The Path to Living Independently
Transcript of The Path to Living Independently
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The Path to Living
Independently
The Office of Developmental
Programs
4/13/2021 1
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SETTING THE STAGE: HOUSING
ISSUES
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Over time, with appropriate supports in
place, participants will become more
independent and work, play and live in the
least restrictive environments.
EXPECTATION
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WHAT ARE THE ISSUES?
• Housing is a major concern for adults with ASD (and
other disabilities)
• 56% lived with a family member
• 11% lived in a home of their own
• 5% lived with a foster family
• 26% lived in a group IDD setting
• 2% lived in a nursing home of psychiatric facility
• 10% lived in facilities housing seven or more people
Larson (2017) 5
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WHAT ARE THE ISSUES?
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WHAT ARE THE CURRENT OPTIONS
Research findings identified 7 major housing settings:
• Remaining at home
• Family Living
• Renting apartment or home
• Purchasing own home
• Shared Housing
• Intentional Communities
• Licensed facilities
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BARRIERS
• Accessing accurate information about housing and
services
• Scarce financial resources to create new housing
• Lack of expertise in developing affordable housing
• Limitations imposed by housing funding sources and
housing regulations
• Need for appropriate service to support people in
housing of their choice
• Need for specific planning and design to accommodate
ID/A related needs
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RES HAB VS. HOUSING
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RESIDENTIAL OPTIONS
• Residential Habilitation: Occurs in licensed 6400
regulated community homes
• Life Sharing: Occurs in licensed 6500 regulated Family
Living homes Course: Understanding Lifesharing: Who would benefit ? (myodp.org)
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RESIDENTIAL HABILITATION
• Assists individuals 24/7 in acquiring, retaining,
and improving skills:• Communication
• Socialization
• Self-direction
• Self-help
• Adaptive skills necessary to reside in the community
– ADLs, cooking, housework, shopping, money
management, time management, safety skills
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RES HAB VS. HOUSING
• What is the true need of the participant?
• Does the participant need housing or residential
habilitation?
• Does the participant require 24/7 supervision?
• Can concerns be addressed and skills be taught in the
family home, participant’s own home, or other non-res
hab setting?
• If participant is struggling, what is the service/support
history?
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RESIDENTIAL HABILITATION
• Should be considered when other housing options
are exhausted AND support needs beyond 50hrs
are necessary OR extenuating circumstances
• Other housing options examples:
• Alternatives within existing funding streams
• Utilizing personal funds
• Creative supports provided through existing waiver
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HOUSING SUPPORT ASSUMPTIONS
AND CONSIDERATIONS
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HOUSING SUPPORT ASSUMPTIONS
• Everyone can live in the setting of his or her choice
when given appropriate supports
• Readiness to live in own home cannot be predicted
• Skills to live independently should be taught in
setting where the participant chooses to live
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HOUSING SUPPORT ASSUMPTIONS
• Participant should make housing decisions to
greatest extent possible
• One size does not fit all – tailored to personal
needs
• Supports should be flexible and change as
participant needs change
• Whenever possible, use combination of natural and
paid support
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HOUSING CHOICES: SOME CONSIDERATIONS
• What housing situation does the participant prefer?
• What safety and supports are needed for participant?
• Can the needed supports be provided in this setting?
• What are the cost factors?
• Is funding/housing assistance available?
• What are the transportation considerations?
• If employed, will the housing location impact
employment?
(Wehman, Smith & Schall, 2009)
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FROM ASSESSMENT TO CREATIVE
SUPPORTS
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MAKING INDEPENDENT LIVING WORK
• What supports are needed in order for the participant
to live as independently as possible in their own
home/apartment?
• Support needs should be assessed at the outset
(SIBR and beyond)
• Inappropriate or inadequate planning for support can
lead to failure
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ASSESSMENT: HOME LIVING SKILLS
• Shopping
• Preparing meals
• Household maintenance
• Laundry
• Knowing what to do in emergencies
• Caring for self when ill
• Medication Management
• Seeking help and assistance
• Managing finances and bill paying
• Time management
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OTHER ASSESSMENT CONSIDERATIONS
• What are the participant’s current routines?
• When does the participant require assistance
or supervision? (e.g., During which routines?
What times of day are most problematic?)– Support times must be flexible to meet these needs
• Are there any accommodations that can be
made? (e.g., assistive technology,
environmental modifications)
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DETERMINING WHAT TO TEACH
• Ecological Inventory
• Steps of conducting Ecological Inventory:
• Identifying and surveying current and future home living
environments
• Dividing environments into sub environments (places
where certain activities occur)
• Inventorying the sub environments by listing relevant
activities performed there (meal prep and food storage)
• Determining skills required for performing those activities
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Sub
environment
Activity Skills
Living Room Vacuuming
Socializing with others
Watching TV
Deciding when to vacuum
Locating vacuum cleaner
Operating vacuum cleaner
Changing bag or filter
Putting vacuum away
Inviting friends over
Greeting others
Talking about shared interests
Asking for help from others
Deciding what to watch
Turning television on
Using remote control to operate channel selection & volume
Turning television off
Kitchen Preparing food in
microwave
Washing dishes
Selecting what to cook
Operating microwave to cook item according to instruction
Removing item from microwave
What can/can’t go in the microwave
Determining if dishes in dishwasher are clean
Loading glasses and cups
Loading plates
Loading silverware
Loading pots and pans
Putting in dishwasher detergent
Turning on dishwasher
Unloading items
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MEETING SUPPORT NEEDS
• Utilize existing services
• Natural Supports (e.g., family, friends, local
community organizations)
• Utilizing non-waiver services/Collaborating with
other service systems (e.g., OMHSAS)
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PRACTICAL SUGGESTIONS AND INTERVENTIONS
• Develop person-centered housing plan
• Advocacy Organization, support groups, Centers
for Independent Living
• Center of all decisions
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SUCCESS STORIES
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PUTTING IT ALL TOGETHER
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PUTTING IT ALL TOGETHER
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Resources
• Bureau of Autism Services Housing Report, http://bastraining.tiu11.org/
• Hewitt, Amy; Nye-Lengerman, Kelly, Housing: A Place to Call Home (AAIDD, 2019)
• Howlin, , P., Goode, S., Hutton, J.,& Rutter, M. (2004). Adult Outcomes for children with autism. Journal of Child
Psychology and Psychiatry, 45, 212-229.
• Wehman, .P, Datlow-Smith, M., and Schall, C. (2009). Autism & the transition to adulthood: Success beyond the
classroom, Baltimore, MD: Brookes Publishing.
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