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The institutionalisation of community care
The social construction of community care


Characteristicts of community care
Social Role Valorisation (SRV)
Deinstitutionalisation
Disability services
Disability and community

What Are Institutions
Institution - Wikipedia, the free encyclopedia
The role of institutions in society
Characteristics of an institution
How does the community care?
The role of social care in the community
Community care Vs Institutional (social) care
The institutionalisation of deinstitutionalisation
Explanation of terms




The institutionalisation of community care
Community Care
Characteristicts of community care
Institutional (or social) Care
Characteristicts of institutional care
The roles of the carer
The institutionalisation of community care


"Institutionalised care for people with disability is alive and well in Western Australia"

Community Care: (Top)
Is about community members getting together to support or provide a service within that community.
... About the members supporting each other.
... A value in being a part of the community.
... Having something to contribute to the community.
... Parents may rely on family members or relatives to look after young children or toddlers..
... A car pool allows the members of a group to share resources within a group.
... A group may get together to help out a neighbour.
... Book clubs are a way to share books.
... A community may use goods and services as a form of monetary exchange rather than cash (barter)
... Is dependent on the skills and resources of the members within the community.
... Relies on community members to provide the service.

Characteristicts of community care: (Top)
Informal ...
... there are no defined roles, structures or hierarchies in the provision of the care.
... care is centered around the skills and resources of the othres providing the care.
... the care is provided in an informal setting that is not designed around a particular model of care.
Spontaneous ...
... care is provided as needed and relies on the availability of others,
... care is improvised and relies on available skills and resources.
Adaptable ....
... the care provided can be easily changed or modified according to the person's/groups needs.

Institutional (or social) Care: (Top)
Where a community can not provide for the needs of it's members the care needs to come from somewhere else. As a result specialised services have evolved to fulfill those needs. People that have a physical or intellectual condition, the aged and other groups are supported by an organisation or service that can provide for the specific needs of each group. These organisations or services have their own institutions that are not the same as the institutions of the wider communities that they are a part of.

We see institutions such as Activ, Identity, TCCP, Rocky bay etc take over the role of the institutions that they replaced in society.
While the outcomes are different to the services that were provided 100 yeqrs ago, they still provide the support, the skills and resources that are not available in the wider community.

The various policies, practices and institutions of government, disability services and organisations provide the community behaviours towards these groups, and expectations of the way these groups are treated within the community.

The shift from community care to institutional (social) care
The dependence on social structures in providing the care

Institutional practices ...
Profiling as a social policy.
Actively supporting people with high needs in the community: the community provides a supportive role.
Service industries become dependent on these institutions.
New communities are built that have the skills and resources to provide for the needs of people with high support needs.
Legatimises the roles of institutionalised care in the community.

Chapter 5, Reinstitutionalising Disability,
In Gerard Goggin, Christopher Newell, Disability in Australia: exposing a social apartheid,
University of New South Wales Press LTD Sydney, First published 2005


Characteristicts of institutional care: (See Characteristics of an institution) (Top)
Formal ...
... there are defined roles, structures or hierarchies in the provision of the care.
... care is centered around trained staff that have spicific tasks and duties.
... the care is provided in an informal setting that is designed around a particular model of care.
Organised ...
... care is provided in an orderly, planned and structured setting,
... care is planned and relies on professional skills and resources.
Fixed....
... the care provided can not be easily changed or modified according to the person's/groups needs.

 The roles of the carer: (Top)
Non-professional:
Provides personal care for a person that can not look after him/her self
Privides for the physical and social needs of the person
Has limited skills and resources in providing for the person
Is often helped by family, friends,
or a community support network/group,
or institutional support that is provided by a government or community service,
that has the skills and resources to help.
Is the best person to provide the support;
Knows the person.
Is often trained by a medical service that has some knowledge about the condition that the person sufferes from.
May support the person in a setting that most suits the persons needs
The care is provided in a non-institutional way, in a non-institutional setting.
The carer may have other roles such as mother, father, son or daughter, brother or sister, or worker, student etc.
The carer may also recieve financial support: child support, carers support or pension.
The amount of financial or social support provided by government or community service is dependent on some criteria that allows access to that financial or social support.

 The institutionalisation of community care: (Top)
The roles of the carer
Professional:
Paid support by way of government subsidies, pensions etc
New government policy and practice mean that a carer needs professional support in providing the care.
Hew technology, equipment, drugs and knowledge means that the carer needs to have a more professional approach to service delivery.
Provides personal care for a person that can not look after him/her self
Privides for the physical and social needs of the person
The amount of financial or social support provided by government or community service is dependent on some criteria that allows access to that financial or social support.

The roles of the volunteer
Provides a service that is not available in the wider community.
Usually not paid for services, but compensated for expenses.
Provides a non-professional approach to service delivery within a service or organisation.
Is bound by the policies, proceedures and other mechanisms of the service or organisation.
Is bound by the institutions of the service or organisation.
Acts as an aid or support to the service or organisation in providing non essential services that supplement or assist service delivery.

The roles of the support worker
Provides a service that is not available in the wider community.
Paid for services provided.
Provides a professional approach to service delivery within a service or organisation.
Is bound by the policies, proceedures and other mechanisms of the service or organisation.
Is bound by the institutions of the service or organisation.
Provides the essential services of the service or organisation

The above shows that while individuals are looking for a local service to provide the skills and resources, so they can better fulfil their own needs, these supports are less likely to be found in the community. There is a growth in the human service industry that is taking over from the traditional roles of the community in providing these supports. Local Rotary, Lions, Apex groups are getting smaller. Church and school groups have less participation as we knew it in the community.

In many ways I see this as the community opting out in providing these roles ...
A lack of community skills and resources.
Communities are more diverse and fragmented these days. They are different places to what they were 100 years ago;
New generations have more things to think about these days. They expect everything to be given to them.
Everything is reduced to a personal cost. My time is more valuable in doing something else.
Permissions, insurance and liability issues, legal implications, and council regulations all make it more difficult for community groups to get together.

The idea of "placing a person into institutional care" is so institutionalised and normalised into the culture of the society through government policy and practice, the medical arena, schools and universities, as well as the media, that there really is no choice these days. A person that can not be supported in the community is placed in institutional care that has the skills and resources that can provide for his/her needs.

Institutionalised care is also about the community not having the skills and resources in providing the care. Sometimes institutional care is important in, and integral to, the way a community functions. These institutions (Organisations and services) complement communities in allowing communities to better manage their own needs, Hospitals, schools and universities, nursing homes, churches etc all provide valued roles in society, However these institutions are used is determined by the values, cultures etc (institutions) of the society in which they are used.


Shows the relationship between the the skills and resources of the community,
 and the amount of support that can be provided within the community.
(See Community care Vrs Institutional care)



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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