Care in the Community

Community Care (of English. Community, Community and Care, care, care ) is a model for how society deals with its members.

• 4.1 Development of Community Care in the U.S.
• 4.2 Development of Community Care in Sweden

Introduction

The term " community care " describes the features of a civilized society that cares about its members and offers them choices for their lives. The term stands for a concept or for a social movement that focuses on a largely equal and partially assisted coexistence of people within a specified geographic size (district, neighborhood or neighborhood ) and strives for full participation in society.

No man is from the offers that the community has to offer its citizens, whether they are day care centers, schools, recreational or cultural activities, or employment and residential services excluded (see Template 2009, pp. 154f ). After Lüpke this approach is best within a social space with approximately 3,000 to 5,000 residents realized ( cf. Lüpke, 2001). He justifies this with the possible intimacy that can arise in such a " small " number of residents. Thimm, however, locates the ideal number of residents at about 20,000 ( Thimm, 1997). His motive for this is the view that only when this number the necessary supporting infrastructure is available.

The Community Care theory is characterized in that people experience in their individuality, appreciation and are set equal despite their different living conditions. Characteristic of Community Care therefore is the absence of segregation and special living environments for people with disabilities. This means that people with and without disabilities, people with different cultural backgrounds and people with lifestyles that deviate from the norm (which may not result in the area of ​​the Penal ) together. Especially for people with disabilities is to this form of living together represent an opportunity by, professional support, experience the support of the community (neighborhood). All people who live in this community, have the opportunity to take political influence. As a result, positive changes, especially in the context of traditional stigmata are broken (eg, the mentally disabled person as a citizen with equal rights and obligations). In this community are resources, such as money demand distributed and managed social space related. This means, ideally, that even people experienced with a high need for support no exclusion due to social or material determinants. In this on Community Care 's mission statement aligned Community integration must not in an artificial special world are enabled, but is almost in our daily life together, according to the idea of inclusion (cf. Hinz 2009, Stone 2005) instead.

In a district that is based on the guidelines of community care, there are no large-scale institutions, and the goal is to resolve this or convert it into a family-like construct. The coexistence of the citizens should be characterized by equal contacts, ie encounter at the same eye level. This respect for each other is also the basis for action by the professional staff within this community. Community Care is here understood as an orientation for a paid support, but only in the third instance, after the informal support opportunities ( family and friends) and the regular support structures (government, associations, etc. ), is used. The slogan " Support instead Supervise " and a radical acceptance of a social, equal individuality, are essential prerequisites to work with the community care approach. The primary responsibility for the support of people in marginalized positions on their way to full participation in social life is in the community, and especially among the citizens.

Definition

The so far only, science-based definition of community care approach in 2009, submitted (see Template 2009: 295, Röh 2009:138 ) Template. It highlights the interplay of the different structural and action-related determinants and locates the concept clearly in the range of action-related theories that turn out to be guidelines to professional specialists, similar to the action-related interpretation of the empowerment approach ( See Theunissen 2001 / Herriger 2002). This provides a demarcation to the related terms " Community Living" / " Supported Living" / " Community Building " and " community organizing " is possible.

" The usable theoretical philosophical- political model, but also practical as a model for action and as a middle-range theory concept of" community care " primarily describes the change with respect to a variety of community within a neighborhood neighborhood. People ( with mental disabilities ) live in the local community; live, work and relax there and get it from the local community the support they need. Changes are made here in the sense of a " grassroots " movement, which is expressed by, inter alia political influence all stakeholders. Community Care of subsidiarity requires a state action, but at the same time safeguards the quality of life and integrative focal points possible. Community Care involves a reduction or resolution of large institutions and an operation preceded by interdependencies life in the community. On the part of citizens and professional staff that calls for the implementation of an ethic of care, recognition and justice for people in marginalized positions " Template 2009:. 295 A so -understood community care approach provides a practical orientation for related approaches (eg, the approach of inclusion), which are also pursuing the goal and the socio-political setting of full participation (according to SGB IX § 4 / or the UN Convention Art.19 ).

The History of Community Care

History can be the guiding principles and the ideology of community care approach to the normalization principle, attributed to the social psychiatry and community work. In these three approaches and in the popular in the 1990s approach of communitarianism ( civil society ) the origin of the community care concept can be seen. One of the earliest writings on the normalization principle ( Nirje 1968 " Christmas in Purgatory " ), the term " community care " is first mentioned. The normalization principle emphasizes the promotion of personal development and self-determination, and the social integration and participation. It assumes that the lives of people with disabilities should be designed as normally as possible. This means that people with disabilities can live their daily lives as normal as possible. The normalization idea was developed in the 1950s by the Dane Bank Mickelsen and developed by the Swede Bengt Nirje. In the 60s, it was further developed by Wolf Berger in the U.S. and in Canada. In Germany it was established in the 90s by Thimm. The normalization principle introduced by the end of the 90s a central vision and concept in special education residential selcetion Disabled facilities opened and (mentally ) disabled people increasingly had the opportunity to appear in public with their own interests.

Normalization principle in comparison with community care

The fundamental difference between community care and the normalization principle is to support the professional hierarchy supporters to the client. The normalization principle is very much seen as a professionally driven implementation model (see life in neighborhoods / Thimm ). Here it is assumed that the professional specialist should be close to the clients it, so that in case of possible difficulties directly support can be given. At Community Care, however, the professional supporters forms the outermost circle and is therefore present to a small extent. First, should the primary network (family, friends ) or the provider of regional groups - non-specific support services provide support. This is a normalized life are made possible, like that of people without disabilities. In addition to the normalization principle can be seen clear parallels to community care understanding within the disabled also in the history of social psychiatry ( Doerner and others). It came in the late 60s and publications of individual professionals and interested parties which would disclose the states in psychiatry. These reports were confirmed by renowned psychiatrist and shook confidence in the institutions. Similar discriminatory living conditions were the late 70s from the field for the disabled known (cf. Time Magazine 1979). In both socio-educational fields of work, the company and the policy have been made aware through press reports and actions on the problematic circumstances. In the field of psychiatry an investigative commission was established. In the written report of the Commission " the inhumane living conditions of mentally ill and disabled people ( criticized ), often over many years in poorly equipped facilities with up to 2000 or more beds were hospitalized " are. ( Federal printed matter 15/9555 of 26 June 2002).

Experience abroad

Development of Community Care in the U.S.

The first, referred to as " Community Care " approach abroad models can be in the year 1983, Rhode Iceland, USA retrace ( Kahn 2001). Scandalous conditions in institutions for people with disabilities resulted in 1983 in the United States establishing a community -care movement. There, for the first time a state funded training for volunteer activists took place, that of John and Connie O'Brain ( Response System Association) was organized, led to a multi-stakeholder dialogue and triggering the community care movement in Rhode Iceland. Again, five principles have been formulated on the basis of the normalization principle:

One consequence of the community care movement was the dissolution of the central institutions, which led to the establishment of a decentralized, federal supply system. Now there stood local support networks for relatives and people with disabilities in the foreground. Private service providers whose services were held in contracts should provide for adequate support. A public competition was made possible through tendered services. The personal assistance stood in the foreground. The tasks of the specialist staff were to allow the client a life in the community in which they can participate. In New Hampshire and Rhode Iceland people living with disabilities in disability organizations have purchased homes they can rent itself. There live three to four people in these houses, which do not differ from other houses and standing within the community. This means for the tenant that they can decide who enters their house. In both countries, a family support is important to ensure adequate support for early stage deals as live here 60-70 % of all people with disabilities in their families. A job coach assists people with this disability to pursue a job in the primary labor market. The job coach is an employee of a service company, whose aim is to help people help themselves. For a normalized participation in the community own income is important. People with disabilities receive a performance-related pay and have no special privileges because they have the same status as any other. A coaching the environment is essential, so that support for the clients is also possible there. Also, there are people with disabilities founded small companies that sell their products within the community. A rehabilitation program for supported employment helps in the search for a suitable profession for the clients. By networking with schools, family initiatives and day design centers concerned both strengths and abilities as well as ideas and wishes of the clients are found.

Development of community care in Sweden

Already in the 1950s and 60s there was to improve (for example, from the parent organization FUB), the living conditions of people with disabilities in institutions in Sweden efforts. In 1997, a prominent law was passed, in which it was written that until 31 December 1999, all institutions must be closed. In the year (2000) there were only two or three very small institutions in which only " a handful of people " lived. Currently (2009) people live with a disability mainly in apartments or in group homes with a total of four to five students. Every three to four of these units are accompanied by a "local manager ". This is also responsible for the hiring of staff and compliance assistance plans, as well as for the operational planning and acting with the " municipality " (similar to a county ) from the budget. Entitled to claim is a " good man ", which is similar to a legal guardian. The daily and workshops operate in small structures with about four to five people and are in normal houses or in public facilities such as Police stations or nursing homes housed. The work done there are mainly considered culturally meaningful activities, sometimes even services that are performed for the cooperating public service.

Theory covers

From a scientific point of view one can prove a theory related to communitarianism, quality of life research and for network research. The term communitarianism is a formed in the 80s in the U.S. socio- philosophical movement that emphasizes the dependence of the individual from society and speaks out against exaggerated individualism and selfishness. In Germany the grassroots momentum of communitarianism was only in the second half of the 80s, triggered by various crises in political and economic processes, rezipiert across party lines. The aim of communitarianism is a civil society, on which the embossed responsibility of citizens to file participates in the form of his identity. The communitarian movement is based on the principle of subsidiarity, according to which institutions generally only take on tasks when subordinate communities are overwhelmed with it. In summary, considered it can be stated that the communitarianism of the idea of civil society and the vision of community involvement ( Community Care ) comes very close. From the communitarianism to concrete ideas can be derived ( public education in the school, use of public buildings by all, etc. ), which were partially realized already in individual municipalities. Communitarianism supports the notion of community care models that citizens represent a large potential support and this would also be used. In summary, it should be noted that communitarianism offers interesting suggestions for increasing participation. The objective is primarily allocated to the state the role of the enabler of citizen decisions to write as many decisions at the local level would facilitate the realization of individual socio-spatial solutions. The local community is responsible for ensuring that every citizen gets the support he needs for a social and political commitment in the understanding of communitarianism. The radical acceptance of every citizen as in his local community with equal rights, regardless of their need for support, provides a constructive impulse for Disabled People dar. Here the direction of the aid is partially reversed: instead of the question of the required support needs of a user is rather the question of its "partial transfer option " ( Dörner 2007) the focus of the professional expert. How can the community be encouraged to give opportunities to the disabled person, to engage in its social space? How can the mentally disabled people succeed in doing something for his social space?

Demarcation and similarities to related approaches

A common set equal with Community Care approach is the model of " Community Living" ( life in the community). The professor of inclusive education (FH Dortmund) Evemarie Knust - Potter in her 1998 book "Disability - Enthinderung " described basics of a Community Living approach. For Community Living is a practice-oriented international movement. The implementation is based on criteria of the normalization principle, the integration idea and adult orientation. Community Living refers to all categories of people who are affected by segregation and institutionalization. In the literature, but is often spoken of the group of people of people with learning difficulties. The European Coalition for Community Living in Brussels writes on this subject: " In order to exercise their rights and full participation in society, people with disabilities need access to comprehensive quality services based in the community. This means to live independently in the community, in small units or alone, with precise support that builds on the needs of the individual. "In addition, it demands access to education, employment, and to social and cultural life in the community. This means " to have choices and to live in dignity. " Community Living is the obvious coexistence of different people in a community. For Community Living can be seen as a way of implementation of the normalization principle. In contrast to Community Care of Community -Living - thought focuses the ideal atmosphere for equal participation and community living. While Community Care structural and action-related determinants, in particular the professional support shows, Community Living outlined the converted result. Especially with the current popularity of the new U.S. President Barack Obama enjoys the approach of the community Organizings great popularity. The in social work the FRG especially with the scientist Penta ( FH Berlin) placed in connection approach has been in the middle of the 20th century in reference to the Union or Labor Organizing, the process of organization in trade unions, in a number of major U.S. cities, especially Chicago, developed and profiled been strongest to date and also differentiated. Community Organizing (CO ) is the establishment and development of people's organizations through the creation of social relations, give the power to act. The people's organizations have the task to change the power relations (development of citizens ' power ) and the immediate improvement of the life situation of the respective Community, the community, to the destination. They explore the problems, select specific topics that they want to tackle, are developing strategies and tactics and lead campaigns and actions for their goals through. For problems that need to be tackled locally, regionally, nationally and globally, if peace, human rights and social rights are to become a reality, coalitions between groups and organizations be formed on the basis of the developed action powerful connections. A Community Organizer (usually a limited time employee social workers) mediates between citizens and institutions, is committed to the needs of citizens or an empowering citizens, to address their needs and concerns themselves according to democratic rules and on an equal footing with all stakeholders to solve. Community organizing shows many parallels to community care approach. However, the focus is more placed on the teaching already committed conspiratorial groups or players here. The process of training and democratically negotiated realization of common objectives is the focus of this usually temporary professional assistance. When community care approach the emphasis shifts to a people with higher support needs and their professionally supported participation in social life. Another related approach is the Enabling community model dar. Enabling stands for " empowering ". Community stands for " community." Enabling community means a unifying lawful understanding of social to ( together ) affiliation. This refers to the strengthening of the human rights idea, of a right to diversity and participation of people with disability and mental illness, as citizens of all civilian political and social forms of recognition.

Practice examples

As already stated is the community care approach for integration in the neighborhood or community. Everyone has skills and strengths, each of which other people can benefit. These skills can be, for example, connect in the neighborhood to synergy effects. Successful implementations in different cities of Germany, for example, consist in the fact that specialized knowledge of a mentally disabled person or alone its physical capacity is used constructively in the field of gardening and he may be responsible for this task in the neighborhood. Another successful example is available in Münster. The institution for the disabled, " Westphalenfleiß ", here offers disabled people the opportunity to work as a car park attendant. People with an intellectual disability go here the typical tasks of this profession after box, such as the once rich fines. Here the role of the disabled person is reversed: the beneficiary is a service provider and is even equipped with institutional power. In Göttingen people work with an intellectual disability in a library and look after the receipt of borrowed books. The Hamburg-based artist group " Schlumpers painter", the mentally disabled artists put their pictures in the regional art gallery and thus have gained international recognition. In these examples is not the support needs of disabled people in the foreground, but the man himself in his role as a citizen in the community.

Opinions of affected people

The seated in a wheelchair academic Esther Bollag summarizes Community Care together in several aspects. For them, the community care concept substantiates the fact that all people have the same basic needs and people with disabilities should remain integrated in their primary social network. Furthermore, the person should get in need of support just as much professional assistance as needed and can bear itself. This assumes that its environment enables the realization of his desires and needs. In general, the environment has to be designed so that man can live " freely " as possible. Bollag considered this concept, however, also critical. You may describe any difficulties that may occur due to the dependence of professional staff in the assistant. One example is the absence of an employee due to illness. Here it is difficult to find a short-term representation that knows the everyday personal preferences of people with support needs. It is then important to be able to rely on their own social network in order to minimize the time spent on training of the employee.