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The traditional approach to disability service delivery
The traditional approach to service delivery

Social Role Valorisation (SRV)
Deinstitutionalisation
Disability services
Disability and community
Explanation of terms

Medical model of disability - Wikipedia, the free encyclopedia
Social model of disability - Wikipedia, the free encyclopedia
Models of Disability : Connections for Community Leadership





The traditional approach to disability service delivery
The medical model of care
The social model of care
Disability service organisations
A new approach to service delivery?



Current disability service delivery has been to support a particular group within society. The origins of this come from the medical model of care.


The medical model of care: (Top)
... is based on the study of a particular illness or condition that prevents a person from fulfilling his/her needs.
... people are clasified or grouped into groups that allow the profession to treat the group within a particular speciality within the medical arena..
... the needs of people presenting with the same illness or condition are generally the same
... the type of interventions used are specific to the particular illness or condition
... the service is built around the needs of the person within the model of care within the medical arena

The advandages of this are ...
... the type on intervention is specific to the illness or condition
... the person or group of people are monitered, protected and supervised until their condition improves
... the cultures, behaviours and expectations (institutions) of the setting and staff are based on a caring and nurturing philosophy
... the skills and resources are used efficiently and effectively in supporting the person or group of people within the medical arena
... the person is protected from society where necessary
... society is protected from the person where necessary

The disadvandages of this are ...
... a person or group of people may loose control over their lives
... a personal loss in not being able to manage their own affairs
... temporaly loose the networks and relationships within their communities that they are a part of
... have to learn the institutions of the community that they are now a part of
... a person or group of people may becomes isolated from society


The social model of care: (Top)
Evolved from a greater social awareness and responsibility of the other social needs of people with high support needs. The principles of Normalisation and Social Role Valorisaton form the underlying framework of service delivery. While built around a medical model, the social model provides a social focus to service delivery that allows people to be included in the normal social activitives of the society in wich they live. Social Role Valorisaton says that in order for a person to be able to participate in society, the person needs to have a valued social role.

The advandages of this are ...
... the type on intervention is specific to the illness or condition within society
... the person or group of people are monitered, protected and supervised until their condition improves
... the cultures, behaviours and expectations (institutions) of the setting and staff are based on a caring and nurturing philosophy
... the skills and resources are used efficiently and effectively in supporting the person or group of people within the social arena
... the person or group of people have a greater chioce in the way the service is provided
... the service tries to break down the social obsticles in the the person or group of people participating in ordicary social activities
... a person or group of people may gain new communities of support (supports, networks and relationships) when being relocated into another setting

The disadvandages of this are ...
... there is the assumption a person or group of people automatically become a part of a community
... there is the assumption that each community that the person or group of people are supported in, has the necessary skills and resources
... a person or group of people may loose the existing the community of support (supports, networks and relationships) when being relocated into another setting
... the service has ownership through direct intervention in providing for the needs of its members


Disability service organisations: (Top)
There are lots of other models of service delivery that are each based along a particular theme or paradigm. I can talk about the Specialist Model, the Rights-Based Model, the Tragedy/Charity Model, the Religious/Moral Model, the Economic Model, the Customer/Empowering Model, the Rehabilitation Model  I personally feel these all confuse the issues that people with high support needs have in being supported in society. Disability service organisations provide the same models of care within society. Each model is specific to the needs of the person and the needs of the service that provides the care.

We see services provide  ...
... specalised care within society
... person centered care
... the skills and resources that are unavailable within other communities within sosiety
... the community networks and relationships within the disability arena, as well as the wider communities that the service is a part of

The advandages of this are ...
... the service is bound by the various government policies and practice that determine service delivery
... the person or group of people get the most appropriate care for the persons needs (Person Centered Planning)
... the service is able to develop a knowledge base in the support of the group in society
... the needs of the group are provided be the service
... the members monitered, protected and supervised
... members have the networks and relationships within the community of the service
... the members have the opportunity to participate in, and develop networks and relationships within other communities that the service is a part of

The disadvandages of this are ...
... the service has ownership through direct intervention in providing for the needs of its members
... other communities support the role of the disability service in society
... disability services often duplicate services within the disability arena, as well as the wider community
... disability services compete for skills and resources within the wider communities
... the institutions of service delivery are generally based on the medical/social model of care


A new approach to service delivery?
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At the risk of confusing things even further, I feel that the roles of the communities (living, recreational, educational and employment) have been completly ignored in the process. Just because a person has access to a community does not automatically mean that a person or group is a part of a community.

... is the community appropriate ot the needs of the person?
... does the community have the skills and resources?
... what roles does the community have in supporting the person?
... what roles does the service have in supporting the person?



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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