Active support研習講義一:為何需要積極性支持?

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2009年3月「積極性支持」Active Support:高密度支持需求者居家自主生活方案研習活動,邀請澳洲講師Tony Harman主講。
主辦單位:瑪利亞基金會、中壢啟智、仁愛啟智
協辦單位:陽明衛福所、德蘭啟智、幼安教養院、社區居住聯盟

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  • Normalisation – giving people with disabilities the same pattern of life as all people. Pattern of the Day Pattern of the week Pattern of the month Was a reaction to segregation and Institutionalisation Deinstitutionalisation Movement Begun in USA late 1960’s Reaction against abuse, overcrowding, dehumanisation Many western countries including USA & Australia still have large numbers in congregate care None in Scandanaivia or UK Medical Model – Disability is in the person – needs to be cured Social Model – the environment is disabling physically & socially
  • Independent living movement Originated with people with physical impairments Beginning of a self advocacy movement ICF – International Classification Functioning Health and Disability Functional Domain – body structure & function Activity Domain – body limitations Participation Domain Environmental Domain Brought together medical & social models of disability Participation a key factor – look at barriers to participation A key feature for Active Support – how do we break down barriers
  • Type of residence alone does not determine QOL outcomes Support staff can adopt Hotel or Nursing Home model of support PWD seen as passive recipients of care rather than active participants Put yourself in their place what lifestyle do you want
  • These points lead on from last slide Get away from bricks and mortar mentality One size does not fit all Where would you like to live?
  • Growing movement for people with disabilities to speak up People first movement in UK, Canada, USA, Australia, New Zealand Power moving from Government policies to PWD & Families PWD need support to become empowered This is where Active Support can help
  • Movement to assess supports rather than impairments IQ level doesn’t always indicate support needs Development of I-CAN Role of PCP – linked to empowerment
  • Latest UN Convention Signed on by nearly 150 countries Many still to implement Is a strong force for Government to recognise rights of PWD for a normal life like everyone else
  • The last point emphasises that disability is a part of the human existence – people born deaf want to be seen as normal Disability does determine to a large extent a persons identity – this should be respected rather than being seen as an aberration.
  • Active support研習講義一:為何需要積極性支持?

    1. 1. Why Do We Need Active Support? Professor Trevor R Parmenter AM PhD Centre for Disability Studies (CDS) Sydney, NSW., Australia. CDS is an affiliate to the Faculty of Medicine, University of Sydney.
    2. 2. 為何需要積極性支持 ? Professor Trevor R Parmenter AM PhD Centre for Disability Studies (CDS) Sydney, NSW., Australia. CDS is an affiliate to the Faculty of Medicine, University of Sydney.
    3. 3. Why do we need Active Support? <ul><li>Historical Factors </li></ul><ul><li>Evidence of Community Living Outcomes </li></ul><ul><li>Trends in Philosophies </li></ul><ul><li>UN Conventions </li></ul>
    4. 4. 為何需要積極性支持 ? <ul><li>歷史因素 </li></ul><ul><li>社區居住與生活的成效實證 </li></ul><ul><li>哲理的趨勢 </li></ul><ul><li>聯合國宣言 </li></ul>
    5. 5. Why do we need Active Support? <ul><li>Historical Factors </li></ul><ul><ul><li>The principle of normalisation </li></ul></ul><ul><ul><li>The deinstitutionalisation era </li></ul></ul><ul><ul><li>Movement from a Medical to a Social Model of disability </li></ul></ul>
    6. 6. 為何需要積極性支持 ? <ul><li>歷史因素 </li></ul><ul><ul><li>正常化原則 </li></ul></ul><ul><ul><li>去機構教養化時代 </li></ul></ul><ul><ul><li>對障礙者從醫療模式到社會模式的社會運動 </li></ul></ul>
    7. 7. Why do we need Active Support? <ul><li>Historical Factors continued </li></ul><ul><ul><li>Independent Living Movement </li></ul></ul><ul><ul><li>The impact of the WHO International Classification of Functioning, Disability and Health (ICF) </li></ul></ul><ul><ul><li>The concept of ‘participation’ </li></ul></ul>
    8. 8. 為何需要積極性支持 ? <ul><li>歷史因素 ( 續 ) </li></ul><ul><ul><li>獨立生活運動 </li></ul></ul><ul><ul><li>世界衛生組織對障礙者健康功能分類的影響 (ICF) </li></ul></ul><ul><ul><li>“ 參與”的概念 </li></ul></ul>
    9. 9. Why do we need Active Support? <ul><li>Evidence from Studies of Community Living </li></ul><ul><ul><li>Not all people living in community residences have a good quality of life </li></ul></ul><ul><ul><li>Staff focus on a “hotel style” home </li></ul></ul><ul><ul><li>People with disability often lead a passive life </li></ul></ul>
    10. 10. 為何需要積極性支持 ? <ul><li>社區居住與生活研究的實證 </li></ul><ul><ul><li>並非所有住在社區的人都有好的生活品質 </li></ul></ul><ul><ul><li>工作人員的焦點在 “ 旅館式 ” 的家 </li></ul></ul><ul><ul><li>障礙者通常過著被動的生活 </li></ul></ul>
    11. 11. Why do we need Active Support? <ul><li>Evidence from Studies of Community Living </li></ul><ul><ul><li>People with a disability do not participate in genuine community life </li></ul></ul><ul><ul><li>An institutional mentality remains in a community-based home </li></ul></ul>
    12. 12. 為何需要積極性支持 ? <ul><li>社區居住的研究實證 </li></ul><ul><ul><li>障礙者並未參與在真正的社區生活中 </li></ul></ul><ul><ul><li>在社區本位的居住家庭 , 教養式的心性仍存在 </li></ul></ul>
    13. 13. Why do we need Active Support? <ul><li>Contemporary Trends in Philosophies and Practices </li></ul><ul><ul><li>Self-determination </li></ul></ul><ul><ul><li>Empowerment of people with a disability and their families / carers </li></ul></ul>
    14. 14. 為何需要積極性支持 ? <ul><li>現今理論與實作趨勢 </li></ul><ul><ul><li>自我決策 </li></ul></ul><ul><ul><li>障礙者與家人 / 照顧者的充權 </li></ul></ul>
    15. 15. Why do we need Active Support? <ul><li>Contemporary Trends in Philosophies and Practices </li></ul><ul><ul><li>Assess support needs rather than impairments </li></ul></ul><ul><ul><li>Person-Centred Planning with the wishes of the person with a disability being fully recognised </li></ul></ul>
    16. 16. 為何需要積極性支持 ? <ul><li>現今理論與實作趨勢 </li></ul><ul><ul><li>評估支持需求而非損傷 </li></ul></ul><ul><ul><li>開始全面性重視以障礙者的希望作為個人為中心的計畫 </li></ul></ul>
    17. 17. Why do we need Active Support? <ul><li>UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH A DISABILITY </li></ul><ul><ul><li>What is a disability? </li></ul></ul><ul><ul><ul><li>Disability is an evolving concept, and that disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders full and effective participation in society on an equal basis with others. </li></ul></ul></ul>
    18. 18. 為何需要積極性支持 ? <ul><li>聯合國的障礙者宣言 </li></ul><ul><ul><li>身心障礙是什麼 ? </li></ul></ul><ul><ul><ul><li>身心障礙是一個仍在演變的概念,障礙是身他們在態度和環境方面遇到的各種障礙相互作用的結果,這些障礙阻礙他們與其他人在平等的基礎上切實全面地參與社會 </li></ul></ul></ul>
    19. 19. Why do we need Active Support? <ul><li>UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH A DISABILITY </li></ul><ul><ul><li>General principles: </li></ul></ul><ul><ul><ul><li>Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons </li></ul></ul></ul><ul><ul><ul><li>Non-discrimination </li></ul></ul></ul><ul><ul><ul><li>Full and active participation and inclusion in society </li></ul></ul></ul><ul><ul><ul><li>Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity </li></ul></ul></ul>
    20. 20. 為何需要積極性支持 ? <ul><li>聯合國障礙者宣言 </li></ul><ul><ul><li>我們如何看待障礙者 ? </li></ul></ul><ul><ul><ul><li>障礙者不應被視為慈善 / 醫療處置 / 社會保護的對象 , 他們應該視為有權的國民 , 有能力行使權利 , 能自由的為自己的生活做決定 , 並且積極成為社會的一份子 . </li></ul></ul></ul>
    21. 21. Why do we need Active Support? <ul><li>UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH A DISABILITY </li></ul><ul><ul><li>How should we view people with a disability? </li></ul></ul><ul><ul><ul><li>Persons with disabilities are not viewed as “objects” of charity, medical treatment and social protection; rather as “subjects” with rights, who are capable of claiming those rights and making decisions for their lives based on their free and informed consent as well as being active members of society . </li></ul></ul></ul>
    22. 22. 為何需要積極性支持 ? <ul><li>聯合國障礙者宣言 </li></ul><ul><ul><li>原則 : </li></ul></ul><ul><ul><ul><li>尊敬對待其與生俱來的尊嚴 , 自律包含可為自己做選擇 , 以及個人的獨立性 </li></ul></ul></ul><ul><ul><ul><li>無歧視 </li></ul></ul></ul><ul><ul><ul><li>全面積極的參與和融入社會 </li></ul></ul></ul><ul><ul><ul><li>尊重與接受障礙者的個別差異 , 視其為多樣與人性的一部分 </li></ul></ul></ul>
    23. 23. Why do we need Active Support? <ul><li>UNITED NATIONS CONVENTION ON THE RIGHTS OF PERSONS WITH A DISABILITY </li></ul><ul><ul><li>General principles: </li></ul></ul><ul><ul><ul><li>Equality of opportunity </li></ul></ul></ul><ul><ul><ul><li>Accessibility </li></ul></ul></ul><ul><ul><ul><li>Equality between men and women </li></ul></ul></ul><ul><ul><ul><li>Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities </li></ul></ul></ul>
    24. 24. 為何需要積極性支持 ? <ul><li>聯合國障礙者宣言 </li></ul><ul><ul><li>通則 : </li></ul></ul><ul><ul><ul><li>機會均等 </li></ul></ul></ul><ul><ul><ul><li>可親性 </li></ul></ul></ul><ul><ul><ul><li>男女平等 </li></ul></ul></ul><ul><ul><ul><li>尊重障礙兒童持續不斷發展的能力 , 並尊重保有他們對自己認同的權利 </li></ul></ul></ul>
    25. 25. SUMMARY <ul><li>Active support provides an enriched environment in which people with a disability can learn and grow their skills. </li></ul><ul><li>It alleviates boredom from a sterile environment </li></ul><ul><li>It helps people look forward to each day in their lives </li></ul><ul><li>It provides an opportunities for people to engage with others in mutually satisfying activities </li></ul><ul><li>It provides a way for people to become involved in the rhythms of the day, the week, the month and the year-the basis of the normalization principle </li></ul>
    26. 26. 總結 <ul><li>積極性支持提供豐富的環境 , 讓障礙者可以學習與提升他們的技能 . </li></ul><ul><li>減低對貧乏環境的無聊感 </li></ul><ul><li>幫助對每日的生活有所期待 </li></ul><ul><li>提供機會與他人一起從事相互滿意的活動 </li></ul><ul><li>提供方式融入每日 / 每週 / 每月 / 每年的正常化生活節奏 </li></ul>
    27. 27. Thank You <ul><li>Contact Details: </li></ul><ul><li>Centre for Disability Studies (CDS) </li></ul><ul><li>Tel: +612 8878 0500 </li></ul><ul><li>Fax: +612 9807 7053 </li></ul><ul><li>Email: trevorp@med.usyd.edu.au </li></ul><ul><li>Web: www.cdds.med.usyd.edu.au </li></ul>
    28. 28. 感謝您 <ul><li>聯絡方式 : </li></ul><ul><li>Centre for Disability Studies (CDS) </li></ul><ul><li>Tel: +612 8878 0500 </li></ul><ul><li>Fax: +612 9807 7053 </li></ul><ul><li>Email: trevorp@med.usyd.edu.au </li></ul><ul><li>Web: www.cdds.med.usyd.edu.au </li></ul>

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