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Exercise Religiously
By Joanne Bauman, National Center on Physical Activity
and Disability
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As he signed the Americans with Disabilities Act in 1990,
President George H. W. Bush said that the law would "ensure that
people with disabilities are given the basic guarantees . . .
freedom of choice, control of their lives, the opportunity to
blend fully and equally into the . . . mosaic of the American
mainstream."
On the 12th anniversary of the ADA, President George W. Bush
announced that the government would be making changes to
Medicare rules to save money and curtail fraud. New rules would
require all persons who receive in-home assistance to be
"homebound." The rule stipulates that a homebound person is one
who has "a normal inability to leave home" where "leaving home
requires a considerable and taxing effort by the individual."
When a person does venture out, it must be "infrequent or of
relatively short duration."
The "homebound" rule has provided governmental agencies and home
health providers with the excuse to terminate service to those
with the severest disabilities who generally need the most
assistance. David Jayne, who has Lou Gehrig's disease, was
initially dropped from coverage for attending a funeral. He
wasn't aware that his home health service would be terminated
for leaving the home, with the exception of doctors' visits or
adult day care. Jayne's psychologist filed paperwork for the
discharge process for homebound violations. Newspaper coverage
of Jayne's case and help from Georgia Advocacy Office lawyers
won him reinstatement.
Jayne said he grew bitter being "forced under house arrest and
missing out on my children's activities." "I didn't know the
federal government was into rationing freedom," he said. Jayne,
once an avid hunter, fisherman and outdoorsman, enjoys his
children's sporting events and vacations. "I know going public
with my activities would cause me to be discharged again," he
says of his lobbying and advocacy, "but I wanted this punitive
restriction exposed." Jayne had services cut again for having
the audacity to attend a football game and speaking out on
disability awareness. Unlike others who have been cut from
services, Jayne has been successful in having his services
restored.
In July 2002, President Bush announced a very limited policy
modification so that people considered "homebound" can
"occasionally take part in their communities, without fear of
losing their benefits." This new language is "a step backwards,"
according to Rep. Ed Markey (D-Mass.), co-sponsor of the
Homebound Clarification Act (H.R. 1490) to eliminate
restrictions. David Moulton, Markey's aide, says Markey
"vigorously objected to this language" because it appears to
narrow permissible absences from the home to "things that take
less than an hour."
The homebound regulation was created at a time when people with
many disabilities really couldn't leave the home. Technology,
advancements and ADA make it possible for people with
disabilities to be active, raise children, live life, and
participate in fitness and recreation opportunities.
The homebound rule puts a real damper on people with
disabilities even attempting to participate in exercise or
recreation. The body cannot sustain inactivity. Does the phrase
"use it or lose it" come to mind? Studies demonstrate that
individuals who are on a few weeks of bed rest have decreased
bone mineral content, lower heart function, higher risk of blood
clots, pulmonary dysfunction, and many other health problems.
Inactivity results in muscle wasting, loss of bone mineral
content, decreased heart strength, decreased mental and physical
vigor, and increased resistance to insulin leading to diabetes.
Worldwide, obesity and sedentary lifestyles are fueling what one
researcher called "a catastrophe to come" in The Wall Street
Journal.
Encouraging Americans to participate in fitness and exercise
(National Fitness Day, July 2002) while at the same time
punishing persons with disabilities unless they stay at home
sends a mixed message. Is it implied that the need for health
and fitness only applies to able-bodied Americans? After all,
the stereotype of persons with disabilities is that of the sick
invalid, not of anyone fit and healthy. It also penalizes anyone
with the desire to maintain health and abilities. Someone with
MS could lose home health services for having the hubris to
pursue yoga or tai chi classes to maintain joint flexibility.
Exercise for persons with cerebral palsy, muscular dystrophy,
ALS, and multiple sclerosis can increase energy, improve
balance, manage spasticity, decrease muscle atrophy, prevent
contractures, maintain respiratory capacity, and maintain or
improve strength for activities of daily living. Yet, if you are
restricted by the homebound rule, to go swimming, participate in
a camp or adaptive recreation program, or go someplace to use
equipment such as hand ergometers for health benefits is
prohibited.
Quite possibly, if people were "allowed" to get out and swim or
go to use adaptive equipment for fitness, the government could
allocate a little less toward medical expenditures for secondary
conditions, such as obesity, high blood pressure, high
cholesterol, osteoporosis, cardiovascular disease, and pain
management.
How did ADA's "the opportunity to blend fully and equally into
the . . . mosaic of the American mainstream," get translated
into "occasionally?" Here's some food for thought. Medicare
rules allow for unlimited trips outside the home to attend
religious services. Although you are seemingly encouraged to do
so, don't be stuck at home to eat, drink, watch TV, play
computer games, surf the Internet, or cruise the chat rooms.
Maybe your form of spirituality and getting in touch with your
Creator is fishing or camping outdoors. Maybe it's riding a Stim-Master.
Maybe it's lying in a canoe and soaking up sun while you float
down the river. Plant some flowers and tend a garden.
Participate in nothing short of a miracle and get out and
exercise religiously.
References
"Person of The Year: David Jayne." New Mobility January
2003: 32-38.
Ervin, Mike. "Homebound Holy Days." New Mobility November 2002.
Medvescek, Christina. New Language for Medicare Homebound
Restriction a 'Huge Disappointment' to Reform Activists.
http://www.mdausa.org. |
