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On the average, it takes about 29 months to rehabilitate a severely disabled client. It is expensive in time and money. The costs for the first two years of the project were $284,295.76. At times complete families were involved in the impact of a client's illness, requiring the coordination of many social agencies and special services. Marriage failures caused repercussions in all areas, postponing the beginning of the rehabilitation process.

Home environment is exceedingly important in the rehabilitation of the severely disabled. The home that is well-equipped to care for the client promises to continue as a stable, functioning unit. Neglect in considering those who care for the client can destroy the best vocational plans.

Another optimistic finding of the study was that every client benefited in some way from the rehabilitative efforts. The 145 who did not achieve employment gained in self-care, better home care, or greater and happier self-acceptance.

The method of rehabilitating the severely disabled was made evident in the study. Needed was proximity to a metropolitan area where a complete evaluation could be made by a team of experts and where there would be available specialized rehabilitation facilities, training, and job opportunities; well-functioning home environment; adequate self-care; a rehabilitation goal based on established work tolerance; suitable training; and modifica-tion of the work area and types of duties performed. Shorter hours of work are often necessary. Maintenance medical care may be required. Rehabilitation services must be brought to the client. All the principles of selective placement need to be applied when rehabilitation services are completed. Energy needed for vocational employment must be conserved by making hone care as efficient as possible. And then, anything is possible!

One of the case studies in the report is a typical example of rehabilitation success. A woman almost totally paralyzed by arthritis required constant attendance for feeding, personal care, and transferring back and forth from bed to chair. Among her limited assets was a gregarious, pleasant personality, and it was decided this could best be utilized with a telephone answering service.

The rehabilitation agency arranged for a ten-line key cabinet with toggle switches instead of plugs to be installed by the phone company. The cabinet was placed on a hospital-type over-bed table, to be operated from her wheelchair during the day, and from her electric Gatch-type bed at night. She could raise herself by using a specially built switch to handle night calls. The agency arranged a zoning change, helped her obtain a business license, provided answering service tutoring, and invited various organizations to contribute services and money.

The result was that this woman eventually cleared a profit of $1500 a month with her telephone answering service. Total expenditure was $3,242.72. Total return to the community was estimated at $85,000 in gross earnings.

The successes and innovations described in this report were derived from one study into rehabilitation of the severely disabled. Another federal grant has been requested by the same agency for a planning program to expand upon the findings of this study. It is now felt that it has not been only the formidable cost of serving the severely disabled that has allowed them to be overlooked, but the lack of knowing how to serve them. As indicated by the 1965 Amendments to the Vocational Rehabilitation Act, these obstacles have been recognized and are thus on the way to being overcome. The first filters of light are opening the darkness. The beam of rehabilitation has expanded to include all handicapped persons, and to this development we say, "Welcome!"