The Divide at 65 - Implications for Domiciliary Care Delivery for Older People with Physical Disabilities in Ireland.
Date of Award
Doctor of Philosophy
Applied Social Studies
Dr. Áine de Róiste
This thesis focuses on the division of services available to adults with a physical disability through the provision of 'disability' services to those under 65 years of age and 'older' people services provided to people over 65 years, overall referred to as the 'the divide at 65'. To uncover implications of such a divide for older people, it explores the services currently available in both sectors, the differences in services, access procedures, assessment and entitlement. It then links the current provision of services to policy, equality legislation and intersectional discrimination, the latter being discrimination against the person and the denial of the right to live independently through the intersecting conditions of ‘disability’ and ‘old’ age. The conceptual framework is based on analysis of discrimination through an ‘intersectional lens’, the contribution to knowledge based on the discover^' of such discrimination against older people with physical disabilities in domiciliary care.
A phenomenological, grounded approach was used in the innovative research methods and mainly qualitative data was gathered. A triangulated research methodology was adopted involving interviews with domiciliary care service users, interviews with professionals with an add on questionnaire, a vignette based service assessment form completed by public health nurses and disability coordinators, and a telephone survey of organisations for people with disabilities.
The main findings were that various differences exist due to the divide in services, the main one being the age limit of 65 on personal assistant services through the disability sector. This results in the separation of people with physical disabilities under 65 against people who may experience the same condition over 65 who are simply classed as ‘old’ and thus experience intersectional discrimination. Other findings showed differences in respite and rehabilitation services due to age and also variances in the number of carers and allocated hours to older people with physical disabilities. Overall it was found that there was no legal entitlement to domiciliary care services; however there was a right to equal services and this is not the case in the set-up of services due to the divide at 65. In Ireland today, age is determining what care supports you receive when you have a disability.
Hence, services, working in partnership and integrated, should be based on a standardised means and needs assessment, with any discriminatory age limits removed. The research reveals discrimination against older people with physical disabilities in domiciliary care. It advocates for the right of the older person to live at home independently- to be equitably realised.
Killeen, Aoife, "The Divide at 65 - Implications for Domiciliary Care Delivery for Older People with Physical Disabilities in Ireland." (2014). Theses [online].
Available at: https://sword.cit.ie/allthe/705