Success of a resettlement or resettlements can be determined or
measured on different counts. One is of how many resettled residents returned
to an institution, the second is the quality of life after resettlement and the
third – to what extent the institutions were downsized. First and third are
relatively simple and easy to observe, the second is more complex and difficult
to measure.
In the latter the question is whether to define quality of life in
terms of subjective values and satisfaction or to compare it to more objective
indicators. It is also a question whether to take for a benchmark of comparison
the improvement from the life in institution or compare it with quality of life
at large and especially with the ideal of independent living.
Figure 3: Criteria of resettlement success
On the first count, we can state the resettlements were quite
successful. Observation in Demir Kapija is that there were thirteen residents
who returned upon being resettled.[1]
Most of them were from the first wave[2]
and from the foster families. In those, two reasons were cited. One was that
the foster family could not cope with the ex-resident (hyperactivity); the
other was that fosterers reached retiring age and did not want to ‘work’
anymore. The return from original families was a consequence of material issues
(bad conditions, parents getting old and not able to care, lack of support, not enough perceived gain in having a child back).[3]
There was also some transinstitutionalisation going on to Banja Bansko (two
recorded cases) and to Topansko Pole (2).
On the count of quality of life, the assessment of the success can
be like half-empty or half-full glass. We can state with certainty that the
life of all resettled residents have improved on the whole (more freedom, more
choice, space, better relationships with staff and flatmates, more
participation in decision-making and more mixing with ordinary people and
activities in the ordinary environment). However, if we compare the present
quality of life with an optimal solution of independent living, the results
are, although positive and encouraging, not achieving this level of life
quality – the arrangements of group homes and foster care are still limiting
the degree of choice, privacy, power and participation in the community.
A third measure of success could be in the degree that resettlement
have contributed to the process of deinstitutionalisation as a whole. This
criterion is not applicable to individual resettlements – the question is –
were the institutions closed down or significantly diminished. The answer is
that none of the institutions was closed (or transformation accomplished).
However, in Demir Kapija, a part of institution (annexe) was closed and that Demir
Kapija is smaller by a quarter of its number of residents before the process
started. What we have termed a ‘silent deinstitutionalisation’ – a decrease in
number of residents happened in Topansko Pole (and there are indices that such
decrease although not so dramatic happened in other institutions). We can also
state that the goals set in the strategy ten years ago, were not met, quite the
contrary they were realised in something as like a quarter of changes planned.
Claimer: This blog is intended as a part of Situation Analysis
and Assessment/ Evaluation Report of Implementation of National Strategy on
Deinstitutionalisation 2008–2018, which will be soon presented to the
public within the EU framework project Technical assistance support for the
deinstitutionalization process in social sector. For this blog, Vlado Krstovski
is considered to be co-author.
[1] From the other reports, the number is lower, e.g. Petrov’s report
lists five examples of reinstitutionalisation or transinstitutionalisation and
Poraka Negotino records another such instance. We took the maximum number
because it seems more reliable and does not underplay the issue.
[2] These two coincide. There is a time factor – more ex-residents
return because the time of observation is longer; and the foster families are
arrangement that is more fragile. They are based on actual providers whereas in
group homes the staff when they retire is supplanted.
[3] N.B. There are many people living with the families who are in risks of
being institutionalised because of the above reasons.
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