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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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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


Table of contents

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

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; …

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


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

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

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.


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

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.


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)
  • ...

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

2. Independent living: support


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.












3. Independent living: ADO Icarus

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


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

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

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.

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.

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

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.

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