Adults With IDD in Supported Accommodation During COVID-19 Lockdown: The Families' Perspective.

The present study aims to understand and describe family caregivers' perceptions and experiences regarding contact and relationships with their adult relatives with intellectual and developmental disabilities (IDD) living in supported accommodation during the COVID-19 lockdown. A qualitative phenomenological approach was applied in which 19 Israeli family caregivers (parents and siblings) were interviewed. Inductive thematic analysis revealed themes at the microsystem level (the resident, the caregiver, and their relationship), and at the mesosystem level (the caregivers' interactions with service providers and other residents' families). The findings highlight the pivotal role of family caregivers in times of uncertainty and the need to develop explicit policies and mechanisms to facilitate family engagement in the residents' lives.

COVID-19 IDD: Findings from a global survey exploring family members' and paid staff's perceptions of the impact of COVID-19 on individuals with intellectual and developmental disabilities (IDD) and their caregivers.

Background: A growing body of evidence attests to the disproportionate impact of COVID-19 on persons with intellectual and developmental disabilities (IDD) during the pandemic. This study asked caregivers about their perceptions of how COVID-19 impacted them and the people they support. Method: An online survey was conducted in 12 countries during August-September 2020 and sought information on demographics, support practices, information and training, experiences of COVID-19, social distancing, and wellbeing, as measured by the DASS12. This study reports on 3,754 family members, direct support professionals, and managers who participated in the survey. Results: Caregivers observed increases in depression/anxiety, stereotyped behaviours, aggression towards others and weight gain in the person(s) they supported. They also reported difficulties supporting the person(s) to access healthcare.  Families reported reducing or ceasing employment and absorbed additional costs when supporting their family member. Direct support professionals experienced changes in staff shifts, staff absences, increased workload and hiring of casual staff. Caregivers' wellbeing revealed high levels of stress, depression, and less so anxiety. The strongest predictor of wellbeing among families was observation of changes in mood in the person(s) they supported, while for direct support professionals, the strongest predictors of wellbeing were reorganisation of staff shifts and increases in new direct support staff.  Discussion: Findings support the contention of this population experiencing a disproportionate burden during the COVID-19 pandemic, reflecting historical inequities in access to healthcare and other human rights violations which are now protected under the United Nations Convention on the Rights of Persons with Disabilities.

Staying connected during COVID-19: Family engagement with adults with developmental disabilities in supported accommodation.

BACKGROUND: Enduring family engagement and informal support is crucial to the health and well-being of adults with developmental disabilities (DD) residing in supported accommodation. The COVID-19 pandemic and restrictive measures enforced in residential settings have resulted in changes in daily routine and modified the ways families can interact with and provide support to residents. Yet, the impact of these changes has not been empirically explored. AIM: Explore how family caregivers have interacted with and supported their relatives with DD residing in supported accommodation during the pandemic. METHODS: Changes in frequencies of communication modes and types of informal support were measured through a cross-sectional and anonymous online survey which completed by 108 family caregivers of adults with DD. RESULTS: Most family caregivers adopted remote communication technologies; however, these were not perceived to be effective in filling the gap created by reduced face-to-face contact. While families were able to provide emotional support and advocacy using digital technologies, they were limited in their ability to provide significant social support. CONCLUSIONS: Findings may help key stakeholders develop and implement novel strategies and policies to accommodate the changing circumstances and to ensure continuity of family engagement and informal support in the context of COVID-19.

Sibling Relationships Over the Life Course: Growing Up With a Disability.

The research explores sibling relationships, and the ways in which they are shaped over the life course by family members, in families with a lifelong disability. In-depth, semistructured interviews were conducted with 15 family units including a parent, a sibling, and an adult sibling with a disability. The content analysis revealed five sibling relationship patterns: (a) "Not a child, but a parent caretaker"-the parent-surrogate sibling; (b) "We somehow grew apart"-the estranged sibling; (c) "It is important for me to maintain some kind of distance"-the bystander sibling; (d) "When there's something they want to tell him, they always send me"-the mediator sibling; and (e) "I love him to death"-the friend sibling. These patterns of adult sibling relationships are discussed in relation to family dynamics, values, and legacies; recommendations for practice and research are made.

The person in the disabled body: a perspective on culture and personhood from the margins.

BACKGROUND: Persons with disabilities (PWD) are one of the most marginalized groups in Western societies. These inequalities are manifested through various disadvantages in the psychosocial, cultural, and economic domains. Inspired by the World Health Organization's holistic conceptualization of disability, the present study examines the relation between the body and personhood in Israeli culture, through cases of newly diagnosed adults with disability. METHOD: Participant observation at a rehabilitation daycare center was carried out for a period of two years. The analysis is based on field notes recorded during these observations, including interviews with individuals with disabilities, their family members, and service providers. RESULTS: The analysis reveals the agonizing experience of individuals who have become disabled in adulthood, who undergo symbolic diminution and social exclusion after their former acceptance as whole and normative persons. This ongoing multifaceted process includes infantilization, denial of their sexuality/sensuality, transgression of gender boundaries, and their construction as categorically different from the "healthy" people around them. At the same time, the analysis also demonstrates the ways in which daily routine at the daycare center also complicates the normative healthy-disabled binary, indicating a continuum on which attendees may attempt to reposition themselves. CONCLUSIONS: This paper aims to make a dual contribution. We draw on anthropological understandings of"person" as a holistic category to resurrect the personhood of individuals with disabilities, as a correction tothe overwhelming tendency to reduce their humanity to their physical injury. We likewise reverse theanalytical gaze by using these individuals' experiences to understand the normative, culture-bound perception of "healthy" persons. We thus highlight Israeli culture's conditioning of normative personhood on having a perfect body, and its concomitant construction of individuals with physical disabilities as lesser persons. By opting to bring back the person into the disabled body, we aim to facilitate a less stigmatized outlook on disability and to create an opportunity for caregivers, researchers, and healthcare professionals to view disabled persons as whole and complex human beings.

Aging With Schizophrenia: A Lifelong Experience of Multidimensional Losses and Suffering.

The aim of this study was to explore the subjective experience of suffering in aging individuals with schizophrenia. Qualitative interviews were conducted with 18 participants aged 60-69. Phenomenological content analysis was performed. Nine dimensions of suffering emerged: social rejection; familial rejection; the symptoms of schizophrenia; hospitalisation; the side effects of medication; loss of employment potential; loss of independent accommodation; loss of social life, and loss of hope to be a partner and a parent. The suffering of aging people with schizophrenia is cumulative and ongoing and thus evokes issues such as existential loneliness and feelings of homelessness.

How aging individuals with schizophrenia experience the self-etiology of their illness: a reflective lifeworld research approach.

OBJECTIVE: In recent years, there are an increasing number of individuals with schizophrenia who are aging within the general society. Self-etiology of the illness refers to its causal attributions by this population as part of the life review process. The aim of this paper is to develop knowledge from the perspective of older people with schizophrenia regarding the self-etiology of their illness. Focusing on the self-etiology of this particular population is useful, to enhance the understanding of their lived experience in the context of their lifeworld. METHOD: The study was carried out using the reflective lifeworld phenomenological approach. In-depth semi-structured interviews were conducted with 18 aging individuals with schizophrenia followed by analysis for meaning. RESULTS: Five major constituents of the phenomenon under study - the experience of self-etiology among aging people with schizophrenia - emerged from the findings: 'It leaves you to your fate' - schizophrenia as a decree of fate; 'I have sinned against God' - schizophrenia as a punishment from God; 'They put something in my coffee' - schizophrenia as a result of witchcraft; 'Her genes are in me' - schizophrenia as genetic; and 'She left me and that's how I got sick' - schizophrenia as a result of personal trauma. CONCLUSIONS: The findings show that self-etiology in old age tends to be stable, externally attributed and culturally oriented, and serves as a central component in the life review process. This is relevant for professionals developing intervention methods for aging people with schizophrenia.

The subjective well-being of individuals diagnosed with comorbid intellectual disability and attention deficit hyperactivity disorders.

PURPOSE: The present study's aim was to empirically explore subjective well-being (SWB) and its correlates among adults diagnosed with comorbid intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD). This exploration was guided by the Theory of SWB Homeostasis as a conceptual framework for examining determinants and processes underlying the SWB of this understudied population. METHOD: A total of 246 adults receiving residential support completed questionnaires measuring their SWB, ADHD symptomatology, functional limitations, and individual internal (self-determination) and external (financial resources, and social support) resources. RESULTS: The participants' SWB was found to be within the normative range. ADHD symptomatology directly predicted reductions in SWB; however, according to the theory, this effect was fully mediated by the individual's internal and external resources. CONCLUSIONS: The main findings support the applicability of the SWB Homeostasis theory for understanding the SWB of individuals with comorbid ID and ADHD. The study findings shed light on the psychosocial determinants of SWB and highlight the importance of psychosocial resources as buffers of the effect of health and environmental conditions.

Psychosocial adjustment of Israeli veterans with disabilities: Does employment status matter?

BACKGROUND: Since its establishment in 1948, the state of Israel has been deeply committed to reintegrating veterans with disabilities into mainstream society. Prominently, the Israeli Ministry of Defence's rehabilitation division provides veterans with disabilities with a wide array of benefits and services aimed at restoring their physical and psychosocial functioning, especially in the workplace. The focus on employment is motivated by a prevailing assumption among professionals that successful adjustment to disability is contingent on an individual's ability to reacquire normative occupational function. To date, however, this widely accepted wisdom has not been empirically scrutinized. OBJECTIVE: To empirically explore whether employment status is associated to psychological, social, and behavioural adjustment attributes. METHODS: One hundred and one employed veterans were compared to 111 non-employed veterans in respect to their self-reported levels of hope, acceptance of disability, social networks size and social participation patterns. RESULTS: Employed veterans reported significantly higher levels psychological adjustment as manifested in elevated hope and acceptance of disability and lighter social network than their non-employed counterparts. However no differences were found between employed and non-employed veterans with respect to their social participation patterns. CONCLUSIONS: The value of these findings, as well as wider implications for rehabilitation professionals and policy makers, is discussed.

Employment, social capital, and community participation among Israelis with disabilities.

BACKGROUND: Employment, social capital, and community participation have emerged in recent years as significant concepts for realizing the human rights of individuals with disabilities. Yet the theoretical interrelationship of these concepts remains largely overlooked, as does the empirical basis for understanding the underlying connections. OBJECTIVES: This study explores the relationship between employment status, social capital, community participation, and well-being among Israelis with disabilities. It also explores the unique contribution of social capital to the well-being and integration of individuals with disabilities. METHOD: 274 participants with self-reported disabilities completed a questionnaire containing measures of individual social capital, community participation, well-being, and background data. Correlation and Univariate analysis were used to compare scores between employed (n=131) and non-employed (n=143) participants, and logistic regression analysis was conducted to test the unique contribution of employment to social inclusion and well-being. RESULTS: Employed participants reported significantly higher levels of social capital and were more integrated in leisure and civic activities than their non-employed counterparts. Moreover, employment status was found to have a significant contribution to the variance in the subjective well-being of participants. CONCLUSIONS: By more fully understanding the importance of social capital for community inclusion, practitioners can better address the importance of network-building during the rehabilitation process as a means of promoting social and vocational integration.

Israeli employers' hiring intentions for recruiting employees with disabilities: how do they compare with US employers?

Focus groups were used to study differences between Israeli and U.S. nonprofit and for-profit employers' hiring intentions of potential employees with disabilities. Major differences were found between for-profit and nonprofit employers' hiring intentions rather than according to their national affiliation. However, U.S. for-profit employers would hire primarily entry-level and seasonal employees when market conditions allowed for it. In contrast, their Israeli counterparts thought that hiring people with disabilities at subminimum wage was an incentive to hire, regardless of the state of the economy. The findings are discussed with respect to the applicability of the theory of planned behavior and social work practice in the two countries.

Arab mothers' involvement with their offspring with severe intellectual disabilities after placement in institutional care.

This study examines the cognitive-behavioral and emotional involvement among 81 Israeli Arab mothers after placement of their offspring with severe intellectual disabilities in institutional care, with respect to mothers' and offspring's background data and measures of divisional roles in the Arab family. Core findings indicate that the most important predictors of maternal cognitive and behavioral involvement are the existence of psychiatric disability in addition to intellectual disability, and the offspring's duration of stay in institutional care. These predictors were poorer in explaining maternal emotional involvement. Findings are interpreted with respect to social work research and practice with Israeli Arab families.

Israeli policy toward veterans with disabilities: a snapshot and insights of the proposed reform.

The policy toward Israeli veterans with disabilities is based on the Invalids Law (Benefits and Rehabilitation) of 1949 . This legislation has served as the foundation for an intricate disability policy, providing benefits and psychosocial services for veterans with disabilities. Sixty two years later, in light of the emergence of a new social model and disability rights conceptualization, there is a need to reevaluate the current legislation and policy. In this article the authors present the essence of the current Israeli disability policy and explore the applications of a proposed reform aimed at adapting the disability policy and services to the new principles of the social model of disability.

Social participation of employed and unemployed Israelis with disabilities.

The purpose of this study was to examine the relationship between employment and social participation among a random, national sample of 597 Israelis with disabilities of working age. Overall findings indicated that employed people with disabilities were significantly more integrated in social and civic activities than the unemployed. Whereas most of the unemployed attributed their restricted patterns of participation to the lack of adequate financial resources, accessible transportation, and encouragement from community organizations, the employed reported lack of time as their main barrier. These findings suggest that employment and rich community participation patterns might reinforce each other and thus serve as a potential vehicle for promoting social integration for people with disabilities in their communities.

Israeli parents' involvement with their adult children with intellectual disabilities after placement in institutional care: a national study.

This Israeli national study examined a research model predicting parental behavioral involvement with their adult children several years after their placement in institutional care. The sample studied consisted of 278 parents of children with intellectual disabilities in Israel between January 1993 and December 2001. Predictors of behavioral involvement were analyzed by a path analysis, followed by several differential regression analyses. Parental behavioral involvement with their adult children after placement is differential, and explained primarily by the children's gender and age at placement. Parental behavioral involvement with their daughters is predicted by cognitive and emotional involvement, whereas their behavioral involvement with their sons is related to background data. The child's age at the time of placement also plays a role in predicting parental involvement. Parental behavioral involvement with their children is related to gender and age at the time of placement in institutional care. Longitudinal research should be carried out to track the involvement process.

Consideration of out-of-home placement among Israeli Jewish and Arab parents of children with disabilities.

This article is based on a secondary analysis of a random sample of 512 Israeli parents of children with disabilities (ages 3-17) regarding their consideration of out-of-home placement. Major findings showed that Arab parents reported greater levels of personal and family burden compared to Jewish parents. Despite that fact, Arab parents rarely considered out-of-home placement. In addition, parents whose children utilized more services reported a greater burden of care than those who utilized fewer services. Findings are discussed with respect to future research and policy implications.

Quality of life of men and women with borderline intelligence and attention deficit disorders living in community residences: a comparative study.

The research studies the quality of life (QOL) of 127 men and women diagnosed as having a borderline IQ and ADHD living in two major residential programs of the Sharon region in central Israel in respect to their personal, disability, and social ecological variables. Core findings indicate that men and women differ significantly according to their educational background. Among those who studied in a regular educational environment, the main predictor of men's QOL is their monthly income, whereas the main predictor for women is their level of attention deficit symptoms. The only predictor of QOL among men who studied in a special education program is the quality of contact with their mothers, whereas no significant predictor is observed among women.