Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-19T07:36:13.370Z Has data issue: false hasContentIssue false

Policy, plans and pathways: the ‘crisis’ transition to post-parental care for people ageing with intellectual disabilities in rural Australian carescapes

Published online by Cambridge University Press:  04 December 2017

BRIDGET GARNHAM*
Affiliation:
Centre for Social Change, University of South Australia, Adelaide, Australia.
LIA BRYANT
Affiliation:
Centre for Social Change, University of South Australia, Adelaide, Australia.
PAUL RAMCHARAN
Affiliation:
Future Social Service Institute, RMIT, Melbourne, Australia.
NILAN YU
Affiliation:
Centre for Social Change, University of South Australia, Adelaide, Australia.
VALERIE ADAMS
Affiliation:
Centre for Social Change, University of South Australia, Adelaide, Australia.
*
Address for correspondence: Bridget Garnham, Centre for Social Change, School of Psychology, Social Work and Social Policy, University of South Australia Magill Campus, St Bernards Rd, Magill, Adelaide SA E-mail: Bridget.Garnham@unisa.edu.au

Abstract

The concurrent ageing of parental care-givers and people with intellectual disabilities is driving academic and social welfare concern for a post-parental care ‘crisis’. The ‘crisis’ typically pertains to a transition from primary care in the family home precipitated by the death or incapacity of older parents without a pre-planned pathway to post-parental care. This crisis is amplified in rural communities given low service engagement with families and a deficit of disability-supported accommodation and services. Academics, service providers and policy makers have responded through a problematisation of post-parental care planning. This focus continues to normalise informal care, burdens families with responsibility for planning, and diverts attention from structural deficits in the socio-political carescape. This paper attends to the Australian policy landscape in which long-term care-giving for families living with intellectual disability is enmeshed. It contends that the dyadic and didactic model of informal long-term care has profound implications for social service support and post-parental care planning. Problematisation of carers’ ‘need’ to relinquish primary care and for people with intellectual disabilities to transition to independent and supported living is necessary to unsettle the dominant policy and service discourse around the provision of services to sustain informal care-giving. Innovation is then needed to forge pathways of support for families in rural communities planning on continuing, transitioning and transforming care arrangements across the lifespan.

Type
Article
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Australian Bureau of Statistics 2014. Intellectual Disability Australia 2012. Commonwealth of Australia, Canberra.Google Scholar
Australian Institute of Health and Welfare 2016. Disability Support Services: Services Provided Under the National Disability Agreement 2014–15. Australian Government, Canberra.Google Scholar
Beadle-Brown, J., Mansell, J. and Kozma, A. 2007. Deinstitutionalization in intellectual disabilities. Current Opinion in Psychiatry, 20, 5, 437–42.Google Scholar
Bellamy, J., Paleologos, Z., Kemp, B., Carter, S. and King, S. 2014. Caring into Old Age: The Wellbeing and Support Needs of Parent Carers of People with Disabilities. Anglicare Diocese of Sydney, Social Policy and Research Unit, Sydney.Google Scholar
Bibby, R. 2013. ‘I hope he goes first’: exploring determinants of engagement in future planning for adults with a learning disability living with ageing parents. What are the issues? British Journal of Learning Disabilities, 41, 2, 94105.Google Scholar
Bigby, C. 1996. Transferring responsibility: the nature and effectiveness of parental planning for the future of adults with intellectual disability who remain at home until mid-life. Journal of Intellectual & Developmental Disability, 21, 4, 295312.Google Scholar
Bigby, C. 2000. Moving on Without Parents: Planning, Transitions and Sources of Support for Middle-aged and Older Adults with Intellectual Disability. MacLennan & Petty, Sydney.Google Scholar
Bigby, C. 2008. Beset by obstacles: a review of Australian policy development to support ageing in place for people with intellectual disability. Journal of Intellectual & Developmental Disability, 33, 1, 7686.Google Scholar
Bigby, C., Ozanne, E. and Gordon, M. 2002. Facilitating transition: elements of successful case management practice for older parents of adults with intellectual disability. Journal of Gerontological Social Work, 37, 3/4, 2543.Google Scholar
Bowey, L. and Mcglaughlin, A. 2007. Older carers of adults with a learning disability confront the future: issues and preferences in planning. British Journal of Social Work, 37, 1, 3954.Google Scholar
Bowlby, S., McKie, L., Gregory, S. and MacPherson, I. 2010. Interdependency and Care Over the Lifecourse. Routledge, Abingdon, UK.Google Scholar
Brennan, D., Murphy, R., McCallion, P. and McCarron, M. 2016. Caregiving capacity and future care planning of family carers for older people with an intellectual disability in Ireland. Age and Ageing, 45, supplement 2, ii1–12.Google Scholar
Browne, P. 2010. The dialectics of health and social care: toward a conceptual framework. Theory and Society, 39, 5, 575–91.Google Scholar
Bryant, L. and Garnham, B. 2016. Bounded choices: the problematisation of longterm care for people ageing with an intellectual disability in rural communities. Journal of Rural Studies, 51, 259–66.Google Scholar
Cairns, D., Tolson, D., Brown, J. and Darbyshire, C. 2013. The need for future alternatives: an investigation of the experiences and future of older parents caring for offspring with learning disabilities over a prolonged period of time. British Journal of Learning Disabilities, 41, 1, 7382.Google Scholar
Carers Australia 2016. Submission to the Department of Social Services (DSS) on Delivering an Integrated Carer Support Service. Carers Australia, Canberra.Google Scholar
Carlson, L. and Kittay, E. F. 2010. Introduction: rethinking philosophical presumptions in light of cognitive disability. In Kittay, E. F. and Carlson, L. (eds), Cognitive Disability and Its Challenge to Moral Philosophy. Wiley-Blackwell, Oxford, 125.Google Scholar
Department of Social Services 2016 a. Carer Recognition Act 2010 Guidelines: A Guide for Australian Public Service Agencies for the Implementation of the Carer Recognition Act 2010. Australian Government, Canberra.Google Scholar
Department of Social Services 2016 b. Integrated Plan for Carer Support Services. Australian Government, Canberra.Google Scholar
Eley, D., Boyes, J., Young, J. and Hegney, D. 2009 a. Accommodation needs for carers of and adults with intellectual disability in regional Australia: their hopes for and perceptions of the future. Rural and Remote Health, 9, 3, 113.Google Scholar
Eley, D., Boyes, J., Young, L. and Hegney, D. 2009 b. Adults with intellectual disability in regional Australia: incidence of disability and provision of accommodation support to their ageing carers. Australian Journal of Rural Health, 17, 3, 161–6.Google Scholar
Fairthorne, J., Klerk, N. and Leonard, H. 2016. Brief report: burden of care in mothers of children with autism spectrum disorder or intellectual disability. Journal of Autism and Developmental Disorders, 46, 3, 1103–9.Google Scholar
Foster, M., Henman, P., Fleming, J., Tilse, C. and Harrington, R. 2012. The politics of entitlement and personalisation: perspectives on a proposed national disability long-term care and support scheme in Australia. Social Policy and Society, 11, 3, 331–43.Google Scholar
Fuller, J., Edwards, J., Procter, N. and Moss, J. 2000. How definition of mental health problems can influence help seeking in rural and remote communities. Australian Journal of Rural Health, 8, 3, 148–53.Google Scholar
Glendinning, C., Mitchell, W. and Brooks, J. 2015. Ambiguity in practice? Carers’ roles in personalised social care in England. Health Social Care in the Community, 23, 1, 2332.Google Scholar
Heaton, J. 1999. The gaze and visibility of the carer: a Foucauldian analysis of the discourse of informal care. Sociology of Health & Illness, 21, 6, 759–77.Google Scholar
Heller, T., Caldwell, J. and Factor, A. 2005. Supporting Ageing Caregivers and Adults with Developmental Disabilities in Future Planning. Rehabilitation Research and Training Centre on Ageing with a Developmental Disability, University of Illinois, Chicago.Google Scholar
Hewitt, A., Lightfoot, E., Bogenschutz, M., Mccormick, K., Sedlezky, L. and Doljanac, R. 2010. Parental caregivers’ desires for lifetime assistance planning for future supports for their children with intellectual and developmental disabilities. Journal of Family Social Work, 13, 5, 420–34.Google Scholar
Hussain, R., Parmenter, T., O’Brien, P., Janicki, M., Knox, M., Leggatt-Cook, C. and Wark, S. 2014. It’s different in the country': supporting ageing-in-place for people with intellectual disabilities. Final Report to National Disability Research and Development Agenda, Australian Government. Available: https://www.adhc.nsw.gov.au/__data/assets/file/0013/304060/8a-Its-different-in-the-country.pdfGoogle Scholar
Iacono, T., Evans, E., Davis, A., Bhardwaj, A., Turner, B., Torr, J. and Trollor, J. N. 2016. Family caring of older adults with intellectual disability and coping according to loci of responsibility. Research in Developmental Disabilities, 57, 170–80.Google Scholar
Irazabal, M., Pastor, C. and Molina, M. C. 2016. Family impact of care and respite service: life experiences of mothers of adult children with intellectual disability and mental disorders. Revista de Cercetare si Interventie Sociala, 55, 718.Google Scholar
Judd, F., Jackson, H., Komiti, A., Murray, G., Fraser, C., Grieve, A. and Gomez, R. 2006. Help-seeking by rural residents for mental health problems: the importance of agrarian values. Australian and New Zealand Journal of Psychiatry, 40, 9, 769–76.Google Scholar
Kittay, E., Jennings, B. and Wasunna, A. 2005. Dependency, difference and the global ethic of longterm care. Journal of Political Philosophy, 13, 4, 443–69.Google Scholar
Laragy, C., Fisher, K. R., Purcal, C. and Jenkinson, S. 2015. Australia's individualised disability funding packages: when do they provide greater choice and opportunity? Asian Social Work and Policy Review, 9, 3, 282–92.Google Scholar
Larkin, M. and Mitchell, W. 2016. Carers, choice and personalisation: what do we know? Social Policy and Society, 15, 2, 189205.Google Scholar
Llewellyn, G., Mcconnell, D., Gething, L., Cant, R. and Kendig, H. 2010. Health status and coping strategies among older parent-carers of adults with intellectual disabilities in an Australian sample. Research in Developmental Disabilities, 31, 6, 1176–86.Google Scholar
Mckenzie, J. A. 2016. An exploration of an ethics of care in relation to people with intellectual disability and their family caregivers in the Cape Town metropole in South Africa. Alter – European Journal of Disability Research, Revue européen de recherche sur le handicap, 10, 1, 6778.Google Scholar
Miller, P. and Hayward, D. 2017. Social policy ‘generosity’ at a time of fiscal austerity: the strange case of Australia's National Disability Insurance Scheme. Critical Social Policy, 37, 1, 128–47.Google Scholar
Muraver, A. R. M. 2001. Undesired life events, life satisfaction and well-being of ageing mothers of adult offspring with intellectual disability living at home or out-of-home. Journal of Intellectual and Developmental Disability, 26, 3, 195204.Google Scholar
Nankervis, K., Rosewarne, A. and Vassos, M. 2011. Why do families relinquish care? An investigation of the factors that lead to relinquishment into out-of-home respite care. Journal of Intellectual Disability Research, 55, 4, 422–33.Google Scholar
Ng, N., Sandberg, M. and Ahlström, G. 2015. Prevalence of older people with intellectual disability in Sweden: a spatial epidemiological analysis. Journal of Intellectual Disability Research, 59, 12, 1155–67.Google Scholar
Phillips, J. 2007. Care. Polity, Cambridge.Google Scholar
Philo, C., Parr, H. and Burns, N. 2003. Rural madness: a geographical reading and critique of the rural mental health literature. Journal of Rural Studies, 19, 3, 259–81.Google Scholar
Pilnick, A., Clegg, J., Murphy, E. and Almack, K. 2011. ‘Just being selfish for my own sake…’: balancing the views of young adults with intellectual disabilities and their carers in transition planning. The Sociological Review, 59, 2, 303–23.Google Scholar
Pini, B., Philo, C. and Chouinard, V. 2017. On making disability in rural places more visible: challenges and opportunities [Introduction to a special issue]. Journal of Rural Studies, 51, 223–9.Google Scholar
Purcal, C., Fisher, K. R. and Laragy, C. 2014. Analysing choice in Australian individual funding disability policies. Australian Journal of Public Administration, 73, 1, 88102.Google Scholar
Qu, L., Edwards, B. and Gray, M. 2012. Ageing Parent Carers of People with a Disability. Australian Institute of Family Studies, Australian Government, Canberra.Google Scholar
Rummery, K. and Fine, M. 2012. Care: a critical review of theory, policy and practice. Social Policy & Administration, 46, 3, 321–43.Google Scholar
Seltzer, M., Floyd, F., Song, J., Greenberg, J. and Hong, J. 2011. Midlife and aging parents of adults with intellectual and developmental disabilities: impacts of lifelong parenting. American Journal on Intellectual and Developmental Disabilities, 116, 6, 479–99.Google Scholar
Senate Community Affairs Reference Committee 2011. Disability and Ageing: Lifelong Planning for a Better Future. Commonwealth of Australia, Canberra.Google Scholar
Taggart, L., Truesdale-Kennedy, M., Ryan, A. and McConkey, R. 2012. Examining the support needs of ageing family carers in developing future plans for a relative with an intellectual disability. Journal of Intellectual Disabilities, 16, 3, 217–34.Google Scholar
Twigg, J. and Atkin, K. 1994. Carers Perceived: Policy and Practice in Informal Care. Open University Press, Maidenhead, UK.Google Scholar
Walker, C. and Ward, C. 2013. Growing older together: ageing and people with learning disabilities and their family carers. Tizard Learning Disability Review, 18, 3, 112–9.Google Scholar
Wark, S., Hussain, R. and Edwards, H. 2014. Impediments to community-based care for people ageing with intellectual disability in rural New South Wales. Health & Social Care in the Community, 22, 6, 623–33.Google Scholar
Wiesel, I. and Bigby, C. 2015. Movement on shifting sands: deinstitutionalisation and people with intellectual disability in Australia, 1974–2014. Urban Policy and Research, 33, 2, 178–94.Google Scholar
Wiesel, I. and Habibis, D. 2015. NDIS, housing assistance and choice and control for people with disability. AHURI Final Report 258, Australian Housing and Urban Research Institute, Melbourne.Google Scholar
Wright, C. J., Muenchberger, H. and Whitty, J. A. 2015. The choice agenda in the Australian supported housing context: a timely reflection. Disability & Society, 30, 6, 838–48.Google Scholar