APD survey: A number of problem areas

A man seated in a wheelchair looking out a window that's slightly open.

By Matt Serres, attorney

DHS’s Aging and People with Disabilities Program (APD) conducted a survey  — the National Core Indicators–Aging and Disability (NCI-AD) Survey — to determine the best ways to meet the needs of the 35,000 older adults and people with physical disabilities who they serve.

The feedback gathered by the NCI-AD Survey is designed to help measure and track the performance of providers serving the elderly and persons with physical disabilities.

The outcomes of the survey suggest that our state is doing well in a number of areas, but improvement needs to occur in a number of key areas including community integration, freedom of choice, and safety.

Background

The survey:

  • Assesses the outcomes of services provided to individuals and families in an array of settings including in-home, community-based care, and nursing facilities.
  • Examines areas of concern for elderly and persons with physical disabilities in these settings such as community integration, decision-making, relationships, service coordination, access, safety, healthcare, and individual rights.

The goal of the survey is to improve services for older adults and persons with physical disabilities in order to address important social, community, and person-centered goals as well as quality of life.  The data is gathered annually.

Oregon is among 20 states that currently participate in the survey.  The state conducted the survey for the first time in the 2016-2017 survey cycle and released the results in late January.

improvement needs to occur in a number of key areas including community integration, freedom of choice, and safety.

The Need for Improvement

The results of the 2016-2017 survey shed light on a number of areas where provider services for elderly and persons with physical disabilities are unsatisfactory or need improvement. While survey results vary depending on the setting, the results exhibit a number of problem areas.

Community Integration

The results indicate that service providers need to do more to integrate individuals in the community.  The data reflect that respondents in a number of settings lack access to community activities, family and friends, transportation, and community employment.

  • Only 35 percent of in-home care recipients, 39 percent of nursing facility residents, and 42 percent of participants in the Program of All-inclusive Care for the Elderly (PACE) indicate they are as active in the community as they would like to be.
  • Only two-thirds of adult foster home residents indicate that they can see or talk to friends and family when they want to.
  • In nursing facilities, only 35 percent of residents report that they have transportation when they want to do things outside of the facility.

The data reflect that respondents in a number of settings lack access to community activities, family and friends, transportation, and community employment.

Employment

The survey results are particularly troubling in terms of community integration in the area of employment.

The data show that only 2 percent of individuals across all settings have a paying job in the community.

That 2 percent statistic is even more concerning given that over 30 percent of respondents from in-home care, adult foster home, and residential care facilities indicate that they would like a job.

Service providers are not even exploring employment opportunities with the residents they serve.

On average, only 17 percent of persons across all settings report that someone has talked to them about job options.

Service providers are not even exploring employment opportunities with the residents they serve. 

Freedom of Choice

The results also indicate that providers need to improve freedom of choice among the populations they serve.  The data reflect that respondents lack choices related to everyday living, such as choosing their roommate or choosing when they eat.

They also lack choices in terms of important services they receive and when they receive those services.

  • Only 53 percent of persons across all categories can choose or change what kind of services they get,
  • Only 46 percent can choose or change how often or when they get those services.
  • Particularly in the area of service coordination, the data show that one-third of individuals feel their needs and goals are unmet, yet less than half of the respondents have had case coordinators who speak to them about services to address unmet needs.

The lack of freedom of choice might explain why:

  • 1 out of every 7 of the elderly and persons with disabilities report feeling that they are never in control of their life.

Safety

Providers operating nursing facilities need to improve safety.  The survey results reflect that:

  • 1 out of 10 nursing facility residents indicate they do not feel safe at home
  • 1 out of 7 residents do not feel safe around their paid support staff.

Emergency planning is also a general area of concern.

More than one-third of all respondents indicate there is no emergency plan in place for them.

Financial Exploitation

Providers operating residential care facilities and adult foster homes need to do more to avoid financial exploitation.

In terms of financial abuse and exploitation, adult foster home residents and residential care facility residents are in harm’s way.

Residents in those facilities that report having had money taken or used without their permission:

  • 1 out of every 7 residential care facility residents
  • 1 out of every 9 adult foster home residents

For more information about the NCI-AD Survey and to review the complete 2016-2017 report for Oregon, please visit http://www.oregon.gov/DHS/SENIORS-DISABILITIES/ADVISORY/Pages/NCI-AD.aspx

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