This study aimed to explore and develop a fresh understanding of the community service needs of persons with spinal injuries. Different concepts of need were explored, which required multiple methodologies including a review of government policies and legislation, analysis of demographic, injury related and service usage data obtained from a survey, and analysis of interviews with persons with spinal injuries and their carers. Normative need was interpreted by government and service providers in terms of functional impairment and economic disadvantage, which did not reflect the individual needs of persons with spinal injuries. Neither were services for persons with spinal injuries provided to individuals according to the criteria of their felt or expressed need for services, their perceptions of the intrinsic importance of services, nor on the basis of redressing comparative inequities in service distribution. Persons with spinal injuries’ need for community services could only be understood on the basis of the contribution services made to the realisation of their plans of life, that is, to be ordinary. In order to parallel plans of ordinariness, services need to be offered in partnership with, or under the control of the person with spinal injuries, foster an essential relationship between the provider and the person with spinal injuries, and not inappropriately assess and judge the life plans of persons with spinal injuries based upon providers’ perceptions of difference. / Doctor of Philosophy (PhD)

Thesis (M. Communication Pathology)--University of Pretoria, 2008. / Includes bibliographical references.

This study examined disabled people’s access to independent living in Scotland and Norway. At the time of the field work for this research in 2012, the literature revealed no comparable social enquiry combining the concepts of citizenship, independent living and governance. Within disability studies, independent living denotes a perspective that recognises the interconnected nature of life areas that affect lived experiences of disablement and inclusion of disabled citizens. From the independent living movement, Centres for Inclusive Living emerged as unique governance structures with full service-user involvement and run by disabled people for disabled people. This study focused upon to what extent the organisational governance structures in the Glasgow Centre for Inclusive Living (GCIL) and Uloba Centre for Independent Living (Uloba) in Norway facilitate or impede disabled people’s access to independent living. The methodology adopted a mixed methods approach. The central method involved organisational case studies with GCIL and Uloba. This enabled an in-depth qualitative exploration through semi-structured interviews with the case study employees, service-user/co-owners and key experts within each country. In addition, an online survey was distributed to other organisations that operated within the disability field. The analytical framework used an integration of the social relational model of disability (Thomas, 1999) and meso level governance analysis (Lowe, 2004). The social relational model of disability provided structural (macro) and agency (micro) level interpretations and an emphasis on psychosocial elements of disability. It also enabled the synergy of a theory of impairment alongside a theory of disability. Meso (organisational) governance analysis focused attention on the connections between organisations in society. This focus revealed the lateral relationships with other meso level bodies, macro institutions and micro individual action. Research participants prioritised the areas of peer support, accessible housing and personal assistance. Peer support was found to take both informal and formal manifestations and acted as a foundation for the other two areas of independent living. The findings highlighted that Centres for Inclusive Living provide facilitation for access to independent living across macro, meso and micro tiers of society. In particular, empowerment, peer support and user led governance formed key strategies that enhanced disabled people’s access to independent living in Scotland and Norway.

Community-based Rehabilitation (CBR) emerged as a response to the failure of the conventional rehabilitation system in developing countries. CBR involves service provision to People with Disabilities (PWDs), changing community attitudes towards disability and transferring knowledge and skills to PWDs, their families and their community. The study investigated the impact of the CBR strategy on PWDs and their families within the Oniipa Constituency in Namibia. The study used a mixed methods research approach and adopted explorative and descriptive research designs. It determined that CBR has initiated positive change processes in community attitudes and increased social integration of PWDs. The study recommends reviewing the definition of CBR, providing financial incentives to CBR Volunteer Workers and reviewing the current legislations on disability in Namibia. A final recommendation is that government should formalise disability studies in the country through the provision of accredited training courses to ensure greater assistance to PWDs and their families. / Public Administration / M.P.A.

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals. ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, assistance, and OC to people of all ages, incomes, and disabilities, and promote long-term care options that honor independence and respect for the needs and preferences of individuals, their families, and caregivers. They are the latest iteration of policymakers' efforts to provide affordable home-and community-based care for older persons and their caregivers. A total of fifteen qualitative interviews were conducted and analyzed using grounded theory methods. Key persons interviewed included experts in the area of aging, aging policy, and aging. Participants were recruited through referrals suggested by Portland State University's (PSU) Institute on Aging (IOA) staff. In addition, several key experts known to the researcher through affiliation with PSU's IOA agreed to be interviewed. Snowball sampling was then used to locate additional key experts. Interview participants were classified as advocates, state decision makers, policy makers, or academicians. Advocates included national and state directors of agencies that promote the development and management of effective services to aging adults. State decision makers included state directors, ADRC directors and supervisors, and program analysts. Policy makers interviewed were national program directors responsible for shaping the future of developing programs to assist older adults. Academicians who participated in the study have been instrumental in developing and researching practices that promote well-being for the aging and the aged. These key experts were selected based on their knowledge and ability to inform the strengths, weakness, and development of ADRCs and Options Counseling. Many have been instrumental in health and aging policy and service development and research, and possess insider knowledge not available to the general public regarding attitudes and interests motivating the actors. Findings indicate that ADRCs and OC are designed to manage within existing social service systems. They can benefit some individuals by providing more options and support in accessing public and private services. It remains to be seen whether they have the capacity to ameliorate some existing system-level problems. Findings highlight program strengths and weaknesses, sustainability issues, and policymakers, state decision makers', and providers' commitment to sustaining ADRCs and OC.