This Life AdviceSM pamphlet about Dealing with Disability was produced by the MetLife Consumer Education Center with assistance from the U.S. Department of Education. Editorial services provided by Meredith Custom Publishing.

The media and the medical community all tout the wonders of a healthy, active lifestyle at any age. And even though the "golden years" may bring some physical changes, most people-young and old-have come to expect they will live long, healthy and unencumbered lives. Consequently, when you or someone you love is faced with a disabling illness or injury, you are taken by surprise. Having to deal with a disability is not something most people anticipate.

When people realize that a disability, their own or a loved one's, is going to be permanent, they may express a variety of reactions from shock to fear to grief to anger. There is no "right" way to respond. People generally react according to what the disability means to them and just how much it is going to affect or change their lives. Generally speaking, those who accept and make adjustments for their new reality will have an easier time coping. If you've developed a disability, acknowledge your limitations, but concentrate on what you can do and how you can adapt to do even more. Set realistic goals, and approach life as a challenge, not an effort.

A disability often requires changes in how a person lives, works, travels or spends free time. If you've developed a disability, you may need physical or occupational therapy. You may also have to make adjustments to your daily routine. Perhaps you have to find a new living arrangement or change jobs or hobbies. Maybe you need to make structural changes to your home. An occupational therapist can help you with these changes. If your doctor agrees, ask him or her to recommend one.

Keep in mind that community services and household help may make the difference that enables you to continue living at home. Examples of help that's available are:

• Housecleaning or yard services to help with chores
  
  
• Grocery delivery or meal services
  
  
• A home health aide to assist with personal grooming
  
  
• A visiting nurse to administer medications and monitor health

There are also a host of products available to help with daily living activities. For more information, contact

ABLEDATA
8455 Colesville Rd. Suite 935
Silver Spring, MD 20910
1-800/227-0216 or 301/588-9284 (V/TDD).

Architectural and Transportation Barriers
Compliance Board
1331 F St., NW, Ste. 1000
Washington, DC 20004
1-800/USA-ABLE (TDD)

The Assisted, Elderly and Handicapped Program
U.S. Dept. of Housing/Urban Development
451 Seventh St., SW
Room 6116
Washington, DC 20410

Special Advisor on the Handicapped
U.S. Dept. of Housing/Urban Development
451 Seventh St., SW
Room 19184
Washington, DC 20410

If you can no longer manage in your own home, you may have to consider a new living arrangement. Medical and social service professionals can offer advice on whether you need skilled or nonskilled daily care and what type of environment (an assisted living, rehabilitation or continuing care facility) may be best for you. They may also be able to provide recommendations on specific living facilities.

Before making such an important decision, you may wish to discuss the options with family and friends. Ask them to help you check out several facilities by researching them and then visiting. At each facility, ask to see the results of the latest state inspection. This is public information, and facilities are required to post it. Also, the local health department can tell you whether the home has ever received an Intent to Deny License because of sanitary or fire violations or patient care inadequacies. For a list of accredited facilities, write to American Health Care Association, 1201 L St., NW, Washington, DC 20005.

Many people with disabilities are able to continue to work and support themselves. Often, simple accommodations in the workplace are all that is needed. You may require a flexible work schedule or special equipment to help you perform your job. Talk to your employer about specific problems, or seek advice from an occupational therapist. If you are unable to continue in your present job, a vocational rehabilitation counselor may be able to help arrange training and other services to help you prepare for an alternative line of work. Each state has a vocational rehabilitation agency (and some states have separate agencies for persons who are blind) to provide these services. These agencies typically have a number of local offices in each state. The Job Accommodation Network of the President's Committee on Employment of Persons with Disabilities at 1-800/526-7234 offers technical assistance primarily to employees.

Sometimes a disability prevents a person from working at all.

If you are fortunate enough to have disability income insurance, it can help to make up for lost wages. Some employers provide disability insurance as a benefit, or you can purchase a private policy. Disability insurance is designed to replace a portion of your income when an illness or injury prevents you from working. Talk to your benefits representative at work or your insurance representative about specific disability coverages.

If your disability is due to illness or injury resulting from your job, you may be eligible for workers' compensation. Again, talk to your benefits representative.

If you're under 65 and your earnings are lost or reduced because of certain disabilities, you may be eligible for Supplemental Security Income (SSI). SSI generally makes monthly payments to people who are aged, disabled or blind and who have limited income and resources. You may be eligible for SSI even if you have never worked. To determine your eligibility, contact your local Social Security office.

Medicare and Medicaid are two of the primary sources of federal medical assistance for people with disabilities. Most people think of Medicare as providing health coverage to those who are over 65. But it is also available to people under 65 who have been entitled to receive Social Security disability benefits for a total of 24 months or who have severe kidney disease. The program is not based on income and is available regardless of financial need.

Medicaid is a joint federal and state program that provides health services to people with low incomes. The eligibility requirements vary by state. Generally, you may be eligible for Medicaid if you are receiving welfare benefits or SSI or are blind or disabled.

For more information about Medicare and Medicaid, contact your local Social Security office, your local or state welfare office, or write to Health Care Financing Administration, Inquiries Staff, 7500 Security Blvd., Baltimore, MD 21244-1850.

A federal law, Section 504 of the Rehabilitation Act of 1973, prohibits discrimination against otherwise qualified individuals with disabilities in programs and activities conducted or funded by the federal goverment. These activities include housing, education and transportation. Section 504 requires the provision of "reasonable accommodations" to allow persons with disabilities to participate in the federally conducted or assisted activities.

The ADA was enacted in 1990 to protect people with disabilities. This federal law generally forbids discrimination in employment, transportation, public accommodations, telecommunications and services provided by state and local goverments. The U.S. Department of Education supports regional technical assistance centers to provide information about the ADA and its implementation.These centers may be reached toll free at 1-800/949-4232. Your call will be automatically routed to the center in your area.

Generally, the protection provided by the ADA extends to:

• Those who have a physical or mental impairment that limits one or more major life activities (working, learning, walking, seeing, speaking)
  
  
• Those who once had a disability but no longer have it (for example, cancer or heart disease)
  
  
• Those who are perceived as having a disability, even if they do not (for example, someone with severe facial scarring from burns)
  
  
• Those who do not have a disability but are discriminated against because they are associated with someone who does (for example, the spouse of a person who has emphysema or the parent of someone with AIDS)

When you're around someone who has a disability, be relaxed and talk about mutual interests. It's okay to talk about the disability if it comes up, but don't pry. Some other helpful hints include:

• Always address the person first-not the disability. For example, say "a person with a disability" instead of "a disabled person." Likewise, say "people who are blind" rather than "the blind," and avoid old-fashioned terms such as afflicted, crippled or lame.
  
  
• Speak directly to someone who is hearing impaired, rather than to an assistant. Don't shout, but speak clearly and slowly and remember that facial expressions and gestures are important.
  
  
• Be patient if the person needs extra time to do or say something.
  
  
• If the person uses a wheelchair, sit down to talk so you're at the same level.
  
  
• Listen carefully and patiently to a person with a speech impairment. Avoid speaking for the person, and try to ask questions that require short answers.
  
  
• Don't touch a guide dog or a wheelchair or crutches used by the person unless you're asked to do so.
  
  
• Offer help if asked or if the need seems obvious, but don't insist.

Those who are close to someone with a disability may experience many of the same feelings their loved ones have-anger, frustration, fear, sorrow and even guilt. If you are part of the day-to-day life of a person who has a disability, your emotional as well as physical support can be an invaluable source of strength. Here are some ways to help:

• Come together with other family members; don't let the situation divide you. While you may all react differently to a disability, the cooperation of everyone will make for a smoother transition.
  
  
• Learn the facts about the person's disability. Knowing what to expect can help prepare you for future challenges.
  
  
• Know how and when to help. Respect the person's feelings. Ask a person who uses a wheelchair if he or she would like assistance before you start pushing.
  
  
• Foster self-esteem. Be positive and encourage independence, to the extent possible. Help your loved one look for new ways to achieve his or her goals.
  
  
• Look for help. Find out about local support groups and community services that can help both the person with the disability and the caregiver.

Millions of Americans have some type of disability, and many more-their families and friends-are also touched by the challenges of dealing with disability. While a disability may be a fact of life, it should not be the focus of a person's existence. The key to coping is knowing what resources are out there and finding the people, programs and organizations that can help you. Take control of your life now, and seek the help you need to live life to the fullest.

Beyond Rage:
Mastering Unavoidable Health Changes
JoAnn LeMaistre, Alpine Guild $24.95

Making Life More Livable:
A Practical Guide to over 1,000 Products and Resources for Living Well in the Mature Years
Ellen Lederman, Fireside Books $14

The First Whole Rehab Catalog:
A Comprehensive Guide to Products and Services for the Physically Disadvantaged
A. Jay Abrams and Margaret Ann Abrams Betterway Publications $16.95

Clearinghouse on Disability Information
U.S. Dept. of Education
Office of Special Education and Rehabilitation Services
Switzer Bldg., Rm. 3132
Washington, DC 20202-2524
202/205-8241

National Council on Disability
1331 F St., NW, Ste. 1050
Washington, DC 20004
202/272-2004

National Rehabilitation Information Center (NARIC)
8455 Colesville Rd., Ste. 935
Silver Spring, MD 20910-3319
1-800/34-NARIC, 301/588-2984

Helen Keller National Center for the Deaf/Blind
111 Middle Neck Rd.
Sands Point, NY 11050
516/944-8900 (TDD)

National Information Center for Children and
Youth With Disabilities
P.O. Box 1492
Washington, DC 20013-1492
1-800/695-0285

If you're a veteran with a disability, contact your nearest Department of Veterans Affairs field office, or write to Department of Veterans Affairs, Washington, DC 20420.

The quarterly Consumer Information Center Catalog lists more than 200 helpful federal publications. For your free copy write Consumer Information Catalog, Pueblo, CO 81009, call 719/948-4000 or find the catalog on the Net

(http://www.pueblo.gsa.gov).

See other Life AdviceSM pamphlets on related topics:

• Disability Insurance
  
• Coping with a Major Illness
  
• Caring for Your Aging Parents
  
• Choosing a Physician
  
• Health Insurance
  
• Nursing Homes
  
• Long-Term Care
  
• Re-entering the Work Force

To order, call 1-800-MetLife.

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