likely to be female than male in all age groups under 75 years. The age groups with the largest number of female primary carers were 25-34 years and 45-54 years.
Four out of five (31,400) primary carers lived in the same household as the recipient of care and over one third (39%) were caring for a partner. The remainder were caring for children, other relatives or friends. Forty three per cent of primary carers spent more than 40 hours per week providing assistance.
Over one third of carers of persons with a disability (39%) had a reported disability themselves (91,600 people). The rate was higher for primary carers where 44% had a reported disability (17,300 people).
In 2003, 55% of carers (aged 15 years or over) of people with disabilities were employed. People in primary caring roles were less likely to be employed than other carers, 41% compared to 58%. More than a half of primary carers (53%) who were employed worked part-time compared to 36% of other carers.
The most common principal sources of income for all carers of persons with disability were government pensions or allowances (40%) and wages and salaries (40%). Over half (54%) of primary carers relied on government pensions and allowances as their principal source of income. Of those who were not carers of people with disabilities, one half (50%) received wages and salaries as their main source and one quarter (24%) government pensions and allowances.
Disability, Ageing and Carers, Australia: Summary of findings, 2003, cat. no. 4430.0.
Disability, Ageing and Carers, Western Australia: Summary of findings, 2003, cat. no. 4430.5.40.001.
Disability, Ageing and Carers, Australia: User Guide, 2003, cat. no. 4430.0.55.001.