Organization of care for people with disabilities

The term design of care for people with disabilities (GBM) describes an overall concept that aims at planning and organizing needs-based services and is mainly used in the area of ​​assistance for the disabled . The basis of the procedure is the survey of the individual need (s) assessment and a concept of the strategic control of professional and voluntary help systems with the goal of demand-oriented service in the sense of controlling and quality management (according to ISO 9001 ).

GBM is recommended by the Federal Association of Protestant Disability Aid (BeB) to its member institutions for work with people with disabilities, but is also used in institutions and services of other associations under the designation Planning and Organization in Care and Assistance (POB & A). The author of the process developed in 1989 is Werner Haisch, Professor of Psychology at the Catholic Foundation University in Munich , who is also developing it further. (In accordance with his language usage, terms such as “care”, “assistance” and “support” are used synonymously below.)

The Federal Ministry for Family, Senior Citizens, Women and Youth (BMFSFJ) sees this mainly as a process for staff assessment , while institutions and services that work with it focus on the professionalism and the quality of care that makes the process possible.

The GBM is one of the first procedures that tries to enable the necessary cooperation between professional or voluntary service providers via generalizable and discussion-capable scientific criteria for individual needs and needs-oriented services. The aim is to plan and organize nursing and social services based on the individual needs of people who are dependent on help. This work can take place e.g. B. in a home, in residential groups or in independent, outpatient assisted living arrangements, but also in day care centers, funding centers, workshops and the like. a. An international meeting of GBM and POB&A users takes place every year. This procedure is currently used to varying degrees for a large number of people with disabilities in all forms of care facilities in Germany and, to a lesser extent, in Switzerland.

Elements of the procedure

Since Haisch wanted to create a connection between pedagogy and business administration in the work for people with disabilities, terms are used that are alien to many educators because they are borrowed from economics as well as sport or the military to the organization to describe a large company or social structure on different levels, whereby the terms have already been expanded and supplemented for the respective purpose.

For example, “operation” does not only mean a procedure “in the field” in the military, with which a practical goal is to be achieved, but also in sport (in football, the attack on the opposing goal or the “operation world championship”). In the field of business administration one speaks of " operational business ", which in social institutions consists of the service that is provided for a specific target group. "Tactics" is the forward-looking planning of the procedure, taking into account possible alternative conditions (who runs forward under specific conditions and who provides the defense) and " strategy " relates to the long-term orientation of the entire organization towards the goal.

The GBM consists of an extensive range of conceptual, methodological and technical instruments that are used to plan and organize work in supervision and assistance in a needs-oriented manner.

• The individual needs of the person being cared for represent the standard from which there should be as little deviation as possible - the target value . In order to assess him, his need for assistance (support) and care services is asked again and again. This survey is carried out using a partially standardized questionnaire (FIL - questionnaire on the individual lifestyle of people with disabilities ), which contains a list of the possible appearances of the clientele in different areas of life: z. B. in the service area care / self-care (body care, toilet, mobility, etc.), in the area of ​​employment / lifestyle (movement, activity, habit, etc.). The selection of the appearances that apply to a person is recorded. The survey of individual needs must not include a preliminary decision on how the need is ultimately to be satisfied (e.g. with which service, in which type of housing, in which assistance system); The participation of the person himself is indispensable and is made possible by methods of the survey / interview, v. a. through concepts “in easy language ” or through “representative articulation” of needs.
• Conceptually justified range of services: The appearances that have been determined for a person via the needs assessment can be assigned standardized services (via MIB: Matrix of individual care needs ) . These service descriptions represent the specific standard of the service which the company / the help system (or the department) considers appropriate and feasible for the respective appearance. They must be justified as needs-based services and provide generally described options for covering needs, which are only related to the individual case and specified in the operative assistance planning (see below).
• Holistic assistance planning: An individual, holistic care or assistance plan is designed for each person from the set of assigned, generally designed (standardized) services: The practical implementation of the standardized services should be presented based on individual needs, in accordance with the performance standards ( Target values, see above), which the helper can and wants to fulfill (who? Where? When? With what means, in what cooperation relationships? Etc.). This is how the funding or care plan (which can becalled an operational plan from a business point ofview) is created by the institution, which is equipped with specific documentation and evaluationtasksand can be viewed as a help plan by the cost bearer.
• Documentation and updating of the planning: In the implementation of the assistance plan via continuous documentation of the services and the feedback from the needy person himself, the planning is updated - also in terms of quality management . This procedure enables "zero-point planning" again and again by continuously and fundamentally questioning the previous forms of assistance services based on individual needs.
• Strategic operational planning and organization: In parallel to the target values ​​of the individual needs (see above), actual values ​​of the actually provided assistance and care services are continuously collected via a questionnaire on work organization (FAO / FOB; questionnaire on work organization / questionnaire on organization of care ) which enable a critical actual-target comparison in the sense of operational controlling and provide the database for further personnel planning and organizational development (e.g. by comparing key figures in benchmarking ).

Each of the above-mentioned elements can and must be adapted or redesigned for the special needs of the respective target group to be looked after and for the objectives and possibilities of the help system that provides the help.

The process of needs assessment, individual help planning and work-organizational implementation of the help not only has a reflected concept of needs (see next section), but also a systematic justification of the basic needs of a person in the process of development, learning and living. For this purpose, the " Model of Life Forms " provides reasons that can be made accessible to all those involved and are therefore also open to discussion - in particular, of course, for the employees at the grassroots level and for the people in need of support themselves. Therefore, these reasons must also be in " easy language " be formulated (see e.g. Liedel, Volker). This also enables a justified approval or rejection of the procedure or its individual methodological steps and theoretical assumptions. In addition, such a basic qualification creates the necessary flexibility in the differentiation of individual needs as well as in the individual conception of different services - against the schematic and standardization that such a systematized procedure could lead to in practice.

Dependent lifestyle needs

For Haisch, the conceptual core of the procedure is the concept of need. He differentiates between “individual needs” and “individual needs” as the target values ​​for planning and organization.

Need: Dependence on social resources

Only those who have already been to the sea, a swimming pool or a lake will be able to say where they prefer to go for a swim. Only after what one has already experienced or experienced will a specific, i.e. H. develop subjective need. Haisch therefore understands the need as an expression of the individual dependence of a person on a product or on a service that a society offers: what the person feeds on, what they clothes with, how they live, which society they prefer, etc. In all of this In the course of their socialization, the person has made and maintained their choices among the available products, social relationships and services.

Since the basis for this is how people have previously been able to participate and participate in what a society offers , they can only provide sufficient information themselves whether and why they have a need for something.

"Independence" does not turn out to be an appropriate ideal to express what a person should be able to do: the dependence on social means and possibilities is fundamental and inevitable for every person. In this respect, nobody is "independent". The only difference between the so-called self-employed and the dependent is the fact that they have access to social resources : the “self-employed” can count on social resources (e.g. because they have the necessary financial means to go from the mountains to the sea) In the long run, the availability of “dependent people” is questioned or disputed - as a person with a disability e.g. B. who may live permanently in poverty and be directly dependent on the will and means of others (because he needs help to get to the beach).

“Independence” is therefore the result of a social relationship that, in addition to individual intentions and desires (“will”), as well as individual skills and knowledge (“ability”), depends crucially on whether the person also has the (external) resources available stand to put their intentions into practice (“decree”).

Requirements: justification and recognition

The person's claim to social products and services, which inevitably arises from the need, is offset by a social demand on the person: the need should be justified as a need . The aim is to give general "validity" to the individual claim to the satisfaction of needs . The person complies with this requirement if he succeeds in demonstrating his own need as a special form of what the others also want - albeit in different individual forms. Needs with self-harming or self-harming consequences, e.g. B. in addiction , do not withstand this evidence. The justification of needs, however, encounters particular difficulties if the needy person is not able to express it himself. Representative justification of the need (by friends, relatives, experts) can only indirectly develop the need.

In the end, offices, authorities (cost bearers) or the legislature decide whether the justification for the need is accepted or rejected: if a need can be justified, i. H. is "understandable" by all others, but is not recognized for - in the broadest sense - socio-political reasons . The validity of the claim, which is based on the need, is made dependent on the circumstance, who registers this claim or with what right he / she does so (“Then he should go on vacation in the mountains if he can not afford to go to the sea ”).

The claim to recognition of the need is thus confronted with the social distribution of power . The justification of needs therefore necessarily also includes a “struggle for recognition” and requires those who are involved to take a socio-political position in the dispute about the distribution of social resources.

Effort: need as problem and disorder

The term “ effort” means on the one hand the type and scope of the services actually provided by the assistant or supervisor. On the other hand, Haisch differentiates from this the “problematic” term of “effort” that a person forces or exerts from their assistants in the form of a “ practical constraint” . This “effort” is often equated with the need in the term “need for help”. The difference becomes plausible if the time required is taken into account. B. demands a person who has learned that he only receives attention if he is more helpless or more costly than he is; a phenomenon that every practitioner is familiar with: people “make an effort” to find consideration in the competition for other assistance tasks (the care activities of employees in a home business). On the other hand, a bedridden person who is dependent on someone to help them in all walks of life will have qualitatively diverse and quantitatively extensive, individual needs that may not be noticed at all. So she doesn't make a lot of effort for an assistant who is fully occupied with other things. This person may not even have the opportunity to draw attention to himself and is therefore only provided with the bare essentials (see the discussion on “basic needs” below).

Forms of expression such as "making effort" due to the need to be noticed in professional operations show, according to Haisch, a poor state of assistance: The need is perceived - if at all - as a practical "problem", as a disruption of the normal process and possibly as a practical constraint that forces the employees or assistants to intervene. If this effort is taken as a measure of the personnel requirement, this does not change the poor support situation, even if attempts are made to improve the situation for those being looked after with “more” personnel, with the result that it persists (“effort orientation”). Increased use of personnel does not guarantee that the individual needs of the person will be recorded and, if possible, satisfied (“needs orientation”).

The model of life forms

For decades, people with an intelligence quotient (IQ) between 20 and 60 were considered “ mentally disabled ” . This assessment, which is still in use by the World Health Organization (WHO) in its International Statistical Classification of Diseases and Related Health Problems ( ICD-10 ), was divided into imbecility , Oligophrenia (“bullshit”), debility and idiocy (“educational inability”). "These [designations] should be avoided, however, because they come from older psychiatry, do not say much and have a strongly negative meaning." (Michel / Novak) The ICD-10 shares, probably around the stigmatization of the terms that have been turned into swear words to reduce, in “mild”, “moderate”, “severe” and “most severe”, as well as additionally “other” and “unspecified” intelligence impairment under the diagnosis codes F70 - F79. In Germany, these have been obsolete in the social sciences since the late 1980s (see year of publication Michel / Novak). An intelligence quotient that is lower than 50 cannot be measured validly because the test person can barely grasp the test situation or task and with the (assumed) decrease in IQ - i.e. greater disability and more difficult comprehension - not at all. Corresponding information must therefore be viewed as free estimates.

Another attempt to make a meaningful diagnostic assessment is based on the “age of development”. Inspired by Jean Piaget's studies, human development was viewed as a step model. The development of people with intellectual disabilities was also used as a guide, preferably the development phase of "sensorimotor intelligence" according to Piaget (0–2 years). A comparable argument can be found when laypeople say that the person in question is “somewhat lagging behind” and that the person in question is described as “retarded” [retard = French: “belated”]. To clarify the level of development in the field of work for people with intellectual disabilities, formulations such as "... is 35 years old and at the level of development of a 5-month-old child."

However, a step model suggests that each step must first be processed so that the next can be reached. However, if you have the vocabulary of a primary school student, your social behavior can correspond to a three-year-old. The fact that there are interactions (those who cannot communicate through language but through symbolic actions must have a minimum level of mobility, and only those who can communicate will be able to enter into social relationships) shows how much this type of assessment is generalized and does not do justice to people with intellectual disabilities. In addition, the childhood is constantly swinging with it and thus the tendency towards a social attitude that does not perceive people with intellectual disabilities as people with needs, but is based on deficits, insofar as they make an effort. and thus, with his rights, also fundamentally question his participation in social wealth.

Haisch, on the other hand, tries to take into account the fact that every area of ​​life is present in its development potential from the beginning and thus moves away from a determination of age. His thinking model of life forms, based on psychological and educational theories and observations, shows how people live and develop and provides the basis for the observation features of the questionnaire and the service catalog of the procedure (MIB). When differentiating the forms of life, he leans on the descriptions of Piaget (especially: "The awakening of intelligence in the child").

Institutions that agree to the introduction of the GBM procedure with the cost bearer do not have to justify the care measures carried out individually (if these can be derived from the catalog of services), even if the need to otherwise only be presented through detailed discussion and explanation of the individual case (justification of needs) would.

Understanding its model is therefore necessary for assistance planning according to GBM.

Psychological and educational content

Life forms according to HAISCH based on Piaget:
The life forms describe different sides of the individual lifestyle. Depending on the needs that the person is currently pursuing, one side is in the foreground, e.g. B. the self-care of the organism in nutrition. But even when man eats (self-care), he leads an individual life and moves its sense of movement ( "Motion"), takes the meal in his familiar surroundings, according to his preferences , he will choose the food and according to his skills will he provides for himself ("habits"), with the special individual skill and in the personal characteristics that he has developed ("design") etc.

According to Haisch, in early childhood different forms of lifestyle differ in the development of physical and mental / spiritual functions, the "forms of life". The “soul” (or “spiritual”) functions are for him the development possibilities of the individual human organism. Therefore, “lower” forms of life (biological, organismic life, for example in the case of a person who is very young or very severely disabled) cannot be distinguished from “higher” forms of life (creativity, imagination, thinking, etc.) - as is the case with a " Dualistic " interpretation might suggest.

Even the demarcation of “basic needs” and “needs serving self-realization” ( Maslow ) contradicts the need for an individual lifestyle: care or self-care e.g. B. does not simply refer to "the organism " and the question of "what a person needs to survive", but just as much to everything that a person makes or could do with his possibilities, the "forms of life": in eating z. For example, humans do not simply take in food energy and nutrients , but rather food that corresponds to their taste, and food intake takes place in a social and objective framework that meets their need for rest and relaxation (“familiar contact”). He will therefore also reject food that may correspond to his physiological “need”, but does not meet his taste - unless “reason” due to need or an insight in the context of a diet force him to do so. According to Haisch, this anthropological situation contradicts a care or assistance that aims at the satisfaction of "basic needs": as a theoretically unfounded and practically painful de-individualized care of the individual (see above).

So people give different meanings and functions to the forms of life, depending on what they want and do, and thus constantly re-create this unity. In sport z. For example, he is interested in effective movement (ball into the opponent's goal), and all of his cognitive and communicative expressions in life (tactical considerations, agreements in team play) as well as his current metabolism , possibly also his other diet and lifestyle, he subordinates to this movement goal . It would therefore be absurd to assume, from the successive descriptions, that the first (physical movement) and the second (“cognition, communication”) are highly valued, or vice versa. Above all, an opposition (or a ranking) of “physical” and “mental” needs would not be appropriate. B. discriminatory for people with disabilities. A need always includes the totality of the individual lifestyle (see above, criticism of the term “basic need”).

In this totality of individual lifestyle, the forms of life are mutually dependent; the formation of one form of life is - in different ways - a prerequisite for the further formation of another. This shows the way for development and promotion. For example, an entertaining game with the ball (life form “activity”) requires a certain amount of sense of movement (life form “movement”) in order to be able to produce and reproduce fascinating effects. Accordingly, in the needs analysis and funding planning according to GBM, particular importance is attached to this requirement ratio in order not to overwhelm the needy and not to press him with funding goals that have nothing to do with his needs.

The promotion is understood as maintaining the existing forms of life. Such support primarily aims to promote the individual lifestyle that can be found - also with children and adolescents - and does not necessarily promote “development”. When it comes to providing assistance in the privacy of people in need, this concept turns against a pedagogy that works with learning goals that cannot be derived from individual needs. Rather, the current way of life is to be developed through “maintaining what is available”. However, this also creates the basis for a person's need for further learning or development - as long as there is no disability or illness.

The life forms

Since the different sides of the individual lifestyle can only be described one after the other, the forms of life also easily appear as a sequence of stages of development from “lower” to “higher”: starting with “organismic life” through “movement”, “activity”, “habit” "," Design "to" Cognition "and" Communication ". In fact, it is about the different sides of an individual unit - of life as a person experiences it in every current moment (which only has to be resolved into various "forms" for the purpose of assessing the needs of the cost bearer) in every physical and mental respect .

The following statements refer to practical experience with the “Questionnaire on the individual lifestyle of people with disabilities” (FIL), including the associated legend and the “Matrix of individual need for help” (MIB) for inpatient living. (The use of other adaptations of the procedure listed below is corresponding.)

Each form of life is described in the questionnaire in five characteristics , which indicate different needs in this form of life. Each of these items is assigned a recommendation in the sense of a typical service description in the "Matrix of individual support requirements" (MIB) - the service catalog of the procedure - based on the above. Haisch's basic assumptions explains how the care / assistance of people should be designed (using the example of skills: starting with substitute execution, through assistance, to support or advice). Each service description corresponds to an intensity value, which makes it possible to estimate the time resources required for the supervisory service or the personnel requirements within the framework of the GBM procedure.

In this way, data is collected for the person in care and assistance via the questionnaire, which records their needs through a series of descriptions of characteristics and services. This "typifying" requirements must be individualized in a joint performance planning with the people and for people's daily life and the assistant operationalized be.

If this is checked within the framework of a quality management system, it is guaranteed that the person in need receives the assistance that is tailored to their needs (see section " Elements of the procedure "). From the summarized explanations that precede the items in the questionnaire, and the conceptual understanding of the relevant way of life, it is also possible to determine the problems and conflicts for which (self-) care or assistance in the non-needs-based (self-) care individual forms of life. This can result in a “special need for care”, which is discussed elsewhere in the questionnaire.

Life form	special care needs
Care / self-care (011-015)	Disease (020)
Movement (030)	(self-injurious) movement stereotype (040)
Operation (050)	(self-injurious) effect stereotype (060)
Custom (070)	Assertion 1 (towards caregivers) (080)
Design (090) + social relationships (110)	Self-assertion 2 (towards co-supervised) (120)
Communication (100) + Privacy and Public (130)	self-evaluating attitudes (140–142)

If the corresponding way of life is examined when considering the special need for care, a context emerges in which not just a symptom is the goal of educational or therapeutic efforts. Rather, the entire lifestyle is thematized and with it the cause of possible "disturbances" and "abnormalities". In this way, behaviors can also be understood that would otherwise appear as “pathological” or simply “disruptive” (they are depathologized).

The colloquial term “curative educational thought model” suggests that the theory is only applicable in curative educational fields, which contradicts the generalizability of this approach (see introduction). This can be seen primarily from the fact that the questionnaire can also be carried out with people without disabilities. This supports the demands of the normalization principle and corresponds to the efforts towards inclusion .

In the following, lifestyles and forms of special care needs are presented in abbreviated form, which can be brought into connection (see also and).

Care / self-care / nursing (self) care

This area concerns all measures that are of direct importance for organic life. This way of life is in turn subdivided into the areas of personal hygiene, nutrition, toilet, mobility (in terms of the ability to move from A to B), domestic care and self-sufficiency. The result and goal of care / self-care is "calm wakefulness" - a state in which the person is awake and satisfied, and an achievement in which the person has no further need than to use and live this alertness and health : to move for the sake of movement. If there is inadequate (self) care, the person loses his "calm alertness". The situation more or less approximates a physical impairment or illness that requires measures by the nursing / self-care or nursing (self) care sector to restore calm alertness.

Movement / stereotype of movement

Movement means the need to use the organic possibilities offered by wakefulness: to move without any further purpose ("purposeless") or for the joy of movement (also in the sense of sport). This does not necessarily mean target movements that serve to pursue other current needs or other practical goals. Movement towards such an external goal would require intermediate actions (see below under “Habit”). If the conditions of the environment, especially other people, offer too little stimulus for this movement, although the need exists, self-harming forms of movement stereotype threaten : The simple, repeated playful movements that humans are able to do on their own quickly become boring . Enjoyment can only be achieved by increasing the strength and frequency of the movement, if there is no stimulation for more entertaining movement variants. So the problem is not stereotype itself - it can be found in all forms of movement that are used for entertainment. Rather, it is the lack of stimulation that makes people resort to such emergency measures.

Actuation / effect stereotype

Activity concerns people's need to give and secure the sensual quality of their environment that is enjoyable for them - or in a more precise sense: to create the effects that fascinate and entertain - and to repeat them (“effect stereotype”). The best are things that let their “life of their own” (the effect) last as naturally as possible and as varied as possible once they have been stimulated: the top is possibly better suited than the rattle, the living animal better than the stuffed animal - and another person surpasses all these “toys” in his “own life”. So that the effects that humans can produce and reproduce themselves remain interesting despite the repetition, they need external guidance for variation. With limited guidance on variation, people bypass the impending boredom by increasing the available effects in their intensity to the point of self-harm (e.g. addiction and other self-harming behaviors). The stereotypical peculiarity is a necessary quality of enjoyment and entertainment ("Again!") - it is in no way a sign of a "disturbance". In reproduction, humans get used to pleasant sensual effects (regardless of whether they come from things, animals or people), they become familiar to them. As "familiar contact" z. B. as a private apartment (with residents, furnishing of the rooms, daily rhythms, etc.) they become something on which the person is both dependent, but on which he also feels free: he feels comfortable in their presence because he is them can cause at any time in his sense or also let it rest if he wants ("impartiality"); he is dependent on their presence because only they offer him this freedom: a lack of familiar contact makes him self-conscious ; a new deal would overwhelm him . Another person is the "epitome" of familiar contact: with his presence, a whole range of other familiarities is more or less certain or also: called into question. Familiar contact can therefore be “absent” in a twofold sense: as untrained familiar contact (“primary hospitalism ”) or as trained, familiar contact to which the external conditions e. B. lost through a change of staff, change of residence, etc. ("secondary hospitalism").

Habit / assertion

Habit means all the expressions of life that are the result of a history of development in the sense of habituation, practice and personal choice. Your own preferences play a central role: A prerequisite for a familiar approach to the environment - especially when it comes to privacy - is that familiar things and people are actually present and available. The person then becomes “picky” about familiar people. He / she will prefer someone from the ranks of his / her familiar people as "preference" and show a spontaneous, possibly passionate interest in playful cooperation with this / these people (affection, sympathy). He will get a feeling for his dependency on the well-being of this person (s) first in his playful needs and later also in his practical needs . As a player, he cannot be indifferent to whether and how the other player develops: His game aims to awaken or provoke the “life of its own”, the “self-development” of the other, because that is where the special entertainment value lies. So he has his own life constantly in view , empathizes and tries to encourage it through his playful actions ( see autistic behavior). In addition, the need to do things that primarily bring no enjoyment or entertainment (in which the person as a spectator ensures that the game continues) becomes more important, but secondarily and serves a personal goal (“Mittelhandlung “After Piaget). To the extent that a person acquires and exercises practical life skills, he gives other people every day to ask the critical question for what purpose and with what result he uses these skills, whether he "behaves correctly" . His dependent life situation suggests to the needy person to fight for the goodwill of those on whom he sees himself dependent. He tries to take care of himself by attracting the attention of the supervisors and assistants through good behavior ( submissive / submissive form). He possibly supplements this by refusing (demonstrative / challenging form) or seeking pity (appellative / seeking help), since the good behavior of a dependent is taken for granted and overlooked (“self-assertion in the caring relationship”). So he does everything to adapt to the demands of others instead of ensuring that his own needs are satisfied. He sees the latter as a matter of those on whom he sees himself dependent: they reward or punish his attempts at adaptation, deny or grant him the opportunity to satisfy his needs. Humans therefore try to build a positive relationship with them by trying to win them over and hope that this will pay off by granting them the satisfaction of their needs. This struggle for self-assertion, which is based on scarce (personal) resources that people usually have to share with others, will therefore also be carried out in competition with other co-supervised people. “His equals” appears to him as an opponent and competitor (“self-assertion in competition”). Since the “lifestyle in dependence” is essentially socio-politically conditioned, the practical work with regard to these forms of self-assertion may be about the formation of needs and expressions of needs, v. a. but also about a socio-political emancipation of the needy.

layout

The "design" way of life means an interest in the environment that goes beyond familiarity with the familiar and the familiar and focuses on the unfamiliar and new: in playful experimentation, in entertaining production and reproduction (e.g. in symbolic games) and in the development of a personal style of living. Here, too, playful repetition is the focus - as in the movement and effect stereotype. However, the pleasure here is aimed at the variation, the novelty value of the same thing , which is staged and entertained as fiction , as a “drama” or as a “radio play” etc. Humans are thus able to generate the variation themselves that their game needs in order to remain entertaining (cf. movement and effect stereotype).

Notification / self-evaluating settings

The form of communication means primarily the form in which a person makes his needs understandable to others: a need should be "understood", that is, appear justified as a need and thus be recognized. This presupposes the awareness of being dependent on other people to satisfy one's needs. This is about

• practical forms of utterance (e.g. action as expression , “indicated action”, “facial expression”, “gesture”) up to
• cognitive forms (“imagination”, “fantasy”, “symbol”) in the sense of playing with your own ideas and the formation of an awareness of your own needs and around
• thinking and communicating, especially about an “argumentative discussion”, as self-assurance about one's own needs and as an attempt to win over others to work towards the satisfaction of one's own needs.

A special need for care arises here particularly when the person being cared for understands the dependency of his or her lifestyle with its limitations and conflicts as personal failures and defeats and draws conclusions from it. Self-damaging ways of dealing with things that are already obvious in self-assertion strategies (see above) are then supplemented by questions of guilt: understood in the sense of self-portrayal and justification (self-worth and value retention) and pursued in practice. This happens e.g. B. in the search for the culprit, in revenge or self-punishment. This special need for care makes special educational / counseling requirements, but it may also create a need for therapeutic or psychiatric action and requires an interdisciplinary, cooperative approach. Four sub-categories form the characteristic groups in the questionnaire, which describe the attitudes explained above with the terms “submissive / submissive”, “appellative / seeking help”, “demonstrative / rebellious” and “fearful”. In them a person tries to assert himself in a particularly submissive, help-seeking, challenging or fearful way in the "shameful" situations of his dependency and to explain his suffering and dissatisfaction in terms of guilt. Such acting and thinking, which is otherwise referred to as “ behavioral disorder ”, “ mental disorder ” or with terms such as “ neurotic ” or “ psychotic ” and thus pathologized , is explained by Haisch from ways of thinking that every person who lives in dependence Idea are well known - even if he does not want to pursue and shape it in life practice with comparable consistency.

Table overview

The following table is intended to enable a comparison of the observation features of the questionnaire with current developmental diagnostic findings. With regard to the "movement" life form, this is difficult, since corresponding statements in developmental diagnostics are aimed at functional abilities of mobility (such as when a person can lift his head), which in Haisch falls under the "mobility" life form (as Subgroup of the area “care / self-care”), but understandably not part of the purpose-free self-movement.

The recommendations that the service catalog of the procedure - the matrix of the individual care needs - gives for each observation feature, derived from the model of life forms, are not shown in the table , although they represent the actual quality of the procedure, the pedagogical, content-related core of quality assurance.

FIL Features of some exemplary LIFE FORMS according to GBM: "The supervised ..." and assignment to other development theories (red)

FIL message : "shows no feature ..." "- Under 3 months, the crying of an infant cannot yet be differentiated. - At the age of 3 months an infant shows differentiated, deliberate crying for the purpose of expressing elementary basic needs such as hunger, discomfort or pain "					“Expresses own moods, wishes and intentions.” “- In the first year of life, the possibilities of expression expand. The child uses facial expressions and gestures to communicate. - A child at the age of 13 months can make wishes clear without screaming. "	"Presents events and facts from his / her experience or provides information about his / her experiences when asked." "- At around 2 years of age, a child understands the term 'more', e.g. B. would like to have more of something [...]. Own thoughts and feelings, such as B. hunger, can be expressed with 3 ½ years [...] "		“Follows the topic of a conversation and makes appropriate, relevant contributions to the topic.” “- At the age of 4, the child uses 'I' to describe himself [...] and can thus express needs related to me. It can answer the question: 'What do you do when you are hungry?' "		"Shows his interest in understanding what others express and represent through inquiries and discussions and justifies a relevant personal point of view."
Design FIL: "shows no feature ..."				"Experiments with objects (examines, dismantles them)."	"Moves or shapes or combines materials to represent objects or situations." 15 months: "Objects are manipulated, checked for their simplest usability (knocking against each other, shaking, trying to adapt to other objects)"		“Designed according to models or templates (scenes, drawings, objects).” At 18 months: “Role-playing with yourself, imitating daily habits, such as drinking from a toy cup, trying to comb your hair, holding the telephone receiver to your ear; Child can occupy themselves for 10-20 minutes (in-out-fetch games), no structured play processes yet "		"Designs the shape and color of his / her clothing or the appearance of his / her personal living space."
FIL habit : "shows no feature ..."			“Selects an occupation differently from among several preferences, i. H. changes preferences. "	"Prefers certain supporters and is guided by him / her (can be helped, corrected, instructed)." "At 9 months it is possible to reliably differentiate between known and unfamiliar people [...]. When dealing with familiar people, the child maintains eye contact, laughs or shows joyful movements "	"Gets involved in a cooperative game and is guided by the rules of the game." "A typical game at 12 months old is the game of hide and seek [...]. At this age, cooperative social play begins in which the child gives a caregiver an object they are holding in their hand when asked to do so "			"Participates in work / household chores on his own initiative and regularly."
Press FIL: "shows no feature ..."		“Reacts to pleasant effects (stimuli) with pleasure (fascinated) and to unpleasant ones negatively." 6 months: Objects / toys are put in the mouth, grasped with both hands, gnawed, but hardly looked at specifically.	"Reacts to pleasant sensual effects by trying to reproduce them."	"Reacts to familiar situations, objects, people by visiting them, to unfamiliar ones by avoiding them." Commonly known as "strangers", behavior described by René Spitz as "eight-month anxiety" (examined on children without disabilities) .	"Has a situation in his / her (living / working) environment that he / she visits again and again spontaneously and purposefully and in which he / she can relax (a familiar space, a familiar way of dealing with people)."
Movement FIL: "shows no feature ..."	"Can be stimulated to spontaneous movement and calm down when he / she is aroused (screams, 'wriggles', etc.)."	"Can be stimulated to rhythmic movement by strange movement, rhythmic accompaniment, music."	"Can be stimulated to develop his / her performance possibilities in the movement through invitation, role model or competition."	"On his own initiative, he regularly seeks opportunities for rhythmic movement or movement aimed at developing his or her ability to perform."
Care / self-care: reflex movements, breathing, metabolism, ... as long as a person lives, characteristics must be recorded here!

Concept of work organization (in a team)

Haisch brings this theory of “individual lifestyle” together with the business requirements of strategic management, quality management and controlling : to name, plan and implement as efficiently as possible organizational goals and requirements goals.

A critical analysis of the work organization in teams submitted to the care and support that Haisch, shows, however, in many cases, a small planning alignment work on necessary targets. Instead, there is more an attempt on the part of employees to react to the limited care time, which is determined by means of the personnel key, with some form of commitment in order to still meet the needs of the people they are supposed to support / care for - a job after " Maximum principle ". In the attempt of a team to cope with the existing human resources and the needs of the people in need of help, current "practical constraints" hinder forward-looking, planning work, constantly require special commitment and overtime and create informal criteria for the expenditure of work of decisive importance ("strengths / weaknesses" of employees, informal division of labor, position battles). Instead of need-based orientation, there is “ effort orientation ”: the needs of people appear to be more complex, i. H. annoying “special request” or as a defiant “obstinacy”. It is not the individual wish that appears difficult to fulfill, but the individuality of the wish itself as the problem - equal treatment as a pragmatic solution is obvious (the work-organizational “core” of “hospitalization”, see above).

That is why the planning considerations in teams must be given significantly more space in operational planning and organization: How do we divide the work of the day, the week, the month so that we can - measured against the individual needs and the operational objectives - be able to cope well. After the work is done, the assistant needs to be aware that he has done what the “agreed and needs-oriented standard” is and that he / she is therefore able to go into the break or after work in a relaxed manner, which improves the quality of work and job satisfaction . The aim is to break the constant tendency towards overtime, which restricts employees' opportunities to relax and lead their own private life. Burnout should be prevented right from the start.

Concept of strategic planning and organization

Demand-oriented care and assistance can only be achieved through strategic planning and organization of the company or the help system with the aim of being demand-oriented. It is important to plan and implement operational standards that on the one hand give individual requirements planning the necessary (time, personnel, structural) means, paths and leeway and on the other hand give the company or the help system (the social institution) an economic one Secure the use of his funds. The planning of how the funds are used and what services an institution wants and can provide is decisive for whether it can meet its self-declared standards - it forms the core of tactical planning and organization: as "catalogs of features and services" (identical to the They contain the "Matrix of individual support needs" MIB, see above)

• typified descriptions of the “appearance” of the clientele that the company has chosen, and
• standardized descriptions of the "services" that the company wants and can provide for the respective corporate image.

Using such a tactical catalog of possible appearances ("scenarios") and assigned services ("options"), the strategic organization adapts to the individual case flexibly and as concretely as possible without losing sight of its strategic goal: it is with personnel and material resources prepared for a number of possible, different situations and can hope that the life situation of one of your clients can also be captured in one of these scenarios. The fundamental difficulty in recording the individual case, however, calls for “planning skepticism” in the planning itself .

According to Haisch, the strategic method as a concept of cooperative work is particularly suitable for coordinating the “rule” (financing, operational standards, among other things on a strategic and tactical level) with the operational “individual case” (individual needs and situational conditions). H. not to allow preliminary decisions about how or where the services will be provided (e.g. in which type of housing) and thus to shackle the individual lifestyle of the people in the assistance in the needs assessment. The individual performance plans must therefore be drafted “in a personal and timely manner” by the executing employees of a team within the framework of the operational standards and their conceptual justification (see “Model of life forms”, above). The practical transfer of the standardized characteristics of the questionnaire to the person being cared for does not result automatically, but requires training for the user. This also applies to the reverse translation of the performance characteristics of the matrix. It is also necessary to train users in planning and organizing the work. The prerequisite, however, is that everyone involved knows that the teams themselves must have the freedom to plan the organization of their work.

These ideas have been implemented in a comprehensive software solution since the mid-1990s in cooperation with a working group of the BeB (Federal Association of Protestant Disability Aid). The principles of the GBM procedure have been adapted to varying degrees by several relevant companies. Haisch itself also offers software for this, which implements the entire scope of the concept ("planning and organization in support and assistance", POB & A).

Further adaptations, different procedures, compatibility

Further adaptations of the GBM

The above-mentioned explanations relate primarily to the “basic variant” of the questionnaire for housing for people with intellectual disabilities. Special adjustments (adaptations) are available for other central areas of assistance for the disabled:

• Workshop : Part of the GBM is a special view of the work in the workshop for people with disabilities (WfbM), which is expressed in a number of work-related areas of need. There is also the generic term "(vocational) education", which has the advantage of doing justice to severely and slightly disabled people equally. In addition, a job-related training requirement can be recorded (for any number of separately defined jobs).
• Daily funding: The areas of need here focus on funding areas. Accordingly - compared to the basic version - the areas of care / self-care and indirect services are correspondingly reduced.
• Assisted living on an outpatient basis: The formulation of the appearance and services relate here, in particular, to practical independence in self-care, in living and in housekeeping.
• Housing by people with physical disabilities: comparable to the arc to outpatient assisted living; In addition, there is (for all areas of life) the possibility of double signing the “willingness” (to do something, e.g. in the sense of self-care) in contrast to the “physical ability” to perform.

The "practical support", a form of further training and advice for assistants, which is based on Haisch's concept of the working group ("team model") and which is intended to provide continuous advice and qualification of natural working groups in order to achieve a common professional standard, is not an express part of the GBM to build and maintain the work. Since in this field of work not only a strong change of personnel, but also different training and motivation (skilled workers / volunteers) can be expected, this represents a special requirement.

Other procedures

Other comparable methods of needs assessment and assistance planning for disabled people in German-speaking countries such as B.

• the "HMB" according to Metzler ( assistance needs of people with disabilities ),
• "SYLQUE" ( system of service description, quality description, quality inspection and fee calculation ),
• "LEWO" ( quality of life in homes for adults with intellectual disabilities ), as well as
• ICF -based concepts of " functional health " (e.g. from INSOS; see below on ICF),

dedicate themselves with different priorities to similar practical concerns in needs assessment and assistance planning, but work with e.g. Sometimes very different methodological and conceptual approaches.

Compatibility with the International Classification of Functioning, Disability and Health (ICF)

The catalog of features and services of the GBM (matrix of individual care needs) is fundamentally compatible with the descriptive categories of the International Classification of Functioning, Disability and Health of the World Health Organization (especially: the categories of "Activities and participation", in addition to those of "Body structures and - functions "). The list of characteristics in the GBM can therefore be assigned to the domains and categories of the ICF. Since these “dissolve” the areas of human lifestyle - in constant change of the level of abstraction - differently, their categories describe partly more abstract and partly more concrete the facts that are also listed in the matrix of the GBM. However, both classifications are open to further differentiation - depending on the practical purpose of the application (depending on the clientele, funding interests, research interests, etc.).

The claim "a common language to describe health and health-related conditions" should be included: procedures such as the GBM should refer to this common language as a classification system .

With its concept of “functional health”, the International Classification also wants to describe the “extent of a person's ability to function”, which is shown in their activities, as an “interaction ... between health problem and context factors”. The "functionality" reflects the abstract fact that the person - in one area of ​​life, in comparison to others and to a certain extent - does not do "what is expected of a person without a health problem (ICD)". The "assessment criteria" offered by the classification of functional ability, disability and health for this purpose range from "problem not present", "problem slightly pronounced", "problem moderately pronounced", "problem significantly pronounced" to "problem fully pronounced" ( on a scale from 0 to 9). Such an analysis of “functional health” is about a comparative assessment of the “problem”, as it is e.g. B. may be interesting for a public health system: as “reasons for the use of health care” and as an assessment of the scope of the public health care entitlements that could result from this.

It remains to be seen whether and in what specific sense the impairments in health or participation represent a “problem” for people themselves . This new variant of a deficit view, on the other hand, wants to assess people as a problem: they can only help themselves to a limited extent or not at all (see above on independence) and depend on support. The concept of individual need has been dropped. Assistance planning that is based on the concept of “functional health” is obviously “effort-oriented” (see above).

criticism

• Since the model of life forms is based on Jean Piaget in the descriptive differentiation of life forms (more precisely: on " sensorimotor development"), the criticism of Piaget's results is also up for discussion here: in particular the lack of representativeness of his sample in the sense of quantitative empirical social research ( Piaget observed his own children), the division of development into stages and the theory of " equilibration " (balance of assimilation and accommodation ) as an explanation of the course of development. Piaget was concerned with the observation of children's intelligence development and with the qualitative differentiation of the phenomena in the course of development (see for example): a "development logic". He pursued this goal with the means of what one would say today - "qualitative social research". From the standpoint of a development logic, it would be nonsensical but also superfluous to ascribe a fixed sequence or even a fixed age curve to the "stages" of development and to empirically prove it - and to set development norms to assess "age-appropriate" development (cf.). With the “ Model of Life Forms ”, Haisch shares the interest in a “ logic ” of development and promotion and takes up the descriptive distinction between the phenomena as presented by Piaget. However, Haisch's interest in needs analysis goes far beyond the pure developmental aspect of intelligence: he examines the phenomena of development as - for further life, for learning and for the entire scope of lifestyle - "lasting achievement". For example, Piaget's “ primary circular reaction ” (“moving in order to move”) appears as a lasting achievement in gymnastics, rhythm and sport. Haisch completely abandoned the theory of equilibration, which is based on the theory of biological evolution, and replaced it with the systematic justification of the phenomena from the “unity of individual lifestyle” (see above: “Model of life forms”).
• The GBM procedure unfolds its full effect when the cost bearers accept the comprehensive concept and are ready to settle according to it. In Germany, the procedure is accepted by individual payers, but it has not yet achieved broad recognition. However, the theoretical and methodological implementation of the concept is already in its parts, e.g. B. a great benefit in funding planning, since the concept focuses on the concept of need and enables a common language or a common understanding of the basic content and methods in the companies. In addition, the method of the GBM in its variant POB & A offers "interfaces" that allow e.g. B. in the sense of the "groups in need of assistance" or the "overall plan procedure" to fully meet the (also formal) demands of the cost bearer.
• The language of the procedure requires explanation. Terms such as “way of life ” are generally understood differently and the content for “ habit ” and “ design ” borders on a redefinition in the opinion of some users. Even the meaning of the term “ communication ” can lead to misunderstandings for experts who, according to Paul Watzlawick's communication theory, assume that one cannot not communicate . If there is no intention to communicate on the part of the " sender " (especially of course in autistic behaviors or in self-related play etc.) and his behavior must first be interpreted as communication by the assistant / supervisor in order to get a message character, it does not fall in the GBM primarily under the life style “communication” - at most also , because matrix recommendations also exist for areas of life for which “no characteristic in this area” was ticked in the questionnaire.
• Some authors note a certain “expert bias” , which leads to permanent reflection and a need for training on the part of the staff. This applies above all to assistance planning . Nevertheless, the service descriptions are usually understandable and implementable even by laypeople (untrained assistants, volunteers, Bufdis or FSJs). An independent qualification of the basic employees and the general obligation of all those involved to justify their approach especially to the person in need, however, are among the essential characteristics of this procedure. This is primarily aimed at the autonomy of the mostly dependent people in need of help. However, this qualification also decides on the ability of the employees to operationally implement the work organization planning of the company or support system - appropriate to the individuality of the situation and the individuality of the person - in assistance plans. Other needs assessment or quality management processes that lack a social science theory on which the content-related (educational) supervision work is based, so that one does not have to deal with them at all, cannot be accused of being expert-heavy.
• Many quality management processes are suspected of preoccupying themselves and increasing bureaucratism. The constant implementation of “zero-point planning” ensures that the focus is on needs, but is difficult to convey to some employees. The introduction of the GBM can therefore cause resistance in the workforce.
• Some employees of professional services consider the procedure under which the human being should be seen as a general grid , which fundamentally contradicts human individuality. Even the attempt to individualize assistance planning at the operational level does not change anything for them. This overlooks the fact that it is also a needs assessment procedure: traceability and generalizability that are required by cost bearers (e.g. through the formation of groups in need of assistance), as well as the need to calculate wages in advance (see the "Matrix of individual care needs" “) Will not do without typing characteristics and services. The alternative would be the complete dependence of the needy person on the subjectivity of an individual who decides on the allocation of resources in the sense of an administrative act.

literature

• W. Haisch, H. Kolbe (Ed.): Shaping the quality of life and work in social services: planning and organization. Centaurus Verlag & Media, Freiburg 2013, ISBN 978-3-86226-223-6 .
• W. Haisch: Cognition - illustrated by the development of sensorimotor intelligence. In: FJ Schermer: Introduction to Basics of Psychology. Würzburg, 1988, pp. 15-71.
• W. Haisch: Behavioral problems and structural conditions in care. In: W. Strubel, H. Weichselgartner: Disabled and behavioral problems - on the effect of systems and structures. Lambertus-Verlag, Freiburg 1995, ISBN 3-7841-0804-0 , pp. 28-68.
• W. Haisch: 'Care today' for the severely disabled - a research report. Bavarian State Ministry for Labor and Social Affairs (Ed.) Munich, 1990.
• H. Kolbe: Educational quality. With ISO quality management for comprehensive quality in homes for the disabled. Modern learning publishing house, Dortmund 2000, ISBN 3-8080-0444-4 .
• G. Latzel, Ch. Andermatt: Pilot experiment assistance budget: Clarification of the need for assistance. Contributions to social security, Federal Social Insurance Office, Swiss Confederation, Zurich, 2007.
• M. Nagel: Need-oriented care and support in institutions of the diaconal handicapped assistance. Diploma thesis at the Stuttgart University of Cooperative Education, Stuttgart, 2004.
• W. Nauerth: The best possible care, quality management in assistance for the disabled - the GBM procedure. In: Diakonie Jahrbuch. 2001, pp. 225–230 Diakonie-Verlag of the Gustav Werner Foundation, Stuttgart, 2001.
• W. Nauerth: Measuring and counting - quantitative aspects in quality management. In: Rainer Seifert, Frank Arentz: Quality through dialogue - Kwaliteit door dialogue. Aachen Verlag, Mainz 2000, pp. 46-55
• J. Piaget: The awakening of intelligence in the child. Ernst Klett Verlag, Stuttgart 1975, ISBN 3-12-929110-5 .
• M. Ramoth: From assistance planning to specific support services. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 248–278.
• G. Schaer: Standards in the context of strategic management - an example. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 365–398.
• H. Schumm: Quality of life for people with autistic traits. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 279–298.
• HE Utz: Work organization and teamwork in support and assistance. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 297–327.
• U. Trojniar-Kachelmus: The GBM process as a strategic management tool . Suitability and use in practice. Master thesis. University of Social Work, Zurich 2007. (Unpublished)

Web links

• Brochure: GBM Design of care for people with disabilities , © Bundesverband Evangelische Behindertenhilfe e. V., Fachverband im Diakonisches Werk der EKD (publisher), developed by the GBM advisory board of the BeB.
• (Download) Concept "Assistance", more detailed information about the POB & A procedure and its possibilities in St. Josefs Stift, developed by: Walter Greubel, Deputy Home Manager & Linda Schmelzer, Quality Officer / POB & A, Eisingen, January 2009
• Homepage Catholic University of Applied Sciences Munich , profile page Werner Haisch
• Homepage of the procedure POB & A Website of the procedure “Planning and Organization in Care and Assistance” by W. Haisch
• GBM Switzerland website

Individual evidence

1. ^ S. Lee, TC Reeves: Roger Kaufman. A Significant Contributor to the Field of Educational Technology. In: Educational Technology. May / June 2009, pp. 43–45.
2. ^ Homepage BeB , About GBM (as of July 11, 2014).
3. ^ W. Haisch, H. Kolbe: Shaping the quality of life and work in social services: planning and organization. Centaurus Verlag, Freiburg 2013, ISBN 978-3-86226-223-6 , p. 14.
4. ^ Website of the POB & A procedure (planning and organization in supervision and assistance) by W. Haisch (status: July 12, 2014)
5. ↑ Brains website , GBM supervisor for Switzerland (as of July 12, 2014)
6. ↑ Homepage of the Catholic University of Applied Sciences in Munich: ( Memento of the original from November 8, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Profile page Werner Haisch, there section: "Work and research priorities" (status: November 8, 2014)  
7. ^ Homepage Federal Ministry for Family, Seniors, Women and Youth. ( Memento of the original from May 14, 2015 in the Internet Archive ) Info: The archive link was automatically inserted and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (Status: June 4, 2014): First report by the Federal Ministry for Family, Seniors, Women and Youth on the situation of the homes and the care of the residents, chap. 7.7 (Status [of the report]: August 15, 2006)  
8. ↑ As examples:
   • Homepage Samariteranstalten Fürstenwalde , section "Individuality and Community" (as of August 18, 2019)
   • (Download) Rummelsberger Services for People with Disabilities (Ed.), "Our professional concept", Schwarzenbruck, p. 10 (as of January 23, 2018)
   • Homepage St. Josefs-Stift Würzburg. (As of June 3, 2014)
   • Homepage Diakonie Kork. (As of June 3, 2014)
9. ↑ Homepage BeB , joint user meeting of GBM and POB & A (as of May 15, 2014)
10. ↑ ^{a b} Annette Clauß: Conference in the Diakonie Stetten: First comes people, then money. Newspaper publisher Waiblingen, May 2008.
11. ↑ Solothurn government council resolution (download), “Department of Child and Adult Protection, Disability and Addiction Aid: Maximum Taxes and Contributions 2010 for the Remuneration of Services and Calculation of Supplementary Benefits - Modalities of Adjusting Supplementary Benefits”, dated December 15, 2009 (status: August 18, 2019 ).
12. ↑ Canton of Solothurn, “Concept for the Promotion of Integration”, Dec. 2009, p. 21 (as of July 28, 2014). (Download)
13. ↑ Federal Social Insurance Office [FSIO] (ed.), (2007a), “Pilot experiment assistance budget - clarification of the need for assistance”, research report No. 7/07, p. 100 (as of September 27, 2017). (Download)
14. ↑ dtv lexicon in 20 volumes. FA Brockhaus, Mannheim / Deutscher Taschenbuch Verlag, Munich 1997, p. 308.
15. ↑ ^{a b} Questionnaire on the individual lifestyle of people with disabilities - FIL. Version 5/95 (AZ 37.1-12 St, September 1, 1995) © VEEMB.
16. ↑ ^{a b} V. Liedel: The model of life forms in easy language. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 217–247.
17. ↑ ^{a b c d} MIB - matrix of individual care needs (AZ 37.1-12 St, September 1, 1995) © VEEMB.
18. ↑ ^{a b} W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 107–216.
19. ^ ^{A b} W. Haisch: Planning and organization in supervision and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11-106, pp. 19ff.
20. ^ W. Haisch: Planning and organization in care and assistance (POB & A). In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 30, p. 19ff.
21. ^ W. Haisch: Planning and organization in care and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11-106, pp. 27 f.
22. ^ W. Haisch: Planning and organization in care and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11–106, p. 28.
23. ^ W. Haisch: Planning and organization in care and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11–106, p. 27.
24. ^ ^{A b c} Christian Michel, Felix Novak: Small psychological dictionary. Freiburg 1975, p. 126 (new edition 1991).
25. ↑ German Institute for Medical Documentation and Information ( Memento of the original from July 27, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. , ICD-10-WHO Version 2013, Chapter V "Mental and behavioral disorders" (F00-F99). (As of June 15, 2014) 
26. ↑ ^{a b} Homepage University of Duisburg Essen , The development stage model according to Piaget (as of June 15, 2014).
27. ^ Christian Michel, Felix Novak: Small Psychological Dictionary. Freiburg 1975, p. 89 ff. (New edition 1991).
28. ↑ J. Piaget: The awakening of intelligence in the child. Ernst Klett Verlag, Stuttgart 1975.
29. ↑ W. Haisch: Cognition - shown on the development of sensorimotor intelligence. In: F. Schermer, J., Introduction to Basics of Psychology. Würzburg 1988, pp. 15-71.
30. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 107ff.
31. ↑ W. Haisch: Cognition - shown on the development of sensorimotor intelligence. In: F. Schermer, J., Introduction to Basics of Psychology. Würzburg 1988, pp. 15-71.
32. ↑ Abraham Maslow: A Theory of Human Motivation. In: Psychological Review. Vol. 50 # 4, 1943, pp. 370-396.
33. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 107-216, pp. 146ff.
34. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 108.
35. ↑ ^{a b} FIL - legend (AZ 37.1-12 St, September 1, 1995) © VEEMB
36. ^ W. Haisch: Planning and Organization in Care and Assistance (POB & A) - short introduction. 11/05 (There: 3.1.2 Performance levels: Grade of service. P. 8), (Download) ; (As of May 15, 2014)
37. ^ W. Haisch: Planning and Organization in Care and Assistance (POB & A) - short introduction. 11/05 (There: 3.1.3 "Methodology for obtaining a quantitative measure for the need for care: intensity value", p. 10), (download) ; (As of May 15, 2014)
38. ^ W. Haisch: Planning and organization in care and assistance. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 101ff.
39. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 107–216.
40. ^ V. Liedel: The model of life forms in easy language. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 218ff.
41. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 124f.
42. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 146ff.
43. ^ H. Schumm: Quality of life for people with autistic features. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 279ff.
44. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 178f.
45. ^ W. Haisch: Lebensformen. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 193ff.
46. ^ V. Liedel: The model of life forms in easy language. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 237ff.
47. ^ V. Liedel: The model of life forms in easy language. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 237ff.
48. ↑ C. Büker, V. Meintrup: Literature analysis on age-appropriate child development. In: Development of a new assessment tool. P. E6. (As of August 2, 2014). (Download from AOK homepage)
49. ↑ Werner Haisch: FLB & A living. Version 4.0, © 2004 [corresponds to FIL of the GBM]
50. ^ GKV-Spitzenverband (Ed.): The new assessment instrument for determining the need for long-term care Series of publications model program for the further development of long-term care insurance (brochure), Volume 2., Berlin 2011, pp. 286–336.
51. ↑ ^{a b c d} C. Büker, V. Meintrup: Literature analysis on age-appropriate child development. In: Development of a new assessment tool. P. E19 (as of July 6, 2014). (Download from AOK homepage)
52. ↑ ^{a b c} C. Büker, V. Meintrup: Literature analysis for age-appropriate child development. In: Development of a new assessment tool. P. E12. (As of July 6, 2014). (Download from AOK homepage)
53. ↑ C. Büker, V. Meintrup: Literature analysis on age-appropriate child development. In: Development of a new assessment tool. P. E33. (As of July 6, 2014). (Download from AOK homepage)
54. ↑ C. Büker, V. Meintrup: Literature analysis on age-appropriate child development. In: Development of a new assessment tool. P. E32. (As of July 6, 2014). (Download from AOK homepage)
55. ^ R. Michaelis, GW Niemann: Developmental neurology and neuropediatrics. Georg Thieme, Stuttgart 2004.
56. ↑ René A. Spitz: The emergence of the first object relationships. Stuttgart 1992, 5th edition, p. 53.
57. ^ HE Utz: Work organization and teamwork in supervision and assistance. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 297 ff.
58. ^ HE Utz: Work organization and teamwork in supervision and assistance. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 302f.
59. ^ HE Utz: Work organization and teamwork in supervision and assistance. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, p. 312.
60. ↑ H. Kolbe, W. Haisch: A new theory on burnout and job satisfaction. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 329–364, 345 f.
61. ^ ^{A b} W. Haisch: Planning and organization in supervision and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11-106, pp. 98ff.
62. ^ W. Haisch: Planning and organization in care and assistance (POB & A). In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 11–106, p. 33.
63. ↑ Organization of care for people with disabilities. BeB (as of June 30, 2014) ( Download )
64. ↑ S. Frietsch: User orientation in software development. In: W. Haisch, H. Kolbe: Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 399–408.
65. ^ Website of the POB & A procedure (planning and organization in supervision and assistance) by W. Haisch. (As of June 30, 2014)
66. ↑ Homepage BAG WfbM , experience report: "Use and benefits of the 'GBM procedure' in the funding practice of people with severe and multiple disabilities" from October 13, 2005 (status: November 24, 2014)
67. ↑ Homepage GBM-Info , “Working aid legend for FIL in the area of ​​life out-patient assisted living (ABW)”, published August 22, 2008, for self-fillers - use subject to license! (As of July 29, 2014).
68. ^ HE Utz: Work organization and teamwork in support and assistance. In: W. Haisch, H. Kolbe (Hrsg.): Shaping the quality of life and work in social services. Planning and organization. Centaurus, Freiburg 2013, pp. 297–327.
69. ^ H. Metzler: Help needs of people with disabilities. Questionnaire for the survey in the area of ​​"living" / individual lifestyle. Research Center for the Living Worlds of Disabled People, Tübingen 2001.
70. ↑ Institute f. Technology and Job; Association of Catholic Institutions u. Services f. Learning u. mentally handicapped people e. V. (Hrsg.): Introduction of a quality management system (QMS) based on SYLQUE: Instructions for living facilities of the Caritas-Disabled Aid. Lambertus, Freiburg im Breisgau 1998.
71. ↑ N. Schwarte, R. Oberste-Ufer: LEWO II. Quality of life in homes for adult people with intellectual disabilities. An instrument for professional quality management. Lebenshilfe-Verlag, Marburg 2001.
72. ↑ D. Oberholzer: The concept of functional health. Basics, meaning and possible uses using the example of assistance for the disabled. Issued by INSOS. Switzerland 2009; http://www.insos.ch/themen/funktionale-gesundheit (as of June 30, 2014)
73. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva 2005.
74. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva 2005, p. 11.
75. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva, 2005, p. 23.
76. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva 2005, p. 4.
77. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva 2005, p. 27.
78. ↑ World Health Organization: International Classification of Functioning, Disability and Health. German Institute for Medical Documentation and Information, DIMDI (Ed.). Geneva 2005, p. 9.
79. ^ L. Montada: The intellectual development from the point of view of Jean Piaget. In: R. Oerter, L. Montada (Ed.): Developmental Psychology. 3. Edition. Psychologie Verlags Union, Weinheim 1995, pp. 548-560.
80. ↑ F. Petermann: Methodical foundations of developmental psychology. In: R. Oerter, L. Montada (Ed.): Developmental Psychology. 3. Edition. Psychologie Verlags Union, Weinheim 1995, p. 1148ff.
81. ↑ ^{a b} Ulrich Raichle: 12 years GBM in the Diakonie Stetten - an interim balance. Greeting to the 12th international GBM user conference, 2008, in the Diakonie Stetten, p. 2. (Download) , (as of May 31, 2014).
82. ↑ Examples of various funding plans. (Workshop documents “GBM in the day care center”), 9th GBM - User Meeting, 2005, Schwäbisch Hall (download) , (as of May 31, 2014).
83. ↑ ^{a b} Ulrich Raichle: 12 years GBM in the Diakonie Stetten - an interim balance. Greeting to the 12th international GBM user conference, 2008, in the Diakonie Stetten, p. 3. (Download) , (as of May 31, 2014).
84. ↑ M. Kief: Think, speak, act independently. Lecture on the comparison of GBM with WKS on the occasion of the 12th international POB & A / GBM user conference 2008 in the Diakonie Stetten. (Download) , (Status: May 15, 2014)
85. ↑ Silke Frietsch: Status of the introduction of the GBM handicapped assistance assistant in the Nieder-Ramstädter Diakonie / Mühltal. Workshop presentation for the 8th international GBM user meeting, 2004, in Brandenburg, p. 14 (Download) (as of May 31, 2014)