living in Flanders Belgium Leen Lankester Coordinator Independent Living Centre Denderleeuw Alex Verheyden Member of the management team ADO Icarus vzw June 8th 2011 Bilbao ID: 414774
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Slide1
Independent
living in
Flanders
(
Belgium
)
Leen
Lankester
,
Coordinator
Independent Living Centre Denderleeuw
Alex Verheyden
,
Member
of the management team ADO Icarus vzw
June
8th 2011, BilbaoSlide2
Disability policy (in Flanders)
Independent living: main components
Independent living: ADO Icarus
ADL-assistance
Service users
Call system
ADL-assistants
Synopsis
Table
of contentsSlide3
1.
Disability
policy
in the
federal
state of BelgiumSlide4
1.
Disability
policy
:
mainly
a regional matter
The
federal
state:
income-replacing
benefits
/allowance; The Flemish community:
subsidising and organising care
The
Flemish
region
:
housing
;
employment
; …
The
provincial
and/
or
municipal level: transport costs; projects; …Slide5
1. The
Flemish
community
:
subsidising
and organising various types of care
Residential
facilities
Nursing
Home
for
working people
Day centre
…
Home services
Integrated
living
Independent living
Assisted
living
…
Personal
assistance
Budget
Care in kind
Cash
paymentSlide6
2. Independent living: background
Independent Living
Origin
:
Sweden
Emancipation
movement (‘70s-’80s)
Inclusion
Autonomy
Physical
assistance
Privacy
1985: experimental independent living projects
1991: legislation and subsidy
2011: 25 independent living
projects
ADO Icarus vzw
10 independent living
projects
230
ADL-assistantsSlide7
2. Independent Living
Adapted housing
Home modifications and technical
equipment
ADL-assistance (24h)
Call system
To live in an independent and autonomous way in their own home environment, people with disabilities need to have access to Slide8
Adapted housing
Twelve to fifteen ADL-houses (ADL stands for ‘activities of the daily life’) are situated in a regular neighbourhood.
The house are fully accessible and they are adapted for the use by people with severe physical disabilities.
2. Independent livingSlide9
Adapted
housing
Social housing project
Builder: social housing developer
Maximum of 12-15 adapted houses and a ADL-centre
Only 2 adapted houses next to each other
Radius of 200 meters
Regulation on surface, accessibility, equipment
Grant: 450.000€
/project
+ 100.000€/ADL-centre
Service users rent the houses
Income related rent
Rent contract linked to support contract
2. Independent livingSlide10
Equipment and modifications
All ADL-houses are equipped with the most elementary and necessary appliances and adaptations.
The Flemish Agency for People with Disabilities (VAPH) can finance the acquisition and installation of a large number of more specific and/or individualised appliances.
2. Independent livingSlide11
Equipment and modifications
Modifications
NBN ISO/TR9527 (design
guidelines
)
Adjustable kitchen sink
Adjustable toiletAccessible electric switchesWheelchair accessible shower
Widened doorways
...
Equipment (standard):
Automatic door opener
Easy use lever taps
...
Equipment (individual):
Hi-low bed
Hoist (patient lift)
...
2. Independent livingSlide12
ADL-assistance
12 service
users
=10
fte
ADL-assistantsNo cost for the service user
Limit of 30
hours
/week
Fragment of
total
care,
next to:Non-professional care (family,…)
Home nursing
Cleaning
staff
2. Independent livingSlide13
Call-system
The users can ask for assistance any time by means of a portable communication system. The communication system can be adapted to the needs of each individual user.
The communication system that is developed by ADO Icarus uses mobile phone technology.
2. Independent living: supportSlide14
3. Independent living: ADO Icarus
ADO Icarus supports people with disabilities from 10 independent living centres that are situated in different regions in Flanders
Kortrijk
Dendermonde
Hasselt
Denderleeuw
Lommel
Zolder
Gingelom
Diest
Halle/Beersel
MenenSlide15
3. Independent Living: ADL-assistance
Tasks
: to help
users
with
Eating
and
drinking
,
heating
a meal, serving food, doing the dishes, ...
Moving around
the house, in and out of bed,
wheelchair
,
car
,
bath
, ...
Personal
hygiene
and
make
up:
mouth care, brushing hair, cutting
nails
,
shaving
,
washing
, (
un
)dressing,
bathing
, ...
Little
things
like
emptying
the letterbox,
inflating
a
tyre
, preparing
an
activity
,
making
up the bed,
administrative
tasks
, ...
Scope:
Users
’ homes and
immediate
surroundings
(Para)
medical
,
psychological
or
social
help
can
only
come
from
specialized
service providers
House
cleaning
,
ironing
, preparing
meals
and transport
fall
out of scope
Definition
: support in
daily
activities
that
users
can
not
perform
themselves
or
only partially due to physical disability. It does not replace aid from other organizations and can not be offered on appointment.Slide16
3. Independent Living: Service Users
As
our
customers
, the service users are placed centrally
within
our
organization
.
They decide autonomously when they use our services (24/7) and how
they want to make
use
of it. At
any
time
they
can
call
for
assistance
through the communication system. The users participate actively in the organization
(e.g. interviews,
evaluation
of the
assistants
) and are
represented
in the
governing
board.
The governing board of the organization consists of 21 members, of which 14 have to be people with disabilities:
7 users of the independent living centres
7 external expertsSlide17
3. Independent Living: Service Users (2)
Service
users
must
comply with
the
following
legal
regulations
:Severe physical disability that demands
a minimum of 7 hours and a maximum of 30
hours
of
assistance
(
estimated
at intake)
Showing
responsibility
when
requesting
ADL-assistanceRegistration with Flemish Agency for People with Disabilities (VAPH) before the age of 65
Approval by the VAPH to use a centre for independent living
The
service
users
are aged between 20 and 70 and can live independently, alone, with their family or partner.
The
service users
need to realize that they use a collective service, which sometimes can mean waiting times.Slide18
3. Independent Living: Assistants
Rules
of
conduct
Assistance
is
delivered on
request
of the
users
and
according
to their wishesThe user determines whether a request belongs to the activities
of the daily life (ADL).
A
request
from
the user
can
be
refused
in case:
Own
safety
or health is endangeredIt clearly does
not
concern
an
activity
of the
daily
life
Moral
objections
exist
In case the user and the
assistant
would
disagree
on
the nature of the
request
, the
responsible
coordinator
is
contacted
.
In case
an
assistant
finds
an
activity
too
dangerous
or
too
heavy to
perform
alone
, a
colleague
can
be
called
up to
come
and help.
If
the user
would
not
allow
this
, the
assistant
may
refuse
further
help.
Assistants
can
use
(
lifting
) aids in mutual agreement with the user.Slide19
3. Independent Living: Assistants (2)
No specific educational level needed, training on the job.
Assistance is provided 24/7, all year long.
Day shifts are organized between 6am and 11pm, nights shifts between 9pm and 7am.
Assistants are not allowed to perform any medical care, not even on request of a doctor or a nurse.
Values
Autonomy
Mutual respect
Privacy and discretion
Team spiritSlide20
3. Independent Living: Call System
Calls
for
assistance
: all assistants
on
duty
are
informed
about these calls and handle them as they
come in. There are 4 types of
calls
:
Alarm
:
emergency
in
which
the
life
of the user is in
danger
Urgent
:
swift
action from assistants
is
required
, e.g.
visit
to the toilet
Short
:
only
for
small
tasks
that
need
prompt
action
, e.g. putting
on
a coat
Normal
: all
other
calls
Calls
are
answered
in
chronological
order,
except
for
the
first
3
types.Slide21
4. Wrap-up
Retrospective:
Inclusion
Independence
High quality of life
Home support
…Challenges:Complexity of the disabilityDisintegration of informal careAwareness of independenceBroadening the target groupWaiting lists
Cost efficiency
…