Current State of the Right to Self-Determination in Residential Care Facilities for People with Disabilities and Its Policy Implications

Abstract

I examine in this article whether the right to self-determination is sufficiently guaranteed for disabled people living in residential care facilities in the course of their daily lives, as well as at the stages of their entry into and exit from institutional care. My observation is based on a survey of the right to self-determination and needs of people with disabilities living in institutional care. The survey involved 119 individuals with disabilities selected from 15 residential care facilities across four cities. I then make several suggestions to ensure their right to self-determination. First, the ongoing efforts to help disabled individuals in facility-based care transition out to deinstitutionalization and independent community living should be pursued based on detailed support strategies that reflect the different characteristics of people of different ages with different disabilities. It is especially important to develop a model of support to enable individuals with the severest of developmental disabilities to live on their own in the community. Second, there is a need to move away from the overly administrative control of resource allocation to residential care facilities to an approach more aligned to the needs of individual residents themselves. Third, a new system can be considered whereby residential care facilities for disabled individuals can have in place support staff tasked with, among others, handling challenging behavior and assisting their residents in community participation. Fourth, there is a need for improving capacity-building education and training for workers serving in residential care facilities for disabled individuals. Fifth, support mechanisms should be built to help disabled individuals, as the subject of their own lives, make self-determined choices regarding their deinstitutionalization and community living.