11th annual Nordic ALS/MND Conference
Inga Skestere, chairperson of “Latvian Movement for Independent living” inga.skestere@lkndz.lv
, phone +372 26176901 , www.lkndz.lv

„Latvian movement for independent living” is non-governmental organization, working in disability sector since 2009., uniting members with long term experience in advocacy work, participation in policy planning processes, social service provision and project implementation experience.
Our members: organizations and individuals

Persons with disability
Family members of persons with disabilities
Service providers
Professionals of social work and other fields, academic staff
Representatives of civic society

Our vision is inclusive society, where every person with disability has the same opportunity of living independent life as all other members of society, where every person can get the support he or she needs, and where disability is not the reason to segregate the person from the society.

Advocacy for the rights of persons with disabilities
society about equal opportunities of persons with disabilities
Focuss of activities
Empowerment of people with disabilities and their families
Development of high quality community based
services for persons with disabilities

Social services and quality of life of service receivers – beginning with the end in mind
• Identifying what personal outcomes should be desired
Input Throughput Outcome
Resources, time knowledge, assessed support needs
Process to ensure support system
Personal outcomes / quality of life

• As a field of social indicators science and empirical quality of life research was born in mid-1960s.
• In the very beginning quality of life was assessed by material wealth.
Higher GDP Higher quality of life
• Today material well-being is just one of the quality of life domains.
• Since 1980s quality of life concept is closely liked with disability issues.

Independence
Social participation
Well-being
• Self-Determination
• Personal Development
• Interpersonal Relationships
• Social Inclusion
• Rights
• Physical Well-Being
• Emotional Well-Being
• Material Well-Being

Factor
Independence
Domain
1. Personal Development
2. Self-Determination
Exemplary Indicators
Education (achievements, education status)
Personal competence (cognitive, social, practical)
Performance (success, achievement, productivity)
Autonomy/personal control
Goals and personal values (desires, expectations)
Choices (opportunities, options, preferences)

Factor
Social Participation
Domain
3. Interpersonal
Relationships
Exemplary Indicators
Interactions (social networks, social contacts)
Relationships (family, friends, peers)
Supports (emotional, physical, financial)
Recreation
4. Social Inclusion Community integration and participation
Community roles (contributor, volunteer)
Social supports (support networks, services)
5. Rights Human (respect, dignity, equality)
Legal (citizenship, access, due process)

Factor
Well-Being
Domain Exemplary Indicators
6. Emotional Well-
Being
Contentment (satisfaction, moods, enjoyment)
Self-concept (identity, self-worth, self-esteem)
Lack of stress (predictability and control)
7. Physical Well-Being Health (functioning, symptoms, fitness, nutrition)
Activities of daily living (self-care, mobility)
Physical activities including recreation
8. Material Well-
Being
Financial Status (income, benefits)
Employment (work status, work environment)
Housing (type of residence, ownership)

Development of quality of life concept:
Theoretical concept
Practically used concept

• Elaborated by LATMIL, based on the theoretical research.
• In the elaboration process active involvement of persons with disabilities and their family members.
• Based on 8 domain model(R. Schalock (2002)), indicators and measurement adapted to local situation.
• Measurement uses both objective and subjective
(perceptual) measurement.
• Used to perform assessment both in long term care institutions and community based social services.
• In most cases, domain scores and descriptions are more useful and expressive than the total scores that are aggregated from separate domain data.

Quality of life concept and social services for persons with functional limitations
Quality of life assessment – tool giving opportunities:
• to identify the weak and strong side of the services;
• to plan necessary improvements and development;
• to improve the understanding of staff on the content of service;
• to involve the receivers of service in the service planning, implementation and monitoring process;
• to evaluate how effective are used resources.

Social services – one of effective ways to ensure support for persons with disabilities
• Community based services;
• Based on Individual support needs assessment;
• Is there place for personal desires and personal goals?
• How individualized and personal are social services?
• What is the role of individual – just service receiver or ...?

Consultation service– example of evidence based service development
• The need for the service was assessed during the analysis of quality of life assessment results.
• Luck of support was identified to ensure the independence of persons with functional limitations.
• Developed consultation service for people with functional limitations and their families to promote the independence.

Consultation service– example of evidence based service development
• Consultation provided in the environment where daily activities take place, mostly in home environment;
• Practical advices how to adapt home environment to promote independence,
• how to use use low tech assistive technologies to keep or promote independence of person with functional limitations;
• Individual action plan elaborated together with staff;
• Mostly low-tech solutions for the moment.