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4102.0 - Australian Social Trends, 2004  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 15/06/2004   
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Contents >> Family and Community >> Support for people with a disability

Services and Assistance: Support for people with a disability

In 2002, over 90% of adults with a disability felt that they could ask for help in a time of crisis from someone outside their own household - most commonly a family member living elsewhere.

The term ‘people with a disability’ covers a wide range of differing life experiences and physical and mental states. However, many people with a disability, particularly those with a severe physical or mental impairment, are amongst the most vulnerable and disadvantaged in our society. Of particular concern are those people with limitations affecting the core activities of self-care, mobility or communication, and those with education or employment restrictions. They are the most likely to experience economic hardship, unemployment, family breakdown, social isolation, and physical or emotional neglect or abuse.(SEE ENDNOTE 1)

WELLBEING OF PEOPLE WITH A DISABILITY

Among adults (aged 18 years and over) living in private households in 2002, those with disabilities rated lower than those without disabilities on a range of wellbeing indicators, the relative disadvantage increasing with the degree of disability. For example, adults with a profound or severe core activity limitation were the least likely to describe their general health as either very good or excellent - 14% compared with 34% of all adults with a disability and 76% of those without disabilities. Similarly, people with disabilities were less able to get easily to the places they needed to go; less likely to have been involved in a community-based social or recreational activity; and less likely to feel safe at home alone after dark.

PEOPLE WITH A DISABILITY

The primary source of data used in this article is the General Social Survey (GSS) conducted by the ABS in 2002. The GSS identifies people (aged 18 years and over) with a disability or long-term health condition living in private households. People living in institutional settings are excluded from the GSS.

Disability is the umbrella term for any or all of the following: an impairment in body structure or function; a limitation in activities; or, a restriction in participation. (WHO ICF 2001). When referring to GSS-sourced data in this article, ‘disability’ means ‘disability or long-term health condition’. This differs from the disability measure produced by the ABS Survey of Disability, Ageing and Carers (SDAC) in that it includes more people with long-term health conditions but slightly fewer people with profound or severe core limitations. The GSS and SDAC both provide reliable data on the characteristics of people with disabilities but only the SDAC is designed to provide a reliable measure of the prevalence of disability in Australia.

People with a specific limitation or restriction have difficulty with schooling, employment or one or more of the core activities of self-care, mobility or communication.

People with a profound core activity limitation always need help with self-care, mobility or communication, or are unable to do these tasks.

People with a severe core activity limitation sometimes need help with self care, mobility or communication; or have difficulty understanding or being understood by family or friends; or communicate more easily using sign language or other non-spoken forms of communication.

SELECTED INDICATORS OF WELLBEING: PROPORTION OF POPULATION(a) BY DISABILITY(b) STATUS - 2002

No disability
Disability
Specific limitation or restriction
Profound/severe core activity limitation
%
%
%
%

Self-assessed health status very good/excellent
75.9
33.8
21.8
13.7
Has a non-school qualification
45.3
36.9
33.9
25.9
Employed (of all aged 18-64 years)
80.4
62.0
48.9
34.4
Middle to high household income(c)
71.0
47.7
39.4
33.2
Can easily get to the places needed
87.7
79.2
69.9
54.1
At least one social activity in past three months
94.6
88.5
85.1
77.7
Feels safe/very safe at home alone after dark
85.9
78.5
73.7
68.2

(a) Aged 18 years and over.
(b) Disability or long-term health condition.
(c) In the top 60% of all persons when ranked according to their equivalised gross household income.
Source: ABS 2002 General Social Survey.

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
GRAPH - ABLE TO ASK OTHERS(a) FOR SMALL FAVOURS: Poportion of poulation(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.



SOURCES OF SUPPORT IN TIME OF CRISIS: PROPORTION OF POPULATION(a) BY DISABILITY(b) - 2002

No disability
Disability
Specific limitation or restriction
Profound/severe core activity limitation
%
%
%
%

Family member(c)
83.8
80.4
76.8
74.5
Friend(c)
70.9
58.9
56.6
44.4
Neighbour
33.0
35.8
34.1
29.4
Work colleague
25.8
15.1
10.7
4.0
Community/charity/religious organisation
13.3
14.9
16.3
16.3
Health, legal or financial professional
12.6
14.3
16.6
18.7
Local council or other government services
7.3
8.4
10.1
11.9
Other
1.2
1.3
1.5
*2.0
All with one or more sources of support
95.1
92.4
91.4
88.4

(a) Aged 18 years and over.
(b) Disability or long-term health condition.
(c) Excludes members of own household.
Source: ABS 2002 General Social Survey.



RECEIVING A GOVERNMENT CASH PENSION OR ALLOWANCE: Proportion of population(a) by disability(b) status - 2002
GRAPH - RECEIVING A GOVERNMENT CASH PENSION OR ALLOWANCE: Proportion of population(a) by disablility(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.

INCOME SUPPORT

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.

PEOPLE(a) USING DISABILITY SUPPORT SERVICES(b) ON A SNAPSHOT DAY - 2002

Primary disability group

All other
Intellectual
Physical
Psychiatric
groups(c)
Total
Service type
%
%
%
%
%

Accommodation support
39.1
32.6
32.8
19.8
34.0
Group homes
19.9
7.9
3.2
6.1
14.5
In-home accommodation support
6.6
9.7
23.9
6.4
8.2
Residential institution or hostel
11.7
6.0
1.1
3.7
8.6
Community access
32.3
20.9
28.9
22.4
28.7
Learning and life skills development
23.9
12.3
3.4
11.4
18.5
Recreation/holiday programs
2.7
4.0
1.1
7.5
3.7
Employment
30.6
21.4
37.4
19.1
27.7
Supported employment
23.5
9.7
14.5
8.1
18.1
Community support
13.6
31.5
2.6
39.6
20.1
Case management, local
coordination and development
6.7
12.0
1.5
14.4
8.5
Therapy support for individuals
2.5
14.1
0.1
9.0
5.0
Respite
4.2
7.9
2.4
6.1
4.9
Total using one or more services
100.0
100.0
100.0
100.0
100.0
'000
'000
'000
'000
'000

Total using one or more services
39.9
8.0
4.9
13.0
65.8

(a) Includes people of all ages and those living in institutional settings.
(b) CSDA-funded services only.
(c) Comprises the following disability groups - specific learning/attention deficit disorder, autism, acquired brain injury, neurological, deaf/blind, vision, hearing, speech, developmental delay, and people whose primary disability was not stated.
Source: AIHW 2003, Disability Support Services 2002.

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.


DISABILITY SUPPORT SERVICES

The disability support services data presented in this article relate to services funded or directly provided by Australian governments in 2002 under the then Commonwealth/State Disability Agreement (CSDA)*. This agreement between the Commonwealth, state and territory governments provides a framework for the provision of specialist support services for people with a disability. These services are designed for people who need ongoing support with everyday life activities.

Statistics on the types of disability support services provided under CSDA, and the characteristics of both the providers and recipients of these services, have been collated by the Australian Institute of Health and Welfare (AIHW) annually since 1995. The data relate to a ‘snapshot’ day each year**. Services that do not receive any funding (either full or partial) under CSDA are not included. For example, many services in the areas of rehabilitation, hearing services, aids and appliances - or those funded solely through the Home and Community Care (HACC) program are excluded. Also excluded are residential aged care services, hospitals and any services that receive no government funding. For more information about this dataset, and a comprehensive report on CSDA-funded disability support services on the snapshot day in 2002, see AIHW 2003
Disability support services, 2002.

* The current agreement is known as the Commonwealth-State/Territory Disability Agreement.

** From 2003, data will be collected in relation to the full year.

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:
  • 34% of recipients used accommodation support services either in a community setting, such as a group home (14%) or in-home support (8%), or in a residential institution or hostel (9%)
  • 29% used community access services, mainly learning and life skills development services (18%)
  • 28% used employment services, mainly supported employment (18%)
  • 20% used community support services which include early childhood intervention, specific therapies, counselling and case management services
  • 5% used respite services.

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)

ENDNOTES

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.

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