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The act requires hospitals that receive Medicare funding and that provide emergency services to evaluate anyone who comes to their emergency room and requests treatment. If the evaluation confirms that you have an emergency medical condition, including active labor, they are then required to provide stabilizing treatment for you regardless of your ability to pay. A variety of federal, state, and local housing programs can help you find and afford a place to live, modify an existing home for disabilities, or help you develop skills to live independently.

People with disabilities are eligible for all public housing programs , rental assistance or subsidized housing , and Housing Choice Section 8 voucher programs. Learn about eligibility, how to apply, and more for each of these programs. Your state and your local city or county governments can explain any housing aid and programs for people with disabilities in your area.

Certain Developments Vouchers can help non-elderly families that include a person with a disability find affordable rentals in housing developments limited to elderly residents.

Oncology Care for Patients With Intellectual Disabilities - The ASCO Post

The US Department of Agriculture USDA Rural Development program offers loans and grants for homeowners in rural areas for removing health hazards and making home modifications to accommodate a household member with a physical disability. State and local independent living centers can help you develop skills to live on your own with a disability. Contact your state to find out how its department of human services or disability office may be able to assist with modifications, housing counseling, locating rental housing, and independent living skills.

You may require things like ramps, grab bars, or service animals. It is illegal for housing providers to deny someone housing because of a disability or refuse to make reasonable accommodations for a tenant with a disability.

Start by contacting your state vocational rehabilitation agency. The agency can point you to state grant and loan programs that may help cover costs. You can also look into other ways to pay. Depending on your situation and where you live, these can include:. A driver rehabilitation specialist DRS will identify the best vehicle modifications for you. To find a qualified DRS in your area, check with your local rehabilitation center.

State vocational rehabilitation agency. State workers' compensation official. Make sure you buy a vehicle that can be modified to meet your needs.

1. Background

Modify your vehicle. Your DRS can provide hands-on training in using your new equipment, which may be complex. Your vocational rehabilitation agency or workers' compensation may pay for the training. Service animals are trained to complete work and tasks for the specific, individual needs of people with disabilities. In some cases, the ADA also recognizes miniature horses as service animals. The aim of this study is to compare the health-related quality of life of unemployed and employed women with disabilities, establish the factors affecting their personal life satisfaction, and give guidelines for advancing their quality of life.

The study included employed and unemployed women with disabilities. The sample was not randomly selected from an open population, but we included only women who voluntary answered the questionnaire. It was initially planned to match the women according to age, residence, marital, and professional background.

Ensuring High-Quality Oncology Care for Patients With Intellectual Disabilities

However, due to difficulties with data collection, only age and residence could be matched. The planned number of respondents for the control group of employed women with disability was recruited through the Croatian Union of Physically Disabled Persons Associations, Croatian Association of the Blind, Association of Multiple Sclerosis Societies of Croatia, and the web-based employment service Moj Posao. Unemployed women with disability were recruited in cooperation with the Croatian Employment Service and their branch offices, which conducted the survey in all counties. The associations were asked to inform all their members interested in participation, while the Croatian Employment Service was asked to include all registered unemployed women with disability.

Implementation coordinators were chosen regionally to distribute the questionnaires to their members and were trained by the researchers on the manner of data collection. The focus was placed on independent, truthful, anonymous, and suggestion-free filling out. In special cases, meetings were organized with interested women with disability, at which researchers further clarified how to fill out questionnaires. In all other cases, questionnaires were sent by mail to coordinators, who after telephone reminders by researchers, sent filled out questionnaires four months later.

The study was carried out between April and April It measures QoL by encompassing 4 domains: 1 physical health, 2 psychological health, 3 social relationships, and 4 environment, as well as two general questions: health and QoL self-assessment. Physical health domain comprises activities of daily living, dependence on medicinal substances and medical aids, energy and fatigue, mobility, pain and discomfort, sleep and rest, and work capacity.

Psychological domain covers bodily image and appearance, negative feelings, positive feelings, self-esteem, spirituality, religion, and personal beliefs, thinking, learning, memory, and concentration. Social relationships domain includes personal relationships, social support, and sexual activity. Environment domain contains financial resources, freedom, physical safety and security, health and social care: accessibility and quality, home environment, opportunities for acquiring new information and skills, participation in and opportunities for recreation and leisure activities, physical environment pollution, noise, traffic, climate , and transport.

Domain results were obtained by combining 24 questionnaire scales. Units of general quality of life and general health were analyzed separately.


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Descriptive statistics was used to present data on age, family status, and education level of participants mean and standard deviation for quantitative continuous variable, percentage for categorical variables. Domain scores were additionally transformed into a scale of , in a form of percentage of scale maximum for the purpose of better result interpretation and comparison, but the statistical analyses were performed on original scores. Statistical analysis was performed using statistical software Statistica, version 7.

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The study included women with disabilities, of whom were employed and unemployed. The median range age of employed women was Two unemployed and unmarried respondents were excluded from the study because they sent poorly filled out questionnaires out of schedule. The study covered different types of physical disability; the inclusion criterion was the ability to fill out the questionnaire independently and properly.

Respondents with mental retardation were excluded.

The Current State of Health Care for People with Disabilities

The majority of employed women were married There were Since the two groups differed according to education and relationship status, we tested if there was a significant relationship between QoL domains and those variables. Education level was not significantly correlated with any of health-related QoL domains in either group of women Table 2.


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  5. Unemployed women showed significantly lower health-related QoL on three domains: psychological health, social relationships, and environment, while no significant difference between unemployed and employed women was detected in physical health. The most notable dissimilarity in percentage of the scale maximum cca. Unemployed women rated their overall quality of life significantly lower than employed women.

    However, two groups of women did not differ in satisfaction with their health in general Table 3. Quality of life on four domains and self-assessment of the overall quality of life and satisfaction with health, with the test and significance of difference between unemployed and employed group of women.

    We explored the main factors that contribute to satisfaction and dissatisfaction with life. The majority of unemployed women listed family Employed women, however, ordered the factors differently — family issues Priority factors of life dissatisfaction and reduced quality of life for unemployed women with disabilities were not having a job Our study showed that unemployed women with disabilities had a lower self-assessed health-related QoL and a significantly lower self-assessed overall QoL than employed women, which confirms that employment is an important determinant of QoL and health.

    Employment cannot be the only factor affecting QoL and health; certain socio-demographic variables, such as education level or relationship status also may have an impact However, our results revealed no difference in QoL between women who lived with a partner and those who lived alone. Also, there was no significant correlation between education level and QoL in either group.

    This deviation from other studies 14 , 15 can be explained by the youth of respondents who possibly did not yet fully appreciate education level and relationship status or by the negative influence that disability may have on the perception of the quality of life and health, thus nullifying the positive effects of education and relationship status For all population groups in an unfavorable position on the labor market, including disabled women, employment or reintegration are essential 16 for health and quality of life 17 - For example, unemployed persons who suffered disability after a burn injury have a lower QoL and more posttraumatic stress disorder symptoms than persons who returned to work after the accident The benefits of work for persons with disabilities include the ability to support their families, earn a social status and respect from their environment, apply their knowledge and skills, as well as advance professionally Our research points to a noteworthy difference between the observed groups in the psychological health domain, where employed women reported This reaffirms the thesis that employed women with disabilities have a better self-image, more self-respect and confidence than unemployed women with disabilities.

    The former were shown to be more socially active, generally more adaptable to change, and competent in everyday life, as well as less prone to illness 3. Women with disabilities who had been unemployed for a longer time reported that their basic problem were functioning disorders 22 , 23 , while this study showed certain other problems aside from unemployment : inadequate societal and governmental care for the disabled, poor economic situation, and financial and general insecurity, despite all the community efforts activities under the National Strategy for Equalization of Opportunities for Persons with Disabilities, and in organization of disabled persons associations , which try to improve the QoL and provide equal opportunities for this particularly vulnerable population group.

    The possible reasons for this are insufficient media support and less information for persons with disabilities about policy and social activities for equalization of opportunities but also scarce and possibly inadequate political and social measures taken to improve their prospects of employment 3. All undertaken measures are, as our study showed, still insufficient to significantly improve the perception of quality of life. This study gives insight into factors positively affecting the QoL of women with disabilities.

    Both groups pointed out family as the most important factor affecting life satisfaction on a larger scale. Since according to the Disabilities Registry 24 , women with disabilities live with their families and their families are exposed to great stress 25 , this is an encouraging finding 26 , 3.

    Successful employment of persons with disabilities has become an important criterion in evaluating the system efficiency in the areas of social security and QoL in every country According to the European Community Household Panel, between and thirteen Member Countries were deemed efficient primarily in terms of self-employment of disabled persons According to the Croatian definition, the self-employment of disabled persons means that one or more persons with disabilities start a craft or cooperative, or freelance, agricultural or forestry activity that is registered in a competent registry 2.

    Experience showed that in this way persons with disability would more likely get self-employed than persons without disability. Self-employment provides flexibility and offers greater adaptability between disability status and work. Also, self-employed people with disability have higher satisfaction with work, type of work, and working conditions than people without disability who work for somebody else A variety of federal, state, and local housing programs can help you find and afford a place to live, modify an existing home for disabilities, or help you develop skills to live independently.

    People with disabilities are eligible for all public housing programs , rental assistance or subsidized housing , and Housing Choice Section 8 voucher programs. Learn about eligibility, how to apply, and more for each of these programs. Your state and your local city or county governments can explain any housing aid and programs for people with disabilities in your area. Certain Developments Vouchers can help non-elderly families that include a person with a disability find affordable rentals in housing developments limited to elderly residents.

    The US Department of Agriculture USDA Rural Development program offers loans and grants for homeowners in rural areas for removing health hazards and making home modifications to accommodate a household member with a physical disability. State and local independent living centers can help you develop skills to live on your own with a disability. Contact your state to find out how its department of human services or disability office may be able to assist with modifications, housing counseling, locating rental housing, and independent living skills.

    You may require things like ramps, grab bars, or service animals. It is illegal for housing providers to deny someone housing because of a disability or refuse to make reasonable accommodations for a tenant with a disability. Start by contacting your state vocational rehabilitation agency. The agency can point you to state grant and loan programs that may help cover costs.

    You can also look into other ways to pay. Depending on your situation and where you live, these can include:. A driver rehabilitation specialist DRS will identify the best vehicle modifications for you. To find a qualified DRS in your area, check with your local rehabilitation center. State vocational rehabilitation agency. State workers' compensation official. Make sure you buy a vehicle that can be modified to meet your needs. Modify your vehicle. Your DRS can provide hands-on training in using your new equipment, which may be complex.

    Your vocational rehabilitation agency or workers' compensation may pay for the training. Service animals are trained to complete work and tasks for the specific, individual needs of people with disabilities.

    4. Self-advocates

    In some cases, the ADA also recognizes miniature horses as service animals. Emotional support animals serve as companions to people with disabilities but do not typically perform specific tasks or duties. They are not considered service animals under the ADA, but some state and local governments permit people to take them into public places.