Disabled In America
The growing need for care homes.
Today, let me challenge you to count the number of people you see. Tonight, divide that by four. That’s how many disabled people you encountered. That’s right. Statically, one in four people, 25.7%, roughly 61 million people in the United States, have at least one disability. This is a number that is expected to continue to rise.
Current stats state that 1in every six children, which equates to 15% of the population, is classified as developmentally disabled. Twenty years ago that number was only 5%. The classification and definition changes since then attributes some to the increase, but does not account for all of it. For this, science has no answer. Theories range from childhood vaccines given too close together to the foods they eat labeled as the culprit.
Lifelong developmental disabilities are discovered in childhood and include Cerebral Palsy, Autism, or Autism Spectrum Disorder, and Attention Deficit Hyperactivity Disorder.
A lifelong disability is defined by a difficulty in hitting threshold marks or higher in one or more of the following areas: physical, language, learning, or behavioral.
Adults, not considered disabled in youth, can be classified as having a disability as they age. Adult disabilities encompass mobility issues, cognition problems, and independent living struggles.
7% of older adults have mobility problems, meaning they struggle with stairs, getting into and out of a tub, arthritis, and balance issues, for example. https://www.pewresearch.org/short-reads/2023/07/24/8-facts-about-americans-with-disabilities/
6% have independent living concerns, which include limited mobility, an example is difficulty in navigating stairs. Another example is the ability to go to appointments or shopping on their own. https://www.pewresearch.org/short-reads/2023/07/24/8-facts-about-americans-with-disabilities/
5% have cognitive degeneration issues which include problems such as memory decline, decision making, and confusion. Aging, studies suggest, is not for sissies or for the weak. https://www.pewresearch.org/short-reads/2023/07/24/8-facts-about-americans-with-disabilities
These numbers are higher according to the Center for Disease Control. They record:
12.1% of the elderly have a mobility disability.
7.2% of older adults have independent living issues
12.8% suffer from cognitive degeneration issues
https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
The one factor which unites both disability age groups is neither can live alone.
Granted, most of the children who struggle with developmental disabilities live in their family home. Parents are the primary caregivers most time in these circumstances, but parents like their children get older. What happens when they can no longer adequately take care of their child? The usual circle of life where a child grows up and goes out into the world on their own never gets completed. It stopped forming, but the aging of both parent and child continues.
Older adults, who become disabled, may have a child who can and will move them into their home, but what about the ones who don’t have children or do not have a child who can physically or financially take care of mom or dad? What happens to them?
Studies have proven that disabled persons, whether they are young adults or seniors, do better in homelike settings. A home feel, rather than an institution situation, provides them with a sense of security, belonging, and community. Staffs made up of caregivers, aides, occupational and behavioral therapists, clinical social workers, drivers can provide the care residents need while offering them the sense of independence each of us crave.
In 1999, the Olmstead Act gave the disabled back their voice. The Supreme Court decided that disabled people have the right, if they receive state supported funding, to live in a community if they choose, not be placed in an institutional facility.
The National Council in 2009 conducted a study on the cost of community housing versus institutional care. They found the average cost of facility care in the US was $188,000. The average for comparable service community based care was $42,000. The price difference means significant savings for taxpayers without a reduction in care for residents.
Studies since then have shown home based care residents do better in their therapies, mental health and physical wellbeing than ones in a facility setting.
So if it’s cheaper and better to house the disabled community in home settings, then why isn’t more being done to get the over two million disabled individuals who are still in a care facility into a residential home? You may ask why don’t state agencies buy or build residential housing, if it’s been determined to be better and cheaper for the care of adult developmentally disabled rather than continue to fund facilities? That seems like the logical thing to do, you say.
Because a competent attorney could make a sound case for conflict of interest should a government agency wish to purchase or lease houses for state funded individuals to live in. It would be easy to make a connection between the funding agency and the care provider. While Peter frequently robs Paul in government, nobody likes anything that smells fishy. Oversight in these situations is often overlooked. The people who are being cared for do not need to be lost in a shuffle game.
What the Olmstead act created is a new business concept. Companies, such as Zuriel LLC, a Richmond, Virginia based business, fill this unique niche. They purchase homes in residential communities and make the necessary improvements to house developmentally disabled and/or behaviorally challenged individuals safely. They then evaluate and staff the home with all the care workers needed to support each person they house.
Per Zuriel standards, a residence can house only the amount of bedrooms listed in occupancy records. A four-bedroom house equals four residents. They stick to their policy of everyone gets their own room. When asked why not put two or three in a room since the need for housing is greater than the amount of rooms, Jevette Smith, executive director of Zuriel LLC, responded, “Each person needs space. They need a space to be alone in, a space to feel safe in and a space to call their own. We give them that.”
Now you may think that only having four residents at a home does not provide many employment opportunities for skilled workers, but you would be wrong. Each home operated by Zuriel, for example, provides 20 plus jobs. These include registered nurses, clinical social workers, occupational therapists, direct support personal (DSP) and individual aides (IA). The downside is the risk of burnout in the DSP and IA roles.
Recently, they received a grant from the Virginia Department of Department of Behavioral Health and Development Services, which will help them open two homes in Roanoke and two in Virginia Beach. Both areas are considered being counties that fall into the second highest need percentile for homes in the state. Four homes, though, are only a drop of water in the bucket of need for disabled housing.
*1,614,174 adults in Virginia have disability. That number equates to 24% of the population. https://www.cdc.gov/ncbddd/disabilityandhealth/impacts/virginia.html
*Disability healthcare consumes one third of Virginia’s healthcare budget. That’s just Virginia. https://www.cdc.gov/ncbddd/disabilityandhealth/impacts/virginia.html
*There are close to 61 million disabled individuals in the United States, according the CDC 2023 records. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html
Disabled individuals suffer from other health issues besides their disability issues. They are more likely to be obese, have diabetes and heart disease, smoke, and have depression. These health risks add to the cost of their care. Costs, that will only rise with time. Unmanaged issues such as diabetes or lung diseases open the door to other health problems and higher care costs. Not to mention limiting the quality of life a person has and shortening its length.
Obviously, there is a need for companies such as Zuriel LLC to open more homes. Taking care of the disabled is challenging and not everyone is suited to working with them, however this is a growing population and skilled labor in this field will always be needed. Yet instead of being proud of their profession, care workers can feel they too, like the individuals they care for, are second-class citizens. The skill set needed to provide developmentally disabled with a high quality of life is often undervalued. Increase wages will add to the work pool, but validation and accreditation can help more.
Some colleges, such as Roanoke College, in Roanoke Virginia, are creating degree programs to help decrease the shortage of qualified disability workers. With institutions seeking to add degreed programs, society will begin to accept and validate the work and the challenges these people take on. The hope lies in history. Nursing, once seen as a no skill menial job, is now called a worthy and honored role in society.
The disabled have been around for ages. More exist now and more will be with us in the future. Isn’t it time for us to make a better effort to ensure they have a higher quality of life? Wouldn’t you want it for your child or yourself? The way the statistics are growing, one day you could be disabled. It will be too late then to want improvement in the system. The time to address this issue is now.
