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

2. Latvian Movement for independent living. Who we are... „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

3. Our members are... Persons with disabilityFamily members of persons with disabilitiesService providers Professionals of social work and other fields, academic staff Representatives of civic society

4. Our vision 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.

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

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

7. Quality of life concept 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. 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. Higher GDPHigher quality of life

8. Quality of life framework: factors and domains (pr.R.Schalock, 2002) Independence Social participation Well-being Self-Determination Personal Development Interpersonal Relationships Social Inclusion Rights Physical Well-Being Emotional Well-Being Material Well-Being

9. Quality of life framework (Schalock, 2002) FactorDomainExemplary Indicators Independence 1. Personal Development Education (achievements, education status) Personal competence (cognitive, social, practical) Performance (success, achievement, productivity) 2. Self-DeterminationAutonomy/personal control Goals and personal values (desires, expectations) Choices (opportunities, options, preferences)

10. Quality of life framework (Schalock, 2002) FactorDomainExemplary Indicators Social Participation 3. Interpersonal Relationships Interactions (social networks, social contacts) Relationships (family, friends, peers) Supports (emotional, physical, financial) Recreation 4. Social InclusionCommunity integration and participation Community roles (contributor, volunteer) Social supports (support networks, services) 5. RightsHuman (respect, dignity, equality) Legal (citizenship, access, due process)

11. Quality of life framework (Schalock, 2002) FactorDomainExemplary Indicators Well-Being 6. Emotional Well- Being Contentment (satisfaction, moods, enjoyment) Self-concept (identity, self-worth, self-esteem) Lack of stress (predictability and control) 7. Physical Well-BeingHealth (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)

12. Quality of life concept Theoretical concept Practically used concept Development of quality of life concept:

13. Quality of life assessment – example of practical use of the 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.

14. 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.

15. 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...?

16. 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.

17. 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.