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Advancing the Inclusion of People with Disabilities 2009

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Chapter 1: Disability supports and services

This chapter explores how Canadians with disabilities use disability-specific supports and services. These supports and services help people with disabilities carry out daily activities. The analyses focus on selected supports: aids and assistive devices, home modifications, caregivers and help with everyday activity, transportation and access to information.

The types of supports needed vary, as every person with a disability has unique needs, goals and challenges that may influence both requirements and ability to have a given need met. Inadequate access to needed supports can create unnecessary barriers to inclusion for people with disabilities.

The need for certain types of supports, such as home modifications and caregiving, has decreased since 2001. Local and long-distance travel have also decreased, with the aggravation of a person’s condition either causing difficulty travelling or preventing it altogether. Cost continues to be the most common barrier to meeting needs for aids and devices, home modifications, and caregiving.

Aids and assistive devices

In 2006, over 2.6 million adults and over 87 000 children required a diverse range of aids and assistive devices for daily activities. Examples of aids include hearing aids, grasping tools, voice recognition software and prosthetic limbs. While nearly two thirds of Canadians with disabilities require aids and devices, the level of met needs varies by age, gender, severity of disability and type of disability.

Six out of ten adults with disabilities who require aids and devices have their needs fully met. Another three out of ten adults have partially met needs, and one in ten has no needs met at all. The overall distribution of met needs changed from 2001 to 2006. Adults with disabilities who required aids and devices were more likely to have all of their needs met in 2006.

Chart 1.1 — Level of met needs for adults aged 15 and over with requirements for aids and devices, 2001 and 2006

1. The chart uses 2006 data that is comparable to 2001 data.
2. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

[Chart 1.1 Description …]

While adults are more likely to have a disability than children, younger Canadians are more likely to have unmet needs than older Canadians. Over half of children with disabilities aged 5 to 14 who require aids and devices do not have their needs fully met. In comparison, 44.2% of working-age adults and 31.8% of seniors with requirements have unmet needs. Between 2001 and 2006, the level of unmet needs for children increased, while the level of unmet needs for adults decreased.

Chart 1.2 — Unmet needs for aids and devices, by age, 2001 and 2006

Age group	2001				2006
	All needs met		Unmet needs		All needs met		Unmet needs
	Number	%	Number	%	Number	%	Number	%
5 to 14	50 950	58.3	36 430	41.7	38 270	43.8	49 140	56.2
15 to 64	127 580	24.3	397 420	75.7	821 160	55.8	650 080	44.2
65 and over	270 850	52.6	244 560	47.4	782 420	68.2	365 110	31.8

1. The table uses 2006 data that is comparable to 2001 data.
2. Not applicable to children aged 0 to 4.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

The level of met needs also varies by type of disability. Nearly three quarters of adults with mobility limitations who require aids and devices have their needs fully met. From 2001 to 2006, adults with communication disabilities experienced a drop in their level of met needs, with just over one quarter of those who have requirements having their needs fully met in 2006. In contrast, 56.5% of adults with learning disabilities who require aids and devices had their needs fully met in 2006, up from 39.1% in 2001.

Chart 1.3 — Rates of fully met needs by disability type, 2001 and 2006

1. The chart uses 2006 data that is comparable to 2001 data.
2. Not applicable to children aged 0 to 14.
3. Pain-related disabilities were not included in PALS 2001.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

[Chart 1.3 Description …]

People with more severe disabilities are more likely to have unmet needs than people with less severe disabilities. In 2006, 40.7% of people aged five and over with severe to very severe disabilities had unmet needs for aids and devices. In contrast, 13.8% of those with mild to moderate disabilities had unmet needs.

The most common reason for unmet needs is the cost of many aids and devices: 58.7% of working-age adults and 44.3% of seniors who have unmet needs for aids are unable to meet their needs due to financial barriers. Other common reasons for unmet needs include lack of information on aids and devices as well as lack of availability.

Chart 1.4 — Reasons for unmet needs for aids and devices by age, 2006

Reason	Age 15 to 64		Age 65 and over
	Number	%	Number	%
Total	650 090	—	365 110	—
Cost (purchase/maintenance)	381 810	58.7	161 620	44.3
Not available locally	14 880	2.3	5 850	3.6
Condition not severe enough	42 460	6.5	34 160	9.4
Don't know where to obtain	69 080	10.6	38 410	10.5

Home modifications

In 2006, approximately 465 000 adults with disabilities (age 15 and over) required some type of home modification to reduce barriers and increase independence within the home environment. Such modifications included grab bars, automatic doors, and widened doorways and hallways. The percentage of adults with disabilities requiring home modifications decreased from 14.1% in 2001 to 11.2% in 2006.

Six out of ten adults with disabilities who have home modification requirements have their needs fully met. Seniors with disabilities are more likely than working-age adults to have all of their home modification needs met; seven out of ten seniors with requirements have their needs fully met, compared to five out of ten working-age adults.

Chart 1.5 — Level of met needs for home modifications, 2001 and 2006

Needs met	2001		2006
	Number	%	Number	%
Age 15 to 64
Total	209 590	100.0	201 960	100.0
All needs met	102 770	49.0	99 510	49.3
Some needs met	29 660	14.2	21 500	10.6
No needs met	77 160	36.8	80 950	40.1
Age 65 and over
Total	273 440	100.0	262 550	100.0
All needs met	200 680	73.4	181 530	69.1
Some needs met	24 130	8.8	16 120	6.1
No needs met	48 630	17.8	64 900	24.7

Of adults with disabilities aged 15 and over, women are more likely than men to require home modifications (13.3% versus 8.5%). Comparison by age and gender shows that 17.9% of senior women with disabilities require home modifications, compared to only 9.9% of working-age women with disabilities.

Although the overall requirement for home modifications decreased between 2001 and 2006, the number of adults with an unmet need for elevators or lift devices within the home increased from 39 620 to 59 020. The most common unmet home modification need in 2001 was grab bars or bath lifts; the number of adults with this unmet need dropped from 87 480 in 2001 to 49 150 in 2006.

Chart 1.6 — Most common unmet needs for home modifications, 2001 and 2006

Unmet need	2001		2006
	Number	%	Number	%
Total	179 590	—	183 470	—
Automatic or easy–to–open doors	27 960	15.60	15 050	8.2
Elevator or lift device	39 620	22.1	59 020	32.2
Grab bars or a bath lift	87 480	48.7	49 150	26.8
Lowered counters in the kitchen	17 890	10.0	6 050	3.3
Ramps or street–level entrances	52 540	29.3	42 960	23.4
Visual alarms or audio warning	13 770	7.7	3 120	1.7
Widened doorways or hallways	20 780	11.6	7 120	3.9
Other special features	57 710	32.1	54 480	29.7

1. The table uses 2006 data that is comparable to 2001 data.
2. Respondents could choose more than one option.
3. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

Cost is the main reason home modification needs are not met. In 2006, two out of ten adults with disabilities who had a requirement (20.1%) were not able to obtain home modifications due to cost. A larger percentage of working-age adults with disabilities have difficulty affording required home modifications than seniors with disabilities (25.8% versus 15.7%). Other reasons for unmet home modification needs include being on a waitlist for modifications or not having the features recommended or approved by a health professional.

Caregivers and help with everyday activities

In 2006, over 2.65 million adults with disabilities (age 15 and over) required help with at least one everyday activity, such as getting dressed, cleaning or cooking. The percentage of adults with disabilities who required assistance remained stable: this figure was 63.4% in 2001 and 63.7% in 2006.

Both informal and formal caregivers are sources of support for help with everyday activities. Informal caregivers include family members and friends of people with disabilities. Formal caregivers typically encompass paid caregivers accessed through organizations. Family members tend to make up the greatest network of support for people with disabilities.

Many people with disabilities receive help with everyday activities from multiple sources. A total of 2 440 570 adults with disabilities (age 15 and over) receive some type of help with everyday activities. Eight out of ten adults with disabilities who receive help with at least one everyday activity rely on family members for assistance (82.4%). In addition, 13.5% receive help from friends, neighbours or co-workers; 13.1% receive help from organisations; and 10.6% receive help from paid employees or workers.

Seniors with disabilities are more likely than working-age adults to receive help with at least one everyday activity (64.8% versus 54.3%). Women with disabilities are more likely than men to receive help with a daily activity (67.4% versus 47.9%).

Chart 1.7 — Caregiver relationships, by age and gender, 2001 and 2006

Type of caregiver	2001				2006
	Men		Women		Men		Women
	Number	%	Number	%	Number	%	Number	%
Age 15 to 64
Total receiving help	477 390	—	730 670	—	515 650	—	807 800	—
Family living in same residence	325 040	68.1	552 360	75.6	354 890	68.8	600 400	74.3
Family not living in same residence	177 350	37.1	275 880	37.8	145 600	28.2	232 180	28.7
Friends or neighbours	150 470	31.5	178 990	24.5	86 310	16.7	116 820	14.5
Organization or agency	75 290	15.8	112 520	15.4	57 440	11.1	66 540	8.2
Age 65 and over
Total receiving help	376 310	—	683 760	—	381 750	—	735 380	—
Family living in same residence	214 770	57.1	336 520	49.2	215 280	56.4	356 880	48.5
Family not living in same residence	170 710	45.4	333 610	48.8	146 200	38.3	322 430	43.8
Friends or neighbours	82 360	21.9	137 140	20.1	45 910	12.0	79 810	10.9
Organization or agency	114 990	30.6	246 500	36.1	67 360	17.6	127 510	17.3

1. The table uses 2006 data that is comparable to 2001 data.
2. Respondents could choose more than one option.
3. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

Just over half of all adults with disabilities who require help with at least one everyday activity have their caregiving needs fully met. The proportion of people with all needs met declined between 2001 and 2006.

Chart 1.8 — Level of met need for caregiving, 2001 and 2006

Needs met	2001		2006
	Number	%	Number	%
Age 15 to 64
Total	1 195 420	100.0	1 464 500	100.0
All needs met	744 290	62.3	777 060	53.1
Some needs met	360 610	30.2	546 080	37.3
No needs met	90 520	7.6	141 360	9.7
Age 65 and over
Total	972 720	100.0	1 188 410	100.0
All needs met	647 240	66.5	692 020	58.2
Some needs met	292 050	30.0	425 110	35.8
No needs met	33 430	3.4	71 280	6.0

Severity of disability is a strong predictor of caregiving need: 85.6% of adults (age 15 and over) with severe to very severe disabilities require caregiving assistance, while 49.3% of adults with mild to moderate disabilities require assistance. Adults with severe to very severe disabilities are more likely to have their caregiving needs only partially met, whereas adults with mild to moderate disabilities are more likely to have their needs fully met.

Cost is the most common reason for experiencing difficulty in obtaining assistance with daily activities. Other barriers to obtaining required help include delays in obtaining assistance and difficulty finding qualified help.

Adults with severe or very severe disabilities who receive help are much more likely to have difficulty making the necessary arrangements than people with mild or moderate disabilities (19.7% versus 6.5%).

Chart 1.9 — Reasons for unmet caregiving needs by age, 2001 and 2006

Reason	2001				2006
	Age 15 to 64		Age 65 and over		Age 15 to 64		Age 65 and over
	Number	%	Number	%	Number	%	Number	%
Total	140 700	—	73 740	—	211 800	—	122 390	—
Difficulty finding qualified help	49 100	34.9	30 950	42.0	62 900	29.7	44 290	36.2
Delay in obtaining assistance	69 750	49.6	33 220	45.1	74 200	35.0	34 460	28.2
Did not know where to look for help	41 460	29.5	13 150	17.8	48 230	22.8	35 730	29.2
Too expensive	69 070	49.1	32 050	43.5	84 430	39.9	47 550	38.9
Other	56 760	40.3	22 370	30.3	86 300	40.7	41 550	33.9

1. The table uses 2006 data that is comparable to 2001 data.
2. Respondents could choose more than one option.
3. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2001 and 2006.

Transportation – Local and long-distance travel

Access to transportation is critical for full participation in society. Most Canadians use some form of transportation to undertake daily activities such as going to work, running errands, participating in leisure activities or being involved in their communities. For people with disabilities, comfortable travel is often influenced by the availability of accessible modes of transportation.

Local travel

In 2006, 86.3% of adults with disabilities (age 15 and over) travelled locally using various modes of transportation such as cars, buses or taxis to move around their environment for personal or business reasons. Most people with disabilities prefer to use a personal car for transportation; eight out of ten adults with disabilities (79.2%) travel in cars either as drivers or as passengers.

While most adults with disabilities do access or use transportation, in 2006, approximately 270 000 adults with disabilities experienced difficulty with riding in a car as a passenger, and nearly 190 000 had difficulty using public transportation. Many people with disabilities experience difficulty with travel because they have trouble boarding the modes of transportation available to them. Those who are able to board vehicles often experience further difficulty because the process of travelling aggravates their health condition.

Some people with disabilities are unable to use any mode of transportation. Of the total population of adults with disabilities, 4.1%—or approximately 170 000 adults—consider themselves to be housebound. Similarly to those who do travel but experience difficulties, six out of ten housebound adults with disabilities (57.6%) are housebound because travel will aggravate their condition or health problem. Other common reasons for adults being housebound include preferring to stay home, needing assistance once arriving at their destination, and not having an attendant or companion to accompany them.

Chart 1.10 — Reasons for being housebound, 2006

Reason	Number	%
Total	170 230	—
Accessible transportation is not available	20 970	12.3
Dependent on non-portable aids	13 660	8.0
Do not feel safe when leaving home	32 320	19.0
No attendant or companion to go with	38 040	22.3
Need assistance once arriving at destination	41 210	24.2
Condition or health problem aggravated upon going out	98 060	57.6
Prefer not to go out	53 520	31.4
Other	31 910	18.7

1. The table uses 2006 data that is comparable to 2001 data.
2. Respondents could choose more than one option.
3. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2006.

Long-distance travel

In 2006, over half (54.0%) of adults with disabilities (age 15 and over) travelled via airplanes or trains in order to take a long-distance trip for personal or business reasons. This percentage decreased slightly from 59.7% in 2001.

Eight out of ten adults with disabilities who travel long distances use personal cars (79.1%). The next most common mode of long-distance travel is by airplane: three out of ten adults who travel long distances use airplanes (33.7%).

In 2006, 9.9% of adults with disabilities had difficulty with long-distance travel and 5.0% were completely prevented from travelling long distances. Working-age adults are more likely than seniors to experience difficulty with long-distance travel (13.2% versus 5.3%). In contrast, seniors are more likely than working-age adults to be completely prevented from travelling long distances (4.3% versus 6.0%).

Adults with severe to very severe disabilities experience more difficulty travelling long distances than those with mild to moderate disabilities (15.3% versus 6.4%). In addition, adults with severe to very severe disabilities are more likely to be prevented from travelling long distances (10.0% versus 1.7%).

Similarly to local travel, the most common reason for experiencing difficulty with long-distance travel is that available modes of transportation aggravate conditions. This is also the most common reason for being completely prevented from travelling long distances.

Chart 1.11 — Reasons preventing long-distance travel, 2006

Reason	Number	%
Total	208 540	—
Boarding or disembarking	65 880	31.6
Hearing announcements	17 120	8.2
Lack of appropriate transportation to and from terminal or station	28 570	13.7
Moving around terminal or station	49 350	23.7
Need an attendant to help	38 490	18.5
Ride aggravates condition	134 990	64.7
Seating on board	42 110	20.2
Seeing signs or notices	29 190	14.0
Too costly	41 020	19.7
Transporting wheelchair or other specialized aids	33 300	16.0
Unsupportive staff	33 740	16.2
Washroom facilities	39 870	80.8
Other reason	51 700	24.8

1. The table uses 2006 data that is comparable to 2001 data.
2. Respondents could choose more than one option.
3. Not applicable to children aged 0 to 14.

Source: Participation and Activity Limitation Survey, 2006.

Access to information

Barriers to accessing information can be overcome through the use of alternative format materials. A variety of technological aids and devices as well as other supports and services are available.

Many people with disabilities use the Internet to receive up-to-date information. In 2006, almost 1.9 million adults with disabilities (age 15 and over) used the Internet at least once in the past 12 months (44.7%). Working-age adults with disabilities are more likely to use the Internet than seniors (62.2% versus 19.8%).

People with different types of disabilities have varied requirements for accessing information. For example, large-print and Braille reading materials are two alternative formats for text that benefit many adults with sight limitations. In 2006, approximately 101 000 adults with sight limitations used large-print materials and 6 000 adults used Braille reading materials. In addition, 36 000 adults with learning disabilities make use of software organizational tools, and approximately 55 000 adults with hearing limitations use closed captioning. Closed captioning allows people with hearing disabilities to read spoken dialogue in television programs.

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Date Modified:

2011-08-06