title: Aging with a disability and state vocational rehabilitation services.
abstract: BACKGROUND
  Disability prevalence in older adults is increasing. Given the low rates of employment among people with disabilities, especially those aging with multiple sclerosis (MS), spinal cord injury (SCI), late effects of polio (LEP), and muscular dystrophy (MD), services from federal-state vocational rehabilitation (VR) programs could positively impact employment status.
  
  
  OBJECTIVE
  To describe VR services for individuals aging with MS, SCI, LEP and MD and the impact of aging on employment status.
  
  
  METHODS
  Thirteen Washington State VR counselors and 26 individuals, 45 to 65 years old, with MS, MD, LEP or SCI.
  
  
  METHODS
  We examined national Rehabilitation Services Administration data (2006, 2007), including case closure, service outcomes and other demographics. We then purposively selected Washington State for our study. Interviews provided consumer and counselor perspectives on the components of successful case closure (employed) and the impact of aging and disability on employment.
  
  
  RESULTS
  Washington State and national data were similar. Organizational and individual factors influence the effectiveness of VR services.
  
  
  CONCLUSIONS
  People who could benefit from VR services are not being served; those who are served, are getting neither comprehensive services nor high quality outcomes. Additional research is needed to understand the variables associated with effective use of VR services.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Pat
authors.initials: P
authors.lastname: Brown
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Kurt
authors.initials: K
authors.lastname: Johnson
mesh_terms: D000368:Aged; D000375:Aging; D006233:Persons with Disabilities / Q000193:education / Q000534:rehabilitation*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000534:rehabilitation*; D019982:Organizational Case Studies; D017009:Professional Autonomy; D012050:Rehabilitation, Vocational / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D014186:Transportation; D014481:United States; D014861:Washington
keywords: Employment; late effects of polio; multiple sclerosis; muscular dystrophy; spinal cord injury