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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, Bilbao. Table of contents. Disability policy (in Flanders)

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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

June8th 2011, Bilbao

slide2

Table of contents

  • Disability policy (in Flanders)
  • Independent living: main components
  • Independent living: ADO Icarus
      • ADL-assistance
      • Service users
      • Call system
      • ADL-assistants
  • Synopsis
slide4

1. Disabilitypolicy: mainly a regional matter

  • The federal state: income-replacingbenefits/allowance;
    • The Flemishcommunity: subsidising and organising care
      • The Flemishregion: housing; employment; …
        • The provincial and/ormunicipal level: transport costs; projects; …
slide5

1. The Flemishcommunity: subsidising and organisingvarious types of care

  • Residentialfacilities
    • Nursing
    • Home forworkingpeople
    • Daycentre
  • Home services
    • Integrated living
    • Independent living
    • Assisted living
  • Personalassistance Budget

Care in kind

Cash payment

slide6

2. Independent living: background

  • Independent Living
  • Origin: Sweden
  • Emancipationmovement (‘70s-’80s)
    • Inclusion
    • Autonomy
    • Physicalassistance
    • Privacy
  • 1985: experimental independent living projects
  • 1991: legislation and subsidy
  • 2011: 25 independent living projects
  • ADO Icarus vzw
  • 10 independent living projects
  • 230 ADL-assistants
slide7

2. Independent Living

To live in an independent and autonomous way in their own home environment, people with disabilities need to have access to

  • Adapted housing
  • Home modifications and technical
  • equipment
  • ADL-assistance (24h)
  • Call system
slide8

2. Independent living

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.

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2. Independent living

  • 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
slide10

2. Independent living

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.

slide11

2. Independent living

  • Equipment and modifications
  • Modifications
  • NBN ISO/TR9527 (design guidelines)
  • Adjustable kitchen sink
  • Adjustable toilet
  • Accessible electric switches
  • Wheelchair accessible shower
  • Widened doorways
  • ...
  • Equipment (standard):
  • Automatic door opener
  • Easy use lever taps
  • ...
  • Equipment (individual):
  • Hi-low bed
  • Hoist (patient lift)
  • ...
slide12

2. Independent living

  • ADL-assistance
  • 12 service users=10 fteADL-assistants
  • No costfor the service user
  • Limit of 30 hours/week
  • Fragment of total care, next to:
    • Non-professional care (family,…)
    • Home nursing
    • Cleaningstaff
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2. Independent living: support

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.

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Lommel

Dendermonde

Menen

Zolder

Diest

Kortrijk

Hasselt

Denderleeuw

Gingelom

Halle/Beersel

3. Independent living: ADO Icarus

ADO Icarus supports people with disabilities from 10 independent living centres that are situated in different regions in Flanders

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3. Independent Living: ADL-assistance

  • Definition: support in dailyactivitiesthatuserscannotperformthemselvesoronlypartiallydue to physicaldisability. It does notreplaceaidfromotherorganizations and cannotbeofferedonappointment.
  • Tasks: to help userswith
    • Eating and drinking, heating a meal, servingfood, doing the dishes, ...
    • Movingaround the house, in and out of bed, wheelchair, car, bath, ...
    • Personalhygiene and make up: mouth care, brushinghair, cuttingnails, shaving, washing, (un)dressing, bathing, ...
    • Littlethingslikeemptying the letterbox, inflating a tyre, preparing anactivity, making up the bed, administrativetasks, ...
  • Scope:
    • Users’ homes and immediatesurroundings
    • (Para)medical, psychologicalorsocial help canonlycomefromspecialized service providers
    • House cleaning, ironing, preparing meals and transport fall out of scope
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3. Independent Living: Service Users

  • As ourcustomers, the service users are placed centrally withinourorganization. Theydecideautonomouslywhentheyuseour services (24/7) and howthey want to makeuse of it. At any time theycancallforassistancethrough the communication system.
  • The usersparticipateactively 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 experts
slide17

3. Independent Living: Service Users (2)

  • Service usersmust complywith the followinglegalregulations:
    • Severephysicaldisabilitythatdemands a minimum of 7 hours and a maximum of 30 hours of assistance (estimated at intake)
    • ShowingresponsibilitywhenrequestingADL-assistance
    • RegistrationwithFlemish Agency for People with Disabilities (VAPH) before the age of 65
    • Approval by the VAPH to use a centre for independent living
  • The service usersare 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 deliveredonrequest of the users and according to their wishes
    • The user determineswhether a requestbelongs to the activities of the dailylife (ADL).
    • A requestfrom the user canberefused in case:
      • Ownsafetyorhealth is endangered
      • Itclearly does not concern anactivity of the dailylife
      • Moralobjectionsexist
    • In case the user and the assistantwoulddisagreeon the nature of the request, the responsiblecoordinator is contacted.
    • In case anassistantfindsanactivitytoodangerousortoo heavy to performalone, a colleaguecanbecalled up to come and help. If the user wouldnotallowthis, the assistantmayrefusefurther help.
    • Assistantscanuse (lifting) aids in mutualagreementwith 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 spirit
slide20

3. Independent Living: Call System

  • Callsforassistance: all assistantsonduty are informedabout these calls and handlethem as theycome in. There are 4 types of calls:
    • Alarm: emergency in which the life of the user is in danger
    • Urgent: swiftactionfromassistants is required, e.g. visit to the toilet
    • Short: onlyforsmalltasksthatneed prompt action, e.g. putting on a coat
    • Normal: all othercalls
  • Calls are answered in chronological order, exceptfor the first 3 types.
slide21

4. Wrap-up

  • Retrospective:
    • Inclusion
    • Independence
    • High quality of life
    • Home support
  • Challenges:
    • Complexity of the disability
    • Disintegration of informal care
    • Awareness of independence
    • Broadening the target group
    • Waiting lists
    • Cost efficiency