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Given the increasing number of older persons relative to the working age population, record level taxes and baby boomers’ demands for self-determination and quality of life, which changes might the Scandinavian welfare model have to undergo in order to deliver long term care to all who need it? In Sweden, direct payments for personal assistance are paid to mainly younger persons with extensive disabilities. In terms of perceived quality and cost per hour of service, direct payments have been found to be more efficient than traditional local government services. But would this favorable experience hold for all persons in need of assistance with the activities of daily living – regardless of age, diagnosis and minimum needs? What would be such a policy’s cost and effects on the labor market? How could it be financed? Would it threaten younger disabled persons’ relative favorable present situation? Today’s Swedish policy of cash payments for the purchase of personal assistance services might be of interest as a long term care solution for tomorrow’s older persons.

Adolf Ratzka, Independent Living Institute, presented at the Second International Conference on Personal Responsibility on the Way to Social Change organized by Jerusalem Center for Independent Living December 2, 2010

[This article cites and quotes historical materials first collected in: M. Miles (1996) Pakistan's microcephalic chuas of Shah Daulah: cursed, clamped or cherished? History of Psychiatry 7: 571-589, from Taylor & Francis, www.tandf.co.uk/] Evidence on microcephalic children (chuas) at the shrine, and how some of them developed a capacity for independent living. Internet publication URL: http://www.independentliving.org/miles201005.html

Internet publikation URL: www.independentliving.org/docs7/anderberg200710b.html (In Swedish.)

This article and the review comment were first published in “EPICADEC News” (from the Foundation Epilepsy Care Developing Countries, Leiden), October 2000, pp. 9-10, titled “Imran’s Djinn”. They are here reproduced with permission, after slight revision. The article concerns an Asian boy living in UK. His family had trouble using the health services, because of different concepts of Imran’s illness. One of Imran’s teachers met the family half way, respecting their beliefs and giving them time to digest a different approach to epilepsy and its treatment. A scientific reviewer comments on the story. Internet publication URL: www.independentliving.org/docs7/miles-christine2000.html

Revised version of a paper first published in the Zeitschrift Behinderung und Dritte Welt, 3/2003, pp. 96-106, and here reproduced with permission. International strategies concerned with disability in developing and transitional countries (DTC) are scrutinised critically, with an historical focus on beneficial traditions and practices in Asia and Africa, attesting the variety and complexity of social responses to disability. Internet publication URLs: www.independentliving.org/docs7/miles200701.html and www.independentliving.org/docs7/miles200701.pdf (112 KB).

Internet publication URLs: www.independentliving.org/docs7/pawba-tatcot200709.html and www.independentliving.org/docs7/pawba-tatcot200709.pdf  

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