Disability Labeling vs. Rehabilitation Rhetoric for the Chronically Ill: A Case Study in Policy Contradictions

Among persons with chronic renal disease, limited encouragement to use self-care treatment options and easy access to disability income benefits tend to reinforce the concept of disability rather than foster rehabilitation goals. More than 80% of all chronic renal disease patients on dialysis therap...

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Bibliographic Details
Published in:The Journal of applied behavioral science 1985-01, Vol.21 (2), p.169-183
Main Authors: Kutner, Nancy G., Brogan, Donna R.
Format: Article
Language:English
Subjects:
Activities of daily living
Biological and medical sciences
Disability
Disease
Employment
Fundamental and applied biological sciences. Psychology
Handicap
Health
Health administration
Health care
Health Policy
Health Status
Hemodialysis
Hemodialysis, Home
Home health care
Humans
Illnesses
Internal-External Control
Kidney diseases
Kidney Failure, Chronic - rehabilitation
Patients
Peritoneal Dialysis, Continuous Ambulatory
Psychology and medicine
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Rehabilitation
Renal Dialysis - utilization
Studies
United States
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Summary:Among persons with chronic renal disease, limited encouragement to use self-care treatment options and easy access to disability income benefits tend to reinforce the concept of disability rather than foster rehabilitation goals. More than 80% of all chronic renal disease patients on dialysis therapy receive treatment in facilities at which they become highly dependent on medical staff, and estimates of unemployment among persons aged 21-59 years suffering from this disease range from 60% to 75%. The authors' data indicate that patients who receive dialysis treatment within facilities experience negative effects on their perceived health status and health locus of control as compared to patients who practice self-care dialysis at home. Although many factors contribute to unemployment among dialysis patients, the availability of disability income benefits seems to act as the most important deterrent to employment. Increasing the emphasis on the rehabilitation of this chronically ill population will require a movement away from disability labeling by providers of care and the patients themselves, as well as adjustments in the dialysis reimbursement system and in the eligibility requirements for disability compensation.
ISSN:0021-8863
1552-6879
DOI:10.1177/002188638502100209