Community Care

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Community Care (from English community ' Gemeinwesen ' and Care , 'Sorge, Fürsorge ') is a model for dealing with society's members.

introduction

The term “Community Care” describes the characteristics of a civilized society that cares for its members and offers them options for the way they live. The term stands for a concept or for a social movement that deals with a largely equal and partially supported coexistence of people within a specified geographic size (district, quarter or neighborhood ) and strives for unrestricted participation in social life.

Nobody is excluded from the offers that the community has to offer its citizens, be it day care centers, schools, leisure or cultural offers or work and housing offers (cf. Schablon 2009, p. 154 f). According to Lüpke, this approach can best be implemented within a social area with approx. 3000 to 5000 residents (cf. Lüpke, 2001). He justifies this with the possible intimacy that can arise with such a “small” number of residents. Thimm, on the other hand, places the ideal number of residents at around 20,000 (Thimm, 1997). His motivation for this is the view that the necessary supporting infrastructure is only available at this number.

The community care theory is characterized by the fact that people are valued in their individuality and are equated despite their different living conditions. Community care is therefore characterized by the renouncement of segregation and special living environments for people with disabilities . This means that people with and without disabilities, people with different cultural backgrounds as well as people with lifestyles that deviate from the norm (although these must not lead to criminal offenses) live together. Especially for people with disabilities, this form of coexistence should represent an opportunity, as they receive professional support from the community (neighborhood). All people who live in this community have the opportunity to exert political influence. This enables positive changes, especially in the context of traditional stigmata , to be broken (e.g. the mentally handicapped as a citizen with equal rights and duties). In this community resources , e.g. B. Funds, distributed as needed and managed in a social space-related manner. Ideally, this means that even people with a high need for support do not experience any exclusion due to social or material determinants. In this community based on the Community Care model, integration does not have to be made possible in an artificial special world, but rather takes place in everyday coexistence, according to the idea of inclusion (cf. Hinz 2009, Stein 2005).

In a district that is based on the guidelines of Community Care, there are no large institutions, or the aim is to dissolve them or to convert them into a family-like structure. The coexistence of citizens should be based on equal contacts, i. H. Encounters at eye level must be marked. This respect for one another is also the basis for the actions of professional professionals within this community. Community care is understood here as an orientation for paid support, which is only used in the third instance, after the informal support options (family and friends) and the regular support structures (authorities, associations, etc.). The motto “accompanying instead of looking after”, as well as a radical acceptance of a social, equal individuality, are essential prerequisites for working with the community care approach. The primary responsibility for supporting people in marginalized positions on their way to full participation in social life lies with the community and especially with the citizens.

definition

The only scientifically substantiated definition of the community care approach was presented by Schablon in 2009 (cf. Schablon 2009: 295, Röh 2009: 138). It clarifies the interplay of the various structural and action-related determinants and clearly locates the term in the area of action-related theories , which are aimed at professional professionals as guidelines, similar to the action-related interpretation of the empowerment approach (cf. Theunissen 2001 / Herriger 2002). This enables a differentiation from the related terms “Community Living”, “Supported Living”, “Community Building” and “Community Organizing”.

“The concept of 'Community Care', which can be used theoretically as a philosophical-political model, but also practically as a model of action and as a theory of medium scope, primarily describes the mutual relationship of a community of diversity within a neighborhood. People (with intellectual disabilities) live in local society; live, work and relax there and get the support they need from the local community. Changes take place in the sense of a ' grassroots movement ', which is expressed, among other things, by the political influence of all actors. Community care requires subsidiarity of government action, which at the same time ensures quality of life and enables integrative crystallization points. Community care includes a reduction or dissolution of large institutions and a life in the community characterized by interdependencies. On the part of the citizens and the professional employees, it is necessary to implement an ethic of mindfulness , recognition and justice towards people in marginalized positions. "

A community care approach understood in this way offers action orientation for related approaches (e.g. the inclusion approach) that also pursue the goal and the socio-political target of unrestricted participation (according to SGB IX § 4 / or the UN Convention Art. 19).

On the history of Community Care

Historically, the guiding principles and ideology of the community care approach can be traced back to the normalization principle , social psychiatry and community work . The origin of the community care idea can be seen in these three approaches and in the approach of communitarianism (civil society) that was popular in the 1990s . In one of the first writings on the principle of normalization (Nirje 1968 "Christmas in Purgatory") the term "Community Care" is mentioned for the first time. The normalization principle places value on the promotion of personality development and self-determination, as well as social integration and participation. It assumes that the lives of people with a disability should be made as normal as possible. This means that people with disabilities can live their everyday lives as normally as possible. The idea of ​​normalization was developed in the 1950s by the Danish Bank-Mickelsen and worked out by the Swede Bengt Nirje. It was further developed by Wolfenberger in the USA and Canada in the 1960s. In Germany it was established by Thimm in the 90s. Until the end of the 1990s, the normalization principle was a central model and concept in remedial educational residential groups. Facilities for the disabled opened up and (mentally) disabled people increasingly had the opportunity to come out in public with their own interests.

Normalization principle compared with community care

The fundamental difference between community care and the normalization principle is the hierarchy of support from professional supporter to client. The normalization principle sees itself more as a professionally controlled implementation model (see Living in Neighborhoods / Thimm). It is assumed here that the professional must be close to the client so that support can be given immediately in the event of any difficulties. With Community Care, on the other hand, the professional supporter forms the outermost circle and is therefore less present. First of all, the primary network (family, friends) or the providers of regional non-specific support offers should provide support. This should enable a normalized life, like that of a person without disabilities. In addition to the normalization principle, the history of social psychiatry (Dörner et al.) Also shows clear parallels to the understanding of community care within assistance for the disabled. Here at the end of the 1960s there were publications by individual specialists and those affected who disclosed the conditions in psychiatry. These reports were confirmed by well-known psychiatrists and shook confidence in the institutions. Similar discriminatory living conditions became known in the late 1970s in the area of ​​assistance for the disabled (cf. Zeitmagazin 1979). In both socio-educational fields, society and politics were made aware of the problematic living conditions through press reports and campaigns. An investigative commission was set up in the field of psychiatry. In the report drawn up by the commission, “the inhumane living conditions of mentally ill and disabled people are (criticized), who have often been hospitalized for many years in poorly equipped facilities with up to 2000 beds or more”. (Federal printed matter 15/9555 of June 26, 2002).

Experience abroad

Community Care Development in the USA

The first models known abroad as the “community care approach” can be traced back to 1983, Rhode Island, USA (Kahn 2001). Scandalous conditions in facilities for people with disabilities led to the establishment of a community care movement in the USA in 1983. A state-funded training course for volunteer citizens took place there for the first time. It was hosted by John and Conny O'Brain (Response System Association), led to a dialogue between all participants and triggered the community care movement in Rhode Island. Here, too, five guiding principles were formulated on the basis of the normalization principle:

  1. Presence in the community, seeking out a common public
  2. Making decisions
  3. Development of competence
  4. Raising status, positive reputation
  5. Participation in the community, development of relationships

One consequence of the community care movement was the dissolution of central institutions, which led to the establishment of a decentralized, federal care system. Local support networks for relatives and people with disabilities were now in the foreground. Private service providers whose services have been contracted should provide adequate support. Public competition was made possible through advertised services. Personal assistance was now in the foreground. The duties of the professional were to enable the clients to live in the community in which they can participate. In New Hampshire and Rhode Island, people with disabilities live in houses bought by disability organizations that they can rent themselves. Three to four people live in these houses, which are no different from other houses and are within the community. For tenants, this means that they can decide for themselves who enters their house. In both countries it is important to have family support that provides adequate support at an early stage, as 60–70% of all people with disabilities live with their families here. A job coach supports people with disabilities in finding work on the primary labor market. The job coach is an employee of a service company whose aim is to help people help themselves. A separate income is important for normalized participation in the community. People with disabilities receive performance-related pay and have no special privileges as they have the same status as everyone else. Coaching of the environment is essential so that support for the clients is also possible there. There are also small businesses founded by people with disabilities that sell their products within the community. An assisted employment rehabilitation program helps clients find a suitable career. By networking with the relevant schools, family initiatives and day planning centers, strengths and abilities as well as wishes and ideas of the clients are found.

Development of Community Care in Sweden

As early as the 1950s and 1960s there were efforts in Sweden (for example by the parents' organization FUB) to improve the living conditions for people with disabilities in institutions. In 1997, a major law was passed stating that all institutions must be closed by December 31, 1999. In the year (2000) there were only two or three very small institutions in which only “a handful of people” lived. At the moment (2009) people with a disability mostly live in apartments or in group houses with a total of four to five flatmates. Three to four of these residential units are accompanied by a “local manager”. This is also responsible for the hiring of employees and compliance with support plans as well as for the deployment planning and negotiates the budget with the “municipality” (comparable to a district). A “good man” who is comparable to a legal guardian is eligible. The day care centers and workshops work in small structures with around four to five people and are located in normal residential buildings or in public facilities such as B. Police stations or retirement homes. The work carried out there is mainly - culturally speaking - meaningful activities, often services that are carried out for the cooperating public service provider.

Theory references

From a scientific point of view, a theoretical reference to communitarianism, quality of life research and network research can be demonstrated. The term communitarianism stands for a socio-philosophical movement that emerged in the USA in the 1980s, which emphasizes the dependence of the individual on society and speaks out against excessive individualism and egoism. In Germany, the grassroots democratic impulses of communitarianism were only received across party lines in the second half of the 1980s, triggered by various crises in political and economic processes. The goal of communitarianism is a civil society in which the responsible citizen u. a. participates in the form of its identity formation. The communitarian movement is based on the principle of subsidiarity, according to which institutions generally only take on tasks when subordinate communities are unable to cope with them. In summary, it can be said that communitarianism comes very close to the idea of ​​civil society and the model of community involvement (community care). Concrete ideas can be derived from communitarianism (public education in schools, use of public buildings by everyone, etc.), some of which have already been implemented in individual municipalities. Communitarianism supports the assumption of community care models that citizens represent a great potential for support and would also use it. In summary, it can be said that communitarianism offers interesting suggestions for increasing participation. The objective of assigning the state primarily the role of facilitator of citizens' decisions, who passes on as many decisions as possible to the local level, would simplify the implementation of individual socio-spatial solutions. In the understanding of communitarianism, the local community is responsible for ensuring that every citizen receives the support they need for social and political engagement. The radical acceptance of every citizen as having equal rights in his or her local community, regardless of his or her need for support, represents a constructive impetus for assistance for the disabled. Here, the direction of assistance is partially reversed: Instead of the question of the user's need for assistance, the question is more its “sharing option” (Dörner 2007) in the focus of the professional specialist. How can the community be moved to give the disabled person opportunities to get involved in their social space? How can mentally disabled people manage to do something for their social space?

Differentiation and similarities to related approaches

An approach that is often equated with community care is the model of “community living”. The professor for integration pedagogy (FH Dortmund) Evemarie Knust-Potter described the basics of a community living approach in her 1998 book “Disability - Enthinder”. Community Living is a practice-oriented international movement. The implementation is based on criteria of the normalization principle, the integration concept and adult orientation. Community living refers to all groups of people who are affected by segregation and institutionalization. In the literature, however, people often speak 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. That means living independently in the community, in small residential units or alone, with tailor-made support that is tailored to the needs of the individual. ”In addition, she demands access to education, employment, as well as to social and cultural life in the community. This means “having choices and living with dignity.” Community living is the natural coexistence of different people in a community. Community living can thus be seen as a way of implementing the normalization principle. In contrast to community care, the community living concept focuses on the ideal life in the community, characterized by equal participation. While Community Care shows structural and action-related determinants, especially professional support, Community Living outlines the implemented result. During the administration of US President Barack Obama , the community organizing approach enjoyed increasing popularity. The approach associated with the scientist Penta (FH Berlin) in social work in the FRG developed in the middle of the 20th century based on Union or Labor Organizing, the organizational process in trade unions, in a number of large cities in the USA , especially Chicago, is developing, where it is most distinctive and differentiated. Community Organizing (CO) is the establishment and development of civic organizations through the creation of social relationships that give power to act. The civil organizations have the task of changing the power relations (building of civil power) and the immediate improvement of the living situation for the community concerned, the community. They research the problems, select specific topics they want to address, develop strategies and tactics for them, and carry out campaigns and actions for their goals. For problems that have 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 are formed on the basis of the relationships that have been developed. A community organizer (usually a temporary social worker) mediates between citizens and institutions, advocates for the needs of citizens or enables citizens to address their needs or concerns themselves according to democratic rules and to solve them with all actors involved on an equal basis . Community organizing shows many parallels to the community care approach. However, the focus here is more on mediating groups or actors who are already involved in conspiracy. The process of mediation and the democratically negotiated realization of common goals are the focus of this mostly time-limited professional support. In the community care approach, on the other hand, the focus is on people with a higher need for support and their professionally supported participation in social life. Another related approach is the enabling community model. Enabling stands for "enable". Community stands for "community". Enabling Community means a unifying legal understanding of social togetherness. What is meant is the strengthening of the concept of human rights, a right to diversity and participation of people with disabilities and mental illnesses as citizens in all civil, political and social forms of recognition.

Practical examples

As already mentioned, the community care approach stands for integration in the neighborhood or community. Everyone has skills and strengths that every other person can benefit from. These skills can e.g. B. in the neighborhood to create synergy effects . Successful implementations in various cities in Germany consist, for example, in the fact that special specialist knowledge of a mentally handicapped person or only their physical resilience is used constructively in the field of garden maintenance and they can be responsible for this task in the neighborhood. There is another successful example in Münster. The institution of assistance for the disabled, "Westphalenfleiß", offers disabled people the opportunity to work as a parking lot attendant. The people with a mental handicap pursue the typical field of tasks of this profession, such as collecting fines. Here the role of the disabled person is reversed: the recipient of help becomes a service provider and is even endowed with institutional power. In Göttingen, people with intellectual disabilities work in a library and take care of the receipt of borrowed books. The Hamburg artist group "Schlumper painter", mentally and mentally disabled artists, exhibit their pictures in the regional art gallery and have thus achieved international recognition. In these examples, the focus is not on the need for support of the disabled person, but on the person himself in his role as a citizen in the community.

Opinions of affected people

The academic Esther Bollag, who sits in a wheelchair, summarizes community care in several aspects. For them, the community care concept concretizes the fact that all people have the same basic needs and that people with disabilities should remain integrated in their primary social network. Furthermore, people in need of support should only get as much professional assistance as they need and can endure themselves. This assumes that his environment enables his wishes and needs to be implemented. In general, the environment must be designed so that people can live as “unhindered” as possible. However, Bollag also views this concept critically. It describes any difficulties that may arise due to the dependency on professional assistants. One example is the absence of an employee due to illness. Here it is difficult to find a replacement at short notice who knows the personal everyday preferences of the person in need of support. Here it becomes important to be able to fall back on your own social network in order to minimize the time required to train the employee.

literature

  • L. Aselmeier: Supported Living. Open Aid for People with Intellectual Disabilities in the UK. (ZPE series no.14). Siegen 2003, ISBN 3-934963-11-0 .
  • L. Aselmeier: Community Care and people with intellectual disabilities. Community-oriented support in England, Sweden and Germany. Dissertation 2007. VS, Verl. Für Sozialwiss. Wiesbaden 2008, ISBN 978-3-531-15650-7 .
  • I. Beck, W. Düe, H. Wieland (Eds.): Normalization: Disabled pedagogical and socio-political perspectives of a reform concept. Edition S, Heidelberg 1996, ISBN 3-8253-8236-2 .
  • I. Beck: Life situations in adulthood in view of obstructive conditions. In: A. Leonhardt (Hrsg.): Basic questions of special education. Beltz, Weinheim 2003, ISBN 3-407-57204-2 , pp. 848-874.
  • K. Dörner: The end of the event. In: Evangelical Foundation Alsterdorf: Self-determination of people with disabilities. Documentation of the Community Care congress from October 23 to 25, 2000. Hamburg-Alsterdorf 2001, OCLC 633833732 , pp. 44–47.
  • K. Dörner: Live and die where I belong. Third social space and new help systems. Paranus, Neumünster 2007, ISBN 978-3-926200-91-4 .
  • Evemarie Knust-Potter: handicap-disability. The community living movement against exclusion and heteronomy. Klaus Novy Institute, Cologne 1998, ISBN 3-932562-01-1 .
  • Kai-Uwe Schablon: Community Care: “From the apartment to the community”. In: Standpunkt Sozial. Issue 3/2007: Aid for the disabled in the reform process. Development and Potential. Hamburg, pp. 17-25.
  • Kai-Uwe Schablon: Community Care: Searching for traces, clarification of terms and implementation conditions of a conception for the disabled education for community integration of adult mentally disabled people. In: Quarterly magazine for curative education and its neighboring areas. (VHN), Issue 1, 2009, pp. 34-46.
  • Kai-Uwe Schablon: Community Care. Professionally supported community integration of adult mentally disabled people. Analysis, definition and theoretical localization of structural and action-related determinants. Lebenshilfeverlag, Marburg 2009, ISBN 978-3-88617-212-2 .

Individual evidence

  1. ↑ Template 2009: 295