Disabilities

Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.

Effective social work practice with deaf and hard-of-hearing people requires a unique, and diverse, collection of knowledge, values, skills, and ethical considerations. Salient issues among this population are language, communication, and educational choices, interpreting, assistive devices, cochlear implants, genetics, culture, and access to community resources. Competencies at micro, mezzo, and macro levels with a deaf or hard-of-hearing population include knowledge of the psychosocial and developmental aspects of hearing loss, fluency in the national sign language, and an understanding of deaf cultural values and norms. In the United States, the use of American Sign Language (ASL) is the single most distinguishing factor that identifies deaf people as a linguistic minority group. This entry presents an overview of the practice competencies and intervention approaches that should be considered in working with deaf and hard-of-hearing people, their families, communities, and organizations. It introduces the knowledge base, diversity in community and cultural orientations, social constructions, and international perspectives, current research and best practices, interdisciplinary connections, trends, challenges, and implications for effective social work practice with this population. An integrative strengths-based transactional paradigm is suggested.

The deinstitutionalization policy sought to prevent unnecessary admission and retention in institutions for six populations: elderly people, children, people with mental illness or developmental disabilities, criminal offenders, and, more recently, the homeless. It also sought to develop community alternatives for housing, treating, and habilitating or rehabilitating these groups. U.S. institutional populations, however, have increased since the policy’s inception by 212%. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house these groups, often referred to as transinstitutionalization. This entry considers how this shift has affected the care and control of such individuals from political, economic, legal, and social perspectives, as well as suggestions for a truer implementation of deinstitutionalization.

The history of military social work in the United States is rooted in the civilian professional social work community and is a microcosm of that sector. Military social work has a rich history of providing services to military men and women and their families during periods of peace, conflict, and national crises. They have been involved in humanitarian operations and have participated in multinational peace-keeping operations. Social work in the Army, Navy, and Air Force is tailored to the mission of their particular service. However, joint operations between the services are becoming more frequent. Military social workers adhere to the NASW code of ethics while providing service to an institution with its own unique culture, standards, and values.

Vocational rehabilitation (VR) services, provided through a jointly funded state–federal rehabilitation system and available in each state, help people with disabilities prepare for, secure, and sustain employment. Since 1920, VR Programs have helped 10 million individuals with disabilities reach employment. Anyone with a mental or physical disability is eligible for VR services. While a range of services is provided, the services most consistent with VR goals are those, such as supported employment, that promote full integration into community life. Social workers are essential to community-based VR services; however, a challenge for the profession is to assume new roles to meet best practice vocational standards.