ASSISTED LIVING in Sweden - an exchange of ideas

ASSISTED LIVING in Sweden

|from an exchange of ideas|

On one of our very first study visits during our sojourn in Stockholm, we were welcomed into a well maintained house with immaculate decor in a suburb of the Botkyrka commune. This was one of the many units set up for “Assisted Living” for Persons with Disabilities, as the revolutionary new system adapted by Sweden is named. Starting with a pilot project in ’87, this grew to be an incredibly well managed system to normalise, to whatever extent possible, the lives of the differently abled. With an extensive mention in the Social Services act and the LSS (Act for persons with Certain Functional Impairments), there seems to be a great amount of research and expertise that has gone into the formulation of this policy. The guiding idea behind assisted living was that it should promote equality in living conditions and full participation in community life for those (with significant and permanent impairments). The objective is to make it possible for the individual in question to live as others do. This is based on respect for an individual’s right to self-determination and privacy.

The residence we visited housed six persons, with three assistants, not all of whom work every day. They spoke to us about how they go about assisting the residents, and the things they do to help them be as independent as they can. Sweden, unlike our own country, has a highly individualistic society – with great importance being placed on independence and self-sufficiency. Children move out by 18-23 years of age, but for persons with disability, this would not be practically possible before. And consequently, most would have no choice but to be institutionalised, or if the family continued to house them, they’d invariably feel like an immense burden. They did not, then, feel respected by the community, leaving them continuously conscious of contempt from the apparently more capable counterparts. This was a vicious cycle which researchers and policy makers seemed to have realised, and very effectively overturned. We also got to know that just like everyone else, the persons with disabilities go to work daily. There are ‘daily activity centres’ set up for this, where the persons with relatively severe disabilities receive therapy and sensory-motor training, and the ones who can, work on making a variety of items and so on. The ‘work’ is thus what they can do to the best of their ability, and self-improvement is considered work too. Thoughtful, is it not?

However, as intelligent as it is, it seems as though the emergence of a similar setup is not even close in the line of vision for our own country, for more reasons than one. Firstly, it is a huge cost on the economy. In Sweden, it is estimated to come upto 5 billion USD per annum, and together with the benefits and social services for these individuals, it takes up about 1% of the GNP and 2% of public expenditure. Definitely not feasible for a country in an awkward, off-balance middle-stage of developing that ours is. It also requires quite a lot of technological support, and well-trained staff. In Sweden, cuurently, about 20,000 people receive personal assistance, and this is 0.2% of their fairly low population. In India, if the criteria to provide it were maintained, the number of beneficiaries would shoot up exponentially, further extending the financial requirements. But one thing to remember is that the concept grew out of their societal and cultural norms, to allow persons with disabilities to live the same way as other adults. Indian society is nowhere near as individualistic. For most part, anyway. Notwithstanding the new age metropolitan lifestyle among younger urban circles, much of the Indian population lives with very collective, community-based values. Moving out at twenty is not a norm here as it is in Sweden – where, failing to do so would definitely cause someone to be extremely conscious of their incapacity to construct and sustain their own separate life, making them feel like a burden on their parents. All the same, that does not imply that it is not required here, it simply means that its implementation and structural details would have to be a little different here. It simply would need to be tweaked in places, modified to suit the Indian style of living and the group-based culture typical of the eastern countries.

As of now, Goa too is working hard for persons with disabilities. We have specialised units, mostly private, providing guidance and assistance and catering to a variety of therapeutic needs, but this is focused on persons still in the developmental age. The state, as of now, seems to be concentrating its efforts mostly on the education of children with special needs, and on general disability-friendly measures that would reduce the obstacles in day-to-day public life of the disabled. For the adult side, the state has reservations in public employment, lifetime pension benefits and such, but we are a long way off from building a uniform, national framework for independent living of these adult individuals with state support.