towards autonomy in housing for the handicapped

8/7/2019 Towards autonomy in housing for the handicapped

http://slidepdf.com/reader/full/towards-autonomy-in-housing-for-the-handicapped 1/113



TOWARDS AUTONOMY IN HOUSING

FOR THE HANDICAPPED

30'2...



TOWARDS AUTONOMY IN HOUSING

FOR THE HANDICAPPED

I

Commissioned by the European Community's Bureau

for Action in Favour of Disabled People

A. de JongeJ.H. Kroes

P.P.J. Houben

1989

RIW-Housing Research InstituteBerlageweg 12628 CR DelftThe Netherlands



Uitgave/distributie en produktie

PublIkatIeburo

Faculteit der Bouwkunde

Berlageweg 1 2628 CR Delft

Telefoon (015) 784737

In opdracht vanRIW, Researchinstituut voor Woningbouw, Volkshuisvesting en Stadsvernieuwing

Type-/korrektlewerk

Inge Kluivingh/lngrid Knijnenburg

Ontwerp/lay-out

Hany Lucassen

Ontwerp/Fotoomslag

Bert Van der Meij

Druk

NKB Offset BV Bleiswijk

CIP-gegevens

K o n i n ~ l i j k e Bibliotheek

Jonge,A.de

Den Haag

Towards autonomy in housing for the handicapped /

A. de Jonge, J.H. Kroes, P.P.J. Houben. - Delft:

Publikatieburo Bouwkunde.

Metlit. opg.

ISBN 90-5269 -024-3

SISO 314.7 UDC351

.778.5-056.26-056.36 NUGI 655

Tref.w.: huisvesting: gehandicapten

Copyrlght© 1989 A. de Jonge/J.H. Kroes/P.P.J. Houben

All rights reserved. No part ol the matarial protected by this copyright notice may ba reproduced or utilized in

any lorm or by any means. eiectronic or mechanica!. including photocopying. recording or by any inlormation

storage and retrieval system, without written permission from the authors .



INHOUD

Introduction

Goals and format of the research project; th e report

1.1 Goals of th e research project

1.2 Format of the research project

1.3 The report

2 Definitions, differentiations and some data2.1 Definitions and differentiations

2.2 Data and statisties

3 Housing policies and housing markets

3.1 Introduction

3.2 Housing policies

3.3 Housing markets

3.4 Conclusions

4 Housing for th e physieally handieapped: knowledge available but

not applied

4.1 Introduction

4.2 Recent trends in housing

4.3 New developments in assistance

4.4 Conclusion

5 Housing for mentally handieapped: looking fo r improvement in a

period of public spendig cuts

5.1 Introduction

5.2 Trends and innovations

5.3 Conclusion

6 Housing fo r people with psychiatrie disorders: new developments

in spite of opposition

6.1 Introduction

6.2 Recent trends

6.3 Conclusion

7 Key themes for a new european policy in discus sion

7.1 Introduction

7.2 Key themes

8 Summary

Annexes

5

7

7

9

10

13

13

14

15

15

15

18

22

25

2527

29

31

33

33

35

40

41

41

43

47

49

49

50

59



INTRODUCTION

This report "Towards autonomy in housing for the handicapped" is the result of a

research project executed by the RIW - Housing Research Institute of Delft

University of Technology. The study was commissioned to the Institute by the

Bureau for action in favour of disabled people on behalf of the European

Commission.

The material has been collected by SibylIe van Haastrecht, Anja de Jonge, Hans

Kroes and Piet Houben.

Administrative assistance, typing, lay-out, etc. was given by H. Lucassen, Inge

Kluivingh and Ingrid Knijnenburg. We would like to thank them for their help, as

weIl as André Mulder, who helped with the translation.

Finally we would like to express our thanks to all those people who helped us by

giving information and advice, sending material, addresses, etc.

Delft, October 20, 1987

6



1 GOALS AND FORMAT OF THE RESEARCH PROJECT; THE REPORT

1.1 Goals of the research project

The European Commision and the housing of people with a handicap.

One of the objectives of the European Community is to integrate people with a

handicap in society; and to minimize the barriers resulting from mental or physical

disabilities.

The road towards the realization of these objectives leads via an analysis of these

barriers and subsequently the formulation of policy guidelines. These policy

guidelines are being developed for the areas of employment, education, transport,

care and housing. In this report the emphasis is on housing and the related care

aspects.

In the last years important steps forward have been made.

We specially mention:

- the first action program, 1982 - 1987;

- the ongoing work for the publication of a second action program, 1988 -1992;- the development of an information network: Handynet.

The stimulus for the development of the first action program, was the adoption of a

resolution by the European Council on December 21, 1981. This action program

subsidized model projects. The idea behind these projects is that practical

experiments cannot only serve as sources of information bu t also as examples and

generators of new ideas for a successful improvement of the housing and living

conditions of handicapped people.

The resolution stated that:"The basic objective (of the program) is to make more housing available, suitable to

meet the needs of the handicapped, including ease of access and use, links with the

public services and, where appropriate, workplaces or other centres of activity."

Another mentioned objective is: "to strengthen and improve the co-operation and

co-ordination between the different organizations and services involved in this

process". Essential in the approach is the aim to realize an increased involvement

of the handicapped themselves in the development of the policies. All this must

result in better opportunities for independent living.

To reach this greater independence, in many cases the introduction of innovative

elements is inevatable. Elements necessary to counter the traditional trend: the

intra-mural approach. Next to this, great attention is given to the development and

7



introduction of new technologies and an architectural design that allows maximum

flexibili ty .

Experiments are only effective if the results are disseminated at the largest

possible scale. This is one of th e reasons why these model projects are also referred

to as example projects. This also explains why these projects are evaluated.

At th s moment the results of these evaluation studies are not yet available. Whichstrategy will be chosen for the transfer of the acquired knowledge and experience is

consequently still unknown. Ideas about th e contents of the second action program

are not yet made public.

The information network Handynet is still in the process of development, although

clear results have already been reached with re gard to the exchange of information

about technical tools and aid.

Policy reorientation.

Research is done to evaluate, and if necessary, to correct the policies of the

European Commision. The research institute ABT Forschung (now called Emperica)

produced descriptions of th e actual trends and developments with regard to housing

and care for th e handicapped. The report indicates that th e emphasis is shifting

from the provision of intra-mural facilities to the development of forms of

independent living for the handicapped. As a consequence, more attention should be

given to the housing opportunities offered to them. What also should be considered

is that the group is most heterogeneous in composition. Generally speaking, there is

sufficient expertise available to select th e right technical solutions, but not to

select the best societal and political approach.

The difficulty here is that this approach al most directly conflicts with the generalinstitutional and societal resistance towards change. Hopefully, the contents of th e

report, "Towards autonomy in housing fo r th e handicapped", provides the European

Commission with adequate information to support new political initiatives in this

field: the housing of the handicapped.

Objectives and limitations of the project.

To inprove th e possibilities fo r independence and for social integration of the

handicapped, firstly a picture has to be drafted of relevant developments in

legislation and in financial and practical rules and regulations. Secondly an insight

in innovative trends in the practice of housing for the handicapped is needed. This

concerns developments that increase th e chances for social integration.

On the basis of these descriptions of institutional and societal developments, "key

themes" ·are formulated. These themes can be important as calalysts fo r a new

political approach of this problem.

The study had to be executed within certain practical limitations. These concerned

for example, the available amount of time and financial support and also the range

of the final report. The project aims at direct policy implementability. Already

during th e execution of the study it rapidly became clear that is is not only difficult

to compare international material but also that a horizontal "European" comparisonis fairly useless and contains dangerous trapholes. As a result of different

8



standards, different definitions and different methods of collecting, it is difficult to

compare quantitative data from the various European countries.

The research question.

To support new political initiatives of the European Community it is necessary to

be bet er informed about:

- developments and trends in initiatives by EC countries, concerning legislative,financial, and practical measures that stimulate or frustrate the opportunities for

living independently;

- innovative trends in housing and care that support the objective of "social

integration".

Therefore "key themes" for a new and innovative policy were formulated (if

possible illustrated by examples of good practice, concrete strategies or solutions

applied in one or more of the EC countries).

1.2 Format of the research project

For the execution, the project was divided in three phases:

- orientation (September 1986 - July 1987)

- further development of potential "key themes" (March 1987 - July 1987)

- assessment of concept recommendations for a new policy (March 1987 - October

1987)

As a result of practical problems in the initial stage of the project, the start was

somewhat later than originally planned. A consequence was that the first two

phases largely overlapped each other.

Orientation.

During this stage the following activities were developed:

- establishment of contacts with representatives of governments and of

organizations of handicapped people: a first meeting with the members of the so-

called Liaison Group on April 16, 1986, was used as ar. opportunity for

establishing contacts; a second meeting (on February 12, 1987) offered the

opportunity to discuss problems with the collection of basic material;

- with the help of EC officials and through existing RIW-relations, contacts weremade with experts, institutions and organizations active in this field of housing

for the handicapped; interviews were made and (field) material collected in each

of the twelve countries;

- a rather extensive library of official documents, reports and research documents

was assembied;

- several relevant conferences were attended:

- IFHP conference (Malmö, Sweden, May 1986);

- congress "Mobility and Handicap" (Brussels, Belgium, January 29-31, 1987):

- meeting of the project leaders of District Network, (Venlo, the Netherlands,

April 13-15, 1987);

9



- workshop "Independent living" at th e Annual General Meeting of Mobility

International (Thessaloniki, Greece, May 8-10, 1987);

- meeting of the Liaisongroup, projectleaders and evaluators (Port Laoise,

Ireland, June 4-5, 1987);

- congress "The Acessibility of Public Buildings and Facilities" (Utrecht, the

Netherlands, September 30- October 2, 1987);

- consultation of the Bureau for Action in Favour of Disabled People of th eEuropean Community, to discuss the potential "key themes" (Brussels, Belgium,

April 29, 1987);

- production of an activity report (June 1987).

Further development of potential "key themes"

Potential "key themes" were already formulated in a fairly early stage of the

research procedure. These themes gradually evolved. This process ot change was to

a large extent based on comments received during the interviews with experts in

the different countries and consultations with representatives of the Bureau.

Extensive discussions within the multi-disciplinary research team resulted in the

final shaping of the themes.

Assessment of th e concept recommendations.

The concept report, containing the concept recommendations, was submitted to a

group of experts and members of the Bureau of Action on Favour of Disabled

People and thoroughfully discussed. The result of this discussion, that took place in

Brussels in the autumn of 1987, helped to formulate the final recommendations and

proposals for further research.

1.3. The report

Structure of the rapportage

In this first chapter of the report, the structure and contents of the research

project are described. In chapter 2: "Definitions, differentiations and some data",

attention is given to th e fact th at different kinds of handieaps ask fo r different

approaches and solutions. A relevant division in categories is made; th e different

characteristies are defined.

The opportunities for the realization of housing desires depends heavily of the

situation on the housing market. This subject is discussed in chapter 3: "Housing

policies and housing markets" •

The next three chapters focus on the developments in the field of housing fo r the

three distinguished categories of handieapped persons. Chapter 4:"Housing for

physieally disabled persons: knowledge available, but not applied". Chapter 5:

"Housing for mentally handieapped: looking for improvement in a period of public

spending cuts" and chapter 6: "Housing for people with psychiatrie problems: new

developments in spite of opposition".

Finally, in chapter 7, the key themes are further developed: "Key themes for a newEuropean policy in discussion", followed by chapter 8, "Summary".

10



Annexe 1, lists the names of the many experts and government representatives who

have been interviewed.

Further material that can be found in the annexes are copies of the letter sent out

by researchers, the Bureau's letter of introduction and the concept "key themes".

Finally it includes a list of relevant publications.

Final remarks

The European Community consists of twelve member states, each of them with it s

own history and pattern of sodal and cultural values and standards. This study was

executed, and the report procuced by a group of Dutch researchers. The

information was collected via Dutch eyes and ears. This almost inevitably contains

the danger of a biassed approach.

An extra reason for submitting the concept of the report to an international group

of experts and members of the Bureau for Action in Favour of Disabled People was

to reduce the number of prejudices voiced by the researchers to the minimum,

preferably to non at all.

The following experts and members of the Bureau provided their -for this process so

important- knowledge and expertise:

- Mr. P.E. Daunt, Head of Bureau for Action in Favour of Disabled People, Rue de

la Loi 200, 1049 Brussels, Belgium

- Mr. G. Leussink, Bureau for Action in Favour of Disabled People, Rue de la Loi

200, 1049 Brussels, Belgium

- Mr. J. Frederiksen, staffmember BMH, Hans Knudsens Plads IA, 2100

Copenhagen, Denmark

- Mr. P. Dollfus, Centre de Readaptation, 57, RueAlbert

Cam us, 68093 Mullhouse,France

- Mr. E. van der Poel, University of Maastricht, Postbus 616, 6200 MD Maastricht,

The Netherlands

- Mr. J. Knoops, district project Genk-Hasselt, Stadsomvaart 9, 3500 Hasselt,

Belgium

- Mrs. T. Serra, president of AIAS (Assodazione Italiana per Assistenza agli

Spastid), Via Rubens 35, 00197 Rome, Italy

11



2 DEFINITIONS, DIFFERENTIATIONS AND SOME DAT A

2.1 Definitions and differentiations

Unfortunately there is no generally accepted definition of the phenomenon

disability. The best known and most widely used are the definitions given by the

World Health Organization. Characteristic is the use of th ree terms to distinguish

the medical-diagnostic aspects of physical and social consequences.

Impairment emphasizes the medical aspects; it refers to a permanent or transitory

1055 or abnormality of a psychological, physiological or anatomical structure of a

function.

Disability describes the functional consequences of an impairment. Disability is the

1055 or reduction of functional ability and activity, that is considered to be normal

fo r a certain individual. It effects in particular the normal (daily) activities of a

person.

Handicap refers to the social consequences. I t indicates to the effects of an

impairment or disability on the individual and his surroundings. This means that in

this terminology a person is handicapped if, as a consequence of a handicap or im

pairment, he is limited in his possibilities and experiences problems to integrate in

normal, social life.

In this report, the emphasis is on handicaps. Given the fact that the main subject is

housing, and especially the housing opportunities for people with a handicap, a

distinction between three categories seems appropriate.

Category 1: the physically handicapped; this category includes (at least partially)

a group th at usually is regarded as a seperate one: the sensoriaIly

handicapped.They

are includedin

the cases that their circumstances

result in special housing requirements.

Category 2: the mentally handicapped.

Category 3: the persons with psychiatric disorders.

It is very difficult to give a precise definition of the two last-mentioned categories

and to indicate the differences between both groups; maybe one could say that

people with psychiatric disorders are as intelligent as everybody else, but have

emotional problems and/or problems in relating to other people, whereas the second

group has an intelligence th at is low and may have emotiQl'lal problems as weIl.

Not included in this study are people suffering from an illness -e.g. rheumatism or

multiple sclerosis- th at leads (or may lead) to progressive impairments. The reason

for their exclusion can be called "force majeur". Very little material is available

13



about the specific problems that they are facing. A fact that seems to be the result

of the often unpredictable development of their illness. Seen from a housing point

of view, it seems defendable to regard people belonging to this group as potentially

belonging to category 1 or category 2. The main difference being that in their cases

timely action to limit the problems can more easily be undertaken.

2.2 Data and statistics

As a result of a.o. definition problems no reliable international statistics are

available. One example:

Table 1 Handicapped population

Country Total population Total no of Handicapped as %handicapped of total population-------------------------------------------------------------------------------------------

Belgium 10 million

Denmark 5,5 millionFrance 54 million

Germany 61 millionIreland 4,5 millionItaly 57 millionNetherlands 13,3 millionSpain 37,5 millionUnited Kingdom 56,6 million

a =physically and mentally handicapped

b =physically disabled

680.000 (a) 6,8-7%

700.0001.4000.000 (c) 25,5%

3 million (c) 5,5%5,3 million (c) 9,8%

6.606.289 (a) 10,8%150.000 (a) 3,3%

1.700.000 (a) 3%

1.198.500 (b) 9%1.145.544 (a) 3,1%1.334.682 (b) 2,4%

7 million (c) 13%

c =not clear wether figures relate to physically disabled or to both physically and

mentally disabled

Source: Travel and the disabled. Study of th e problems and provisions. J.R.Vordegger and C.J. Verplanke (Consumentenbond, The Hague). (Commissioned byth e European Community's Bureau fo r Action in favour of disabled people).

Because of th e use of different sources and different definitions these figures can

in fact not be compared. The main reason fo r including this table was to stress this

facto

As a result of the lacking of reliable figures it is quite difficult to determine how

many people in the European Community belong to the three indicated categories.

I t seems rather generally accepted that the total number of handicapped people is

around 10% of the population. The higher figures in some countries, especially when

they are concentrated in a certain age and sex group, can often be explained as th e

result of military activities in which the country was involved.

Progression in science has given people who some decades ago would have died, a

chance of survival; babies with severe disabilities can be kept alive and victims of

accidents or illnesses can survive as a result of recent developments in medicine

and technology.

14



3 HOUSING POUCIES AND HOUSING MARKETS

3.1 Introduction

A housing policy, in several respects, can be seen as an element of social policy.

And, in spite of European integration, these policies still vary extensively from

country to country. The explanation fo r this variation can be found in a combination

of cultural, social and economie factors. As a consequence of this, housing policiescan only be assessed within their own national context.

In general, a family's chances to find decent and affordable housing are closely

connected with it s financial possibilities and th e situation on the housing market.

Both the priee-income relationship and the availability of housing, usually ar e

elements of the national housing poliey. However, as mentioned, different

approaches obviously are possible.

In this chapter, attention is given to th e way in whieh housing policies and housing

market conditions can actually influence the possibility to integrate people with a

handieap in society; to minimize th e barriers resulting from mental or physieal

disabilities.

3.2 Housing policies

Over the years many authors, many organizations and many governments have made

efforts to define th e fundamental right of access for everybody to affordable

housing of a decent quality. This does not mean that the situation is clear. In most

cases the definitions are so broad that it is diffieult to estimate the operationalvalue of them.

A housing policy ca n be se en as an element of the in every country existing

complicated network of social policies. Especially in that area, social and cultural

factors create a variety of nationally different meanings and interpretations, of

words and expressions that seem so identieal. Add to this the fact that the

definitions tend to include one or more normative elements and it will be clear that

efforts to define "the" european housing policy are, at least ambitious. This

conclusion is supported by the contents of official documents and newspaper

comments that appeared after the so called "Colloque de Rambouillet"; a meeting

of the ten European housing ministers that took place on January 17 and 18, 1985.

15



This colloqium ("Politiques publiques dans Ie domaine du logement urbain") that

aimed at an exchange of opinions and experiences between the housing ministers,

did not develop as smoothly as some had hoped.

Good housing requires impressive investments. This fact seems undeniably true in

al l the countries included in this report. Large investments are necessary not only

to finance the construction of th e buildings but also for the acquisition of the landand the provision of the necessary infra-structure.

Also universal is the rising trend of these costs. For this development a variety of

factors is mentioned, ranging from speculation to the relatively slow increase of

productivity in the building industry.

Already more than a century ago, the "Royal Commission on Housing of the

Working Classes" reported about the worrying housing conditions in England. They

mentioned poverty, th e imbalance between income and rent, as one of th e main

explanations for the existing situation. Already then, a certain percentage of the

population had insufficient means to cover th e expenses for decent houses.

Since then, house priees have risen more rapidly than incomes. This became

especially apparent shortly af ter the second world war. It was during this period

that many European governments increased their involvement in housing affairs. Inmany countries governments reduced the priees by granting increasing (housing)

subsidies to those who could not afford to pay the cost priee.

The changes in the world economy and administrative reforms tend to have a

negative influence on th e housing prospects of the financially less privileged. Social

housing has been at the forefront of public expenditure cuts. Retrenchment and

decentralisation in some respects make the situation more complicated. In an era of

still rising costs, most governments are no longer increasing - and in some cases

even decreasing - their"financial support for th e housing sector. The "consequences

of such a development are obvious: if no third party bridges th e developing gap, the

tenants will have to pay more for their accomodation, or th e general housing

quality will decline. Unfortunately, also a combinat ion of both developments is

feasible.

In a recent study commissioned by The European Foundation for the Improvement

of Living and Working Conditions (Living Conditions in Urban Areas, an overview of

factors influencing urban life in th e European Community , Luxembourg: Offiee fo r

Official Publications of the European Community, 1986), the following features and

concerns of contemporary housing policy in the EC are mentioned:

16

fiscal constraints and pressure on subsidiesj

monetary inflation and high interest ratesj

demographie change (smaller households, multiple earner households, fewer

households with children, growth of elderly housholdsj

a general reorientation of policy towards individual home ownership with the

parallel development of more residual policies for marginal groupsj

an overriding concern with economie restructuring and the recession.



Housing policies and the disabled

Not all housing is suitable, accesible for disabled persons. In general, one has to pay

for deviations from the standard. This would mean that to house handieapped people

asks fo r extra investments.

Concerning this subject, the information that we collected in the different

countries is far from clear. In th e next chapter we will return to this point.

Our first conclusion when analyzing the material is th at a more detaHed study is

necessary to give an adequate answer to this question of costs.

Another step that could be made is to indieate clearly in the different national

housing policies that all housing should be accessible for (for example) wheelchair

users. Material from th e various countries supports the idea that the more normal

th e application of such a rule is , the lower the level of extra expenses involved.

The effective introduction of such a policy not only allows handieapped people more

freedom to live where they prefer, but also allows them access to the dwellings of

e.g. friends and relativesj a fact of social importance that of ten is underestimated.

Income and housing costs

We identified that in most cases, to built housing for disabled people will cost more

money than the production of standard hou sing. Not only at the expenses side but

also at the income side handieapped househunters are in a less favourable position

than average. In many cases theircondition, or the present labour market

circumstances do not allow them to generate a sufficient income to meet th e real

costs of housing. Many will need support fr om third parties to be able to meet their

living expenses. Statisties about the percentage of handieapped people with an

independent income were not available. In most countries some kind of "quota

poliey" existsj a policy th at stimulates employers to employ a certain percentage of

handicapped people.

In th e northern countries of Europe this financial support usually (to a large extent)

comes from public sourceSj in southern Europe, supplementary support will have to

be provided by family, friends or charitabie organizations.

In both cases the solution has unattractive aspects. Being dependent of others, by

definition does not increase the feelings of independency and contains an element

of instability.

In countries with a developed social housing system the financial support given to

disabled people to meet their housing expenses, usually comes from different

sources, some times from different administrative levels. Income support schemes,

supplementary benefit schemes, housing subsidies, etc.j of te n a relatively unclear

mixture. In many cases one needs to be an expert to find the way in the maze of

subsidies and organizations.

For the authors of "Inquiry into British Housing" (NFHA, London, 1986) this unclear

situation is one of the main problems in the housing field. They strongly advocate to

abolish all the special housing subsidies and to replace them by an income support

17



scheme. By proposing this approach they implicitly define housing problems as

income problems. All financial assistance then can be channeled through one

organization, one ministry for example. They are convinced that this approach will

not only be much easier accessible for those who need support, but that it will also

result in a more equitable distribution of the available funds.

The lack of sufficient income is an important barrier on the road towards

independence.

Housing policies, health care policies, social policies; th e need for coordination.

As indicated above, we found many examples of a lack of coordination, or even

competition between different ministries. This easily results in a situation that is

very complex or even inaccessible for those who need support. Rules and

regulations are not always compatible, responsibilities not always clearly defined.

Especially in the present period of fiscal austerity this is dangerous. Austerity

measures taken by th e one ministry can have effects in th e policy area of another

department.

3.3. Housing markets

Housing policies are an indicator for government objectives. The possibilities fo r a

household to find at this actual moment th e housing that it wants, depends very

much on the situation on th e housing market now: is the right housing available at

the right time, at th e right place, at affordable costs?

With regard to these questions a distinction should be made between countries (and

indeed also regions) where a quantitative shortage exists and those where the

market is in balance or where offer exceeds demand. Especially with regard to th e

demand for "non-standard housing", the different situations demand for different

strategies.

Also here international statistics can be very misleading. Different countries use

different definitions, data are collected at different moments. Really reliable

figures that answer the question whether a housing shortage still exists, apparently

are not available. An extra problem is that especially fr om countries that joined the

European Community recently, of ten relatively little statistical material is

available. The extensive differences between the European countries, incombination with th e non-existence of an overall European housing policy make it

difficult to formulate conclusions and recommendations.

The housing stock

The necessary size of th e housing stock naturally depends of th e number of

inhabitants, or more precisely of the number of households. Before paying attention

to some of th e characteristics of th e housing stock, a general picture of the

demographic developments in the countries of the EC is given.

18



Table 2 Estimates of mid-year population (x 1,000.000) and th e rate of change-------------------------------------------------------------------------------------------1980 1982 1983 1984 1985 rate of

country change-------------------------------------------------------------------------------------------Belgium 7.55 9.85 9.86 9.85 9.86 0,2

Denmark 5.12 5.12 5.11 5.11 5.11 -0.4France 53.88 54.48 54.73 54.95 4.9

Germany 61.56 61.64 61.42 61.42 61.12 -1.2

Greece 9.64 9.79 9.85 9.90 6.7

Ireland 3.40 3.48 3.51 3.54 3.55 8.7

Italy 56.42 56,.64 56.84 56.98 57.13 2.5

Luxemb. 0.36 0.37 0.37 0.37 0.37 5.5

Netherl. 14.14 14.31 14.36 14.42 14.48 4.8

Portugal 9.90 10.03 10.10 10.16 10.23 6.6

Spain 37.43 37.93 38.23 38.51 38.60 6.2

U.K 56.31 56.34 56.38 56.49 0.8

source: Annual Bulletin of Housing and Building Statistics, 1986

The table shows fairly large variations in the rate of change. In countries like

Ireland for example, th e population is still growing relatively rapidly, while in

countries like Germany and Denmark a decline can be seen. Although it may be

concluded that a growing population demands for more housing, it would be wrong

to suppose that a declining population implies that new building activities can be

stopped. Table 3 indicates why.

Table 3 Average number of persons per household

1970 1975 1980

Belgium 2.98 2.96

Denmark 2.69 2.48

France 2.88 2.76

Germany 2.74 2.60 2.48

Ireland 3.94

Italy 3.4 3.3 3.2

Luxemb. 3.13 2.84Netherl. 3.2 2.95

U.K. 2.88 2.77 2.70

source: GEWOS, Wohnversorgung in Europa, 1983

In al l th e countries th at were included in the 1983 GEWOS-study we see th e trend

of declining household size. A consequence of this development is that, even when

th e population is stabie or declining, the total demand fo r housing will (or in the

last case, may) increase.

Table 4 shows the number of dwellings per 1000 inhabitants in each of the countries

included in this study. Also here large differences exist. Also with regard to this

table it must be repeated that the value of international comparisons is dubious.

19



The definition of a dwelling may differ from country to country. Another important

difference is that in some national statistics second, holiday houses are included

and in others not. More reliable are "horizontal" comparisons, i.e. per county.

Table Dwelling stock per 1000 inhabitants

country 1980 1982 19831 9 8 ~

1985-------------------------------------------------------------------------------------------Belgium 386 ~ o o ~ 0 2 ~ o ~ ~ 0 5 Denmark ~ 2 2 ~ 2 7 ~ 7 0 ~ 7 ~ ~ 7 7 France

Germany ~ 1 3 ~ 2 3 ~ 3 0 ~ 3 8 ~ ~ 3 Greece

Ireland 265 271 271 276 278

Italy

Luxemb. 383Netherl. 3 ~ 3 3 5 ~ 361 367 372

Portugal

Spain 390 3 9 ~ 398 398

U.K. 382 388 391 393

source: Annual Bulletin of Housing and Building Statistics, 1986

Many of the existing dwellings are not adapted to the requirements of handicapped

people. In general, it can be said that more recently built houses are easier to adapt

than older ones. Newer housing is usually of a higher quality; larger room

dimensions, more elevators, etc. The age of the housing stock therefore can be used

as an indicator fo r the percentage of th e houses that is accessible or adaptable for

th e use by handicapped people.

Table 5 Age of housing stock, (%)

pre 1919 1 9 ~ 6 post

1919 1 9 ~ 5 1960 1960-------------------------------------------------------------------------------------------Belgium 30 17 19 33

Denmark 23 20 20 37

France 38 16 11 35Germany 27 15 25 33

Greece 18 58(figures: 1970)

Ireland 38 18 18 26

Italy 29 13 22 36

Luxembourg 33 19 19 29

Netherlands 17 22 21

Portugal

Spain

U.K. 32 22 18 28

source: Nationwide Building Society; Housing and Housing Finance in th e European

Community

20



In Northern Europe, France, Ireland, Luxembourg and the U.K. have a relatively

high percentage of old houses. Remarkable is the large difference bet ween th e

situation in the Iberian countries (more than 40% of the existing stock built before

1919) and Greece. This difference is mainly the result of an enormous increase in

Greek building activities in the recent years.

Housing productionThe chance to find a house depends of th e number of vacant houses th at becomes

available annually. Important in this respect is the number that every year is added

to the already existing stock. The next tab les give an indication of the building

activities in Europe.

Table 6 Housing production (x 1000)

1980 1982 1983 1984 1985-------------------------------------------------------------------------------------------BelgiumDenmark 30.3 22.1 23.3 28.6 24.5

France 378.4 370

Germany 452.3 422.7 416.7 477.6 387.2

Greece 102.1 113.9 72.8

Ireland 27.8 26.8 26.1 24.9 23.9

Italy

Luxemb

Netherl. 126.3 117.6 117.4 103.4

Portugal 40.9 42.1 40.5 44.1

Spain 262.9 235.0 227.1 179.9

U.K. 252 195 219 230 220

source: Annual Bulletin of Housing and Building Statistics, 1986; L'Europe du

Logement, 1985

These figures can also be given in another form, as the next table shows.

Table 7 Dwellings completed per 1000 inhabitants 1980-1982/3

Belgium 3.7

Denmark 4.7France 7.3

Germany 6.0

Greece 15.7

Ireland 8.1Italy 4.4

Luxemb. 5.3Netherl. 8.3Portugal

Spain 7.0

U.K. 3.8

source: Living Conditions in Urban Areas

21



Rather worrying is the fact that the general trend in the production figures is

downwards. In some countries there may be good reasons for such a declining

production, but it at least is dubious whether this development is justifiable in

countries with a recognized housing shortage. Especially in some of th e southern

European countries th e real production figures may differ quite considerably from

th e figures presented here; official statistics usually do not include the illegally

built houses.

The final table shows the same downward trend. This table shows the development

of investments in residential buildings.

Table 8 Investments in Residential Construction as a percentage of GDP

1980 1982 1983 1984 1985-------------------------------------------------------------------------------------------Belgium 6.4 3.3 3.2Denmark 5.3 3.6 4.0 4.6 4.7

France 6.1 5.5 5.2 4.8 4.6

Germany 6.8 6.2 6.4 6.4 5.5

Greece 9.0 5.9 6.0 4.4

Ireland 6.3 5.5Italy 5.3 5.3 5.1 4.8

Luxemb.

Netherl. 6.2 5.3 5.2 5.1 4.6

Portugal 7.3Spain 5.5 5.1

U.K. 3.7 3.4 3.6 3.7 3.6

souree: Annual Bulletin of Housing and Building Statistics, 1986

3.4 Conclusions

What do these statistics tell us? In the preceeding paragraph we concluded that the

large majority of handicapped people cannot afford the real cost of hou sing. In a

really free market their chances to find decent shelter are very limited. To this

conclusion we now can add the statement th at these chances to find housing are

declining. The time of rapid expansion of the housing stock seems to be over; the

investments in building activities fall.

In th e countries with a quantitative housing shortage this development will have

dramatic consequences, especially for the weaker parties in the housing market.

These concequences are even more severe since they of ten go hand in hand with

reductions in government spending fo r hou sing.

But also in countries where th e housing shortage has been overcome the situation is

not promising. As a logical result of declining production figures, more and more

people will have to find the solution fo r their housing problems in vacant dwellingsin th e existing housing stock. Most of those housing were designed for "s tandard"

families, with "standard" wishes. This means that especially persons and households

22



with "special" housing wishes will have problems to find an adequate dwelling.

It seems logical to allocate a relatively large part of th e (declining) production for

these households. However, it is dubious whether this idea is supported by the

private developers. For understandable reasons they will no t voluntarily target their

initiatives on fringe groups, but continue their preferenee fo r sectors of the market

where demand is relatively large and risks of vacancy low.

It is the objective of the European Community to integrate people with a handicap

in society, a.o. by minimizing th e barriers in the field of hou sing. The conclusion

seems to be that this objective can only be realized with public help. Help in th e

shape of an adequate housing policy, and of assistance for th e handicapped when

entering the housing market.

23



4 HOUSING FORTHE PHYSICALLY HANDICAPPED: KNOWLEDGE AVAILABLE

BUT NOT APPLlED

4.1 Introduction

In chapter 2, we distinguished three categories: the physically handicapped, the

mentally handicapped and th e psychiatric patients. With regard to integration, to

participation in normal life and normal daily activities the problems faced by th e

physically handicapped seem easier to solve than those faced by members of th e

other categories.

In this chapter we concentrate on a group of people th at need help to transform

their desires into action. The necessary assistance can in some cases be provided by

technical equipment, in other cases human help is necessary.

Physically handicapped people are able to formulate their wishes. However, an

often mentioned problem is that these wishes are not always accepted.

Paternalistic tendencies seem difficult to get rid of. The process of seeing them as

fully normal members of society, capable to run their own lives and make their own

decisions has not yet everywhere reached the ultimate stage.

Another problem is the tendency to concentrate attention on people with severe

handicaps, forgetting th at th e characteristics also for members of this category are

diverse. By doing so, the problems of th e less severe handicapped citizens can easily

be overlooked. And simple solutions that ca n make buildings, offices or other work

places accessible for large groups with for example walking problems, or a length

that deviates from th e average mentioned in the architects handbooks, are not

implemented. This is remarkable and disappointing for at least two reasons.

Firstly physically handicapped persons are better organized than representatives of

th e other mentioned groups. They do not need help to formulate their wishes. In

many countries they founded already in the last century organizations to support

th e individuals in their claims for a norm al life.

The second reason is that especially with regard to the problems that they face and

th e sometimes very simple measures that ca n be taken to remove those problems

relatively little wás reached. An impressive amount of literature appearedj i t is

virtually impossible to count th e number of design books that was published.

Nevertheless, the impact of all that work and all those publications remains

limited, so the main problem is that although the knowledge is available, it is not

applied.

The necessary assistance can be provided by people or by technical aids. In the past

25



the accent was heavily on personal assistance; help that was available in the house

of family of friends or in larger institutions.

Technological developments have increased the possibilities fo r physically

handicapped people to participate in normal daily life activities. It is not without

cynicism that the conclusion is drawn that large scale wars have contributed to the

development of those technical means. The combination of large numbers of

handicapped men and limited care facilities stimulated this. Or in the words of the

researchers of ABT-Forschung: "The second world war left many physically and

emotionally disabled. Many people were concerned and directly involved and the

demand for more and bet ter provisions grew. Disability was increasingly seen as

something that could happen to anyone and less the fate of a few misfits".

In the USA originated in the early seventies the philosophy of 'Independent Living';

the movement for IL stressed the right of disabled people to live as independently

as they want, and to live in community. Many people with a physical disability still

had to live in large institutions at that moment.I t

was started by students whowanted to live on the university campus; maybe also the presence of soldiers who

got disabled in the Vietnamese war, played a role. Partly as a re sult of activities of

the IL movement it became obvious that many people, even with very severe

disabilities, can live independently. Important issues stressed are: the disabled

themselves know best what their needs are, and disabled people should live

integrated in the of community. Started by physcially disabled persons, later the

movement was joined by people with mental or psychiatric problems. In Berkeley,

California, the first Center fo r Inpendent Living was founded. in accordance with

the concept, at least 50% of the staffmembers working in the Center, has to be

disabled. By using methods like peer-counseling and role-modeling the workers at

the center help other disabled people to reach a higher level of independence.

Advice is also given in practical matters; in the field of housing potentially

adaptable dwellings are indicated, and information and advice is given on possible

adaptations and technical aids. In a way they see themselves as a "consumer

movement".

The ideas of IL crossed the ocean and gained influence in Europe.

The present, general trend is fr om institutionalization towards community care.This

does not mean that al l fundamental problems are solved. Different opinions fo r

instance exist on the desired level of concentration and integration. In some

countries, like Spain for example, much energy is invested in a campaign to make

clear to everybody th at handicapped people not only exist, bu t that they also are

normal citizens. People with exactly the same rights as every other inhabitant of

the country. This "sensibilization" is regarded as the necessary first step towards

integration.

Continuing along this line, it seems logical to leave the ultimate decision about the

sort of housing, the living place and the organization of the support facilities to the

handicapped themselves.

26



4.2 Recent trends in housing

Three levels of access

In several interviews the remark was made that it is only useful to pay attention to

the actual dwelling af ter securing the possibility for handicapped people to reach it.

This means that th e environment of th e house or the estate must be accessible for

th e prospective tenant. Attention not only for th e design of the urban environment,but also fo r th e accessibility of e.g. public transport facilities, reserved parking

places etc.

Naturally, these requirements are easier to meet in projected estates that still are

in the design stage than in already existing areas. Especially in older quarters it

may be difficult to solve the problems; sometimes it is impossible. In this case the

objective of the study can only be reached by offering opportunities to the

handicapped person to move to another area.

The second level concerns th e accessibility of th e dwelling. It is surprising to hear

that in some countries, in spite of al l the publications that appeared during the last

decades, still elevators are projected that are not accessible for wheelchair users.

Thus limiting, in an unnecessary way, not only th e housing possibilities but also th e

possibilities to visit friends and relatives. The example is depressing because a

slightly bigger elevator is not necessarily more expensive than the one used now:

adaptation after th e construction of the building is virtually impossible. In other

countries rules concerning the accessiblitity of dwellings do only apply to housing

situated at groundfloor level. The effectiveness of this approach is very limited.

Especially in newer housing estates (but certainly also in existing inner cityareas) a

large percentage of groundfloor space is not allocated for housing purposes but forshops and offices. It is difficult to find an explanation for the in some countries

existing unwillingness of the building industry to increase the accessibility of

residential buildings. However, an excuse may be that the situation really is very

complicated. Rules and standards may differ from region to region or even from

city to city. A good example of developed standardization can be found in Germany,

where the standards for an adapted dwelling (Ilbehindertengerechte Wohnung") are

laid down in socalled "DIN-norms".

The third level concerns th e adaptability of housing. In many countries studies have

been made and architects competitions organized to find the ultimate answer to

this problem. Seeing the results of these efforts, and th e variation in the results,

the conclusion seems to be that such an answer does no t exist. We already

mentioned the many technical studies and the lack of standardization. On the way

towards improved accessibility and usability the moment seems there to collect and

analyze all these studies and produce one European set of design guidelines. The

adaptability of housing depends very much on th e possibilities to alter the standard

lay out of the house; to add extra space where it is necessary. In this respect

constructions without load bearing walls inside th e house offer good opportunities.

In some countries, the Netherlands fo r example, a large proportion of more recently

built housing allows this internal design freedom. A consequence of this method of

27



construction is that the designer has the freedom to decide where to position th e

inner walls without the penalty of being confronted with (much) higher costs.

The question of higher costs is unclear. In the collected material we find estimates

rangeing from 3% extra to more than 100% extra. This seems illogical. But, more

detailed information and calculations are necessary to answer the question

decisively. The quality of decision making would improve if this material becameavailable for international use. We do not exclude the possibility that in some cases

estimates about th e extra costs are not based on a realistic survey.

Adaptations

Measures to obtain maximum accessibility of a house are easier to apply to

buildings that are in th e design stage than in existing ones. For many disabled

people a new house will not be available. For them, existing housing will have to be

adapted. Then it is extremely important that they get what they need and want.

Choosing and deciding is difficult; paternalism is imminent. Although much

information is available, it is no t always "accessible", not easy to consult for the

user.

Different ways of providing people with information and advice are being tried. In

Ireland a district project of th e EC was started for that purpose. The HILAC, th e

Housing and Independent Living Advice Center,is a place where one can get the

necessary information on possibilities. Next to the centre, some houses have been

adapted with different equipment and aids; here people ca n take a look, and get

help to find out what adaptations and aids suit them best.

In th e future the Handynet project may come to play an increasingly important role

in the supply of relevant information as weil.

Following the American model Centers for IL have been started in Germany (a.o. in

Cologne and Bremen) and in the United Kingdom. Some of them also give training in

practical skills.

For the financial consequences of adaptation many countries do have provlslons:

there are different sorts of loans and grants. Applying for this money however of te n

is a difficuit and time consuming procedure. To the user it is not always clear what

the rights and possibilities are; information on this subject is necessary.

Adapted housing should remain exclusively available fo r disabled people. In Berlin

e.g. adapted houses are not "reserved" for handicapped people, the new tenant isn't

necessarily a disabled person. By reserving adapted houses for this group the list of

people waiting for a house will get shorter and no capital will be destroyed.

With regard to the existing housing stock our critical remarks about architects's

competitions are not fully justified. Especially in countries where large quantities

of (more or less) identical dwellings were built in th e past, adaptability studies and

design competitions are very useful. A good example of such a study exists in

Ireland.

28



4.3 New developments in assistance

Related to housing facilities are the services. Some obstacles on th e road towards

independent living can be removed by technical innovations. The advantage of these

solutions is that they are always available and do no t ask for gratitude. But in many

cases human help cannot be missed. In this respect the situation, like always,

differs from country to country. Who provides this care and assistance and who paysfor it? The answer to this question varies from: unpaid volunteers, friends and

relatives, to full time (government) employed professionals. With regard to this

question no "best" solution can be indicated. The optimum depends of factors like

the national interpretation ot the "welfare state concept" and other nationally

defined social and cultural factors. Several ways to organize and finance assistance

for persons with a physical disability have been tested.

A weIl known example, that originated in Sweden, is the Fokus-system. This model

has been introduced in th e Netherlands in the seventies and at this moment in

Belgium some compartable schemes operate. The Dutch Fokus-schemes do not

provide housing, bu t the necessary assistance. The help is organized from a service

unit, where 24 hours a day assistants are present. They can be called whenever

necessary and will give the assistance required at that moment. They only give so

called ADL-assistance (ADL = Activities of Daily Life); help to clean the house or

do the shop ping has to be asked fo r elsewhere. The assistants regard themselves as

a sort of "extension piece" of th e disabled person. Usually one unit services some 14

or 15 apartments or houses. The centres are spread over th e neighbourhood to

prevent ghettoization.

In the Germany ambulatory services are growing quite rapidly at th s moment. Theoldest, VIF in Munnich, started some ten years agoj the concept has been taken over

in several other places. It started as a self help initiative. VIF e.g. was founded by a

group of disabled people in co-operation with workers in a center for persons with

disabilities. They saw th e need for help and assistance, especially fo r people who

need many hours of (quite intensive) help, since especially they of en are excluded

by th e existing organizations. In the concept of VIF th e disabled person decides how

much and what assistance is needed. The bureau of th e ambulatory service only acts

as an intermediary between user and attendantj those two parties wil 1 make an

agreement. Assistance can also be given in weekends, at night time, etc. The help

isn't limited to ADL-assistance. Depending of th e needs, assistance with transport,

shop ping can also be given.

The attendants don't have a special training for the job. Some of them are

"Zivildienstleistende" (men who instead of doing their military service do other,

useful jobs). The decision chosen not to employ professionals is deliberate. It

prevents the attendants from becoming authorities who take the decisions for th e

disables person since such a situation may create nwe dependencies.

The attendants of VIF receive a salarYj other organizatiq,ns also employ volunteers.

The financing of these services still is a problemj they don't fit in th e traditional

pattern and work in a different way.

29



In Paris th e GIHP (Groupement pour l'insertion des Handicapes Physiques) has taken

action to start a service for socalIed "auxiliaires de vie". Like in Germany existing

services organizations only worked during office hours, but assistance is also needed

during weekends and in the evenings. Because of th e needs of disabled people GIPH

runs a flexible system, although this costs more. This system can operate grace to

subsidies granted by th e city of Paris and the state. The service of GIPH is given

from 7.30 h. till 21.30 h. fo r th e inhabitants of the quarter (some 15-20 persons usethis service). In Pontcanal 8 adapted apartments are inhabited by disabled persons,

who ca n get ADL-assistance 24 houres per day. The users have to pay; the more

help they need the lower the contribution per hour is .

Organizing this assistance is difficult: during the day and night only a few hours are

really "rush'hours", many persons then need help at the same time, on the other

hand there are hours that the assitants are idle. The attendants do no t receive a

special training, bu t GIPH would like to introduce that. They would also like to

improve the wages, which are quite low at the moment.

I f a person with a disability stays with family, those care takers mayalso need

assistance in one way or another. The Crossroad scheme provides help to th e family

who takes care of a severely (physically or mentally) disabled person. Tt started in

th e United Kingdom and was, later imported in th e Netherlands. The scheme helps

in situations of crisis, e.g. when the relative who takes care is ill or in cases where

it becomes necessary to place someone in an institution, because the burden for th e

family is too heavy. In such cases they replace th e one who is taking care. In the

English scheme th e aim is to prevent situations of crisis.

Because of the fact that there is someone, an organization, that ca n take over,

people ca n stay in their house and stay with the family.

Being dependent on human help ca n be an obstacle for autonomy, i t limits the

freedom of choice. In many cases however human help cannot be missed. An

important development with regard to this help exists in Denmark. The basic

approach is to provide the person needing assistance with sufficient tools to make

his own decisions on how th e help should be provided. Crucial is to provide him with

sufficient financial means: an allowance. With this money a disabled person,

physicaly or mentally, can employ an assistant for th e hours that help is needed; th e

help is not limited to ADL-assistance.

The height of th e allowance depends of the help needed.The level is determined by

a committee; the disabled person applies for it and states his wishes. As th e

attendant's employer th e disabled person has to fulfill certain obligations (Iike

savings for holidays, conform certain legal consequences, etc.) A model contract

has been made by the organizations that run these schemes, but conditions can be

adapted on the basis of agreement between the two parties. This gives a

considerable freedom to decide on how th e assistance will be arranged.

Despite these initiatives there still are many problems in getting the right amount

and sort of assistance. Most existing services have strict conditions and operateonly during working hours; of en they provide just one sort of assistance. More

30



coordination is necessary. Sometimes even "sneaky ways" have to be used to get

obtain necessary assistance. In Belgium, in a quarter where disabled people live

together with non-disabled people, an attendant care scheme for 24 hours per day is

operative. But as a consequence of th e rules and conditions, it has to deal with

three different organizations. Each of them with own working schedules and own

ways of financing. This obviously causes a lot of problems for the users.

One of the major problems for ADL-assistance that covers the need of th e user is

to obtain the necessary funds. Especially in this period of economic recession

people point at the possibility of volunteers who could do th e job.

Although some organizations work with volunteers only, others object to that

solution. There is the fear that the continuity of th e help can't be guaranteed.

4.4 Conclusion

Summarizing we can say that housing facilities, adapted to the needs of dis ab ledpersons, are not available on insufficient. Next to this the housing market position

of disabled people is weak. Adaptable housing can be a solution. Unfortunately it

can only be applied in new-built housing. Since many disabled persons are dependent

on the existing housing stock adaptations are necessary. This can cause financial

problems, although most countries offer some sort of financial support. The

procedures to obtain grants of subsidies can be long and difficult. A lot of technical

information on technical adaptations is available, but it is amazing how little is

used. Awareness of the existence of disabled people will improve th e situation and

may increase the number of architects and planners that use th e knowledge and

expertise that is at their disposal.

To give people a real chance to live independently, it is necessary to ar range

support. Without th e assistance, autonomy is not a real option. Services for ADL-

assistance should be financed and arranged such in a way that the are available for

anyone who needs them. Attention should be given to the fact that this support can

be necessary at any moment during the day and night and not only during office

hours.

31



5 HOUSING FOR MENT ALL Y HANDICAPPED: LOOKING FOR IMPROVEMENT IN

A PERIOD OF PUBLIC SPENDING CUTS

5.1 Introduction

Menta1 disability occurs in different degrees. Some persons have a light handicap

and are able to perform most daily activities quite independent1y, they need very

Iittle assistance. Others are severely disab1ed and need help with (almost)

everything, even e.g. with eating their meals. They may need a place where their

daily Iife is taken care of and in fact maybe taken over: where (almost) everything

is arranged for them. The requirements for housing facilities for those two groups

are very different. And in between the extremes a variety of handicaps with

different consequences for daily Iife, individual needs and potentials exists. It is not

one group, having all th e same possiblitities for autonomy, bu t al l these personal

differences have to be taken into account.

The group of multiple handicapped persons, with both an intellectual and a physical

disability, requires special aids and adaptations in a house, adapted to both their

handicaps. It ca n make high demands on the designer of th e house, because both

handicaps have to be into account.

For a long time only two options have been available: staying at home with th e

family, or living in an institution. When mental handicap wasn't recognised as such,

before a good diagnosis could be made, mentally handicapped persons sometimes

had to live with e.g. psychiatric patients or old people in th e same residential

center; of en an asylum fo r persons considered difficult or without another place to

stay. These centers changed, when it became clear that mentally disabled persons

are a different category, with specific problems. When it became clear that these

people could learn things, special provisions were considered useful and necessary.

When new ideas about handicap and care were developed, th e asylum function of

those centers was rejected, other ideals became important.

In the Scandinavian countries normalization became the leading principle. A recent

definition given by Wolfensberger: "Utilization of means which are as culturally

normative (valued) as possible in order to establish, enable or support behaviors,

appearances and interpretations which are as culturally normative (valued) as

possible". In fact it contains three elements: to help persons that are "a-typical" to

become more "typical", to give that help in such a way 1;,hat simularities instead of

differences are accentuated and to increase public tolerance regarding "a-typical"

persons. The goal that is to regard people formerly seen as abnormal as normal, andto reach th s by app1ying normal means. In practice the result was that in Sweden

33



residential centers are closed down and substituted by group homes. Houses for

around 5 persons, each with an own room; some rooms and a bathroom are meant

for communal use. At least one member of the staff is present. Not only persons

with a light mental handicap but even severely disabled persons can get a piace in

such a house. They use the general services of the community; only when it's

inevitable a separate service will be created, but even than within the normal

provisions and centers.The philosophy of normalization is known in many other European countries, bu t

outside Sweden, never as the one and only principle.

Other ideas came to be important and many new experiments started. The general

direction: out of the institutions and into th e community. It was feit that the

mentally handicapped person has a right to live a human life. Terms like

"integration" and "humanization" (of living conditions) became important in the new

way of thinking, and experiments started to give people a chance to become as

independent as possible and to live in the community. Parents played an important

role in these changes: they of ten took initiatives and organized themselves to

improve the situation of their children.

Special mention should be made of a philosophy that originated in the seventies in

th e Netherlands, the socalIed "verdunningsfilosofie" (dilution filosofy); the followers

of this idea wanted to integrate persons with a mental handicap and other people.

When first introduced in practice i t caused much uproar, now i t is applied in several

places.

Of course the developments haven't been th e same in al l the EC-countries. In

Germany almost a complete generation of mentally handicapped was killed during

the nazi-period; after the war many parents kept their mentally disabled child athome; these "children" now are in their 30's and 40's, the parents too old to look

af ter them. It is clear ' that these children never had a chance to learn to live as

independently as possible, to use al l their capacities. As a result of this

development, workers in the field and policy-makers now see themselves confronted

with a large group of grown up mentally handicapped waiting for a piace in a house

somewhere.

In Greece even today many children with a mental handicap are kept at home,

because their parents don't believe they can learn anything. When they send their

child to a day-center they sometimes are astonished to discover the possibilities

and capacities their child actually does have. Although most children are kept at

home, there do exist some institutions in Greece. An important question is: wilt

Greece follow th e same route as other countries, making th e same mistakes,

meaning: wilt they build large institutions to close them down af ter several years,

or will they avoid th e mistakes made elsewhere? One of the advisors of the

government pointed out that they were starting services on a small scale, and

decentralised, and he wasn't very keen on building large provisions. Especially in

this respect European co-operation and exchange of knowledge and experience can

be very useful; it prevents people from inventing the wheel over and over again.

34



5.2 Trends and innovations

In the field of housing for mentally handicapped persons innovative developments

seem more or less a continuation and an improvement of ideas developed before.

Progress is made on th e basis of what was felt necessary when evaluating the

experiences. No huge laps forward are made but there is constant evolution. Several

aspects of these ongoing developments will be given here.

Small scale facilities

Large scale institutions are out of fashion. Most new facilities are designed and

built on a smaller scale. Some.times th e institutions themselves started to build new

and smaller facilities, in other cases private organizations, e.g. parents, took th e

initiative. A home or a hostel set up by an institution, is sometimes built on th e

grounds of the old center; in that case the residents of the house of ten use th e

services provided by the institution (meals from a central kitchen, therapies,

laundry, etc.). Although they now live in a different, small house, their lives are

still run from the center and they have little more responsibility than before. There

will be little impetus to leave th e grounds of th e center and go to town.

Other solutions opt for houses built within a community. In that case it depends on

the amount of services provided by th e institution whether th e inhabitants have a

real chance of autonomy or not. There are many sorts of group homes, varying in

the amount of assistance and care, depending of th e needs of th e residents.

When care and assistance have to be very intensive, several units of ten are put

together. The idea is that otherwise staffing of the groups would hardly be possible

within th e available budget. Sweden shows th at this is not necessarily true, even

severly handicapped people do live in small groups where several houses are puttogether, the units consist of 5-8, sometimes 12 or more persons. Homes are

developed, where several groups can live, each group with separate rooms and often

a central staffroom. Bedrooms for personnel can be necessary, and e.g. extra large

bathrooms, where members of th e staff can help the residents.

For persons that are more independent, group homes and hostels are developed,

with as much assistance as they need. In most of the houses everybody has a private

room, sometimes with a bathroom, and there are some rooms for communal use,

like a kitchen, a sitting-room, etc.

Group homes are quite common nowadays and many examples could be given, each

with its own remarks, successes and failures. But even in Greece, a country where

many handicapped people are kept at home, and others are sent to institutions,

some initiatives have been taken that follow this line. One center built a house fo r

seven of their ex-pupils, who had no other place to go. They moved in several years

ago, and in the beginning every day a member of the staff would come and help

them. Gradually they didn't need that much assistance anymore, and now only once

a week somebody drops by, just to see how things are going. Another day-center

owns several houses in the city and is planning to move pupils there in October

1987. Before they leave, they are training at the center al l tasks in and around thehouse, like handling money, going to th e post-office, etc. The plans are still in a

35



preparatory phasej the initiators are anxious to know more about what happens in

other countries.

In a group home people should have a choice with whom they want to share their

lives, they should have a vote when a new person is moving in. In some cases they

could also (co)decide about the hiring of new attendants. In a group home in Berlin

the residents did have a say in who was entering the group either as a tenant or as a

new attendant. Staffmembers felt that as a result of this system, very few changeshad taken place, continuity not only in the tenants group but also in the staff, was

bet ter secured.

Sometimes persons with a mental handicap live alone. In the Netherlands e.g. there

are schemes called "Begeleid Kamerbewonen" ("living alone with attendance"); in

Berlin th e organization "Lebenshilfe" is running a model project for mentally

handicapped, who want to live alone or as a coupie. Several hours a week an

attendant will drop by and provide help in practical problems, like going to

authorities and help with everyday tasksj furthermore they assist with social and

emotional problems, like contact with other people, loneliness, etc. Before moving

in they give a training to the future tenants. The scheme also includes a research

project that will evaluate the experiences and will give recommendations.

A rem ark made by several people, concerned the importance of regular day

activities for people who are living quite independently. Persons living in a small

group or alone run a risk of getting lonely. In th e residential centers everything was

arranged, including activities during the daytime and there were always other

people present. Moving out of the center and not having work to go to , they can

stay at home all day, get lonely, depressed and apathetic; there must be a reason togo out of doors. A place where they can go to during th e day and meet other people,

must be included in planning new facilities.

A center in Noordwijkerhout (the Netherlands) put th e Dutch ideas of th e

"verdunningsfilosofie" into practicej a special neighbourhood was built, called "de

Hafakker". There about hundred persons with a mental handicap will be living with

about the same number of not disabled people. Some of those handicapped have

lived in the institution for many years, they now move into group homes, where

they will live in groups of 3 to 8 persons. No central services of the institute will be

used. The other inhabitants of the quarter are no t expected to pay special attention

to their neighbours, or to give assistance, the only condition to them is: "being good

neighbours", having contacts as in any other neighbourhood.

Training

To be able to live alone or in a group, outside an institution, requires certain

abilities. Practical things like cooking, shopping, cleaning, how to handle money,

etc, have to be learned and social skills have to be trained to be able to get in

contact with other people, neighbours, colleagues, etc. For this purpose several

training programs have been developed, among which the mentioned program inBerlin. Sometimes homes are started to provide mentally handicapped people with a

36



piace where they can develop the necessary ski lIs. They stay there fo r maybe two

years, and move then to a group home or an individual apartment.

Assistance for those who take care of a disabled person

Possibilities to remain at home have in some countries been improved by services to

help not only the handicapped member but also the rest of the family. Short term

care can be of great importance to both the family and the handicapped person.During th e period the individual has been admitted to a unit, tests can be taken

which otherwise wouldn't be possible (because of lack of equipment or of skilled

staff, or because they take some time). For the family it can be arelief to be free

from taking care for a period of time, they can take a holiday, have some rest, etc.

In cases of crisis or ilIness it is good to know someone is taking care of the

handicapped relative. Some hospitals and institutions reserve places especially for

the purpose of short-term care. In Belgium special units have been set up, the so

called "Homes de court sejour". This solution has some disadvantages: the centers

are of en too far away to enable the family to visit their relative and they may turn

out to be quite costly because the beds aren't always needed, while staff is present

all the time. Places in existing institutions may take less money, and they might be

closer to the piace where the family lives. Personnel will have the necessary

knowledge and expertise.

To give support to the family at home several schemes have been started. The

assistance can vary from practical help like being present for emergencies or

staying at home when the family wants to go out and can't leave the handicapped,

to help with emotional problems. In Germany socalIed "Familienentlastende

Dienste" (Family Relief Services) are set up; they can provide assistance, · thus

allowing the family to leave the house every now and then, fo r hobbies, etc. Insituations of crisis the availability of assistance is of crucial importance In the

United Kingdom the Crossroads scheme started, which later on also became known

in the Netherlands. Crossroads helps the persons who take care of severely

handicapped people, both physically and mentally, that are living at home. Help can

be given on a regular basis, (e.g. every evening helping someone to get in bed, or on

an irregular basis. In this way the move to an institution may be avoided (or at least

delayed).

Integration into community

New small-scaie facilities are often planned as parts of a larger community. The

idea is to promote the possibilities of integration. Family houses or apartments are

often used fo r group homes; the members living like a family, with staff coming in

as much as necessary. It is considered to be an advantage if the outsi de of the home

doesn't look different from the rest of the neighbourhood. On the other hand many

family houses are not designed to be used by a group: bedrooms are too small to be

used as a bedsitter, kitchens may be too small to prepare a meal with more people

at the same time, etc.

In a house that is designed fo r the purpose, the wishes of the users can be taken into

account, e.g larger rooms, and possibly a bathroom and toilet for every resident.When extra and intensive care is needed extra facilities can be made. But also in

37



th at case it is important that outside of th e building doesn't differ too much from

the other houses in th e neighbourhood, it shouldn't give the idea of an institution

where a different sort of people lives.

The neighbourhood isn't always enthusiastic to get in contact with th e new tenants.

In the past special programs we re made to prepare the community, but these were

mostly unsuccesful. A basic mistake in this approach seems to be thati t

labelledth e new tenants as different, people who could cause trouble. Most people are not

in favour of these programs anymore; the newcomers are tenants like the rest, and

like other people they don't have to announce their moving into the neighbourhood.

Especially when a small group, for example the size of a family, is moving in, no

special attention is given. I f problems do arise, they can be dealt with at that

moment, not before.

However when a large group is moving in it may be useful to try to make contacts

in one way or another. In KasseI (Germany) the organization starting a new home

for mentally handicapped persons go t into contact with th e smallest local

administrative unit th e socalled "Ortsteilbeirat" (council of a quarter of th e city)

and explained the plans. All questions were answered and th e way cleared. In that

way th is council was made responsible for what was happening, they we re a part of

it.

Visiting shops and the hairdresser in th e area can be another method to get in

contact with th e neighbours, or going to the same pub, clubs etc. Since acceptance

by th e communitiy is of great importance, it is advisable to plan new facilities near

shops and other facilities (sport, recreation, cultural).

Another method used to facilitate integrations, is to invite people into th e house,

for a party or to drink some coffee or to open the house to groups in theneighbourhood, for lessons, meetings etc, when there is a large room available.

How are these developments frustrated?

Despite policy plans and good intentions to facilitate autonomy and different ways

of living, it of ten turns out that rules on financing and design favour traditional

institutional care. Sometimes a patient in bed brings even more money to th e

institution than one walking around. The existing ways of financing are more

according to the needs of institutions than of other forms into account. This

impedes new developments and experiments, and especially private initiatives are

obstructed by many rules. Institutions get money for each place or bed, the money

isn't given to the residents. In this institutional model there is a budget for staff,

one for food, another for the building, etc. In new forms of living it is important

that each person has his or her own budget to pay fo r the house, the food, personal

expenses, etc. but when the house is part of an institution this is hardly possible. 50

financial dependence continues. In those new houses it is difficult to get money for

staff and other general expenses; when staff is employed by the residential center

there is no problem, bu t when they are hired for a certain scheme it may be hard to

find th e right way to finance them. In fact rules tend to favour traditional and

known forms of care, where it is clear what is necessary, how much it costs.Many new initiatives, especially when taken by (future) residents and/or parents

38



hardly stand a chance; first there is an abundance of rules they have to deal with,

secondly these rules often are very poorly coordinated. This makes i t difficult to

find a way through. Private initiative is sometimes even not possible according to

the existing rules .

Regarding th e income position of mentally handicapped: work is often difficult to

find. Especially in this period of economic problems, the growing importance of

technology in industry takes away a lo t of the jobs they traditionally did. In fact

many of them are dependent on social benefits, that is to say if those exist. When

living in an institution, they often just get pocket-money.

In Germany some houses are connected with workshops; staff is only present outside

the working hours; all residents are absent for 8 hours a day (part-time work is not

possible in those workshops). When someone doesn't go to work anymore the

consequence is that he has to leave the place, even if he may lived there already

for many years.

Staffing of new, and especially of experimental facilities can be a problem. In some

cases a group consists of more persons than considered best. When for instance four

or five persons would be ideal, it still may be necessary to double it, because of the

lack of sufficient funds and, consequently, staff.

Another problem is the lack of staff with expertise. Especially those new forms of

living require other capacities and attitudes than the traditional ones like the old

residential centers. Special training is necessary but often not available.

What are the chances for mentally disabled people to find the facility that fits

them best? Sometimes there is just not enough information on possible facilities to

be able to make a choice. There are many organizations, of ten working separately,

many services, etc. Sometimes people tend to choose the safe way, an institution,

where everything is available, instead of something they don't feel secure about and

fo r which they have to make arrangements themselves and take the risks.

A second question is: who makes the choice? The one who is moving in , the parents

or other relatives, professionals, etc.? The handicapped person isn't always

considered as able to make a choice, but who is then to decide? I t isn't certain that

parents, relatives or professionals, though having th e best possible intentions, do

what is best, or act according the wishes or needs of the mentally handicappedindividual. In that case an intermediary, a sort of "advocate", may be able to help;

he may try to understand the wishes and "negotiate" with parents and professionals

to find out what is best.

The absence of services in th e community can force one to leave home and move to

a center or group home. But in many European countries there is a trend to close

these institutions, whilst alternatives are not always provided. This development is

dangerous and frustrates of new initiatives.

39



5.3 Conclusion

To meet the different needs and potentials of mentally handicapped persons a

variety of housing facilities is necessary. Small scale facilities are built, group

homes and schemes for living alone (with attendance) are developed. Most of the

new developments are improvements of already existing ideas; more attention is

paid e.g. to training schemes to live independently and to day activities.

New services like short term residential care, services that support the family that

takes care of a handicapped relative, and attended housing schemes give people

with a handicap more chance to live in the community and to be as autonomous as

possible.

Rules however sometimes frustrate new developments, since they are made for the

traditional forms of housing and care. Public spending cuts are another problem.

Austerity measures can easily hinder or even stop the development of new services,

while at the same time the old provisions are closed down. As aresult people are

getting in trouble, and may even become homeless.

40



6 HOUSING FOR PEOPLE WITH PSYCHIATRIC DISORDERS:

NEW DEVELOPMENTS IN SPITE OF OPPOSITION

6.1 Introduction

It was not easy to obtain an insight in the developments in the field of housing for

persons with psychiatrie disorders. As a result of that, this chapter will be rather

impressionistie. We collected a lo t of information about all sorts of problems that

this category of people face in all aspects of (everyday) lifej but relatively little

about housing. The impression that we got is that new developments exist, but that

the opposition against implementation is great. I t seems that they are not really

accepted and little notieed by policy makers. As a consequence this group is the

first to suffer from the present policy of public spending cuts.

Experts mentioned th e fact that among the homeless the number of people with

psychiatrie disorders is growingj people without a place to go to or a person to turn

to for help.

Also this third category, consisting of persons with social and emotional disorders,

is very diversej not only because of a difference in the degree, the seriousness ofthe disorder, but also in the nature. The World Health Organization uses this

definition: "All forms of illness in whieh psychologieal, emotional or behavioural

disturbances are the dominating features. This broad definition is used to cover

minor disorders (neuroses etc.) as weIl as major disorders (psychoses etc.)".

There are many sorts of psychiatrie problems, some of which can have serious

consequences for the situation in life of the person, both private and social. And

even after the disorder has disappeared people get a stigma when they have had

psychiatrie treatment. The social image of this group is more negative than that of

mentally handicapped and acceptance is far awayj factors like fear of aggressive or

other "deviant" behaviour, the impossibility to understand what's the very essence

of the disorder, what's happening with that person, feelings of guilt, etc, may be of

influence on the possibilities of social integration.

For a long time words like "insane" and "mad" were of common use to indicate

persons with psychIatrie disorders. They were kept at home i f family and friends

could deal with it (or afford special help at home) or sent to institutions: some of

them were considered dangerous to themselves or to other people, whieh was (and

still is) a reason to loek them up. For others it was thought to be benificial to be

sent out of community, into free nature, where it was quiet and peaceful and they

could get rest. But often they were put institution with other "outcasts", mentally

handieapped for instanee or old, demented people, where not much was done about

41



their specifie problem. Institutions became asylums, where patients stayed for

years and years, or even their entire life. It is not impossible that the consequences

of the long hospitalization sometimes created a bigger problem, than th e original

disorder that they were taken in for.

For many years social and emotional disorders were considered a disease, a medical

problem, that could be cured by medieal methods (medicine, electroshock, or even

surgery). The medieal model however isn't the only point of view anymore, new

theories on psychiatrie problems, causes, and therapies were developed; new visions

on the individual, society, disorders and treatment came to play a role and

introduced a lo t of changes in the practiee of psychiatry including th e way housing

should be arranged. These developments were not only started by professionals, but

also movements of (ex)patients led to important changes. De-institutionalization,

hospitalization syndrome, preventing that people become chronic patiens, ending of

segregation and promotion of integration, the role of society, etc. became major

issues in discussions.In the sixties and seventies new ideas originated. In England th e antipsychiatry

originated. The followers of this philosophy were against traditional psychiatry in

institutions (not against psychiatry in genera!) and used a social and interaction

model to describe disorders. In Italy th e socalled "democratie psychiatry" became

important. The followers of th e democratie psychiatry stressed that a psychiatrie

diagnosis doens't say anything about th e handieaps of people, about which aspects of

life are difficult fo r them and where they are hindered in life. They were quite

pragmatie: where should one give help? Poeple are hindered in society, so there you

should find solutions. The followers of th e democratic psychiatry did no more

believe in th e traditional psychiatrie institutions and theories as th e English

antipsychiatry had. Institutions can not "cure" those people; help to them should be

given within society, not outside th e community. This meant creating alternative

ways of dealing with people with problems.

In 1978 a law was passed in !taly to close down all psychiatric insti tutions. Patients

should stay in the community and get help there; only in case of crisis, some sort of

intervention in a general hospital would be possible. Mental health care should

become integrated in general health care. Alternatives had to be developed, to give

persons leaving institutions th e therapies, as sistance etc. that they needed and

wanted. This asked for a lo t of inventive thinking and improvisation.

No other country has th e way of closing down institutions by law, but other ways to

reduce toeir importance for mental health care are tried.

In Germany a "Psychiatrie-Enquete" was held in the seventies and a

"Modellprogramm Psychiatrie" was started. The concept of a "therapeutie chain"

was introduced. The general idea was that a psychiatrie patient would have to pass

through several stages of help, care and assistance: from a lo t of care, in a

residential center e.g., to houses with less and less support and more responsibility

to a pIace where one lives alone, if necessary with some assistance. The more

serious the problem, th e longer it would take and the more steps on this road would

be necessary.

42



In practiee ho wever this concept proved to be wrong. Apart from disadvantages like

the necessity to move regularly, it turned out that not the seriousness of the

problem was the decisive factor of being able to live alone, but the nature of the

disorder. Some persons, whose disorders were considered to be very serious, li ved

alone and managed bet ter than when they lived in a group home or an institution,

(possibly because they couldn't cope with people too close around them). On the

other hand, others who were considered "light cases", couldn't live alone, but didneed people around them. Another important aspect was the capacity to run a

household; those who had learned to keep house before, even if it had been many

years ago, regained the skill quite easily. Those who never had a chance to learn it,

have great diffieulty in learning it later.

The central issue in the field of housing should be: whieh social environment does

this individual need? Social functioning often is a major problem, so the social

context is very important. Starting point should be the individual needs.

One of the experts distinguished three major groups, according to their needs.

Sometimes people have temporary disorders, what they may need is a change of

place. A second group of people has been in hospital many times and can't live on

their own. They need special housing. The third group consists of people who need

specifie at endance in the house. For some of them it will be a temporary need.

others have long term needs. Many patients do remarkably wel! in community, but

they need attendance as a "buffer". The second and third group may do wel! in

apartments with communal facilities.

Many people don't belong to one of these groups; a large group has been

institutionalized by a long stay in residential or semi-mural (sheltered housing)

facili ties.

6.2 Recent trends

Housing

To diminish the importance of residential care new initiatives have been started.

Firstly, as a consequence of the growing awareness of the harmful aspects of

hospitalisation, institutions try to improve the living conditions inside. Buildings get

divided into smaller units, where a form of group housing is possible, large wards

disappear. In Italy some psychiatrie hospitais, very old buildings sometimes, were

changed into apartments, where people, ex-patients, find a place to live. Sometimes

some serviees of the former hospital still are provided, a central kitchen for

example. Assistance comes from outside the former center. The tenants are called

"guests" to indicate their new status.

Alternatives for residential care are promoted at this moment in more countries. In

the Netherlands it is a goal of government policy to substitute a certain number of

beds in psychiatrie hospitals by places in smal! scale housing facilities. These

socalled "Beschermende woonvormen" (sheltered housing) are considered a better

method of housing fo r persons with psychicatrie disorders than a residential setting.In fact reintegration is the aim of th e houses, but th at doesn't always work out.

43



Many sorts of group homes, hostels, etc., are started. Some of them are meant fo r

chronie patients, to gi ve them a better more pleasant life than in the old

ins ti tut on. Others are meant as a piace where one is prepared fo r living in the

community again, a form of half-way housing, between residential center and life in

society. Grouphomes vary very much: in some much assistance is given, in others a

weekly visit is paid by the helper.

With regard to the number of people in a group no optimum seems to exist; it

depends of individual needs. Sometimes the size of a family (4-6 members) is

considered best; other people however like to be a bit "anonymous" within a group,

they want to have the opportunity to withdraw easily and be alone, and make

contact when they feel up to it. In that case, a somewhat larger group will be

preferred. Furthermore staffing and financing can be a factor that determines the

groupsize. Facilities too differ: sometimes a standard family house is used, but in

that case the bedrooms often are too small to be used as bedsitters. In other cases

houses are designed and built for the purpose with rooms that are large enough, and

a central kitchen.

In a new house in Kassei th e rooms were of an acceptable size, but without a

private bathroom. The organization wanted to prevent that residents would isolate

themselves, not leaving their room, so they decided to leave out private bathrooms.

Basie furniture like a bed, a table and achair, is provided by the organization,

because they know many of th e fu t ure residents don't have the money to buy it

themselves. Unfortunately there is no place to store th e furniture, when somebody

wants to bring in his or her bed or tabie.

However, a phenomenon new fo r Kassei was introduced in the house: a socalIed

"Begegnungsstatte" (meeting place). Here people fr om outside can come, and groups

can meet there, and especially other people with psychiatrie problems who have

left hospi ta l or sheltered housing can come and have a coffee, read a newspaper,

etc. Inviting people in has been done by various organizations, in this example here

they already took it into account in the design of the building. On the other hand

this solution may have a disadvantage. People don't have to leave th e house fo r

recreation or contacts with other people anymore, they can go downstairs to this

room to meet other people instead of leaving th e building.

Alternative organizations have started housing facilities tooi an example can be

found in a project in Nijmegen, called "De Uitriehting", (whieh means somethinglike "the extitution"), where five persons, who have been in a psychiatrie hospita!

(or run a chance of having to go there), can live in an apartment and get a form of

ambulatory care. Housing and assistance are separated. The assistance is given by

voluntary workers; th e organization has chosen for this form of support, because

they want to avoid inequality in the relationship between the "expert" helper and

the dient and in their opinion, support should be given on a basis of solidarity. The

workers get supervision and can turn to a professional organization if necessary, to

ask for help. A problem is th e lack of continuity, workers often change. For

staffmembers, one unit in the same building as the apartments, is available. This

unit is also used as meeting place.

When assistance is no longer required, the tenants don't have to move; they have

44



rented the apartment themselves and can stay there. Important difference with

"institutional" sheltered homes is the fact that here people do have an income and

pay their rent, etc., themselves, instead of getting pocket money via the

institution. A fundamental condition is of course that their income is sufficient.

Other people are living all alone, with someone visiting them on a regular basis;

therapies, if necessary, are provided by ambulatory services. In KasseI an

organization gives this kind of attendance to a few psychiatric patients who are

living on their own. Although these persons rented the flats themselves, the

landlord knew there was this organization looking after the new tenant; it was felt

as a sort of guarantee, that e.g. the rent would be paid.

The ideas of the Dutch "verdunningsfilosofie", that wanted to mix persons with a

handicap with other people, is not only applied for mentally handicapped but also in

the field of psychiatry.

A psychiatric hospital in the Netherlands has taken the initiative to open it sgrounds and buildings to society and give the people who originally lived th ere a

chance to integrate and regain their own responsibilities. In the old buildings a

number of apartments were realized for 1 up to 4/5 persons, furthermore some new

houses were built on the grounds as weIl as in the village. The apartments are easy

to adapt to the size of a group, when changes take place. People choose the other

group members themselves, (with the help of an independent agency), the staff does

not interfere in this procedure.

Community care

Community care is meant to be care in the community, not by the community. It

should be an integrated system, induding housing, social and health services, with a

coherent approach. This should make reintegration of persons in society more easy.

This type of menthal health care should prevent people having to go to hospital, it

may not be necessary to move them there if the right assistance is given

immediately. In many countries community care is being reinforced.

In the United Kingdom community based services are a very popular issue. A

network of mental health services is set up within a city or district. People with

mental health problems can turn to this service and get help, therapies, be involved

in day-activities etc. The community teams are multi-disciplinary, in some teams akey-worker is assigned to persons asking for help. The advantage is that the patient

has to deal with only one person and does not have to teIl his story every time fr om

the beginning. All groups of persons with a handicap can make use of the services.

Mind, the organization for the interests of psychiatric patients in the United

Kingdom considers this form of care very important, but has formulated some

conditions. The consumer or dient should be treated as a full citizen with rights

and responsiblities. The services should be locally accessible and provided to the

dient in the usual environment. Dependence should be minimized, self

determination of the individual responsibilities stimulated, etc •Unfortunately these beautiful policy-initiatives don't always fulfill the

expectations. It seems easier to reduce beds than to build up alternatives.

45



Sometimes it is lack of the necessary financial means that stops alternative ways of

care and assistance, sometimes it is a lack of coordination between the various

departments. 50, in many cases the wards are closed but the new networks, serviees

etc. aren't there, because the financing of the work, whieh should be arranged by

another authority, isn't done (and sometimes never will be, because there is no

money). In that way it is just words and good intentions but the people who need the

help are (sometimes literally) out in the cold.

The same goes fo r the work in institutions: also there cuts in public spending of te n

are felt: to o many patients and too few staff members, an unhappy combination

that makes real progress diffieult.

In Italy socalled "Centri di Igiene mentale" were started. Two examples: in th e

province of Arezzo centers were initiated, that provide ambulatory care, as well as

assistance fo r persons who have been admitted in a general hospital in a situation of

crisis. The staff works in th e center and makes house calls; they try to help not only

with the psychiatrie problems, but also try to solve th e practieal diffieulties, likefinding a job or a house, help budgetting or spending the leisure time. This is done

because these things are se en as important fo r the situation in life of clients. In

Triest the center has some beds where people can spend the night. But also her, like

in Arezzo house calls are made and help is given in case of crisis. The staff also

assists five groups in the area, each consisting of of 23 persons. The kitchen

provides meals, not only for the clients of the center, but also for the

neighbourhood and there is a "cassa" (cash desk) to help people to control their

money.

In th e Netherlands the social workers of the city of 's Hertogenbosch started a

project when they were confronted with th e needs of ex-pyschiatrie patients. They

created a place where they could come whenever they wanted, for a. talk, help, or

just a cup of coffee. Furthermore they started groups: the members of a group, who

meet once a week, help each other with practical and emotional problems, and they

can contact each other whenever necessary. A form of self-help was created. The

needs of the users of the serviee are the starting point, that's where help is focused.

After the first period of the project some people who would have to go to hospital

were taken in the groups as well; in most cases hospitalization could be prevented.

By now the project is becoming independent of the municipal organization.

As said before, in this period of public spending cuts the group of homeless people is

growing and among them there are many persons with psychiatrie disorders. Very

recently however, in the Netherlands it was discovered that in some facilities for

homeless people, or in pensions, many persons with psychiatrie disorders are living.

Some of them are moving from one place to another, others stay in the same

facility. It seems that many of them are doing fine that way. They often have their

private income (a social benefit) and, what is more important, they have a social

network and a role in the place where they are staying. For some persons that kind

of housing seems to be acceptable, or even a good solution, one that fits their

needs. Further research is necessary on how these facilities function and the

46



advantages as weIl as the disadvantages of this sort of living conditions for some

people with psychiatrie disorders.

An issue that always returns in conversations with people is th e need for

information. In the United Kingdom a project caIled "Good Practiees in Mental

Health", started, to encourage exchange of information on local mental health

serviees. The project collects data about projects and makes them generallyavailable. They publish reports with descriptions of projects that are judged to be of

special interest to follow up. The information is used by workers in the health and

welfare services, and also by other groups of workers who may be caIled on to

advise people with problems related to mental illness.

Formal rights of psychiatrie residents aren't very weIl developed. In the

Netherlands for example psychiatrie residents officiaIly have the same rights as any

other citizen, bu t th e opportunity to exercise these rights doesn't always exist. Two

new developments are important: first the introduction of the socalIed "trusted

representative of patients" ("patientenvertrouwenspersoon"). This person has to

fight for the rights and the interests of the patients that come to him, he has to

defend them. They are employed by a special organization, not by th e hospital to

guarantee their independence. Their task is to treat complaints of patients and help

them to sort things out. As a matter of principle they are on the side of the patient.

Secondly new legislation on the judicial position of patients in general is in a

preparatory stage. A few elements of this legislation (that is going to be inserted in

existing laws) are: th e consent of the patient is required for any medieal treatment;

the right to information and last but not least the protection of privacy. A new law

on being committed is also prepared.

6.3 Conclusion

New smaIl scale facilities are built, and ways to promote integration in com munity

for this group are tested via a number of new initiatives. A special role is played by

serviees fo r outpatient care and community based services. However, research is

necessary on many subjects. EspeciaIly in this period of economie recession these

people seem to become th e first vietims; among the growing group of homeless

people many (ex)psychiatrie patients can be found, who are excluded by provisions

and in fact live outside society. Despite some new developments the possibilities

for th s category seem limited; acceptance is far off.

47



7 KEY THEMES FOR A NEW EUROPEAN POLICY UNDER DISCUSSION

7.1 Introduction

Key themes in the research process

Draft key themes played an important role in the interviews with experts. They

were discussed during a meeting with members of the Bureau for action in favour of

disabled people on April 29, 1987. During each interview one or more of the key

themes were introduced, depending upon the orientation and experience of the

persons interviewed.

These draft key themes were discussed during the formal interviews but also at

other meetings with experts, employees of projects that were visited,

representatives of national and local governments and organisations. They were also

viewed in th e light of the literature consulted.

This chapter summarizes the outcome of those discussions. The rapportage is based

on the resulting new, definitive key themes. It gives an insight into th e

transformationthat

the original key themes (see annexe3)

underwent. Thenew

themes are presented in th e form of statements; they are the outcome of the

. (thinking) process of the study.

The key themes

Overall theme: Toward autonomy in housing fo r th e handicapped.

Key theme 1: More awareness and attention in European policies concerning the

handicapped, also in the perspective of th e growing number of

elderly people.

Key theme 2: Better data, to make th e housing situation of the handicapped more

visible.

Key theme 3: A clear definition of the entitlement of the handicapped to housing

and care, to prevent discrimination and to stimulate participation in

decisionmaking.

Key theme 4: National building codes, insuring th e accessibility and adaptability of

al l new and renovated buildings are more adsivable than special

housing for th e handicapped; general services are preferred over

services exclusively for the handicapped.

Key theme 5: The improvement of th e social-economic position of th e handicapped

is more important than good housing and services; in this respect

Europe as an important authority in the economic field has a task.

49



Key theme 6: A further stimulation of the de-institutionalisation processes by

improving and extending care and services in local communities.

Key theme 7: Especially at th e European level the stimulation of new

developments in housing and meeting the demands of th e disabled is

very usefull; th s implies a.o. a better, innovative development

program and a better education of European architects and policy

makers.

In these new themes attention has shifted from elements in the draft key themes

concerning care and support, to policy developments at th e European level. The

issues concerning care, like "support made to measure", proved to be an "open door"

and thus less relevant than topics regarding developments in (European) policy.

Key themes as a method for policy making

By formulating key themes we intend to stimulate the development of factual

policy perspectives. Without such perspectives policy making is very diHicult. It

might be useful no t only to reach agreement over a general objective, but also over

policy themes. Both are crucial for the direction in which new policies are to be

developed; the themes should what is expected of fu t ure policies. The word "theme"

makes clear that we are not dealing with policy implementation. The current state

of affairs concerning housing fo r the disabled in Europe prevents this. Furthermore,

since each European country has its own traditions and opportunities in this field,

th e idea to develop one policy th at can be "universally" implemented is unrealistic.

The previous chapters show, that this is even more so since housing for th e disabled

is closely interrelated with health and social services, employment, physical

planning etc.

By offering an overall theme and a limited number of key themes, disçussions about

th e process of policy making, and its limitations, are facilitated. The overall

concept should also be recognizable as a stimulating "slogan" for students and

people working in this field. For this reason we aimed at the formulation of a

compact definition of the overall theme for policy making. During the interviews

we used th e concept of "autonomous living" a concept also referred to that has

returned in the title of th is report.

7.2 Key themes

Overall theme "Towards autonomy in housing fo r th e handicapped"

This theme emphasizes the rights, financial possibilities and general provisions for

the handicapped. The handicapped are normal European citizens. They should not be

discriminated as a result of inaccessible and unadaptable housing, the obligation to

live in specific places and institutions, a (sub-)minimal income level or other

physical and social barriers.

50



Key theme 1: more awareness and attention in European policies concerning th e

disabled, also in th e perpective of the growing number of elderly

people.

Economie co-operation has always been one of the main components of European

policy. Within this economie approach, social aspects played an important part.

Since a couple of years attention is given to the position of disabled people, this

resulted in the formulation of th e first action program. When assessing the present

state of affairs it should be noticed that, as a result of the economie recession and

world wide trade wars within Europe, attention for minority groups has decreased.

The international Year for the Disabled helped to raise awareness and stimulated

policy making, both at th e European level and at that of th e individual countries.

However, since then, attention has switched to economie problems. Policies

concerning housing, heaJth and social services are influenced by:

- public spending cuts;

- privatisation;

- stressing th e responsibility of citizens to solve their own problems (by hel ping

themselves and their neighbours, by using volunteers etc.).

This shift in policy has a major and al ready visible impact. I t should be notieed that

individual policies often work in the same direction. On the one hand they force

individuals, groups and organisations to become less dependent of the authorities

and to develop new forms of housing and care. On the other hand these policies may

limit th e opportunities of minority groups to participate in society. A clear

indieater is the increase in th e number of homeless people. Many of them are

people with psychiatric problems, forced to leave th e institutions an insufficiently

helped by th e traditional housing and social services sectors.

Just Iike many other groups within Europe, the disabled face declining incomes (in

real terms). On top of this problem, the current level of unemployment in many

countries, makes it, especial!y for the disabled, hard to find a job. Growing numbers

of handicapped people are dependent upon social security payments and this makes

it even more difficult for them to pay fo r housing according to their needs.

Decreasing incomes also make it more diffieult to take part in different kinds of

social actitivities. As a result more time has to be spent at home. But these homes

are no t very appropriate for this situation. Rooms may be too smal!. For those

living independently, neighbourhood activity centres are not always available; or

are closed down. When an individual, disabled or not, can not develop himself by

meeting and co-operating with other people, serious health problems may arise.

Therefore Europe has every reason to consider it s general policy in the light of its

effects fo r the disabled. I t may wel! be that th e present state of affairs shows

several unexpected and undesired elements.

Quite remarkably, during some of the interviews in th e "richer" EC-countries, like

Denmark and the Netherlands, the following question was asked: "Would it not be

better if the funds for services for the disabled were re-allocated?" Possibly this

51



question emerged as a result of certain feelings of guilt. One thinks about the

situation in the poorer southern countries as being even worse and wants to help.

But the same time it is stressed that the situation in th e richer countries, is

worsening recently. It is regarded as inacceptable that improving the situation in

other countries may further deteriorate the situation for the handicapped in th e

own countries. From this discussion we draw th e conclusion that extra efforts for

the disabled and a redistributing force are needed at the European level, in order to

neutralise the shift of attention to national economic policies.

Many of the people we interviewed considered th e division, made at the European

level, between the disabled and the elderly as an actual or potential group at risk as

being artificial. In the past it was decided that policies concerning the disabled

could only include people within th e age group of potential wage earners. As a

result of that reason only little attention was paid to, handicapped children while

handicapped pensionners we re excluded. Some of the people we interviewed

objected however.- The proportion of elderly people in Europe is growing. The problems of the

elderly and the disabled show many similarities. Both policy areas are strictly

seperated in most countries and it would be a major improvement if the people

concerned could learn from each other.

- Many elderly people were not handicapped during (most of) their working lifes

and, for this reason, do not fall within the European definition of disabled

persons. However, their complaints may be a result of the work the did. A society

that allowed those working conditions to exist should at least care fo r its victims.

Some experts point at the mobility problems of pregnant women, mothers with

perambulators and houswives with shopping trollies. Also for them th e accessibility

of buildings, houses and' th e environment is an important factor.

Special attention has to be paid to disabled "guest workers" and disabled immigrants

from former colonies. These people of ten have extra problems to find a job in a

period of declining labour market conditions. Help fo r these people can be

considered a task at a European level. Their problem is not only unemployment and

th e resulting low income. The cultural gap between them and the society in which

they live is also important. Language problems, and sometimes social judgements

and taboos within these cultural minority groups, may prevent handicappedmembers of these groups to express their problems and have them recognized. The

combination of migration, unemployment and being handicapped can as such be a

hazard to one's mental health. I f one can not find the right words to express it, th e

problem becomes even more worse.

Key theme 2: Better data to make the housing problem of th e disabled more visible

For several reasons the housing problem tends to be overlooked at the European

level. Factors mentioned during the interviews were:

lack of recent, mutually comparable statistics;

- lack of an undisputed classification of handicaps;

52



lack of nomenclature of services, which makes it hard to get a good insight in

what is on offerj

- decentralisation of policies, diminishing the need to collect data and statisticsj as

a consequence an overall view of the situation is absentj

- special housing and care are more designed for the individual (in comparison with

the large scale facilities), making it hard to develop standards and preventing

them being made into statisticsj

- some categories of handicapped people are only smalI, especially at the local

levelj fo r this reason they can easily be overlooked by the decision makersj

- in most countries a large number of different organisations for the disabled existj

this may prevent them fr om standing up for their common interestj especially the

mentally handicapped and people with psychiatric problems are placed at a

disadvantage.

It is clear th at a policy, based upon sufficient information, ca n hardly be developed.

I twas pointed out to us that the European level could be very suitable fo r

collecting this information. Small groups of people with a special handicap would

still be counted if figures were collected at this level. I t would also allowan easier

comparison between housing and services for each category between the European

countries. Furthermore, i t could be an advantage for the larger categories, like the

mentally handicapped and people with psychiatric problems. Especially for these

two categories the search for what is the best solution continues. There is astrong

need for information in the field (see also theme 7).

From all these remarks we draw the conclusion that, in order to improve policies,

bet ter information is of vital importance. The national level doesn't seem

appropriate for focusing attention to the smaller categories and to judge

experiments.

As we have seen, decentralisation and individualisation have side-effects. It

becomes more difficult to compiIe statistics at a national level. The people with

whom we discussed this problem emphasized that both tendencies as such are to be

judged favourably. However, they stressed that governments remain responsible for

the impact of policies, however decentralised and individualised they may be.

Information at the national level is needed to asses the effects of new trends in

policy and to have a good view on the developments.

A great number of organisations for the disabled exists, every disease and disability

seems to have its own organization. Apart from this, but considering the complexity

of European societies, the existence of a whole range of organisations is hardly

surprizing. The European administrative level could give these organisations better

opportunities to present themselves, because of the greater number of people that

they then represent. For improving housing and services for the disabled it is vital

that they themselves ca n put forward their opinion and needs. Support by a

powerful European institution which can give good information on the situation

would be of great help (compare for example the economomic statistics on

European level).

53



Key theme 3: A clear definition of the entitiement of the handicapped to housing

and care, to prevent discrimination and to stimulate participation in

decisionmaking.

For a variety of reasons, the people interviewed, didn't really believe in th e

usefulness of describing the rights of th e disabled in special rules and regulations.

- Rules and regulations are not always effective (e.g. th e compulsory use of certain

minimal measurements in new buildings that are prescribed in several countries

in order to make them accessible to wheelchair users);

- Rules and regulations are useless if there is no money available to implement

themj public spending cuts have shown what so called "rights" are really worth.

- Rules and regulations are also useless if there are no penalties for offenders.

- Special rules and regulations for the disabled are conflicting with the principal of

equal rights for every member of society.

- Special rul es and regulations for minority groups seem to affirm th e presumption

th at the people concerned are "different", which can result in keeping themisolated.

- Special rules and regulations are not in line with the concept of normalisation,

which only became accepted after severe efforts.

Rules and regulations can easily lead to dependencej when asking fo r something

one has to prove one's handicap and one has to fit in with th e standards that apply

to the service that is needed.

Af ter studying these objections one tends to think that no rul es and regulations is

th e best solution. However, when discussing these matters more deeply, it becomes

clear that a wide gap exists bet ween the positition of the disabled, above all the

mentally handicapped and people with psychiatric problems, and that of other

citizens. At the European level important steps were made to help the "liberation"

of women (e.g. equal rights in social security). Now the same effort is needed for

th e liberation of the disabled. It is very stimulating that they can go to the

European Court of Justice and refer ot their rights when claiming accessible

housing, good service systems in th e neighbourhood ans so on. This has a very great

impact on the public opinion in a country and the awareness of policy makers at the

local level. Many of the people with whom we discussed these topics are interested

to know what legal solutions were found in other countries. One such legal solution

is the appointment of "trusted representatives" for pecple with psychiatric

problems in the Netherlands. Another interesting field are the standards for

accessible buildings.

Key theme 4: National building codes, insuring th e accessibility and adaptability of

all new and renovated buildings are more desirabie than special

housing for the handicappedj general services are preferred over

services exclusively for the handicapped.

When developing new policies for the handicapped it is important to distinguish

between:

54



attention at a political level;

2 research and development;

3 laws and regulations defining th e rights of groups and individuals;

4 actual provision of housing, care etc.

The first three activities do not necessarily mean that the creation of actual

provisions exclusively for the members of a minority group. When we distinguish

between policy development and legal instruments on the one hand and actual

provisions for th e every day life on th e other hand this means an important step

forward towards social integration. By making priori ties within the general process

of policy making and by providing legal instruments one can help th e minority

groups to strenghten their position. Building houses and by creating services

accessible for everybody pre vents th at some groups of people are isolated in

everyday life. This is an important step towards the social integration of the

disabled.

More specifically:- in every country there must be a building code fo r all buildings (houses, offices,

public buildings etc.) urban renewal and renovations to make buildings accessible

and adaptable for the handicapped;

- this building code will differ from country to country depending on level of

prosperity, cultural standard, climatic conditions and so on (thus no European

standards);

the implementation of such a code should result in sufficient number of

accessible houses; then it is no longer necessary to have special housing

regulations and livings fo r the handicapped;

- it is equally true that, when the general services and care-facilities are at a such

a level that they can handle th e problems of the handicapped, it is no more

necessary to have specific services and facilities;

- th e lesser specific buildings and facilities especially designed for handicapped

people, the sooner the disabled will be integrated in society.

Many of th e people that we interviewed indicated the neighbourhood level as the

optimal level at which the planning of housing and services should take place. This

is even more so since many people, like pensioners and unemployed, (but also

working people with shorter working weeks), tend to spend more time in their home

and its immediate surroundings. The neighbourhood replaces of the work floor as

th e focusing point for everyday life. Work is no longer the most important thing in

many people's life. This means that there is a demand for unpaid activities

(voluntarily jobs) and the opportunity to meet people. The neighourhood should offer

better opportunities fo r those who cannot easily go elsewhere. Of course this type

of social integration doesn't come out of the blue. However it can be expected that,

when more people get acquainted with a disabled persons, th e original bias will be

replaced by understanding and friendliness. Attention the reception of th e disabled

in th e neighbourhood is vital for sol ving the housing problem. This goes for old as

weIl as for new neighbourhoods.

55



Key theme 5: The improvement of the social - economic position of the disabled is

more important than good housing and services; in this respect

Europe as an important authority in the economic field has a task.

The creation of excellent housing facilities for th e disabled, is necessary but not

sufficient. The main cause of the social problems of the disabled is th e fact that

they are treated differently. Discrimination on the labour market means a socialdisadvantage for the disabled. Social security payments have decreased as aresuIt

of public spending cuts. This results in a lower level of independency, bu t th e

services that should render help are often also cut back as a result of decreasing

public grants.

The people that we interviewed state the importance of a regular job fo r all

handicapped people th at can work. A job will give them a more equal position

within society. A sufficient income or a budget, and the freedom to decide about

standards of living and care, adds to this equality.

The over-all concept autonomous living, can only be reached if th e disabled have a

sufficiently high income, that allows them to make their own decisions concerning

care etc.

Key theme 6: A further stimulation of de-institutionalisation processing by


As already mentioned, th e growing number of the homeless people is a c1ear

indicator for th e failure of th e European countries to cope with people with

psychiatric problems. Some of the people th at we interviewed feel ashamed about

this growth. I t indicates in their opinions th at society doesn't really care aboutmany of its citizens. Everyone agrees that the proces of de-institutionalisation,

although good in itself, quite of ten was not followed up by an extension of care

outside institutions. They think that by stressing th e need to help oneself and one's

neighbours, governments only hope to make their privatisation programmes and

public spending cuts more acceptable to the public. The speed with which some new

policies now are implemented has almost inhuman consequenses. For this reason

some people think th at th e roots of European civilisation are at risk. Everybody

emphasizes that th e de-institutionalization processes have to be stimulated by


Sometimes, basing their statements on conclusions on cost-benefit studies, experts

stay that, at the macro level, independent living of th e handicapped people is

cheaper than living in institutions. Several respondents say that many of those now

living in institutions can live outside with minimal to medium level support. The

interests of th e established institutions conflict with th e tendency towards

independent living. It is necessary to rechannel th e money streams from the

intramural sector to the extramural one and to a1low th e handicapped themselves to

choose th e way of living and care that they want. There is a lack of good economic

analyses on this topic

Very important is the way in which service systems are organized and the way inwhich the local community is involved. As an example of a new vision on these

56



topics we give here the definition of community psychiatry; an approach that is

developed on the base of Italian experiences. This definition can be transformed fo r

the other categories and also for the older people with geriatric problems. Tansella

(zie annex) proposes th e following definition of: "A system of care devoted to a

defined population and based on a comprehensive and integrated mental health

service, which includes:

and which ensures

- out patient facilities;

- day and residential training centres;

- residential accomodation in hostels;

- sheltered workshops;

- in-patient units in general hospitais;

- multidisdplenary teamwork;

- early diagnosis;

- prompt treatment;

- continuity of care;

- sodal support;

- a close liaison with other medical and sodal

community services and, in particular, with general

practioners"•

Key theme 7: Espedally at the European level the stimulation of new

developments in housing and meeting the demands of the disabled is

useful; this implies a.o. better, innovative development program and

bet er education of European architects and policy makers.

Under key theme 2 we pointed at th e "invisibility" of the housing problems of the

disabled at a European level. We stated that the small numbers of people in some

(sub) categories make the international level the best one for the development of

information systems and polides. Most of the people that we interviewed expressed

great interest in an international interchange of ideas. In order to create bet ter

aids, housing opportunities and care, one is anxious to know what developments are

taking place elsewhere. Many of them are also interested in the rules and

regulations that all ow these developments.

The working visits of experts to projects abroad, show that this interest is sineere.

It is interesting to trace the routes that some new developments took as a result of

these working visits. Denmark for instanee is often visited, while the Danish at

their turn use Sweden as an example for the housing and education of and care for

the mentally handicapped. Italy was visited by many experts from the Netherlands

after it closed its psychiatric hospitais. Experiments in the Netherlands, to disperse

people with psychiatric problems over the neighbourhood, partly inspired by the

Italian example, are now being visited by the Danes and other foreigners. The

"independent living movement", originating from the United States, was introduced

in Great Britain and now serves as an example for other Western Europeancountries.

57



During the interviews th e suggestion was made to organise employee interchange

programmes. By asking people to work one or two weeks in an other setting they

can see for themselves that alternatives exist.

Working visits are also essential for building experts, to show them new housing

opportunity schemes and accessible housing projects. Many building experts were

convinced thatin

the training of people, not enough attentionwas paid

to the

problems and needs of th e disabled, ergonomics and social and institutional barriers.

As far as technical accessibility is concerned, this is highly remarkable, because

technical text books are generally available. Working visits seem to offer good

opportunities to convince students and architects of th e problems they cause and

th e interesting solutions th at have been developed in building practice. Some

experts plead for amending th e curriculum for th e architect-title with knowledge of

ergonomics for the handicapped and th e elderly and the needs of these categories.

As they stress the need for information about new projects and solutions the

positive attitude to th e principle of European demonstration projects, part of the

first action programme (1982 - 1987), hardly comes as a surprise. However, there is

also some criticism, leading to recommendations to improve the way demonstration

projects are being set up.

- Whatever ca n be learned from demonstration projects should reach those who ca n

put it into practise. Until now th e people who know about these projects are

often those who meet each other at conferences,

- New experimental projects should be part of an innovative policy of a country. In

other words: experiments should only take place if th e national government is

ready to use th e experience to change its policy. This also means thatexperiments should take into account the cultural and political background of th e

country concerned.

- More money should be made available for experimental projects because of the

complexity of the problem. As it is , the program is not sufficient to be seen as an

important European innovative project. I f compared with other European

innovative projects, e.g. on technology and economic developments, it is only

peanuts.

- Universities should be asked to pay more attention, both in education and

research program mes, to the handicapped, their needs, possibilities for

independent living and ergonomics. Incentive grants ca n be very helpful. Until

now those university teachers and researchers that do their best in this field are

quite 9ften not taken seriously. Some European support would be very welcome.

- Better evaluation and th e introduction of scientific development projects would

make innovative policies more substantial. Therefore th e results would be more

easily accepted by decision makers. Very important are good comparable cost

benefit studies of the several proposed solutions. Special attention should be

given to the cost-benefits of adaptable building and de-institutionalization

solutions especially for the categories: mentally handicapped and people with

psychiatric disorders.

58



instanee wheelchair users. Also a social reason can be given fo r choosing this

solution: people will be able to visit friends and relatives, because all their houses

are accessible. However it will be difficult to make this a rule: private investors

don't like to build for small groups, with needs that differ from the "standard"

needs. Besides many people are sceptic about introducing new rules in this field.

Adaptable building seems to be a good solution, although the extra costs aren't

quite clear, but this is only a solution fo r new houses. Many disabled people however

are dependent of housing out of th e existing stock; these dwellings may have to be

adapted in order to make them suitable for a handicapped person. In a number of

countries there are provisions, financial support schemes for people needing to

adapt their homes; however most of these regulations are to o complicated to be

really effective.

It is amazing how much technical information on accessiblity, adaptablity and aids

is available, but even more amazing it is to see how little this information is

actually used. With small changes sometimes a home can be ready for a disabled

person, but of te n nobody thinks about simple solutions. Archi tects and policymakers don't use th e available konwiedge; they don't seem to be aware of the fact

that disabled people exist in society and need housing; therefore this subject should

be part of their training and education.

On th e other hand the "consumer" of these aids and adaptations needs information

as weIl; this is provided by several organizations.

Besides technical solutions disabled people may need help with daily activities.

Several services are started to provide this assistance in one way or another. It is

important that these schemes are flexible and "made to measure"; they should

provide help not only during working hours (as many of the traditional services did),

bu t also in weekends, during night-time, etc. Financing and coordination of services

that give assistance is a problem in many countries. ft shouldn't be necessary to

apply for each sort of help to a different organisation. When arranging assistance

th e needs of the user should be starting point. In that respect th e Danish system of

an attendance allowance seems to offer possibilities: in this system the person with

a disability gets an allowance to hire an attendant. The disabled employs th e

assistant and determines for instanee on what times assistance is needed.

For mentally handicapped new developments are more or less a continuation and an

improvement of ideas developed before. Small scale facilities, integrated incommunity, forms of attended living schemes, be it alone or in a group, are

developed in most countries. To give people a real chance of becoming independent,

it turnec\ out to be important th at they had a training before moving into such a

scheme. Furthermore it is important that there is a possibility fo r day activities

nearby, especially for those people who don't work. To promote integration, people

are living in family houses in a neighbourhood, near shops, recreational facilities,

etc.

To increase th e possibilities fo r staying at home, services are started to assist the

family that takes care of a handicapped relative.

However, as pointed out in chapter 5, rules on financing and design of en favour

traditional institutional care; in th at way it becomes very hard to start new

60



initiatives, new forms of living and care for this group. The present economie

situation makes the situation even worse. Facilities are closed down and policy

makers promise replacing serviees, whieh should improve the possibilities for

integration. But it turns out that sometimes facilities, institutions, serviees stop

before these alternative provisions are made. This causes much problems.

For the third category, persons with psychiatrie disorders, new developments arealso directed towards small scale facilites, more integration in community, offering

more possibilities for autonomy. Schemes fo r (different sorts of) group homes,

living alone with attendance, etc., are developed at several places.

Ambulatory care, care in the community, is getting more important for persons

with psychiatrie disorders. However this group faces more problems in getting

accepted; they are in a way rejected by society. In policy making they don't play a

very important role. As stated in the sixth chapter, they are th e first to suffer th e

consequences of the economie reces sion , the first that are becoming vietims of th e

present policy of public spending cuts. Consequences of the lack of support fo r this

group can be seen in some cities on th e streets: among the growing group of

homeless people there are many persons with psychiatrie disorders, partly ex

psychiatrie patients, who were released from institutions, but had no place to go, no

place to turn to fo r help.

Chapter 7 contains th e definitive key themes, that were formulated as a result of

the discussions held during the research project. Special attention is paid to policy

developments at the European level. The themes can be considered as first steps for

developing a new policy.

The key themes:

Overall theme:

Key theme 1:

Key theme 2:

Key theme 3:

Key theme 4:

Key theme 5:

Key theme 6:

Towards autonomy in housing fo r the handieapped.

More awareness and attention in European policies concerning th e

handieapped, also in the perspective of growing number of elderly

people.

Better data to make the housing situation of the handieapped more

visible.

A clear definition of th e entitlement of the handieapped to

housing and care, to prevent discrimination and to stimulate

participation in decisionmaking.

National building codes, insuring the accessibility and adaptability

of al l new and renovated buildings are more desirabie than special

housing for the handieapped; general serviees are preferred over

services exclusively for the handieapped.

The improvement of th e social-economie position of the

handieapped is more important than good housing and serviees; in

this respect Europe as an important ~ u t h o r i t y in the economic

field has a task.

A further stimulation of the de-institutionalisation processes byimproving and extending care and serviees in local communities.

61



-------Key theme 7:

62

Especially at the European level the stimulation of new

developments in housing and meeting the demands of the disabled

is very usefull; this implies a.o. a better innovative development

program and a better edueation of European arehiteets and poliey

makers.



ANNEXES



ANNEXE 1 Names and addresses of persons who were interviewed

Belgium

Laboratoire de Pedagogie Experimentale, Mrs. J. Beekers, Universite de Liege, au

Sart Tilman, 4.000 Liege I Belgium

Similes, Groeneweg 151,3030 Heverlee/Leuven, Belgium

HIVA, Universiteit van Leuven, Mr. E. Samoy, E. van Evenstraat 2e, 3000 Leuven,

Belgium

EC districtproject G e n k - H a s ~ e l t , Mr. J. Knoops, Stadsomvaart 9, 3500 Hasselt,

Belgium

Ministerie van de Vlaamse Gemeenschap, Mr. G. Hertecant, Nijverheidsstraat 37,

1040 Brussel, Belgium

Vlaamse Federatie Gehandicapten, Mr. B. Rubens, St . Jansstraat 32/38, 1000

Brussel, Belgium

Katholieke Vereniging voor Gehandicapten, Mr. P.J. Meirens, Arthur Goemaerelei

66, 2018 Antwerpen, Belgium

Vormingsinstituut voor de Begeleiding van Gehandicapten (VIBEG), Mr. S. Schoofs,

Guimardstraat 1, 1040 Brussel, Belgium

VZW Monnikenheide, Ms. G. PIessers, Zoersel, Belgium

Interact, Ms. M. Kyriazopoulou and Mr. L. Jon iaux, Square Ambiorix 32, Brussel,Belgium

Denmark

Hoskov Centre, Danagervej 26, 8260 Viby (Aarhus), Denmark

Boinstitution Esbjerg, Mrs. B. Hensen, Aadalsvaenget 2, 6710 Esbjerg, Denmark

BMH, Mr. J. Frederiksen, Hans Knudsen Plads IA, 2100 Copenhagen, Denmark

Nat. Board of Social Welfare, Mr. P. Senderhof, Kristineberg 6, 2100 Copenhagen,

Denmark

The Danish Building Research Institute, Mr. I. Ambrose, Postboks 119, 2910

Horsholm, Denmark

Set. Hans Hospital, Mr. F. Jorgensen, 4000 Roskilde, Denmark

France

Ministere des Affaires Sociales et de l'Emploi, Direction de l'Emploi Sociale, 124,

rue Sadi-Camot, 92 Vanves, France



CTNE RHI (Centre Technique National d'etudes et de recherches sur les handicaps

et les inadaptations) 124, rue Sadi-Camot 92 Vanves, France

Projet Euramis, Mr. G. Zribi, 2 Avenue Marthe, AFA-ACR Champigny, France

Pont Canal, Mr. Millot, 24-26 rue des Ecluses-Saint-Martin, 75010 Paris, France

GIPH (Groupment pour I'lnsertion des Personnes Handicapees Physiques), Mr. P.Saint Martin, 10, rue Georges de Porto Riche, 75014 Paris, France

Federal Republic of Germany

EC district project Berlin-Spandau, Landes Versorgungsamt, Mr. J. Schneider,

Postfach 310929, Berlin, FRG

"Behindertengruppe KasseI", researcher for "Berufliche Rehabilition" University

KasseI, Ms. G. Hermes, Parkstrasse 47, 3500 KasseI, FRG

Gesundheitsamt Stadt KasseI, Mr. P.L. Eisenberg, Wilhelmshoher Allee 32A, 3500

KasseI, FRG

Diakonie Wohnstatte Nordhessen e.V., Ms. H. Lauer, Bergshauserstrasse 1, KasseI,

FRG

Bundesministerium fur Arbeit und Sozialordnung, Mr. H. Haines, Lengsdorfer

Hauptstrasse 80, Bonn, FRG

Ms. Moya, Empirica (formerly ABT-Forschung), Kaiserstrasse 29-31, Bonn, FRG

GreeceMinistry of Environment, Physical Planning and Public Works, Ms. A. Leventi and

Ms. K. Skountzou, Amal1ados street 17, Athens, Greece

Ministry of Health, Welfare and Social Security, Mr. N. Vrionis, Aristotelous 17,

Athens, Greece

Chairman of the National Association of the Blind, director of the Institute of the

Deaf, Mr. I. Vardakastanis, Athens, Greece

Ireland

Department of Health, Mr. J. Robins, Hawkins House, Dublin 2, Ireland

National Rehabilitation Board, Mr. T. Page, 25, Clyde Road, Dublin 4, Ire1and

National Association of the Mentally Handicapped of Ireland (NAMHI), Mr. G. Ryan,

5 Fitzwilliam Place, Dublin 2, Ireland

Italy

Comunita di Capodarco, Mr. A. Battaglia, Mr. A. Matteo and Mr. M. Bucerelli, Via

Lungro 3, 00178 Roma, Italy

AIAS, Mr. R. Belli, Via Giuliano Bugiardini 10,50143 Firenze, Ita1y



Ministerio del Lavoro, O.G. Affari Generale ePersonale, Mr. N. Agnini, Via Flavia

6, 00184 Roma, Italy

A.N.C.E. (Associazione Nazionale Costruzioni Edili) , Mrs. P. Inserra, Via Guattani

16,00161 Roma, Italy

E.N.A.I.P., Mr. Calmarini, Via Marcora 18/20, Roma, Italy

Regione di Lazio, Mr. F. Vescovo, Lungotevere Testaccio, 15,00153 Roma, Italy

AIAS, Mrs. T. Selli Ser ra (presidente), Via Rubens, 35, 00179 Roma, Italy

S.I.V.A., Don Gnocchi (Servizio Informazione Valutazioni Ausili), Mr. R. Andrich,

Via Gozzadini J, 20148 Milano, Italy

Luxembourg

Ministere de la Famille, du Logement Social et de la Solidarite Sociale, Ms. C.

Greisch, 14 Avenue de la Gare, Luxembourg

Netherlands

Stichting Fokus, Mr. E. Wiersma, Burg. Triezenbergstraat 30, Ten Boer (Gr.),

Netherlands

Department of Welfare, Health and Culture, Ms. Brenninkmeyer, P.O.Box 5406,

2280 HK Rijswijk, Netherlands

Mr. J.F. van Leer, Tollenslaan 8, Aerdenhout, Netherlands

St . Nederlandse Gehandicaptenraad, Mr. M. van Ditmarsch and Mr. D. Vogelzang,

St . Jacobsstraat 14, 3511 BS Utrecht, Netherlands

E.C.- district project Drechtsteden, Mr. F. v.d. Pas and Mr. M. Kamp, Stadskantoor,

room 180, Spui boulevard 300, 3311 GR Dordrecht, the Netherlands

University of Nijmegen, Prof.dr. T. Guffens, Thomas van Aquinolaan 4, Nijmegen,

Netherlands

Portugal

Secretariado Nacional de Reabilitacao, Dr. F. Fouto Polvora, Avenida Conde

Valbom, 63, 1200 Lisboa, Portugal

Secretariado Nacional de Reabilitacao, Mrs. M. de Lurdes Machado Faria, Avenida

Visconde Valrnor, 63, 1000 Lisboa, Portugal

Mr. J. Pires Marques, Av. Sidonio Pais, 20 - 1 0 , 1000 Lisboa, Portugal

NIPRED, Camara Municipal de Lisboa, Av. 5 de Outubro, 213, Lisboa, Portugal



Spain

Direccion General de Accion Social, Subdirectora General de Programas de

Servicios Sociales, Ms. T. de Benavides Castro, Ministerio de Trabajo y Seguridad

Sodal, Jose Abascal 39, 28003 Madrid, Spain

Coordinadora Estatal de Minusvalidos Fisicos, Mr. M. Pereya Etchyerria, Eugenio

Salazar 2, Madrid, Spain (and Subdirector Tecnico del Hospital Nacional de

Paraplejicos, Toledo)

Director de Centro Estatal de Avudas Tecnicas para Minusvalidos INERSO, Mr. P.

Gil de la Cruz, Augustin de Foxa 31, 28036 Madrid, Spain

United Kingdom

Centre on Environment of the Handicapped, Ms. S. Langton-Lockton, 35 Great

Smith Street, London SWIP 3BJ, UK

Department of Environment, Mr. S. Goldsmith, 2 Marsham Street, London SW lP

3EB, UK

Lambeth Accord, Ms. R. Pickersgill and Mr. D. Leaman, 336 Brixton Road, Brixton,

\ London SW9 7 AA, UK

Camden Society for Mentally Handicapped People, Mr. S. Codling and Ms. H. Jarvis

245 Royal College Street, London NW 1, UK

Centre for Independent Living, Mr. P. Swain, 112 Hamlin Gardens, Exeter, Devon,

UK

MIND (National Association for Mental Health), Ms. J. Every, 24-32 Stephenson

Way, London NW 1 2HD, UK

Department for the Disabled, Fr. C. Webb, Diocese of Westminster, 73 St Charles

Square, London WIO 6EJ, UK



~ I U Deltt

ANNEXE 2- I

IU\.' - l ' \ S ' ~ l 1 \ 'Tt Rl}; >{: R ! : . ~ t ' 1

2t>2S 0; n.l1t

~ ! . h u lA.-.:is

31 15 78X)1.6

Ttiex tntw 381S1

().lr rc l J"'I!:lce

CJR-87-27Dl.ree t l1ne31 15 78):)58

IBteHly 27, 1987

Dear Sir , Madam,

!he European Communi ty

RIW, of the Technlcaldevelopments and trends

physlcally aod sensorlal

has asked the lns t l tu te for Bousing Research,

University Delf t to do a research onn e ~

In th e housing of d1sabled persons (Including

d16abled, .ente l ly disabled and mentally 111)

In the memberstates. Through th e Bureau for Action In favour of Dlsabled

People we recelved your Dame as one of the e ~ p e r t s In your country.

Besldes the iDformatlon requested In the l e t t e r hereby lncluded ve vould

l lke to have ansvers to the folloving quest ions:

1. Could you give US some impressions of trends in your country on

housing fo r dlsebled persoDs over the past ten years?

2. Which are th e Il1O st important points of view regarding houslng for

dlsabled people? (as I l lustrated In ar t lc les , at meetings, etc . ; anydocumentatlon 6uch as ar t lc les , summarles of reports e t c , or t l t l es ,

yould be very helpful to us).

3. Whlch developoents do you foresee In your country and vhat do you

personally thlDk should happen In th ls field? (please refer to

relevant projects l f posslble) .

4. The European Comrnunlty vants to promote lntegratlon of dlsabled

persons In 60clety. Unt11 D"'" the C o m ~ n 1 t y has glven financiel

support to e DUJ:lber of projects In the 12 memberstates end ha s

8tar ted an Information network, cal led Randynet. Is thefe anythlng

else the EC should do accordlng to yOu, do you have any Buggestlonsabout the role of the C ~ m m u n l t y ?

We vould t:>e very pleased 1f you vould vant to help us, 1f posslble

before July 15, 1987. We look forward to hearing from you.

Yours slncerely,

Anja de Jonge,

~ s . Slbylle van Haastrecht.



Direct contacts ",ith ~ x p e r t s are vi ta l for th e success of this study.

Please inform US before January 8, 1987 about the i r naDes, eddress€s,

phonenUI:Jbers end profession. \.Ie ",ould apprec1ate i t very IllUch i f you

could eend us this information by te lex. !he nurnber i s 38151 bhthd n l .

For information you cen reach th e researchers d1rectly by ph one.

Yours sincerely,

S.C. van Raastrecht,

Contactperson RI\.I-study'Trends in the housing fo r

the disabled in the

European Community'

Enclosure(s) : 2

Researchers

Mr. J.H.Kroes

Ms. S.C. van Raastrecht

Mr. P.P.J. Houben

Phonenumbers (direct l ines)

(31) 15 78 3065

(31) 15 78 3058

(31) 15 78 3077

- 2 -



&Jbject!hls1.ng for the le d

f e "'e1l:e

EIR.!Svll/JvdB

Rl\,' - Rf.S[)..1(Ql ! N':,lTI\JIL POR HJJ SN;

Delft lhiwrs1ty

~ ~ I Z628 CR 0ClFT

'!he ~ t h e r l a ! ) d 6 'lhlex 38151 lntW nl

Datelke::ber 16, 1986

For the progress of th e RIW-study 'Trends in the housing for the

disabled 1n the European Comrnunity' we ask your cooperation an d

attention for the f o l l o ~ 1 n g :

The emphasis of this study is on housing faci l i t i es for adult

physically and/or mentally - disabled people.

Referring to · the introduction l e t t e r sent to you by th e Bureau for

Action in Favour of Disabled People last November, we would l ike to ask

you to send written information as indicated in that l e t t e r before

January 15, 1987 to:

RIW

Delft University

B e r l a g e ~ e g 1

2628 CR DELFT

The NetherlaDds

- 1 -



A""EXE 2 -)

-.ÇOMMISSIONOF THE

EUROPEAN COMMUNITIESBrussel s .... Nov.e",be r ..1986

OI"EClO"AH-GE"ERAL[MPlOYMEN1 . SOC iAl AFF .... IRS

A"O EDUCAllON

V.C.3

TO WHOM lT MAY CONCERN

The Commission of th e European Community, in i ts work to support the

ful l integration of disabled people is promoting, among other things,the improvement of their housing conditions as an essential pre

requisite to the successful achievement of this aim.

The Commission wi shes to expand th e frame of reference for i ts future

housing policy and,in order to see if an adjustment of i t s current

policy would be desirable or necessary, has asked RlW lnst i tuut voor

Huisvestingsonderzoek (lnsti tute fo r Housing Research) to study andreport on th e "Trends in hous i ng po licy development for disabled

people in th e ~ e m b e r Stat es of the European Community".

ln i ts work, the RlW lnst i tu te is interested to receive in particular

th e following informat i on:

policy documents, leg i slation and other regulations, possibil i t iesfor receiving subventions and grants and other stimulation measures

(eg. experimentaL programmes), in particular these that further

independent living of the handicapped;

reviews Iwith figures) and re cent reflections in reports, books or

art ieles on hous i ng of the ha ndicapped and the development of this;

concrete data of e xperimental projects, innovating ini t iat ives orsuggestions (na me, place, person to contact, possible written

documentation) aimed at a renewed approach;

names of knowledgeable personIs) who can be contacted in the Member

States;names of experts well informed about situation in a Member State

and/or known fo r their assessment or surveys at the internationaL

level:

shall , therefore, be most grateful fo r any assi tance y_ou are able to

give to R.l.W. in th e preparation of this report .

ProviSÎona! aclcites$ . Rue de 18 LO l 200 • 8 -1049 Brussels - Belgium

P. E. DAUNT

Head of Bureau for Action

in Favour of Disabled People

Telephone : Telephone exchange 235" , 1/ 23611 " - Dlrecl IIne 23 .

re/ex COMEU B 2' 877 - Te1egraph,c acldress · COMEUR Brussels



ANNEXE 3 Concept key-themes

These concept key-themes are iormu:ated in April, after a iirst search ior relevant

documentation and visits to several countries. In th e next mO:lths, these therr,es will

be discussed with experts in the other member-States oi the European Community.

Central theme: AUTONOMOUS LIVING

1. strengthening juridical position

2. needs during the liie-cycle as policy-input

3. participation and grants ior extra costs

4. awareness among architects

5. general housing schemes ior everybody

6. support made to measure

7. de-institutionalization and integral approach of services

8. integrat ion in the neighbourhood

1. Strenghtening juridical position

Strengthen the juridical position of disabled persons. An important example of anti

discrimination legislation is the 'Human Rights Act' in Canada. In the field of

housing disabled citizens have the same rights as any other citizen to choose where

and how they want to live; they should be regarded as consu:ners of housing and

social services, not as patients.

2. Needs during the life-cycle as policy input

The needs of a disabled person during his or her life-cyc]e as input for policy

development. Disabled persons should participate in the process of policy and

decisionmaking, since they are experts on their needs and potentials. Their ideas

should be taken into account in the planning and designing of housing and social

services.

3. Participation and grants for extra costs

Disabled persons should be able to a full participation in th e society. Therefor theextra costs for daily living should be met.

4. Awareness among architects and policy-makers

Architects and policy-makers as weIl as any other person involved in housing

matters should be aware of the existence and of th e needs of disabled persons.

Attention should be paid to this subject in their training and education.

5. General housing schemes for everybody

Provide general housing schemes accessible for everybody, not for specialcategories. Weil designed ordinary houses, products and physical environment can

prevent th e disability to become a handicap (adaptable and visitable housing). As

fa r as possible, the present housing of disabled persons should be adapted according

their disabilities.



6. Support made to measure

The support should be made to measure and flexible. Giving the disabled person

more help than what he needs is undervaluating him, giving him less help will do

harm to his possibilities for his realization as human being. Therefor an attitude of

discretion and dialogue from care assistants is indispensable, as well as the

assurance of 24-hours available help if needed. Also different needs according to

cultural differences must be taken into account.

7. De-institutionalization and integral approach

De-institutionalization together with an integral approach of services in the

communit). The entire life of a person with a physical or mental disability must not

be taken over by an institution. By providing a range of accomodations and a

coherent network of community-based services an optimal choice can be given to

meet individual preferences. Collaboration between authorities of different

disciplines is important.

8. Integration in the neighbourhood

Inform and prepare the neighbourhood to increase awareness and understanding of

needs and potentials of disabled persons. Attention must be paid to possible

communication problems from both si des.



ANNEXE 4 Literature

Accesbilidad para las personas con minusvalia, Madrid, 1987;

Acts of the European seminar "Mobility and Handicap", Brussel, 1987;

A home of their choice, implementation of the all-wales mental handicap strategy,

the All Wales Advisory Panel, september 1986;

Behindertenaufzuge, Bau- und Wohnforschung, 04.066, Bonn, 1981;

Beispieldokumentation Behindertenfreundliche Umwelt, Bau- und Wohnforschung,

04.4070, Bonn, 1981;

Beispielhafte Behindertenwohnungen, Bau- und Wohnforschung, 04.092, Bonn, 1983;

Bereitstellung von Behindertenwohnungen, Bau- und Wohnforschung, 04.109, Bonn,

1985, (nr 10 1233);

Bericht der Bundesregierung uber die Lage der Behinderten und die Entwicklung der

Rehabilitation; Bonn, 1985;

British Council of Organisations of Disabled People, Schemes and Initiatives,

London;

Centres for Independent Living, Seminar Report, Centre on Environment of the

handicapped, London, 1983;

Commissie van de Europese Gemeenschappen, Mededeling inzake modelacties op

huisvestinggebied ter bevordering van de sociale integratie van gehandicapten en

migrerende werknemers, Brussel, 1980, (COM (80) 491);

Die Wohnsituation der Korperbehinderten in der Bundesrepublik Deutschland, Bonn,

Bau- und Wohnforschung, 04.017, 1976;

Exeter Health Authority, Exmouth Community Mewal Health Team, Policy, March

1987;

Familienentlastende Dienste, Marburg/Lahn, 1986;

Geboden Toegang, handboek voor het toegankelijke en bruikbare onderwerpen en

bouwen voor gehandicapten mensen, Stichting Nederlandse Gehandicaptenraad,

Utrecht 1986;

Housing and living conditions of disabled people, Abstracts of the reports and

recommendations, Commission of the European Communities Rehabilitation

International, Comite National Francais pour la 'Readaptation des Handicapes,

Seminar, Bois Larris - Chantilly, 12 - 14 November 1984;



Housing, th e foundation of community care, National Federation of Housing

Assodations and MIND, London, 1987;

Information of the EC district project of Midlands (Ireland) on HILAC and the

Technical Advice Panel, 1985;

Intergration of disabled persons into community life, United Nations, New York,

1981; (ST/ESA/111)

La casa senza barriere, Quaderni del segretariato generale del CER (Comitato per

l'edilizia residenziale), Roma,1985;

Making a reality of community care, A Report by th e Audit Commission fo r Local

Authorities in England and Wales, London, 1986;

On employment of assistants in own home, Instructions re. th e scheme and re . the

general lines to be followed, Arhus Kommunes Soda1 - and Sundhedsforvaltning,

Sodal Afdelingen;

Profielschets, Integratieproject gehandicapten Drechtsteden, Dordrecht, 1986;

Simposio sobre supresion de barreras arquitectonicas y urbanistacas, real patronato

de prevendon y de atendon a personas con minuvalia, Madrid, 1985;

Toelichting op de beschikking geldelijke steun huisvesting gehandicapten, Ministerie

van VROM, 's-Gravenhage, 1986;

Towards a full life; green paper on services for disabled people, Dublin;

Tweede Kamer, Vergaderjaar 1982-1983, Beleidsnota, Geestelijke Gehandicapten,

17900, nr . 1-2;

Tweede Kamer, Vergaderjaar 1983-1984, Nota Geestelijke Volksgezondheid, 18463;

nrs. 1-2

Voorstel van wet tot wijziging van het Burgerlijk Wetboek en enige andere wetten

in verband met de opneming in het Burgerlijk Wetboek van bepalingen omtrent de

overeenkomst inzake geneeskundige behandeling, Memorie van Toelichting, 's

Gravenhage, 1987;

What does th e "Friendship Quarter" represent?, brochure;

Wijziging van het Burgerlijk Wetboek en enige andere wetten in verband met de

opneming van bepalingen omtrent de overeenkomst tot het verrichten van

handelingen op het gebied van de geneeskunst, 's-Gravenhage, 1987;

Wohnungsumbau fu r Rollstuhlbenutzer, Bau- und Wohnforschung, Bonn, 1985;

Woonschrift, Woonwensen van gewone mensen, Antwerpen, 1979;

ABT Forschung, Ontwikkelingen en trends in woonvormen en woon- gerelateerdezorg voor de gehandicapten in de Europese Gemeenschap, Bonn, 1985;



ABT Forschung, Report lIl: Compendium: Housing Schemes and Related Services for

Handicapped People, Bonn, 1985;

Barille, E., Logement et Handicap, Les Nouvelles de Delta 7, Hiver 1984/85, p. 5-6;

Bick, 0., Nouvertne, K., Wessel, H., Betreutes Wohnen als Alternative zur

Psychiatrischen Anstalt, Solingen, 1985;

Blach, K., A study of the need for information on acces to buildings fo r disabled

people, Report submitted to the Commission of the E.C, Denmark, 1986;

Borsay, Anne, Do Housing Pqlicies Stigmatise Disabled People?, Housing Review

Vol. 35, No. 5, September-October 1986, p. 150-153;

Breemer ter Stege, C., Psychiatrie staat voor gigantische

samenwerkingsorganisatie, HZH, 15-22 aug. 1985, p.p. 541-544;

Chadderdon, L., Malhotra, S., Goals of Independent Living Movement Underminedby Conflicting Policies, The Interconnector, Vol VI no.l, East Lansing, Michigan,

1982, p.1-4;

De Jong, Gerben, The Movement for Independent Living: Origins, Ideology, and

Implications for Disability Research, East Lansing, Michigan, 1979;

De Jong, G., Independent Living & Disability Policy in the Netherlands: Three

Models of Residental Care& Independent Living, Boston, Massachusetts, 1984;

Frieden, Lex and Joyce, Gini Laurie, Living independently: three views of the

european experience with implications for the U.S., New Vork, 1981;

Galjaard, J., Toegankelijkheid van openbare gebouwen voor gehandicapte mensen,

Rapport in opdracht van het "Bureau voor de activiteiten ten behoeven van

Gehandicapten" van de Europese Gemeenschap, Oktober 1986;

Gailly, J.P., Le logement des handicapes, Institut National du Logement, Bruxelles,

1981;

Galluf Tate, D., Ph.D. Linda M. Chadderdon, B.A., Independent Living: An Over view

of Efforts in Five countries: Denmark, Federal Republic of Germany, Yugoslavie,Costa Rica and Japan, Independently Living, Michigan, 1982;

Goldbach, A., B. Paschke, "Betreutes Einzelwohnen geistig Behinderter", I.

Zwischenbericht des Modellversuchs, 1985-1986 en 2. Zwischenbericht des

Modellversuchs, 1986, Lebenshilfe, Berlin;

Guffens, Th., Building design fo r the handicapped in the Netherlands, not published,

Nijmegen, 1986;

Guffens, Th., J. van Westerlaak, Biografie van het E.G. - districtenproject voor

gehandicapten in Nederland, Beginsituatie, Nijmegen, 1985;



Guffens, Th., E. Hijmans, "Je staat er niet bij stil", ervaringen van gehandicapten in

de openbare ruimte, Nijmegen, 1985;

Haen de, F., Wie beschermt de beschermende woonvormen?, Maandblad Geestelijke

Volksgezondheid, 1983, 2, p. 111-119;

Heginbotham, C., Webs and Mazes, Centre on Environment for the Handicapped,

London, s.a.;

Kooij, C.H. van der, De theorie hetzelfde, de praktijk niet, HZH 14, 31-7-'86, p.

518-519;

Kosters, R.H., W. Lans, R. Lijbers, H. Westra, Beschikking geldelijke steun

huisvesting gehandicapten, RIW, Delft, 1985;

Laane, W.L.J.M., Commentaar op het concept rapport van de Werkgroep

beschermende Woonvormen en Psychiatrische Hostels, Maandblad Geestelijke

Volksgezondheid 1982, nr . 2, p. 120-124;

Leijenhorst, R. , De WHO en Malotaux als reisgids, Veldonderzoek naar de

organisatie van de psychiatrie in landen rond de Middellandse Zee, HZH, 13-2-

1986, p. 80-82;

Leijenhorst, R. , Portugal koos voor de open-deur psychiatrie, HZH 10, 22-5-'86, p.

356-360;

Leventi, A., Public Audition Regarding, Transport - Transfer of special needed and

elderly people, European Parliament Commission of Transport, Brussels, 29-1-'87;

Lieshout, P .A.H. van, en P.L. Meurs, Geestelijke gezondheidszorg in Frankrijk.

Principes en praktijk van de "psychiatrie de secteur", Maandblad Geestelijke

Volksgezondheid, 1987,3, p. 282-294;

Lopez, Manuel A., P.A., Berra, E.N., Raez, Integracion Social de los Minusvalidos,

Madrid,7-4-1983;

Maassen, ir. C.J.J.M., OnderWIJS in Toegankelijkheid, Onderzoek naar de aandacht

die in het bouwkundig onderwijs in Nederland wordt besteed aan toegankelijkheid

voor lichamelijk gehandicapten bij het inrichten en vormgeven van de gebouwde

omgeving, Leidschendam, 1986;

Molleman, C., Bouwstenen voor een informatiesysteem over gehandicapten,

Deelrapport 3: Leefsituatieonderzoek van jong - volwassenen met een fysieke

handicap, Leuven, 1986;

Poel van der, E., Is er een leven na de inrichting, Marge 1982; no . 2, p.68-73;

Poel, E. van der, Democratische psychiatrie in Italie, Marge 1979, 12, p. 355-360;

Pries, H., E. van der Poel, A. ter Laak, D. Kal, Het 1evenna de inrichting,Amsterdam, 1985;



Prinsen, J., Guffens, Th., Kropman, J., Evaluatie van ADL- Clusters en ir. Drouven,

L.E., Mols, J.F.J.M., Globale kostenvergelijking tussen het wonen van lichamelijk

gehandicapten in een ADL - cluster en het verblijven in een intramurale instelling

voor lichamelijk gehandicapten, samenvattingen, Den Haag, 1985;

Ratzka, Adolf D., Independent living and attendant care in Sweden: a consumer

perspective, New York, 1986;

Rutter, Jutta, Die entstehung und entwicklung selbstorganisierter ambulanter

hilfsdienste fur behinderte, AG SPAK, Munchen, 1986;

Saint Martin, M. Philippe, U" exemple d'alternative a l'herbergement en foyer: la

Residence "Pontcanal", Paris;

Samoy, E., Gezinsbegeleiding voor Gehandicapten, Brussel, 1982;

Samoy, E., Bouwstenen voor een informatiesysteem over gehandicapten,

Deelrapport 1: afbakening van de doelgroep, Leuven, 1985;

Samoy, E., Bouwstenen voor een informatiesysteem over gehandicapten,

Deelrapport 2: Kenmerken van de doelgroep, Leuven, 1986;

Shearer, A., Living Independently, London, 1982;

Steyaert, R. , E. Samoy, C. Klynkens, Profiel van Gehandicapte Volwassenen in

voorzieningen van het Fonds 81, Leuven, 1987;

Thimm, W., Das Normalisierungsprinzipe

Marburg/Lahn, 1984;

Eine Einfuhrung, Lebenshilfe,

Vanistendael, C., Fragmentatie kenmerkend voor het karakter van de Italiaanse

psychiatrie, HZH 2. 24-1-'85, p. 40-43;

Vanistendael, C., Integrale geestelijke gezondheidszorg is een realistisch ideaal in

Italie, HZH 3, 7-2-'85, p. 83-87;

Veen van der, H., Een pleidooi voor actieve resocialisatie, Maandblad Geestelijke

Volksgezondheid, 1983, nr . 2, p. 125-134;

Van der Voordt, D.J.M., Bouwen voor iedereen, inclusief gehandicapten, september1983;

Vorderegger, J.R., C.J. Verplanke, Travel and the disabled, Study of the problems

and provisions, The Hague, 1985;

Wennink, H.J., Beschut wonen in een algemeen psychiatrisch ziekenhuis. Onderzoek

naar het effect van een nieuw zorgmodel voor chronisch psychiatrische patienten,

Maandblad Geestelijke Volksgezondheid, 3, p. 251-266;



I

D K t ~ 9 . 0 3 : 7 2 5 : 6 1 6 - 0 5 6 . 2 6 DEUTSCHL: NOliMEN April 1975

- - - T ~ n ~ E i : I ~ C ~ : n ~ ~ ~ ~ ~ ~ ~ e ~ l f ~ ~ t l ~ C e : ~ ~ d ~ ~ ~ i C h -·[1' 00'N24--1Planungsgrundlagen I

____ _. _ _ Öff:lltliCh z u g ä ~ ~ i g _ e Gebäude .•_ ~ _ Construction measures for disabled persons and aid human beings in the pUblie field: design prineiples;

publie aecessible buildings

MaRe in cm

Zur Rehabilitation der Behinderten und zur Verbesserung der Lebensverhältnisse de r alten Mensehen wurden in denletzten Jahren erhebliche Anstrengungen aul vielen Bereiehe n unternommen. Eine de r wichtigsten Voraussetzungenlür den Erfalg aller MaBnahmen ist jedoch das Vorhandensein einer hindernisfreien bauliehen Umwelt. und zwar nichtnur in der Wohnung ader am Arbeitsp'etz, sondern aueh im gesamten ölfentliehen Bereieh, das heiBt auf StraBen,Plätzen und Wegen sowie in ölfentlieh zugängigen Gebäuden. Ziel is t eine weitgehende Unabhängigkeit van fremderHilfe.

AuBerdem erfordert die intalge höherer Lebenserwartung steigende Anzahl alter Mensehen die Berücksiehtigung derfür Behinderte geitenden baulichen Anforderungen in gröBerem MaBe als bisher .

Die Vermeidung und Beseitigung baulieher Hindernisse trägt, über die spezielIe Aufgabe der Rehabilitation undIntegration hinaus, ganz allgemein zur Rehumanisierung des Städtebaues und zur SehaHung einer m e n s e ~ e n -gerechten Umwelt wesentlieh bei.

:n dieser Norm sind Ma8nahmen genannt. die den Behinderten und alten Mensehen gröBere Bewegungsfreiheit undSicherheit in öffentlich zugängigen Gebäuden ') ermögliehen. Die Varteile dieser MaBnahmen kommen zugleieh allenanderen P'2rsonengruppen, insbesondere Personen mit Kinderwag'3n oder Traglasten zugute.

Die MaBnahmen sind nicht nur bei Neubauten, sond.ern aueh be i allen bauliehen Verändefungen anzuwenden.

') Oer gegriH "öHentiieh zugängig" ist im V(eitesten Sin ne zu verstehen. Wenn nur ein Teil eines Gebäudes öffentlieh:!Jg;;ngig ist (z. B. eine Bankfiliale in zinem mehrgeschossigen Haus). sind die Festlegungen dieser Norm nur auf den'3ntsprechenden Teil des Gebäudes anzuwenden.

. Is öffenUich zugängige Gebilude dieser Norm geiten insbesandere:

a) Öffentlich zugängige Verwaltungsgebäude (z. B. Arbeits;;mter, Beratungsstellen, Finan,ämter, Gerichte, Geschäfts'stellen van Kranken- und Sozialversieherungen, Gesundheitsämter, Pfarrämter, POlizeidienststellen, Postämter,Sozialämter, Standesämter, '/erkehrs- und Reisebüros, Versorgungs;;mter).

b) Bahnhöfe, Flughafengebáude. Parkhäuser, Raststätten u. a.,e) Gaststätlen und Beherbergungsbetriebe (z. B. Cafés, Hotels, Jugendherbergen, Kurheime, Restaurants),d) Versarnmlungsräume (z. B. Gemeindesäle, Kinos, Kirchen, KongreBhallen, Theater),e) Ausbildungsstätten (z. B. Hochschulen, Lehrwerkstätten . Schulen),

f) Spartanlógen (z. B. Freiloäder, Hallenbäder, Turnhallen, Stadien).g) Läden, Warenhäuser,

h) Banken, Sparkassen,i) Apotheken, Arztpraxen, Krankenhäuser, Kureinriehtungen,

j) Ausstellungsbauten, Bibliotheken, Museen,

k) Kindertagesstätten

Fortsetzung Seite 2 bis 4

FachnormenausschuB Bauwesen (FN8au) im DIN Deutsehes Institut für Normung e.v.Fachnormenausschu6 Masehinenbau (FM) im DIN

. _ - - - - - - - - - - - - - ~ - - - - _ . _ . __ _-_.__._------



SeHe 2 DiN 18 024 Teil 2

Zugal1g ZUI11 Gcbäude

1.1 Ein Eingan g des Gebäudes. möglichst der Haupt·eingang, muB stufenlos erreictlb8r sein . Oer Zugang istdurch Beschilderung k(;nntlich IU machen.

Rampp.n sind zulässig. Ihr Gefälle darf jedoch nicht mehrals 6 "'0. Ihre Breite muB mindestens 120 cm bctragen . Sei

Rampenlängen von mehr als6

mist ein Zwischenpodestvon mindestens 120 cm Länge erforderlich. Podeste v.on

miMestens 120 cm Länge sind auBcrdem am Anlangund am Ende der Rampe anzuordnen. Rampen sind miteinem Handlaul auszustalten.

1.2 Der stulenlos erreichbare Eingang (siehe Abschnitt1.1) muB eine lichte Durchgangsbreite von mindestens95 cm aulweisen. Die Tür ist als Drehflügeltür') oder alsSchiebetür auszubilden. Sie sollte mit automatischemTürbflner (Bodenkontaktschalter oder Lichtschrankenschalter) ausgestattet sein. Drehflügeltüren mit automa'tischem TÜlo flner ctürlen nur bei Richtungsverkehr ver·wendet w€! den.

Drehlüren und Pendeltüren sind für RolIstuhlbenutzer

unpassierba r.Schwellen und Niveauunterschiede sin d nur bis zu2.5 cm ·zuI2ssig.

Vor Drehflugellüren muB einc Bewegungsfläche nach denin Bild 1 dargesleillen MaBen gcsichert sein.

Bild 1. Bewegungsfläche vor Drehflügellüren

a b

r - - - - ~ ______ _________ _7_0_ _ _ _ _ _

35 I45

r ------- - - - -• 55

Zwischenwerte in terpolieren.sind Vorzugswer1e.

2 Pkw-Stellplätze

160

150.._---_ .__._...--

140

Fellgedruckte Werte

2.1 Aut den tür den Publikumsverkehr anzulegendenParkplàtzen sind mindest.ns 3'l'o der Pkw-Stellplätze tür

Schwerbehinderte (Gehbehinderte oder RolIstuhlbenutzer) lU reservieren . Oiese Siellplätze sollen in

Gebäudenahe liegen und moglichst überdach t sein . inP a r ~ h ä u s e sollten diese Stellplätze in unmiltelbarerNähe der Aufzüge angeordnet werden.

2. 2 Die tür Schwerbehinderte resentierten P k w ~ S t e l l ~ plätze sind - urn den E i n ~ und Ausstieg zu ermöglichen -350 cm breit anzulegen. Schmalere Stellplä!ze sind zulässig, w8nn parallel eine freie, Fläche yen mindestens

'5 0 cm 8relte - z. 8 . ein Gehweg - vorhanaen ist.

2.3 Die Pkw ' Slellplälzc für Schwerbehlnderle sind durch

Beschilderung kenntlich zu machen.

2.4 Der Zugang zu den Pkw·Stcllpliitzen tür Schwerbehinderte is l na eh DIN 18024 Teil 1. Ausgabe November1974. Abschnilt 1 und 2. zu geslalten.

3 Bewegungsfreiheit innerhalb des Gebäudes3.1 Niveauunterschiede. deren Überwindung ausschlieBlich über Stufen oder Treppen mbglich ist. sindunzulässig .

3.1.1 In bes onderen Fällen (z. B. bei Gleisunterfütvungenaut Bahnhöfen) kbnnen zur Überwindung des Niveauunterschiedes Rampen zweckmäBig sein. Diese Rampensollen ein GetäHe von 8 % nicht überschreiten. Sie sindin ihrer ganzen Län ge und beidseitig mit Handläulen auszustatten. Sie müssen - zwischen den Handläufengemessen - mindestens 150 cm breit und mit griffigerOberfläche'l verse hen sein .

3.1.2 Im übrigcn sind zur Überwindung von N i v e a u u n t e r ~ schieden vellikale Betörderungsmittel (z. 8. Aulzug)erforderlich.

Der Fahrkorb minde stens eines Auf.i:uges ist wie folgtIU bemessen:

a) lichte Breite

b) lichle Tiete

c) lichte Türbre ite

;:: t 10 cm

;:: 140 cm

;:: 80 cm

und mit Haltegri:!en auszustatten.

In Gebäuden mit gröBerer Besucherzahl ist mindestensein Aulzug mit einer lichten T ü r b r e i t ~ = 110 cm vorzu'sehen .

Var den Aufzugszugängen ist eine Bewegungsfläche von

mindestens 140 cm X 140 cm erlorderlich.

3.2 in a l l ~ n Räumen (ausgenommen Sanitärräumen) muBeine Bewegungsfläche von mindesten. 140 cm X 140 cmvorhanden sein.

3.3 Alle Türen müssen eine lichle Durchgangsbreite von

mindestens 85 cm aufweisen.

Vor Drehtlügeltüren') muB in dem Raum. in den die iü rschlägt. eine Bewegungstläche nach den in Sild 1 dargesteilten Abmessungen gesichert sein.

3.4 An Durchgangssperren sollte eine lichte Breite von85 cm nicht unterschritten werden

3.5 Zugänge zu besoneeren Plätzen tür Rollstuhl

benulzer in Versammlungs- und Vcranstaltungsräumensind durch Seschilderung kenntlich zu machen.

3.6 Die über die Fesllegungen von Abschnilt 3.1 hinausvorhandenen Treppen sollen mbglichst geradläufig sein.Bei gewendelten Treppen sind Handläufe aut beidenSeiten anzubringen.

Der H2ndlaut am Treppenauge dart nicht unterbrochensein. Der Wandhandlauf soli Antang und Ende desTrerpenlaufs rechtleltig e r k e ~ n b a r machen . Die Hand,läute müssen guten Zugrrtl und sicheren Hall bielen.

Die Stufen sind mi l griftiger Oberfläche zu versehen.Vorkrägende Trittstufen sind zu vermeiden.

') Darstellung n"ch DIN 1356

') Z. B. GuBasphalt mi t Quarzeinstreuung



3.7 In Sporlbaulen sind enlsprechend bemessene

Umkleidekabinen tü r Behinderle und mindeslens ein

Duschplalz nach DIN 18025 Teil 1. Ausgabe Januar 1972,Abschnitt 4.3, vorzusehen .

4 Öffentllche Fernsprechstellen

In ötfenllich zugängigen Gebäuden soli mindeslans eine

öttenlilcha Fernsprechslelle sa geslaltel werden, daBRoIIsluhlbenulzer unmiUelbar bis zum Fernsprech·

apparal gelangen können. Bei Fernsprechslellen. die

nichl durch Sei!enwända begrenzl sind, isl der unmiUa!·bare Zugang am etreslen gewähr!eislet.

Nummernschalter (Wählerscheibe), Handapparal (Hörer)

und Münzeinwurt soillen sa angeordnel sein, daB sie vaneinem RoIIsluhlbenulzer bedient werden können.

Die Fernsprechslelle isl durch Beschilderung kennllichzu machen.

5 Sanitärräume

In Gebäuden mil gröBerer Besucherzah! isl mindeslens

je ein WC für Schwerbehinderle vorzusehen.

ClC:!Alt

1

/

I~ 8 5 - - 1

15

15 ~ 3 0 I :

. /

~ 2 5 I

,I

DIN 18 024 T ail 2 Se ile 3

5.1 Das WC isl mindeslens mil

Spülklose1t b = 40 cm

Handwaschbecken b;;: 40 cm

Ha Ilevorrichtungen

auszusla1ten .

t nech Fabrikal

t;;: 30 em

Die Sitzhöhe des Spülklosetts soli 50 cm bet ragen. Es

wird emptohlen, die Bedienungsvorrichlungtü r

die Spü·lung seitlieh anzuordnen.

Aut einer Seile des Spülklose1ts muB eine 80 cm breileBewegungstläche vorhanden sein. Die treie Zutahrt zu

dieser Bewegungstläche muB gesichert sein.

Var dem Spülklose1t ist eine 120 cm tie te Bewegungs·

tläche treizuhalten.

Abslände und Bewegungstlächen siahe Bild 2.

5.2 Die Türen dürfen nicht naeh innen autsehlagen,

Pendeltüren siM unzulässig.

5.3 Der Zugang muB den Festlegungen van Abschni1t 3

entsprechen.

5.4 Das WC ist durch Beschilderung kenntlich zu machen.

o

Maaewie linkes Bild

o. / D

/L __

~ 2 Z 2 Z 2 2 Z Z Z 2 Z Z Z Z : 1 MaBewie linkes Bild

Bi ld 2. Bemessung eines WC (spieg ell) ildl iche , r d n u n g möglich)



Se;le 4 DIN 18024 Teil 2

6 Beschllderung

Bei der Besehilderung (siehe Abschnilt 1.1,2.3,3.5, 4 und

5.4) ist das in Bild 3 dargestellte internationale Bildzeichen

zu verwenden .) .

A n mer kun g: Oas Bi/dzeiehen sollre auch in Reise-

führern, Sradrp/änen, Unrerkunftsverzelchnissen und dgl.

ro r Kennzelchnung von Gebäuden, die d/eser Norm enr-sprechen, verwender werden.

') Die Darsteliung entspricht nur der graphischen Ge-staltung. Für die technische Ausführung gilt DIN 30 600

Blalt 496.

Weitere Normen

Bild 3. Internationales Bi/dzeiehen

DIN 18024 Teil 1 Bauliehe MaBnahmen !ür Behinderte und a/te Menschen im öHenllichen Bereich; Planungsgrundlagen;SlraBen, Plätze und Wege

DIN 18025 Teil 1 Wohnungen tür Sehwerbehinderte; Planungsgrundlagen; Wohnungen für Rollstuhlbenutzer

DIN 18025 Teil 2 Wohnungen für Sehwerbehinderte; Planungsgrundlagen; Wohnungen tür Blinde und wesentlich Seh-

behinderte



DEUTSCHE N ( ) I \ ~ I E : " J Janu:!r 1972

r - - - - " r - W ~ i ; ; ; ~ l : l l ~ ~ ; ~ ~ ~ : ~ ~ ~ ; ( ; f ~ ~ ~ ~ i ,;d erte - - - - - ~ ~ ~ ~ 5 - -Wohl1l1l1gcl1 fu r HolIstuhlbcl1l1tzcr Blett 1

D \ \ l " . n g ~ :o r "'flously d"abled p"rsolls. de>lgn prlnelples. d\\ellings for \I heel ehalr users î \ i . ! eP!<lU. T\u! ,..,' eT\stll>

oV).e T\ v ) .

f o t O ~ n \,e!\\eMal3e in cm IICrI ).

Roll stuhlbesitzer sind Personen. die sowohl im Freien wie innorhalb von Gebäuden auf Fahrzeuge angewiesen sind.

Uberwiegend halldelt es sich hierbei um Körperbehinderte, die an beiden Beinen gelähmt bzw. beidseitig beinamputiert

sind.

Jlau shalte, denen ein llollstuhlbl'llulzrr unbcliörl, haben einen ~ r ü r . l e r e n \I 'ohnniichenbeuuf als vergleichbare.J\'ormal·haush,lte. Im wesenl.lichen sind grö!>ere, dcm \\'elldekreis des Zimmerrollstuhls entsprecliende Bewegungsnächen

erfcrderlich. i\u13rrdem sind einige der ill DIN 18011 und DIN 18022 feslgeicgten Wnueslstellnächen breiIer zuberne",en, da der Stauraum, der sich aufgrund der Mindl s tsll'I:f,jchcn nach DIN 18011 bzw. DIN 18022 ergibt, vam

RolIslllhlhenutzer infolge seines g('ringen Greifboreichs Ilichl voll g,·nulzl werden kann. Daneben isl eine Reihe beson·

dl'TCr GmndrifJ- \lncl Ausstflllungsmerkn!<1lc Z\I bC';Jchten, die d(' 111 I3chindrrtcn dasWohncn\lndWirlschaflencrleÎchlern.Die vorlicgcnue Norm gehl davon aus, dall dem 1l0iLstuhlbenulzer jeder Raum der Wohnung zogängig und alle Einrich·

tungs- und Ausslnltungslcile erreichbar sein müssen. In Wohlll1ngl?n fliT t1lrhrere Personpn z. B. darf der Rollstuh)·

br!1utz(,T nichl [:!ezwung<'11 sein, sirh nur auf sc ine Schlaf· und S i ' n i t ä r r ~ u m e zu b('schränken. DUJch entsprechende

Bemc5'tl ng und Jltlsslattung allrr Iliillille der Wolrnung wird uer Ilollstuhlbenutzer hingcgen in die Lage versetzt, nichtnur I'On fremder Hilfe weilgehend unabhängig zo sein, sondern im ~ l e h r p e r s o n e n · H a u s h a l t auch lätig milzuwirken.

Das triigl zu seiner Ilclrabililation wesentlirh bei.

Für edleillstehende RolIsluhlbenutzcr, die bei ihren Alilagsverrichlungen weitgehend oh ne fremde Hilfe auskommen,

sind Ein.Personrn .Wohnungen \'orlusehen.Die ~ o r m gilt nichl fur Wohneinhei\.cn in Heimen.

Die in dieSel Norm enthallenen H i n w c i ~ auf DIN 18011 und DIN 18022 beziehen sich auf DIN 18011, Ausgabe

März 1967, und DIN 18022, Allsgabe Novomber 196'/. Sowei! diese Norm nichts anderes bestimrnt, sind die FestIe·

gungen de r Normen DIN 18011 und D I ~ ' 18022 sinngemiifl ~ n z u w e n d e n . Die .ngegebenen LängenmaJ3e sind als AusbaumaJ3e zu vcr:;tenen.

1. Begriffe1.1 . Einrichtung

Einrichtung im Sinne dieser Norm sind Gegenslände, die

vom Wohnungsnutzer einJ;<:bro.chl wl"rdcn.

1.2. Auss\.altung

Ausstatlung im Sinne dieser Nonn sind bauseitig einge-brachte und io der eingebaule Teile des Innenausbaues.

1.3. Stcllnächen

Stelln.iche n im Sinne dir,er Norm geben den Platzbedarf

de r Einrichtungstcile nach Breile (b) und Tiefe (I) an.

1.4 . Ikweguilgsniichen

Bewrguilgsniirhen nach diesrr ~ o f l n sind die zwischen

den vorderen hzw. seitlichen Begrenzongen von Steil·

närhen bzw. Jlusstaltungsteiien

und gegenuberliegenden Stellnächen bzw. Ausslatlungs·

leilen IlZw. Wiinden

frei bl"i benden Flnrhen. Sie schlier:len den Platz, der zur

Benutzung der Ein richtung bzw. Ausslattung erforderlich

ist, sowie die Flächen für in den Raurn schlagende Türen

ein.

Zu den Ilewegungsnächen zählen darüber hinaus au eh

diejenigen Flächen, die nolwendig sind, urn zu allen

Räumen sowie Ausslatlungs· und Einrichtungsteilen zu

gelangen.

2. Bemessung von Wohnzimmer, Freisitz, Flurund Abstellraum

2.1. \\'ohnzimmer

Für \\'ohnzimmer durfen folgende RaumgröJ3en nicht

unlerschritlen werden:

a) in Wohnungen rur 1 Person 20 m 2

b) in Wohnungen rur 2 bis 4 Personen 22 m 2

c) in Wohnungen fur 5 Personen 24 m 2

dl in Wohnungen fur 6 un d mehr Personen 26 m 2

Fortsetzung Seite 2 bis 4

F:lchnornH'n;llIsschlll3 BallWCSt'n im Deulschc'n Normcn"ausschuB (DNA)

A""ni'-'"-',-"u-r " : ; : - , , , , , , . " ; ; ; : ï , - ' - " " , , , , v - . . , : ; ; ; : . C - ' ' ' ' ' : ; · ' - I l -, , , , I O - u - , d - ' ~ , , ' n - , "7:'

DIN 18 025 81. 1 Jon. /972 Prcisgr."

\\



Seile 2 !JIN 18025 Blalt 1

\lïrd - auet" dem Woh",.ill1l11cr - ein b e ~ o n d c r e r Roul11

orlor I'oulllleil als El3plalz grm:ir.l DIN 18011,

J\bschnitt 2.2, nachgewÎesen, gpniigt flir das Wolm-zÎllllller rille Héllll1lgrüt3c vun mindrslens 20 m2,Vildurch;;khti,'e Teile der Fensterbrlislungen sollten -

rI", bosseren J\usblicks _. nicht höhcr als GO cm·reiche n.

2.2. FreisitzFür jeele Wohnung ist ein Balkon, eine Loggia oder eineTerras.'e mit den in DIN 18011, Abschnilt 2.3, geford.rten

Mindcslabmcs.>lmge n vorwsehen.Empfohlen werden Oberdochung und seitlicher Schu!zg e ~ e n Welter u nd Sicht.Undurchsichtige Teile von vorderen BfÜstungcn dürren -wegen d . besseren Ausblicks - nicht höher als GO cmreichen.

2.3. Flur

B e w e ~ u n g s f l i i c h e n in Fh",'n dûrren die Abmessung140 cm x 140 cm nicht unlel'schreiten.DIN 18011, Abschnitl 2.7, is! zu beachten.

2.4. Abstollrallmlnnerhalb der Wohnung ist J\bslellraum von 2 % der1V0hnfliiche, jedoch von mindeslens 1 m 2 Grundfliicheedorderlich. In Wohnllngen ru, 1 Person ist Abs!ellraumvon mindes!cns 4 m 2 Grundfläche erforderlich, wenn derKeiler· bzw. Bodenverschlag nicht stufenlos - z. B. übereinen Aufzllg - errcichbar is!,Begchbarer Abstellraum darf die Abmessung140 cm x 140 cm nicht unterschreiten.Abslellraum in Farm von Nische n darf höchsleo, 7G cmtief sein.Der Abstellraum muJ3 einem Flur zugeordnet sein.

3. Stcllflächen in Schlafzimmern

3.1. EinbettzimmerFlir folgenrle Einrichlllng sind Stellflächen erfo rderlich :a) 1 Belt b ;;: 205 t ;;: 100b) 1 Schrank b ;;: 120 t 65

c) 1 tischhohes Möbelstlick b ;;: 120 - 65

3.2. Zweilbet!zimmerFlir rolgende Einrichtung sind Stellfächen erforderlich:a) 2 Betten je b;;: 205 t <: 100b) 2 Schränke je b 0:: 120 t 65

c) 1 tischhohes Möbelstiick b i': 120 t

4, J\usstnttllng und Stellflächen in Kiiche,

IInw;arbeilsraum und Sanitärriiulllen4.1. Küche4.1.1. Folgende Aussl attung ist erforderlich:a) Àbstellplalte. b ;;: 60b) Dopprlbcckcnsplilc b i! 80c) kleine J\rb\'itsplalle b ;:: GO

65

d) Ilerrlmulrle (mit mindestens3 1<0cl"lollen) b nach Fabrikat

e) J\bslellplattc b ;;; 30Die Allss:altllng ist in rorstrlll'nder f\eihenfolge aufeiner 85 cm hohen, rlurchlaurcnden Platte, I = GO cm,nnzuoruncn.

IIf'rc1muldr, /\rlH'it!'pl;,Ul' ulld Spii!(· n l l i ~ ( " n unlC"rf.,hrbar!.:..,.·În. dit' (kIJft> J!illll' tlWfl da"lu m i l l ( h ~ ~ l l ' l i S GIJ cm b l ' t r ; l ~ c n .

4.1.2. Fiir rolgende Einrichlllng sind Slellflächenerrorckrlich :a) ,t St! lr.l:1khohr Einrich·

je b 2: GO 1 ·60tUllg ,;I"i le J)

b) tischhohcr I<iihlschrallk b 0: 60 2) t = 60c) grol.le Arbt'itsplatte b ;;: 120 t = 60DIN 18022, Abschllitt 3.1.1.2 und TabelIe 2, sind nichtanzuwrndcn.

4.1.3. fiir Wohnullgen fur 1 Person wird die Ànordnungder Kiiche als ein dem Wohnzimmer angeschlossencsKochabteil el11prohlen. Alldern ralls is! in der KüchezlIsälzlich ei n Platz zlIr gclecrntlichC'1l Einnahme vonMahlzeilen (siehe DIN 18022 Abschnitt 3.1.1.7) erfor·derlich.

4.2. H.u s,crbci!sraumFlir lIauS:llbeitsräume gilt DIN 18022 Abschnitt 3.1.3.

4.3. S>llit"rräume4.3.1. f . ~ n i l ä r r : \ u m in Wohnungen für 1 ~ r s o4.3 .1.1. Folgende Ausslattllng isl errorderlich:a) s c : ' , ~ l a t z mil

FuC:Jodrneiniauf b;:: 140 ;;: 140

b) Waschtisch b;;: 60 ;;: 50c) Spiilk lo sett b - 40 t nach F"brikat

Duschplatz und Spiilldosett sind nebeneinander anzuordnen.

Der Duschplatz mul3 mit dem RolIstuhl befah"rbar sein.Si . Silzhëhe des Spülklosetls soli 50 cm belragen. Es wirdp m p r ~ t , l e n , die Bcdienungsrorrichtung fUr die Spülungscitl'.' h . d. h. im Greifbereich des RolIs tuhlbenutzers,ilJl;.uo:dnen.

Nach Ilozug der Wohnung sind am Duschplalz und nebendem Spiilklos.tt. den individuellen Errordernissen desjeweiligen f\ollsluhlbenulzers angepal3l, Halte· bzw.Stützvorriclltungen anzubringen. Slabile Verankerung islerrorderlich.

4.3.1.2. ISl ein Hausarbeitsraum mil Wasseranschlut:\(Slohe Abschnitl 4.2) nicht vorhanden, so sind im Sani·tijrraum Stellfläche und Anschllisse fur ei ne Waschmaschine.b ;;;: 60 2), 1 = 60, erforderlich.

4.3.1.3. Der Sanitnrraum mul3 unmiltelbar 1'001 Sehlaf·zimmN 7.ugängig sei n. Ein zweiter Zugang vom Flur wirdemprohlcn.

4.3.1.4. Ln.1bhängig da"on, ob der Sanitärrallm durchrensIer beliJrtet wird, isl Lürtung durch ~ I o t o r k r a f t errordorlich.

4.3.2. S a n i ~ ä r r n \ l m in \\'ohnunccn rür 2 Personen

4.3.2.1. In \\'ohnungen fur 2 Personen genligl ein Sanilär·raum nach Abschnilt 4.3.1. Ein zweiIer Zugang vom Flur(siehe J\b,rllllitl 4.3.1.3) ist jedoch slels erforderlich.

4.3.2,2. En'pfohlen wird eine Lösung nach Abschnilt 4.3.3.

4.3.3. Sanitärräumc in Wohnungcn fl.ir 3 und

t n ~ l 1 t P t " ' r ~ o n c n 4.3.3.1. In Wohnungon rlir 3 und mehr Personen ist eindcm RolIstuhlbellutzN 1'0rbehaltenN. unmillelbar I'onseinem é l r z i m l l 1 ~ r zugängiger Sanitärraum !lach

Abschnitl ·1.3.1.1 und 4.3.1.4 anzuordnen.

1) In WohnungPIl rur 1 P N ~ o n gcnligcn 2 schranl.;hohe

Einric:lt 1I Ilt!slrile.

2) Diesc ~ l : n d " s t a b m e s s l l n g wurde kleiner als in derderzeitigen Fa ssung von DIN 18022 restgelegt, dainzwisc:hf'n (!Nartig(' H a u ~ h a l t s g e r ä t e mil kleineren

\ h m ( , ~ s l l l l ! ! e n , aher mil ~ I l ' i c ' h e r mier höhercrLcistllll1:. ;J1I1!t'uulen Wl' rI..Il'n.



4.3.3.2. Daruber hinalls sind die üblieh"" Sa"it.irr'illme

I'.'(h DIN 18022, i\b,chnitl 3.2, anwordncn.

Der in DIN 18022, i\lJschnilt 3.2, 3.2.2 und 3 . ~ . 3 . ge·nannte GrrnzwNl von .. W o h l l l l n ~ ( ' n fijr Ille!lr Jls 5Per:iolwn" "'rh0hl ~ i c h , da ruT dril zum lIaushalt zjhlrn·

'". HolIstllhlbenutzer cin separater Sanilärrilum !lachAbschnitt 4.3.2.1 : o'eits vanusehen ist, auf ,.\\'ohnungen

fur insgesamt mehr als 6 Personen",

5. Abslände

5.1. Bei der Bemessung van Räumen bzw. Rallmteilen,

in denen ein Ef.lplatz nachgewicsen wird, und bei de r

Bemessung van Schlafzimmern sind die i\bstandsregeln

van DIN 18011, TabelIe 5, anzuwenden.

5.2. Bei der Bemessung van Küchen, Hausarbeitsrällmen

unr! Sanitärriiumen sind die i\bstandsregeln van

DIN 18022, TabelIe 8, anzuwenden.

6. Bewcgungsflächcn

G.1. Die Breite der zur BenlltZ\lng der Einrichtunr, bzw.

Ausstattung erfarderlichen llewegungsnächen ergibtsich aus der Breite der Stellmichen bzw. der Allsstattungs·

teile.

Bei L· un d U·förmiger Küchenanardnung können Steil·fläehen flir tischhohe Einrichtungsteile lInmittelbar an die

Varderkante der Abstellplatten (Abschnitt 4.1.1 aund e) staf.len. .

Ein mindestens 85 cm breiter ZlItritt zum D,,,rh platz

(Abschnilt 4.3.1.1. a)) mllf.l gesicherl sein.

G.2. Die Tiefe der Bewegungsflächen darf 14 0 cm nichl

unterschreiten; das gill all eh flir die Sanitärräume nach

Abschnitt 4.3.1, 4.3.2.111nd 4.3.3.1.

Für die Tiere van BewegungsOächen in SaniUirräumen

nach Abschnitt 4.3 .3. 2 genügen die Aniarderungen nach

DIN 18022, Abschnitt 6 .Werden in Zweibeltschlafzimmelll die StellOächen fur

die Betten unmittelbar nebeneinander angeardnet, genügt

auf einer Seite eine BewegungsOäche van mindestens

85 cm Tiefe.

Vor dem Dlischplalz (Abschnitt 4.3.1.1 a) bralIcht eine

BeweglingsOäche nicht besanders nachgewiesen zu werden.

Sie ergibt sich in ausreichender Gröf.le durch die erfarder·

Iiehen BewegulIgsOächen var den anderen Ausstattungsteilen.

6.3. lm Hinblick auf die in Abschnitt 6.2 gefarderte all·gemeine 11indcstliefe der Bewegungsfliichen erübrigl si eh

ein besonderer N ~ c h w e i s für Spielmichen nach

DIN 18 C11, Abschnitl 4.3 .

6.4. Alle Tiiren müssen ei ne Iichle Durchgang,breile van

mindestens 85 cm und hüchslens 110 cm huhen . Auf der

Bandseite dt'T Türblälter isl ein Griff anzubringen, mildem der Rallsluhlbenutzer die Tür zuziehen kann (siehe

Bild 1).

/ rr· ·· /./,'',,, "

:! \V)I i

__ _ .____J10 ' 1 : L

>-. Tür -< a -

a I b

25

i

1 /0

35 JGO

45 15 0

55 14 0

Z\''''ischcnwC'fteilllerpolicrcn

Dild 1. B e w e g u n ~ ~ n ä c h c vor 'fün'll

DIN 18025 lJIatt 1 Seite 3

6.5. 1\ nWohllllllgscillCOlngslün'I1,élnS;mitärrallmtUren und an'l'lirrn. die ins Fede flihn'I1, sind Schwrllcn oder Niveauunlersl'hiede bis Z\ I 2,5 cm zwlä"ig. Weitere Sehwellen

oder : \ i \ ' C é ~ u l l l l t e r 5 C h i c · d l · innrrhalb der Wohnllng sind~ j ~ . s i g .

6.6. Var Türen muf.l in dem Raum, in den die Tür sch lägt,eine !lewegungsOäche nach den in Bild 1 dargestelllen

AbmC'ssungen gcsichert sein.

7. Bc :;ondcre Anforderungen an die Ausstattung

7.1. Alle Bedienungsvarrichlungen (Sleckdasen, Taster,

Sicherungcn, Armatllfl'n, Griffe, Rolladengetriebe, Tür·drucker, Briefklappen usw.) sind sa anzuardnen, daf.lsie

im GreiOaereich des Rallstuhlbenutzers liegen . Es wird

empfahlen, die Höhe van 105 cm über dem FlIf.lbaden

nicht zu überschreiten.

Ansiclle van Schaltern werden Taslplatten empfahlen.

7.2. In Sanilärriiumen nach Absc hnill 4.3.1, 4.3.2.1 und

4.3.3.1 sowie in Küchen und Hausar bcitsräumen sind

die \\'orlllwas,<,rzapfslcllen mil Tcmperaturbegrcnzern

all:i'l.lIslallen.

Heif.l',\'asserrahrc sind zu \'erkleiden.

7.3. Als Beheizllng kommt nur Zenlralheizung ' - mil

Heizkörpern ader Ful3baden·Slrahlllng sheizllng in allen}\ufrnthaltsrälllllcl1und Sanitärriiumcn - in Betracht.Die Heizung isl fur eine Raumtemperatur van 22 ae, inSanitiirrälllllen nach Abschnitt 4.3.1, 4.3.2.1 un d 4.3. 3.1

fur ei ne Raumlempe ratur van 24 ae zu bemesse n.

Hciz körper und lleizrohrleitungen sind sa anzuardnen,

u"fl sie auf.lerhalb der erforderlichen SlellOächen, Abstände

und BcwegungsOächen liegen.

7.4 . Es wird empfahlen, an allen Fenslern Varrichtungen

zur Dallcrlüftung. z. B. Kippnügel, anzubringen . .Au f

zwedonär..ige Anordllung der Bedienungsyorrîrhtungen(siche Abschnitt 7.1) wird hingewiesen.

7.5. Anschlul3möglichkeit an das öffentJiche Fernsprech·

nctz is l erfardcrlich. Ballseits ist die Anlage mindeslens

bis zur Abzwcigdas. nach DIN 18015 Blal! 1, Allsgabe

August 1965, Abschnilt 3.2.3.2,auszurtihren .

l\atrufanlagen - in sbesandere Feuermeldeanlagcn - sind

je nach Erfordernis einzubauen. Sie sind in Wohnungen

reir 1 Perso n stets erfarderlich.

Eine Sprcchanlage zwischen Haustür un d Wohnung

saw ie elektrische Türöffner fur Haus· un d Wahnungslür

werden empfahlen.

7.6. Als Hilfe für das Ulllsleigen sind tragfähige Schienen

in der Dcckea) \'an Sanitiirrriumen nach Abschnitt 4.3.1, 4.3.2.1

lInd 4 .3.3. 1 n"ch Bild 2,

b) des Rallstuhl·,\bslellplalzes (Abschnill 8.3) nach

nild 3,

c) dor Garage (Abschnitt 8.5) nach Bild 4,

rÎlll.ubauen.

Die Decken der Schiafzilllmcr müssen den nachlriiglichen

Einh:lll t r a g r ~ i ! l i g e r Schi0nrll zulassen.

8. Zllgang zu HallS und \\'ohnung

8.1. Der Zugang ZUIll HallS mllf.lstufenlas gestallet sein.Der Zugallgsweg mu1'3 mÎndestros 120 cm breit sein.Rampen sind zulässig, ihr Gefälle darf jedach nicht mehr

a:$ GC;n bctri1gC'll. Dei Rampenlängen \'on mehr als 6 mist

ein Zwischenpadesl von mindestens 12 0 cm Länge erfar·

derlich. Pod ('slp\ '00

mindcstcns 12 0 cm Längc sind aul3er·dcm Olm J\nfang und an1 Ende der Rampe anzuordnen.



Seit.c 4 DIN 18025 Blall 1

.. . · / / . / 7 7 7 / ~ 7/ <L.:.2.LL-i

I Dusd;'::l 0! p{o{z IL I , ., __ :.t

. r - ' ~ ' - " " - '-+ __ __ --1 •

i I

L--

125

- -1

Bild 2. Schiene im Sanilärraum

/ .>/,

Bild 3. Schiene im RolI sluhl·Absleliplalz

·---- 1

I ' I

I i I. ;:; : 7 / ? ' ~ - : ; : : ' ~ : ' " 7 ? ~ J <_"::::_ /__ /' <t '/ '/ // ,/ /L'L.' • ~ _ 8 C"\j t

!_ -- - 200 - -- --J.-- - 2 0 0 - - - ,

Bild 4. Schi,'non in der Garage

Rampen von mehr als 3 m Uinge sind mil einem lIand·lauf in 80 cm Höhe auszuslalten.

8.2. Der Wohnllngseingang mul3 vom Hauseingang stufen·

los erreichbar sei n. Die Gangbreite mul3 mindeslens

J20 cm bl·tragen,

F.ür in Obergeschossen liegende \\'ohnungen isl ein Aufzug

erforderlich. Die Aufzugskabine is! wie folgl zu beml'"en:

aj lichle Breite ;;;; 110

bj Iichle Tiefe ;;;; 140

cj lichle Türbreile ;;: 80

Die Aufzugskabine is! mi t lIaltegriffen auszust"llen. Die

Dnlckknopftafel isl an der Stimsrite der A u f Z l l ~ s k a b i n e , in 105 cm lIöhe über Fuflboden, anwordnen.

Vor dC'n J\urZu{!szugäng:f'n ist eine Brwt'gungsO:iche ,"'onmindestens 14 0 cm x HO cm rrforderlich.

8.3. Sofern nicht Caragen nach Abschnitt 8.5 vorgcsehensind, ist innerhalb des Hauses. jedoch aur?erhalb der

lI'ohnung ein HolIsluhl·Abstellplatz, de r zugteich lu m

Umsteigen vom Straf)enrollsluhl in den Zimmerrollstuhldient, anzuordnen, Der Rollstuhl·Absteliplatz mulJ mit

Heizung ausgeslattet sein,

Der RolIstuhl·Absteliplatz mul3 - unbeschadet der Gang·breite (siehe Abschnitl 8.2) oder anderer Bewegungs·flächen - je RolIstuhlbenul7.er eine Fläche von mindestens

175 cm Breite und mindeslens 150 cm Tiefe haben.

8.4, Hauseingangstüren müssen eine lichte Durchgangs·brei te von mindeslens 95 cm und höchstens 110 cm

haben.

Abschnille 6.5 und 6.6 geiten sinngemiifl.

8.5. Garagen müsscn ei ne lichte Breit.e ron mindestens350 cm haben. Si€' müssen mit Ileizung ausgestattet sein.

Orr ZUg:.1l 6 \·om H ~ u s Zllr G:ifage mur., stufen!os gestalletsein. Du}jeÎ sind Lösunben a!1 zustreben, die es dem RolI·sluhlbenutzer ersparen, den Weg zur Garage durehs Freie

zu nE'hIJlen.

Eine automatische Ste\lenlng des Garagentores wird

emprohlen.



,

c

§oZ

Dwellings far seriQusl)' disabled persans; design principles; dwellings far blind persans and thase having essentialdiffieull)' in seeing

Marle in cm

Fotokopienur fü r den

i n t e rnen

Di ell:'> t .."br<1 uch

Haushalle, denen ein Blinder ader wesentlieh Sehbehindl'rter angehört, haben einen grörleren Wahnnächenbedarf alsNarrnalhaushalte. Im wesentlichen sind grör.lere Bewegungsnächen erfarderlich. Daneben ist eine Reihe besondererGrundrir.l· und Ausstattungsmerkmale zu beachten, die <jem Blinden und wesentlich Sehbehinderten das Wohnen IIndWirlsehaften erleichlern.

Diese Narm gilt auch rur Wahnungen in Bllndenzentren l ), jedoch nicht rur Wohnplätze in Blindenheimen.

Die in dieser Norm enthaltenen Hinweise auf DIN 18 011 beziehen slch auC die Ausgabe Män 1967, die HinweiseauC DIN 18022 auC die Allsgabe Noyember 1967. Sowei! diese Norm nichts anderes bestimmt, sind die Festlegungender Normen DIN 18011 und DlN 18022 sinngemäl:l anzuwenden.

1. Begriffe

Es geiten die BegrifCsbestimmungen nach DIN 18 025

Blatl 1, Ausgabe Januar 1972.

2. Bemessung von,Wohnzirnmer, Freisitz,Flur und Abstellraum

2,1. Wohnzimmer

2.1. 1. ~ I e h r p e r s o n . n w o h n u n g e n In \\'o hnungen rur Mehrpersonenhaushalte, denen einBlinder oder wesenllich Sehbehinderter angehört, sindzwei Wohnlimmer vorzusehen, ei nes, das allen Haushaltsmitgliedern dient, das andere, das dem Blinden oder

wesentlich Sehbehinder ten vorbehalten ist,

2,1. 1. 1. Das allen Haushaltsmitgliedern dienende Wohn·zimmer muG in Wohnungen rur Haushalte bis zu insge·samt

4 Personen mindestens 20 m2

5 Personen minde,tens 22 m2

6 Personen mindestens 24 m2

grorl sein. Wird der EGplatz als selbständiger Raum (siehe

Abschnitt 2.1.1.3 b) oder in der Küche (sieheAbschnitt 2.1.1.3 cl eingeplant, so genügt- ungeachtetder Haushaltsgrörle - flir das Wohnzimmer eine Raum·grö(le von mindestens 20 m 2 ,

2.1.1.2. Das dem Blinden oder wesentlich Sehbehindertenvorbehallene Wohnzimmer mul:l mindestens 15 m2 grol:l

sein, Es ist mit mindestens 6 Steckdosen auszustatten.2.1.1.3, Ein EJ:lplatz nach DIN 18011 mul:lstet.vorhanden sein, Er kann entweder

a) im Wohnzimmer oder

b) als splbständiger Raum oder

cl in der Küche

eingeplant werden, In den Fällen a und b muG er

unmiltelbar der Küche zugeordnet sein.

2,1,2. EinpersonenwohnungenDas Wohnzimmer in Wohnungen rur alleinstehendeBlinde oder wesentlich Sehbehinderte mul:l mindestens22 m2 grol:l sein, Es ist mit mindestens 6 Steckdosenauszustatten,

Für den I::Gplatz gilt Ab,chnitt 2,1.1.3.

2.2. Freisitz

Für iede Wohnung ist ein Balkon, eine Loggia oder eineTerrasse von mindestens 180 cm Tiefe und 5 m2 nutz·barer Grundnäche vonusehen.

Empfohlen werden Uberdachung und seitlicher Schutzgegen IVetler und Sicht.

2.3, Flur

Eingangsnure müssen mindestens 140 cm, Stichnuremindestens 120 cm breit sein.

Es wird empCohlen, rur die Kleiderablage eine Nische 'lor·

zusehen.

2.4. Abstellraum

In Geschor.lwohnungen ist Abstellraum von 2 % der Wohn·näche, mindestens ie doch 1 m2 Grundl1äche, erCorderlich,

Begehbarer Abst.llraum muG mindestens 85 cm breitsein.

Abstellraum in Form von Nische n muG mindestens ÓO cm,höchstens iedoch 75 cm, t ief sein.

Der Abstellraum muG einem Flur zugeordnet sein.

3. Stellflächen in Schlafzimmern

3.1. Einbettzimmer

Für Colgende Einrichtung sind StelInächen erCorclerlich:

8) 1 Bett . ' , , , . , , . . . , . . , . ' b 205, / - 100

b) 1 Schrank" . . """.". b;:;:llO, / - 65

c) 1 ti5Chhohe.s Möbelstück . , . b;:;: 110, / - 65

I) Als Blindenzentr.n werden Anlagen bezeichnet, die ,owohl Wohnungen 31s auch S r e z i a ! . i n r i c ~ t u ~ ~ e n (Werk·stätten, BJchereien , Restaurants u • . ) mr Blinde umCassen,

Fortsetzung Seite 2 und 3

Fachnormenausschul:l Bauwesen (FNBau) im Deutschen NormenausschuG (DNA)



6.5. G"radlinige Raumgrundrisse sind anzustreben.

Grun onäche n, die sich dem Quadrat a n n ä h ~ r n , ~ i n d langgestrecklen Rechteckflöchen vorzuziehen. Slumpf.

oder sp ilzwinklige Raumecken sowie W a ~ d y o " p r ü n g e sind lU vermeiden. '

6.6. Fenster sollen direkt und hindernisfrei zugängig

sein. iJnter renstern von Wohn· ulld Schlafzimmerndurfen keine Stellflächen vorgesehen werden. Unter

Küchenfenstern ist die Anordnung von tischhohen

Ausstaltungsteilen und Stellllächen rur tischhohe

Einrichtungsteile zulässig, wenn gewährleistet ist, daG

die Unterkante von nach innen aufschlagenden Fenst ....

nugeln mindest.ns 12 5 cm ijber dem Fuf.lboden liegt.

7. Allgemeine Anfordcmngcn an die Ausstatt,1tng

7.1. Alle Bedienungsvorrichtungen (Schalter, Steekdosen,

Taster, Sieherungen, Armaturen, FenslergrHre, Rolladen·

getriebe, Turdriieker usw.) mussen ein sicheres un d

leichtes Zugreifen gewährleisten. Versenkte Bedienungs

vorrichtungen sind ungunstig. Scharfkantige Bedienungs.

vorrichtungen sind zu vermeiden.

Bei der Anbringung der Bedienungsvorriehtungen ist au f

einheitliche Einstellung - z. B. aller Kippschalter - zu

achten. Abtastbare !Y!arkierungen sind zweekmäf.lig. Fur

die Höhe von Sehaltern und Steckdosen uber Fuf.lboden

gilt DIN 18015 Blatt 2.

7.2. Aufentbaltsräume und Sanitärräume mussen zentral

beheizbar sein. Einzelöfen mit festen, nüssigen ader

gasförmigen 8rennstoff .. sind unzulässig.

Heizkörper und Heizrohrleitungen sind so anzuordnen.

dal.\ sie auf.lerhalb der erforderliehen Stellnächen,

Abstände und 8ewegungsnäehen liegen.

7.3 . Durch entsprechende Fensterkonslruklionen, z. B.

dureh Dreh·Kippnugel, muf.l verhinderl werden, dal.\zum Luflen geöffnele Fensterflugel weit in den Raum

hineinragen. ~ ! ö g l i e h k e i l e n rur die Anbringung einesSonnensehutzes sollen vorhanden sein.

7.4. Türen sollen mögliehst gegen eine Wand, einen

Ausslattungsteil oder eine Stellf1äehe aufsehlagen. Sie

rnüssen sich urn mindestens 90 0 öf[nen lassen. G r o ~ näehige Glasfüllungen sind zu vermeiden.

DIN 18025 Rlalt 2 Seite 3

7.5. Die 8eläge van Ful.lböden und Treppen sind rIltseh·

fest auszubilden .'luC gute Begehbarkeit der Trepp.n .

ist Wert zu legen. Slark profilierle Stufellk,nten ,illd

zu vermeiden.

7.6. Ansehluf.lmöglichkeit an das örfenlliche Fernsrreeh·

nelz isl erCorderlieh. Die A n l a ~ e ist bauseil. mindestpns

bis zu r Abzweigdose - nach DIN 18015 Blall I,;\usgabe August 1965, Abschnilt 3.2.3.2 - auswftihren.

7.7. Eine gule 8eliehtung aller Räume ist erforderlieh.

8. Zugang zu Haus und Wohnung

8.1. Der Zugang zu m Haus 5011 mögliehst stufenlos

gestaltet sein. Sind StuCen nicht zu vermeiden, soli ten

sic beidseits mit einem Handla"C verse hen sein.

8.2. Treppen in Mehrfarnilienhäusern durCen nicht

gewendelt sein. Es wird ompCohlen, beidseitig des

TreppenlauCs Handläufe vorzusehen.

Der Handlauf am Treppenauge darf nicht unlerbrochen

sein. Der äul.lere Handlauf soli Anfang un d Ende desTreppenlaufs rechtzeitig erkenllbar machen.

[n MehrCarnilienhäusern sollte durch laktile G e s c h o ~ und Lagebezeichnung die Orientierung erleichtert

werden.

8.3. Aufzüge sind mit akustischen und laklilen Anzeigen

auszustatten.

8.4. Freistehende und vorstehende Dauteile sind unzu·

lässig.

8.5. Eine gute Belichtung de r Zugänge un d Treppen is!

erforderlich, um Sehbehinderten, die noch uber eillen

Sehrest verfugen, ein sicher.s Begohen zu errnögliehen.

8.6. Die Wohnungseingänge sind mil einer Gegensprech.

anlage auszustatten.

Die Wohnungsoingangsturen sind mit einer Sieherhei!s·

kette ader einer ähnlichen Vorriehtung zu versehen.

8.7. Abschnitte 6 .5 un d 7.1 bis 7.5 geiten sinngemäl.\.

8.8. Alle Aul.lenanlagen müsscn gefahrlos begehbar se'n.



INGEKOfJlEN iJ 6 dE 11987

ON ENPLOYMENT OF ASSISTANTS

IN OWN ~ o r 1 E

INSTRUCTIONS RE THE SCHEME AND RE THE GENERAL llNES

TO BE FOLLOWED

WITH KIND REGARDS

ARHUS KOrll'lUNES SOC lAL - AND SUNDHEDSFORVALTN I NG

SOCIAL AFDELINGEN

INTRODUCTION

1. WHAT DOES THE

WHO CAN COME U

f. WHO CALCULATES

MEET ING • • • • • •

FOLLOW-UP • • • •

E ~ \ E R G E N C I E S , I

RIGHTS FOR APP

) . How IS THE AID

MEîlNG OUT ...BENEFIT!PAYMEN

MANHOURS • . • • •

PAYMENT FOR HO

y. How IS THE MON

5.

EMPLOYER • • • • •

WAGE - ACCOUNT •

WAGE- AND EMPL

AGREEMENT ABOU

TERMS OF EMPLO

ARRANGEMENT OF

AGREEMENT AB OU

SAVING • • • • • • •

TEMPORARY ADJU

WAGERATES • • • •

HAGESHEETS ••• •

TAX • • • • • • • • • •

VOW OF SI LENCE

ASSlSTANT'S HO

PAYMENT OF HOL

YOUR HOLl DAY •GRANT-IN-AID F

ATP AND AUD (=

INSURANCE

ILLNESS .• • • • •

KARENSDAG (= W

ANNUAL STATEME

INTEREST • • • • •

PRES-ENT RATES



6, CONSULTATION ANP GUlpANCE . • • . . • . • . • . • . . • . . • . • . • • . . . .

ÄPPP. 1: PRESENTATION OF PRAFT FOR MEETING

2: AGREEMENT ABOUT EMPLOYMENT

21

THIS LO

THE MOST

WE UPDAT

ING LOO

You ARE

IDEAS TO

IN ARHUS

FOR THE

ACCORDIN

AT PRESE

PERSONAL

OTHER IM

ADV

TELEAREA

TELE

INSU

BANK

EMPLS



How IS THE MONEY PAID ?

You ARE EMPlOYER FOR YOUR ASSISTANTS. THAT MEANS THAT YOU I EMPLOYER

YOURSELF MUST ENGAGE YOUR ASSISTANTS AND PAY THEM THEIR

WAGES.

THE SOCIAL DEPARTMENT ADVISE AND GUlDE ONLY REGARDING THE

ADMINISTRATIVE PART OF THE ARRANGEMENT.

1/12 OF TH E YEARLY AMOU NT IS TRANSFERRED TO YOUR ACCOUNT

IN THE BANK OR S ~ V I N G S BANK AT TH E END OF EACH MONTH.

PLEASE NOTICE THAT YOU MU ST OPEN A SPECIAL ACCOUNT IN

YOUR BANK/SAVINGS BANK WHICH SHOULD ONlY BE USED FOR

YOUR ASSISTANT'S WAGES. WE WOULD RECOMMENO THAT YOU

ARRANGE WITH TH E BANK ABOUT TRANSFERRING THE WAGES

DIRECTLY TO YOUR ASSISTANT ' S ACCOUNT .

W A G E A C C O U ~

5, TERM S OF WA GE

THIS SECTION CONT

MATION - ALSD FOR

PRINTS (COPIES) O

STANTS.

A WRITTEN AGREEME

OUT BETWEEN TH E E

A STANDARD LETTER

SOCIAL COMMITTEE

FOR AS HANY COPIES

IF THE STANDARD L

TEE GUARANTEES TO

EMPLOYHENT PROVID

1: THAT TH E AG

SPACES FIlLE

2: THAT THERE

3: THAT A CO PY

IMMED IATELY

DATE OF S IGN

IF THE STANDARD lE

POSSIBLE TO HAKE

CO HMIT TH E SOCIAl

IN TH E SPECIFIC C

THE HORE REA SON IS

LETTER OF EM PLOYM

THERE AR E SO ME EX

WI TH YOUR ASS ISTA

1: THE MUNICIPA

HOURS PER DA

PERSON .

2: THE MUNI CIPA

STANTS BELOW

3: THE MUNICIPA

ISSUED: 111 1985



EACH JANUARY ALL EMPLOYERS HAVE TO REPORT TO THE TAX AUTHO

RITIES ABOUT WAGES PAID.

THE SOCIAL D E P A R T ~ E N T REPORT ON YOUR BEHALF - BASED UPON

ALL THE WAGE PAYMENTS MADE BY YOU THROUGHOUT THE YEAR -

REGARDING PRESENT ASO PREVIOUS ASSISTANTS.

~ l l i S T A N T ' S COPY OF THE "TAX 1N F O R ~ A T ION S H l i L . . J . ~ ~ E N T DIRECTLY TO YOUR ASSISTANT.

~ N O T H E R COPY IS FILED IN YOUR FILE AT THE SOCIAL DEPART

~ E N T - FOR CONTROL PURPOSES.

IF YOU WISH TO BIND YOUR ASSISTANTS TO SECRECY LIKE A

DOMESTIC HELP YOU CAN GET NECESSARY FORMULA

FROM THE SOCIAL DEPARTMEST.

VOW OF

SECRECY

- - - - - - - - --- - - - -. - - --

ISSUED: I I I 1935 SUBSTITUTES: PAGE 11 AMENDEO: 1/12

J 3 b ~

THE ASSISTANT IS E

DAY BONUS HAS BEEN

OR NOT.

ACCORDING TO THE HTO A 5 WEEKS' HOLI

HAS NOT EARNED ANY

THE HOLIDAY PERSON

4s FAR AS POSSIBLE

WISHES ABOUT A SPE

Do ARRANGE IT WELL

HOLIDAY BONUS IS A

IT IS CALCULATED A

CALENDARYEAR, BUT

LIER THAN APRIL 1

IS TAXABLE IN THE

UNTIL THE F O L L O W I ~

HOLIDAY BONUS IS A

POSSIBLE "BEING AW

OR TO SOME ACCIDEN

THIS RIGHT TO HOLID

JECT TO THE ASSIST

TIVE MONTHS WITH T

ILLNESS.

THE"HoLIDAYS WITH

FOR THE PERSO

THE HOLIDAY IF SHE

THEREFOREYOU MUST

VIDED THAT YOU DO

VANT ASSISTANT IN

IT.

ISSUED: 1/ 1 1985



ÄFTER AGREEMENT WITH THE ASSISTANTS YOU CAN SRING

THEM WITH YOU ON YOUR HOLIDAY OR FOR A HIGH SCHOOL.

OR YOU EMPLOY LOCAL ASSISTANTS FOR THE MONEY.

BU T YOU MUST NOT EXPECT EXTRA GRANT FOR SUCH REASONS.

You MUST SAVE (Up).

You MUST CONSIDER. HOWEVER. THAT YOU MUST GIVE THE

ASSISTANTS 3 MONTHS' NOTICE. IF YOU AR E G O I ~ G ON

HOLIDAY. AND THEIR EARNINGS AR E THEN DISCONTINUED.

THESE 3 MONTHS CORRESPOND TO THE NOTICE WHICH EMPLOYEES IN AN ORDINARY PLACE OF WORK SHOULD HAVE

WHEN CLOSING DOWN FOR THE HOLIDAYS.

BUT IF BOTH YOU AND THE ASSISTANTS HAVE AGREED UPON

A SHORTER NOTICE THE C O ~ \ M I TTEE WI LL NOT INTERFERE.

IF YOU WERE GRANTED EXTRA HELP DURING THE HOLIDAY

WHEN YOUR AID WAS ALLOTTED PHASE INFORI1 THE SOCIAL

DEPARTMENT WHEN THE HOLIDAY WILL BE TAKEN.

YOUR HOLl:>A'

IF YOU WISH TO APPLY FOR AN ADDITIONAL GRANT TO ADDITIONAL

COVER A NECESSARY COMPANION'S TRAVELCOSTS IN CON- GRANT FOR

NECTION WITH A HOLIDAY ABROAD. YOU MUST AlWAYS TRAVELCOMPANIONAPPROACH YDUR ADVISER IN THE AREAOFFICE.

ISSUED: 1/1 1385 SUBSTITUTES: PAGE 13 ÄMENDED: 1112 1985

YOUR ASSISTANT

MENTARY PENSIO

(ATP). THE AS

YOU SHOULD DED

HOURS PE

!)

~ 3 . 33 -

86.67 -

13Q.OO -THE COMMITTE

TO ATP TOGETHE

BEING THE DOU

CONTRIBUTION

EACH YEAR THE

MENTS FROM THE

AR E CALCULATED

SUBMITTING TO

EACH JANUARY

MENTS MADE TO

THIS STATEMENT

IN THE TAX-STA

AN AMOUNT TO

SHOULD ALSO B

ASSISTANT SHO

WHICH YOU SHO

HO

o~ 386

130

li KE THE ATP

WITH THE EMPL

SAME AS A30VE

SY THE COMMIT

I SSUED: 111



THE AMOUNTS WHICH YOU AR E DEDUCTISG fOR UP AND .\UD

SHOULD BE PAID TO THE COMMITTEE EACH MONTH . THEY

WILL INSTEAD BE INCLUDED WHEN YOUR STATEMENT Of A C C O U ~ T IS CALCULATED AT THE END Of THE YEAR (SEE PAGE 19).

.4T THE END Of THE YEAR THE AMOUNTS YOU HAVE DEDUCTE9

THROUGHOUT THE HAR MUST BE ·1N YOtJR SAN KACCOUST, AN D

fROM THE COMMITTEE YOU WILL RECEIVE A STATEMENT OVER

THE AMOUNTS YOU ARE LIABLE TO RE fUND THE COffi1ITTEE .

ALSO fOR THE SAKE Of THE STATET1ENT Of THE :lUARTERLY

INSTALMENTS Of ATP, A U ~ AND HOLIDAY BONU S IT IS IM

PORTANT THAT THE PAY-SLIPS ARE SUBMITTED TO THE COM

MITTEE, AS MENTIONED IN PAGE 10, NOT LATER THAN THE

~ T H WEEKDAY Of THE MONTH.

ISSUED : 111 1935 SUSST ITUTES : PAGE 15 ~ M E N D E D 1/12

IN ALL EMPLOYMENT-

EE aUESTIONS ABOUT

THIS INCLUDES ALSO

BEIN G AN EMPLOYER Y

IN SURAN CES YOU SHOU

TH E COMMITTEE WILL

WTH THE EMPLOYMEN

THE RE ARE 3 TYPICAL

1: THE RISK THAT

A RE SULT Of A

2: THE RISK THAT

OR THIRD PERS

3. THE RISK THAT

PE RS ON OR Hl S

IHE CO MITTEE HAS CH

STATE IN SURANCE BOA

FOLL OWS:

RE 1: THE HEA LTH IS

CORD ING TO TH

DIS ABLED PERS

INSURE , WHEN

PE RSONAL EMPL

SO NS FOR PRAC

IN THIS CONNE

TO THE "LABOU

1, SUBSECTION

If BETWEEN A

THE BILL RE T

BE REIMBURSED

RE : 2 IT IS RECOMME

PA RTY LIABILI

INS URANCE THE

SUCH HELP, AS

INS URANCES AL

IF NOT 50 YOU

INSUR AN CE.



lACH YEAR BETWEEN 2ND AND lOTH JANUARY THE SOCIAl

DEPARTMENT ACCOUNTS FOR THE PREVIOUS YEAR. FIRST OF

All YOUR PAYMENTS TO YOUR ASSISTANTS MUST BE ACCOUNT

EO FOR AND REPORTED TO THE TAX AUTHORITIES. SECONDlY

IT ~ U S T BE CHECKED WHETHER YOU HAVE EXCESS MONEY.

IHE ASSISTANT'S INCOME IS MADE UP AFTER THE MONTHLY

PAY-SlIPS. HOLIDAY ALlOWANCE IS AlSO INCLUDED. BUT

NOT AlP AND AUD.

YOUR ACCOUNT IS MADE IN THIS WAY:

PAYMENTS FROM THE MUNICIPAllTY

POSSIBlE INTEREST

WAGES PAID

10 PAY BACK

(INCL. Alf> KR.( • AUU KR.

+

+

DEFICITS ARE NOT ACCEPTABLE AND SHOULD EVENTUALLY BE

COVERED BY YOU YOURSELF.

IIF THE CAUSE OF A DEFICIT IS THAT YOUR NEED FOR AID IS ,

BIGGER THAN ALLOTTED YOU SHOULD REMEMBER THE POSSIBILITY

FOR A NEW EVALUATION AT ALOMHITTEE ilEETING, SEE PAGE

'L AND 3.

BUT TH E GRANT MUST BE GIVEN B E F O R ~ ~ T H E MONEY.

WHEN TH E COMMITTEE TRANSFERS THE MONEY TO YOUR ACCOUNT

EACH MONTH INTEREST MAY ACCRUE.

WE INFORM THE TAX-AUTHORITIES SO YOU WILL NOT HAVE TO

PAY TAX OF YOUR INTEREST, PROVIDEO:

1. You MUST PROVE THAT THE ACCOUNT IS USED

FOR THE MONEY GIVEN YOU BY THE SOCIAl COMHITTEE.

2. lHROUGH THE PAY-SLIPS YOU MUST PROVE THAT THE

MONEY HAS BEEN USED FOR WAGES.

THE YEARLY

STATEMENT

OF ACCOUNT

ISSUED: 1/1 1985 SUBSTITUTES: PAGE 19 ÄMENDED : 1/12 1 3 g ~

IN PRACTICE STIPUlAT

INCLUDED IN THE BALA

INTEREST IS US EO FOR

IF UNUSED AT THE END

DUCT IT FROM THE PAY

PAYING-BACK TAKES IN

STATEMENT OF ACCOUNT

THE RATES ARE INDEX

lST OCTOBER .

FURTHERMORE IN CASE

RATES CAN BE SEEN IN

CONNECTION WITH ANY

CURRENT RATES CAN BE

FROM SOCIAL DEPARTM

ISS UEO : 111 1985



· 2, CONSULTANCY ANp GUIpANCE,

THE SOCIAL COMMITTEE WILL - AS PREVIOUSLY MENTIONED - AT

LEAST ONCE A YEAR APPROACH YOU FOR A REVALUATION OF THE

ALLOTTED AID,

THE COMMITTE CAN ALSO ADVISE GENERALLY,

I, IF YOU WANT ADVICE ABOUT THE CARE lTSELF YOU CAN

ASK YOUR DISTRICT NURSE,

2, AoVICE AND GUIDANCE ABOUT WAGES, EMPLOYMENTS AND

ACCOUNTING WILL BE GIVEN YOU IF PHONING TO THE CONTACT

IN THE SOCIAL DEPARTMENT, MENTIONED IN THE PREFACE,

" ANY OTHER PROBLEMS REQUIRING THE ASSISTANCE OF THE

COMMITTEE SHOULD BE DISCUSSED WITH YOUR ADVISER AT

THE AREAOFFICE,

IT IS OBVIOUS THAT YOU CAN ASK YOUR ASSISTANT TO CONTACT

US ON YOUR BEHALF, BUT IT IS JUST AS OBVIOUS THAT WE CANNOT

DISCUSS YOUR PERSONAL PROBLEMS WITH THE ASSISiAI,r WITHOUT

YOUR KNOWLEDGE AND CONSENT, AS THE ASSISTANT IS NOT EMPLOYED

SY ÄARHUS MUNICIPALITY, BUT BY YOU.

ASSISTANTS WANTING AOVICE AND GUIDANCE ABOUT WAGE- AND EM

PLOYMENTTERMS, SHOULD BE REFFEREO TO CONTACT A TRADE UNION .

A ·USER CLUB· HAS BEEN ESTABLISHED, "§ 48 SECT , 3-USER'S CLUB

IN ARHUS·, WHICH ADVIS6AND GUID6THE MEMBERS, AND WORKS

AS A CO-OPERATION- AND NEGOTIATION PARTNER TO THE PARTIES

CONCERNED.

THE CLUB SECRETARY,LARS RAVN, OR THE CHAIRMAN, FLEMMING LAR

SEN WILL INFORM ASOUT MEMBERSHIP ETC,

ISSUED : 1/1 1985 SUBSTITUTES : PAGE 21 ÄMENDED : 1511 8i



ANNEXE 5-3

Michele Tansella, "Community psychiatry without mental hospitals - the Italian

experience: a review", Journalof the Royal Society of Medicine, Volume 79,

November 1986, pp. 664-669.

Summary

In the last decades a shift from hospital-centred to community based psychiatry has

been observed in many western countries. There are different definitions of

"community psychiatry". One au thor expressed th e view that it is possible to

reformulate community psychiatry as a use of the techniques, methods and theories

of social psychiatry, as well as those of the other behavioural sciences, to

investigate and treat the mental health needs of a functionally or geographically

defined population over a significant period of time. In his view community

psyhiatry is concerned with the mental health needs not only of the individual

patient but of the district population; not only of those who are defined as sick, butthose who may be contributing to that sickness and whose health or well-being may,

in turn, be put at risk.

Another author described community psychiatry as having three aspects: first, a

social movement; secondly, a service delivery strategy, emphasizing the

accessiblity of services and acceptance of responsibility of the mental health needs

of a total population; and thirdly, provision of the best possible clinical care, with

emphasis on th e major psychiatric disorders and on treatment outside total

institutions.

The author of th e article, Tansella, proposes th e following definition of community

psychiatry: "A system of care devoted to a defined population and based on a

comprehensive and integrated mental health service, which includes outpatient

facilities, day and residential training centres, residential accomodation in hostels,

sheltered workshops and inpatient units in general hospitals and which ensures with

multidisciplinary team work, early diagnosis, prompt treatment, continuity of care,

social support and a close liaison with other medical and social community services

and, in particular with general practitioners".

The aim of community care is to reverse the long-accepted practice of isolating

mental patients in large institutions, to promote their integration in the community

offering them an environment th at is socially stimulating, while avoiding exposingthem to too great social pressures. Hsopital is not a natural social environment, and

hospital-based treatment therefore cannot provide the full range of opportunities

which enable the patient to acquire confidence and self-esteem through success in

social roles (although it has also been suggested that it is the features of the care,

and not where that care is provided, that determine the patient's quality of life). In

any case it is not sufficient to just transfer the patient from a hospital to th e

community, the move in itself is insufficient.

In th e Italian experience the aspect of being a soçial movement has been

particularly important Starting in the early sixties, it involved a large part of the

population as well as professionals in th e field, it was part of a general 'socia!

movement', that was very much connected with students' and womens'



organizations, and with trade unions. It aimed to combat the 'total institution',

promoting health as a 'right for all', including the poor and the neglected.

In I.taly the law 180 was passed in 1978. The reform aimed gradually to dismantie

mental hospitals and called for a comprehensive, integrated and responsible

community mental health service. One important aspect of the Italian model of

'community psychiatry' is that the phasing out of th e mental hospital is being

achieved gradually through a block on first admissions (1978) and subsequently onall admissions (1982). It is therefore a very different model from the American

community mental health experience, where an abrupt deinstitutionalization

occurred. In the Italian model the hospital is complementary to community care,

instead of vice versa. In the years between 1961-1978 various pilot experiments

were introduced, which demonstrated the possiblity of giving an alternative for

mental hospital admissions. The new services include group homes, supervised

hostels and unstaffed apartments, as weil as day centres and cooperatives run by

patients.

However, standardized data collection and epidemiological evaluative studies have

been few, and there is a need to evaluate anew what has been and is being done.

Tansella evaluates the Italian experience, using three sorts of data:

1. national statistics on mental hospital activity; there is a gradual decrease of

hospital beds and the period during which a patient is admitted becomes shorter;

2. the effect of the reform on suicide;

3. patterns of psychiatric care in three case register areas; in these three areas

that provide both inpatient care (in 15-bed units in general hospitais) as weil as

outpatient services most patients are treated outside hospital only, the admission

rates are low. Day and outpatient contacts have increased, compulsory admissions

have decreased substantially since the psychiatric reform, certainly by comparisonto the 1977 rate.

Conclusion of Tansellar in Italy community care is the principal component of the

system, with a very careful integration between the various facilities within the

geographically based system of care, and the same team providing outpatient as

weil as inpatient and community care. Hospital admission is still considered

necessary for some, bu t it should not be the first resort, according to law 180. More

research will be necessary, a.o. on the qualitative aspects of the care offered and

its outcome. However the results seem to be positive, there is a low inpatient rate

in the areas that were evaluated.

Appropriate action must be taken to ensure a national homogeneity in the

implementation of psychiatric reform and development of community services that

aren't implemented everywhere. In recent years the new mental health policy has

been neglected by politicians and administrators. Tansella concludes by saying that

there is a long way to go, but that Italy is moving in the right direction.



ANNEXE 5-4

AANPASBAAR BOUWEN

(Adaptable building)

Since 1985 experiments are in progress in the Netherlands that aim to increase thegenera1 accesibility and usability of housing also for disabled persons. The initiator

of this experiment is the NWR - Nationale Woningraad, an umbrella organisation of

non-profit housing associations. For the description of this experiment we quote

from publications produced by the NWR.

"Aanpasbaar bouwen" (adaptable building) attacks the concept of housing that is

specifically intended for handicapped inhabitants. It refers to a design that contains

the possibility, the flexibility, to adapt the building in a later stage, when

necessary, to the needs and wishes of an handicapped tenant. A basic condition is

that the adaptation can be done in a relatively simple and cheap way. The approach

reduces the necessity to build expensive "specially tailored" dwellings. An extra

advantage is that this kind of dwellings, also in non-adapted form, is accessible for

handicapped visitors. Thus "aanpasbaar bouwen" offers advantages for al l parties

involved: the tenant, the landlord and also the (subsidizing) government.

To be labelled "aanpasbaar" the design must conform a set of requirements and

recommendations. This design aid guarantees a certain minimum quality level: it

does not replace the existing set of rules. Basic in these design guidelines is that in

al l piaces where special equipment or space may be necessary to make the house,whenever necessary, really inhabitable for a disabled tenant, such adaptations are

possible without impressive building operations. Another basic element in the

filosofy is the so-called zere option: the application of the requirements and

recommendations may not result in extra building costs. The adaptability is the

result of positioning materiais, space and equipment that it allows the necessary

flexibility. There is no reason why this should lead to higher costs. The core of the

approach is to think about the possibility of later adaptations right fr om the disign

process.

"Aanpasbaar bouwen" is still in an experimental stage.

The initiators prefer to delay the publication of definitive recommendations t il I

practical experience (plus an evalution of the pilot projects) is available.



The European Community aims to integrate people with ahandicap into society and to minimize the barriers resulting from men

tal or physical disabilities in the area of housing. The basic objec

tive is to make more housing available ,suitable to meet the needs

of the handicapped, including ease of access and use and good

links with necessary care facilities and services. Another objecti

ves are cooperation between the different organizations and

involvement of the handicapped themselves in the planning and

tenure of the facilities .

This report provides information on trends and new developments in policy making in the European countries that stimulate

or frustrate the opportunities for living independently.Furthermore innovative trends in experimental solutions are

described and distinguished for the three categories: the physi

cally disabled , he mentally handicapped and persons who suffer

from psychiatric disorders . During the research project in many

interviews and discussions in all member states of the European

Community key hemes for a new policy have been formulated

and at the end in ameeting in Brussels amended by experts fromdifferent disciplines. Therefore the report gives apractical basis

for developing innovative policies in the field of housing and rela-

ted care facilities for the handicapped.

towards autonomy in housing for the handicapped

Documents