Residents of facilities for people with disabilities need more self-determination and co-determination

Grievance teams visit elderly people and nursing homes as part of human rights prevention monitoring. In 2022 and 2023, the focus on facilities for persons with disabilities was residents’ right to self-determination and right to express their views.

Office of the Ombudsman

If people with disabilities live in institutions, they face a greater degree of external control due to the general conditions in institutions. For example, this applies to living space and roommates, as well as daily and leisure activities.

There is no room for maneuver in many areas of daily life. Commissions report that people with facilities are well cared for, but there are none.

The Ombudsman clarifies that the primary objective of facilities for persons with disabilities should be to promote and support a self-determined lifestyle for their residents.

In his report on the commissions’ work for 2023, the Ombudsman highlights the following problem areas:

Free selection of doctors

The Ombudsman visited 161 facilities for people with disabilities during the 2022/2023 reporting period. The statistics regarding the free choice of doctor are very disturbing: in 27% of the facilities visited, residents cannot freely choose their doctors.

According to the Ombudsman’s Office, urgent measures should be taken to implement the free examination of the doctor. For example, adequate staffing should be available to support transportation and doctor’s visits. Video meetings may also be considered.

Steps should be taken by the Medical Societies and BMSGPK to improve the medical facilities for the differently abled especially in the rural areas and with regard to various special facilities.

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Self-determination in time planning

The Ombudsman’s studies have recorded the extent to which it is possible, under conditions of convenience, to have an opinion and express one’s own preferences in everyday life. This refers to areas such as personal hygiene, preparing and eating food, sleeping at night or spending leisure time. The following image is shown here:

In 84% of facilities, requests for personal care time are taken into account. When preparing food, 60% of companies consider 75% of facilities respond to time-related requests during dining. When it comes to a good night’s sleep, 80% of facilities take residents’ needs into account.

The extent to which night rest is tailored individually depends on the circumstances of the employees.

AAC application

For people with limited verbal expression, the use of assisted communication can help determine what the person wants. The Office of the Ombudsman found that AAC was not being used in many facilities.

In some cases, staff have developed their own means of communication, such as sign language, or said residents may not accept AAC.

The Ombudsman recommends that individual measures for supported communication be developed based on a person’s abilities. Each facility is recommended to make the wishes of its residents a priority of its mission.

Regardless of the type of disability, no one should be excluded from self-determination and participation. Particular emphasis should be placed on the right of self-determination of residents in their own living space. All residents should be included in academic goal planning. In addition, organizational constraints should be reduced to a minimum.

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Activities outside the facilities

Residents’ lives are often reduced to special worlds. Both housing and employment are arranged by the same providers, in the same places and by the same people. Like all people, people with disabilities have the right to do things outside of their normal life and work environment.

The ombudsman’s investigations showed that activities were carried out in the surrounding area at almost all facilities. There are many types such as eating out, going shopping, engaging in sports, visiting coffee houses or sightseeing.

Problems arise when many of the residents rely on wheelchairs. Spontaneity is not possible later, as actions have to be planned over a long period of time. Inaccessibility in public places is added to this. 86% of facilities have organized group excursions and holidays.

Activities should be provided outside the facility. The Ombudsman recommends ensuring adequate human and financial resources for this purpose. Residents with a negative attitude towards activities should be encouraged. Central, state and local governments are called upon to ensure a barrier-free environment.

Self advocacy

People with disabilities need self-representation in organizations so that they can express their preferences in a self-determining manner and independently of the organization. It is a mouthpiece towards convenience for residents. It helps everyone discover what they want and express this desire.

The results in this area are sobering, as only 56% of the companies visited have self-representation. The potential for self-advocacy to exert influence is also limited: in only 28% of organizations, self-advocates report that their preferences are taken into account to a greater degree.

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However, requests from many organizations are either ignored or addressed only on a case-by-case basis. The ombudsman demands that institutions create an environment for self-representation.

A major topic of sexual self-determination

Sexual self-determination and protection against sexual violence were central to the reporting period. In February 2024, the Ombudsman presented the results and recommendations of this section at a press conference. For example, the importance of a sexuality education concept that is accessible to both staff and residents is emphasized.

Other topics include creating privacy for residents, self-determined contraception and parenting, and access to sexual companionship.

In general, the ombudsman recommends taking measures for institutionalization in connection with the 2023 state exam results.

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