The 130th Annual Meeting of APHA

Abstract #44537

Monika Mitra, PhD¹, Nancy Wilber, EdD¹, Deborah Allen, ScD¹, and Debbie Klein Walker, EdD². (1) Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington St, 5th Floor, Boston, MA 02108, 617-624-5557, monika.mitra@state.ma.us, (2) Associate Commissioner, Massachusetts Department of Public Health, 250 Washington Street, 2nd Floor, Boston, MA 02108-4619

Data from a survey of independently living adults in Massachusetts with major disabilities suggest a high level of unmet need for personal care assistance (PCA). Of 656 baseline respondents, 67% reported needing PCA hours, 57% reported using PCA hours, and 42% reported needing more PCA hours than they were receiving. Having an unmet need for PCA was associated with respondent-reported ADL and IADL status, unmet need for ADL and IADL assistance, need for more mobility aids, need for more communication aids, difficulty with access to care, and experience of abuse in the past 12 months (P<.05). In addition, unmet need for PCA was associated with the following health outcomes: greater number of secondary conditions, fair to poor self-reported general health, worsening health over the past twelve months, a greater number of days unable to work or go to school, and more physician visits in the past year. Respondents reporting an unmet need for PCA were significantly more likely (P<.05) to report the following secondary conditions: fatigue, falls and injuries, chronic pain, contractures, skin problems, problems with bowel movements, and spasms. In the final phase of the survey, respondents were asked if they experienced problems with the PCA service. Almost half (49%) of respondents using PCA services reported having problems with the PCA program. Of these respondents, two-thirds reported problems with the PCA program and payment system and about 20% reported problems with unreliable attendants and unsatisfactory care by attendants. The presentation will also provide details on the nature of PCA problems reported by respondents.

Learning Objectives:

• Participants will be informed about the unmet need for personal care assistance among adults with major disabilities. They will develop an understanding of the connection between unmet need for PCA and poor health outcomes among people with disabilities. Finally, participants will recognize the importance of incorporating questions on personal care assistance in disability research.

Keywords: Disability, Personal Assistance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.