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CommentaryIn Rural West, Fight for Independence Not Over YetBy Cathy Owen Most people with disabilities who live in cities have resources available at their fingertips, from getting personal care to arranging transportation to finding programs that provide assistance. Even some smaller cities and towns provide a wealth of services to help them obtain ramps, wheelchairs, lifts and, most important, personal care. In the rural West, those with physical disabilities typically struggle to find these resources in order to live independently in their homes. For many who live with a family member, personal care is not an issue, but those not so fortunate must, on their own, find attendants to help them in their homes. Some of these individuals, who do not have family nearby, advertise at their local job service or rely on a friend or neighbor to come in and help. Disabled individuals generally dread the idea that their last resort is moving into a nursing home. They do whatever it takes to live as independently as possible by getting jobs, a Medicaid-funded long-term-care waiver, motorized wheelchairs and a competent case manager to assist them. People who live in rural western states seem to fight fiercely to retain their independence. For most people with a physical disability and a desire to be independent, personal care is their top priority. A disabled individual in rural areas can have reliable help for several months and then all of a sudden need to find someone new because the person relied on is moving, going back to school or for some other reason. Then, he or she has to run a new ad or list with a job service again. This can go on for years because there is such a high burnout rate among caregivers. n some cases, a daughter or son caring for a parent can get frustrated by the stress of the daily tasks involved, the isolation, the physical demands and shrinking socialization time with their peers. n rural areas, a person with a disability generally does not have a large pool of aid to draw from for their personal care as there are few, if any, home-health agencies available. For some, the only agency available for personal care is not to their liking. Some individuals talk of moving to urban areas so they can get the services they need to live independently. knew of an agency in a southwestern state that provided 24/7 care that was not a nursing home. This agency had staff that worked rotating shifts, so that the disabled individual could receive round-the-clock home care.That example, however, generally is not the case in rural western states because the population does not support those agencies. A number of home-health agencies in rural areas fail because of a dearth of reliable staff. The Long-Term Care/Home and Community Based Services waiver is a good option for disabled individuals desiring to remain in their homes. It is a Medicaid-sponsored program that provides services for disabled individuals who meet certain medical and financial requirements. Several clients involved in this program are pleased that they can live in their own homes. I believe that the program has improved lives, allowing people more freedom than they had previously and providing a better quality of life. The program, for example, pays for transportation for such things as senior bus rides into town for haircuts, grocery shopping and trips to pick up medications. Once in the program, individuals can remain in it indefinitely or until their health improves. This option is a good way for disabled individuals to get their personal-care needs paid for. It is especially beneficial for disabled persons who live in areas where there are no services offered. Many disabled clients work while in the waiver program, but they must adhere to a dollar limit on their earnings. In some cases, a job may offer a health-insurance package enticing enough for a client to work full-time again. . Generally, those who work while in the waiver program have more financial flexibility than those who don’t. Some clients even run their own businesses with the help of vocational rehab, which may provide start-up equipment. Many of the disabled who live and work in rural western America face challenges getting to and from each town. It may take an hour or more to get to the nearest doctor or grocery store. Although some western states offer transportation programs, those that don’t leave disabled individuals hoping to find reliable vehicles. In sum, people with disabilities live and work much the same as those without them, and most don’t want their conditions to limit their dreams of independence. Cathy Owen is from Wyoming. She is taking writing courses twriting courses at College and hopes to become an author. |
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