Assistance (handicapped assistance)

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The term assistance for people with disabilities stands for self-determined help for the disabled .

personal assistance

Personal assistance is the support and care provided by disabled people themselves . Assistance not only includes care, but also help with all other activities in daily life. The term assistance was coined in order to distinguish self-determined from externally determined handicapped assistance through the choice of words. The originally neutral words “care”, “care” and “care” are often synonymous with external control and tutelage for disabled people .

In the employer model , disabled people hire their helpers themselves, provide the necessary training and also do most of the administrative work themselves. Financing is usually ensured by health insurance companies , long-term care insurance companies and social welfare offices .

Assistance cooperatives are self-help groups similar to nursing services .

According to the Duden , the word "assistant" comes from Latin and means something like "assistant, helper". This is someone who assists another. Assisting means, also according to the Duden: "To help someone according to his instructions" (cf. Duden 1997: 89). In this context “according to his instructions” seems significant.

The assistance model (preferred term in Switzerland) or "personal assistance" was developed exclusively by physically handicapped people. Therefore it can be applied to these people first of all. In the course of today's development, it has been shown that many content-related parts of this model can also provide very useful suggestions and impulses when working with people with cognitive developmental impairments .

Development of the assistance model

The assistance concept stems from the debates of the “self-determined living movement”, to which physically disabled people in particular had come together. In this context one often encounters the term “personal assistance”. This means any form of personal help that helps the assistant to live their life as independently as possible. Personal assistance includes both the areas of personal hygiene , household or medical nursing , as well as communicative aids by, for example, sign language interpreters for people with hearing impairments or reading services for people with visual impairments (cf.Niehoff, 2003: 53).

Self-determination is a central point of the assistance model. So that people with developmental disabilities can live as independently as possible, it is necessary that assistance is organized as independently as possible from organizations and their externally determined constraints. Also restrictive is externally determined, incapacitating help, as it has long prevailed in traditional disabled assistance and in some cases still is. The idea of ​​assistance has emerged to meet these requirements. The central point here is that the person in need of help selects the assistant himself, guides him, uses him and pays him (cf. Steiner 2001: 18).

From a dialectic between the criticism of the help system (fight against outside determination) and the design and implementation of alternatives, the paradigm of outpatient services developed in Germany via the home criticism . Self-organized help emerged again from the criticism of the outpatient services. In the first half of the 1980s, these led to a largely common concept of the Federal Republic of Germany and the USA of self-determined life and assistance (ibid. 2001: 20).

The criticism of being incapacitated by the experts follows on from the expert criticism of the 1970s. It is seen as problematic when professionals have the power to define the “good life” (cf. Baumgartner 2002: 68). They are not supposed to determine what the “good life” looks like. This provision should lie with the data subject. Everyone should be able to define this for themselves. This view also contributed to the development of new models.

The American philosophy of independent living (IL = self-determined living) also had an influence on the emergence of the idea of ​​assistance. The initial development in Germany happened independently. The "Disabled and Cripple Movement " had a major influence on this. In Germany, the form of self-organized help existed before the American IL philosophy became known (cf. Steiner 2001: 21).

Today's campaign by the Forum for Self- Determined Assistance for Disabled People ( ForseA ) in Germany follows on from the criticism of the external determination of the organizations and the dominance of experts . It is called “March out of the institutions - Tear down the walls!” And its aim is to enable people with developmental disabilities to lead as self-determined a life as possible in the environment they choose. That is why it is also important to the campaign to prevent people with developmental disabilities from being introduced to institutions or to enable them to leave organizations.

The "disabled and cripple movement" was important for the development of the assistance model.

Assistance / assistance contribution in Switzerland

As part of the 6th revision of the Federal Act on Disability Insurance (IVG), the assistance contribution (AB) was introduced with effect from January 1, 2012. Eligibility are the recipients of a helplessness allowance (HE) of the IV. The AB is cost-neutral for the IV because the HE for home residents is halved and the cantons are indirectly involved in the financing.

For some of the recipients of a helplessness allowance, the conventional nursing and care offers by institutions and Spitex organizations are not tailored to their needs. They want to be able to decide for themselves who will help them when, where, how and for how long. As an employer, you or your legal representative employ selected people (assistants) to support you in everyday life. The principle of “self-determined life with personal responsibility” includes real freedom of choice between living at home or in the home, between working in the regular labor market or in a workshop, between regular or special schools. This promotes integration and equality.

A five-year test (2006-2011) in the cantons of Basel-Stadt, St. Gallen and Valais confirmed the advantages of the AB:

Those affected welcome the greater freedom to make independent decisions and act, their quality of life increases significantly and they have more opportunities to participate in everyday life (integration). Relatives are relieved. Leaving the home and fewer people entering the home relieve the municipalities and cantons, less Spitex relieves the burden on health insurance companies and the public sector.

The AB covers the additional costs of personal assistance due to the disability. These additional costs burden those affected due to their regular need for help for everyday life, household, leisure, education and work / charitable commitment, child-rearing as well as monitoring and help at night through the direct employment of personal assistants. The AB is paid in addition to the helplessness allowance and determined on the basis of a clarification of the need for help in each individual case. Billing takes place within the framework of fixed tariffs. The parliament decided with a narrow majority to only partially allow the employment of relatives. You must not be directly related to or be in a relationship with the disabled person.

It is calculated with 3,000 recipients (around 10% of those entitled). Originally, the Federal Council wanted to limit the AB to responsible adults. However, Parliament has stipulated that minors and adults with limited capacity can also receive the AB under certain conditions. According to the will of all disability organizations, any discriminatory restrictions must be removed. Children, adolescents and adults with legal representation may not be excluded.

See also

literature

  • Edgar Baumgartner: Assistance services for handicapped people - social policy conclusions from a pilot project . Peter Lang-Verlag, Bern 2002, ISBN 3-906769-00-3 .
  • BIZEPS - Center for Self-Determined Living: Self-determined living with personal assistance . Vienna 2008. Download
  • Bundesvereinigung Lebenshilfe for people with intellectual disabilities e. V. (Hrsg.): Self-determination: Congress contributions . 2nd edition. Lebenshilfe-Verlag, Marburg 1997.
  • ForseA (Ed.): 20 years of assistance. Disabled people on the way to more self-determination. Mullfingen-Hollenbach 2001. Download brochure
  • Ulrich Hähner et al. (Ed.): From supervisor to companion. A reorientation under the paradigm of self-determination. 4th unchanged edition. Lebenshilfe-Verlag, Marburg 2003, ISBN 3886173003 .
  • MOBILE - Self-determined life for the disabled e. V. / Center for Self-Determined Living Cologne; Birgit Drolshagen et al. (Ed.): Handbook Self-determined life with personal assistance. A training concept for assistants. Volume A and B. AG SPAK books, Neu-Ulm 2001, ISBN 3930830264 .
  • Ralf Monréal (2018): Care can be so human - personal budget versus outside control . proroba Verlag, ISBN 978-3-96373-000-9 .
  • Ulrich Niehoff: Basic concepts of a self-determined life. In: Hähner, Ulrich et al. (Ed.): From supervisor to companion. A reorientation under the paradigm of self-determination. 4th unchanged edition. Lebenshilfe-Verlag, Marburg 2003, 53–64.
  • Gusti Steiner: How it all started - the consequences of political self-help for the disabled . In: INFORUM, 20 years of assistance - disabled people on the way to more self-determination. Publication about the past, present and future of personal assistance. December 2001. Forum of self-determined assistance for disabled people, ForseA e. V., Berlin 2001, 14-33.

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