If forms of residential care exist in your country, are there any alternatives to institutions and do people with disabilities have choice and control over the services they use?


The question is about whether people with disabilities in your country are able to choose between different types of services in the community, or some people have no option but to live in an institution. Safeguards should exist to ensure that no one is placed into residential or institutional care unless this is their own preference. People living in institutions should be provided with the necessary support to move back into the community. No one should be forced to live in an institution just because there are no other alternatives available to the community, or because this is their families’ preference.

In detail

41% of respondents state that institutions are the predominant forms of care and people with disabilities have partially the choice to control over the services they use. This is due to barriers such as:

  • Lack of financial resources, government cuts or poverty have been jeopardizing the opportunity for other types of care for PWDs: alternatives such as private care and insurance are available as long as people can afford them, as in most cases, they are more costly than residential care institutions. Due to poverty many PWDs prefer to stay in these institutions
  • The lack of or replaced decision-making have a heavy impact on PWDs’ choice on alternatives to institutions. People with psychosocial disabilities face the only option of living with family due to social stigma and family pressures to put PWDs in care centres

There are however, community-organised, initiatives led by volunteers and a culture of “home support” that offer alternatives to institutions. Other alternatives include semi-autonomous or self-determined living options in institutions, but are still under the authority of the institution. The issue is that these options are difficult to manage, not very available, poorly financed, not well supervised and are costly. The National Housing Strategy for People with a Disability 2011-2016 in Ireland for instance, aims establishing a framework for housing for people with disabilities through mainstream housing policy. It aims to facilitate access for housing and related support services sustainably to promote equality of opportunity, individual choice and independent living.