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Disability services role models

Social Role Valorisation (SRV)
Deinstitutionalisation
Disability services
Disability and community

Understanding disability service organisations
Disability services - three models of service delivery
The role of the service provider in the community
How does the community care?



Disability services role models
Role
Service role models
Types of service models
Full integration
Partial integration
Enclaves (separated)
Segregated (isolated)



Role: (Top)
Is not exclusive to how we see ourselves or each other, a role can describe anybody or anything that we associate with or have any interaction with.

Roles are neither positive or negative. The value that placed on the role is determined by the expectations and behaviours associated with the role within the activity. At a shop, for example, there are a number of roles of the people in the shop. Two of those roles are 1) sales person and (2) customer. If a customer can not behave accordingly, or has some characteristic that does not fit into to the expectations of the sales person the customer may not be treated with dignity or respect.

1) We learn strategies (a set of behaviors) that we find useful in coping with our personal feelings and day to day situations. These strategies can be described as the person's role (or function) within the activity that the person is participating in. We learn these strategies through our relationships with others in society. In the family, at school, recreation or work all involve strategies. A lawyer, for example, learns a set of strategies in defending someone in court. A person learns set of strategies in teaching a class or being a father. A general learns strategies in defeating the enemy. A person with an intellectual disability learns social skills, life skills, employment/recreational skills and other positive behaviors that provide a valued role for the person (friend, painter, gardener, musician etc.). These strategies are often used in various similar situations, or mixed and matched in new situations, where the person has no existing sets of strategies. We generally have 2 or more sets of strategies that are used in different activities and situations, however, a person may apply one strategy to all activities and situations that may arise. Labels are also a way to describe these roles, where a person is characterised by a set of strategies or behaviors.

2) The term "Role" (also known as a social role or social function) is also used to describe the activity, the setting and the various interactions of the members within the activity and the setting, where these interactions are consistent and can be defined and measured (in the sense of comparison with other consistent interactions), and have a particular function within the activity and the setting.
These roles are determined by the society, community, club, team or group that we are participating in, in that there are a set of expectations and behaviours associated with the role within the activity.
(Note: I have avoided the term "behaviors", as a behavior describes a person's actions and reactions, rather than the various intercourses that happen between members, and their relationships with each other, within the activity and the setting.)

Our role in a particular activity is often predetermined by the type of activity, the setting and the other members of the activity. In a classroom, for example, (1): the type of activity is structured towards learning and the gaining of skills and knowledge in applying the learning, (2): the setting is separated (restricted to members that fulfil a set of criteria etc) and (3): the roles of the members are Teacher (imparts the knowledge) - Students (learns the knowledge). In order for a person to have a valued role within the activity and setting, the person must be able to satisfy the criteria associated with the activity and setting. Introducing other roles into the classroom (social system) may create some problems.

A particular role (or Label) is also placed on a person or group of people by a society, community, club, team or group as a way to justify or legitimise a policy or treatment of the person or group. This happens all the time where a particular behaviour or characteristic of the person or group does not fit into the normal behaviours or characteristics of the society, community, club, team or group. These policies or treatments often become institutionalised into the society, community, club, team or group.

Buildings also have different roles or functions within society. The role of the building describes the various ways buildings are used, and the various interactions that happen within the building. The function of the building is determined by these interactions and how they relate to the members. The most obvious of this is a "Function center" that is designed to be used for different functions. A concert hall has a particular role and function within society. Communities, hospitals, classrooms, groups/teams and even a knife can have a different role and function according to the user and others within the activity and the setting.

Service role models: (Top)
Service role models are services that:
... Are successful in providing for the needs of its members
... Have been tested in providing the best outcomes for the members
... Have a valued role within the community that it is a part of, and the wider community
... Act as a model for other similar services

Services that look after people with high support needs are often modelled around service models that are successful in providing for the needs of its members.

Types of service models: (Top)
Four broad types of service models that support people with high support needs could be described as:
... Full integration
... Partial integration
... Enclaves
... Segregated (isolated)

Full integration: (Top)
The person is a part of and supported within each community that is most suitable for his/her needs. The service provider supports the community, where the community has the skills and resources in providing direct intervention (takes ownership).




Partial integration: (Top)
People with high support needs may not be able to be a part of all communities because of the nature of the disability, or a lack of skills and resources within each community. Just because a person is a part of the community of a service provider does not mean that the person does not have the opportunity to participate in the activities of other communities.



It can be seen that while the person may have various interactions within other communities, the person is still a part of the service provider. This is not a bad thing, in as much as the person still has the opportunity to participate in other community activities. Whether the person feels a part of each community (Living, recreational, educational or employment) would depend on his/her associations (connectedness) with the other members of each community.

Enclaves (separated): (Top)
Where people that have a severe disability, or for some other reason may not be able to participate in any community activity, the service provider creates new communities (recreation, employment or education) within the wider community, or it is provided in another service setting that is a part of another service provider.



It can be seen that while the communities are separated from the service provider, they are still a part of the service provider or within the service setting.
The advantages over segregated services are:
... They are treated as individuals
... Have more variety in their life and daily living patterns
... More choices and decision making
... Able to socialise with others in different settings
... The opportunity to experience other experiences that are not available within the setting of the service provider

Segregated (isolated): (Top)
People that may have a condition or characteristic that needs full time intensive care, or may be a harm to themselves or others in the wider community are generally isolated from the rest of the community. Some hospitals (psychiatric, paraplegic etc), nursing homes (dementia etc), prisons etc are examples of communities that are removed from society. While these communities are separated, there is still some interaction with the wider community by the staff, other professionals, family, friends, volunteers etc.





In all of the above, the person has the opportunity to develop relationships with family, friends, volunteers and others that are not a part of their community, and therefor has a greater opportunity to become accepted as valued members of each community that he/she participate in. People with high support needs may have more difficulty in being able to access the wider community, or a particular community that they wish to be a part of. Through the development of skills and resources within each community, as well as technological innovations, the person may have a greater opportunity in the future to become a part of each community. Whether a person is in a integrated, partially integrated, an enclave or segregated community, he/she still has the opportunity to move from one to another according to their own needs as well as the needs of the wider community that he/she is a part of.

Services can also be a mixture of integrated, partially integrated, an enclave or segregated. A service may support people in their own community, as well as providing full time support in it's own facility (nursing home, respite or a group home etc). The members also have the opportunity to move from one community to another within the service according to their own needs as well as the needs of the service.


When providing the most appropriate care for people with high support needs ...
1) The community is not where the person is living, but where the person participates, shares experiences and has valued relationships with others.
2) People with high support needs (severe disability, aged etc.) will always need support structures as a part of their lives.
3) The amount of participation in a community (living, education, employment or recreation) is directly related to the skills and resources of the person, and, the skills and resources of the community that the person wishes to participate in.
4) Institutions are going to be around in one form or another whether we like it or not, It is the way that they are used that is the problem.
5) The institutions of a society towards a particular group determine the way the group participates in society.
6) The institutions of a particular government department, organisation, profession or service define the way the person is supported within that society.
7) Facilities that support people with high support needs do not need to be the nursing homes or prisons in the sense that they are today, but can become warm inviting community places that offer a range of services to the community, as well as be a part of the wider community within that society.
8) People with high support needs are a minority group in our society, and will have the same problems as other minority groups in being a part of society.


01/10/2010
Peter Anderson
http://www.psawa.com

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