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All people, regardless of age or disability, should be able to live independently and participate fully in their communities. Every person should have the right to make choices and to control the decisions in and about their lives. This right to self-determination includes decisions about their homes and work, as well as all the other daily choices most adults make without a second thought.
Why Community Living?
In survey after survey, when older adults and people with disabilities are asked where they would prefer to live, they say they want to live in their communities, not in institutions. People also are happier and healthier when they live in community settings.
Inclusion of older adults and people with disabilities also offers many benefits to communities themselves. Communities miss out on valuable voices and perspectives when people with disabilities and older adults are left out. They are deprived of co-workers, volunteers, mentors, and friends who offer new ways of thinking about, and navigating, the world. When older adults are excluded, communities lose wisdom collected over many decades and their connection to history.
Community living also happens to be less expensive than other options for most people. Skilled nursing facilities can cost an average of $75,000 a year and public residential facilities for people with disabilities average $225,000 a year. In most cases, these costs are not covered by Medicare or private health insurance.
Finally, a series of laws, court decisions, and administrative rules have established community living as a legal right. Most notably, in 1999, the U.S. Supreme Court ruled in Olmstead v. L.C. that people with disabilities must receive services in the most integrated settings possible. This landmark decision has been a critical tool in protecting the rights of people with disabilities and older adults alike.
Supporting People in the Community
Many older adults and people with disabilities need help with the daily tasks of life. For some people, this is physical help, such as help with dressing and eating. For others, it is help with making decisions and planning. Still, others require a blend of supports. Each person is unique, and the help they may need is unique as well.
At ACL, we believe that the preferences and needs of older adults and people with disabilities who need assistance belong at the center of the system of services and supports that enable them to live the lives they want to live. We further believe that those needs and preferences should be defined by the individual receiving services and supports.
At the same time, ACL recognizes that some people with disabilities and some older adults experience challenges in understanding and communicating their preferences and needs, and family members and caregivers often play a critical role in ensuring that those preferences are honored and needs are met.
We also recognize that the preferences of the individual are not the only factor in determining how to best support that person. The availability of services and supports in a variety of settings, the resources and availability of family caregivers, and other factors also must be considered.