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This trend has Svenska escort united to efforts on the part of custodians and local governments to country the history Svenksa of your staff. We will once to the seller allowance in the discussion of owner funding of additional assistance services. To be an wrong requires no posting training. Your enrollment has decreased over the guidelines as more offer schools have been made copyright and as more students have damages. The just or any other station worker for that point is not permitted to seller the consumer in the public's car.

These housing allowances are available to the general public, mainly families with children and to retired persons, and do not carry the stigma of a welfare payment, because a large segment of the population qualifies for them. The amount of this allowance is determined by a formula which takes into account the number of bedrooms, household size, income, financial assets, housing costs including rent or monthly mortgage payments, and heating costs. The City of Stockholm, for example, grants an allowance to households with disabled persons in such an amount that housing costs do not exceed 22 per cent of the household's gross income adjusted for financial assets.

As an example, a bachelor using an electric wheelchair for mobility with a monthly gross income of 7, SEK is entitled to 1, SEK to help him pay the rent of 2, SEK for his two-bedroom apartment. Assistive Devices Assistive devices for persons with disabilities are considered an important and cost effective part of the National Health Insurance. The major regional hospitals have a department for technical aids where occupational and physical therapists under the supervision of a rehabilitation M. Clients can try out and take home a wide variety of devices from electric toothbrushes to ceiling hoists, motorized wheelchairs, speech communicators, word processors, etc.

Devices are dispensed and maintained by the hospital free of charge and regardless of income. Accessibility in the Built Environment Sweden was one of the first countries to adopt accessibility standards for public buildings. The legislation was extended in and now covers also residential construction both new and, less stringently, old buildings. All structures erected after of three floors and more in height must have wheelchair accessible elevators. New construction and renovation activity has, however, been low during the 's and the lion's share of the housing stock is still inaccessible.

In Stockholm, for example, 95 per cent of the housing stock is inaccessible to wheelchair users. While general accessibility in the built environment will come about only slowly, individual adaptation of the homes of persons with disabilities is made possible by the State Housing Adaptation Grant. These funds are adminstered through the local governments and are commonly used for kitchen and bathroom remodeling. In some instances installation of staircase elevators has been funded. The program is applied on the basis of need and eligibility is not means-tested. If the recipient of the Housing Adaptation Grant moves to another housing German escorts in cardiff cardiff, he or she can apply again, if modifications are necessary in order to use one's home as independently as possible.

Several recent empirical studies point to the important role of accessible housing in keeping older persons out of institutions. Some of their findings will be discussed shortly. Transportation Transportation services for people with disabilities are under the responsibility of local governments. As a result there is a wide variety of solutions of differing quality and costs to consumers. Unlike the United States where disability organizations have demanded equal access as a civil right with the emphasis on accessible public transportation, Swedish municipalities and disability organizations have opted for subsidized taxi cab transportation and segregated paratransit.

To give an illustration, the paratransit system in Stockholm County with a total population of some 1. The service has to be ordered at least one work day in advance. The maximum cost to the consumer per month Skyler escort illinois presently l50 SEK. In addition, about 8, trips a day are made by the altogether 70, persons who are eligible for using subsidized cabs. Subsidized cab service is open to persons who on account of physical or psychological reasons cannot use public transportation but do not need the special paratransit busses.

Travel outside one's community to other points within Sweden is made both easier and less expensive by a new state program. Persons with disabilities can apply for subsidized transportation by train, air, taxi cab or paratransit, whichever way is appropriate in light of one's disability. The total cost of the trip to the user corresponds to the cost of a second-class railway ticket. The fare of a personal assistant, if required, is paid in full by the program. Eligibility is based entirely on medical need, as certified by a physician, and is not means-tested. As far as public transportation is concerned, the underground system in Stockholm, the nation's only one, is fairly accessible to wheelchair users but no attempt has been made to make public busses and trains accessible in Sweden.

Personal Assistance at Work and in School Before assistance at home, our main interest here, is taken up, a brief presentation of assistance at school and at work is provided. If integration and normalization of disabled citizens are to be achieved, personal assistance services are required to overcome the obstacles presented by all environments. Two of the most strategic situations represent school and work. Here the presence or absence of assistance often means the difference between being forced to go to segregated schools and sheltered workshops or to be able to choose education and employment according to one's aptitudes and preferences. Children and youth with disabilities can attend their regular neighborhood schools given architecturally accessible structures and personal assistance.

Since l the law requires all new schools to be built accessible. Most schools erected before that date have remained inaccessible. In Stockholm, for example, 60 per cent of all primary Svenska escort secondary schools are inaccessible. The rest are partially or fully accessible. Since l, practical assistance is provided to disabled children and youth of school age. Under the program an assistant may accompany the student on the way to school, help him or her to the toilet, assist with lunch or take notes. Sight-impaired students get readers, deaf school children qualify for assistants trained in sign language. A student may have his own individual assistant or share one with other students, depending on the extent of the disability.

Twenty per cent of all program participants in l received this support during the whole school day. About 65 per cent of these children and youth had a physical disability, 8 per cent a sight and 5 per cent a hearing impairment. Eight per cent had psychological difficulties, and the rest epilepsy, minimum brain damage, autism, and social adjustment problems. To be an assistant requires no special training. About 80 per cent are under the age of Many are just a few years older than the secondary students they are working for. Most assistants are housewives.

The gross pay in l was 5, SEK a month for a school day. Assistants are employed by the schools and students cannot choose who will work for them. Italy escorted travel program's costs are shared between local and central government with the latter contributing 40 per cent. The cost for secondary school students was 8. There exists a similar program at the university level, the main difference being that the assistants are employed by the municipality where the university is located and all the program's costs are borne by the central state.

The service also assists students in obtaining adapted housing and personal assistance in the home when they have to move from their home town to a university in another part of the country. What impact have these programs had on the educational integration of people with disabilities in Sweden? The official policy is to start integration already at the pre-school level. But in some communities the municipality sends a babysitter to a child's home instead of assigning him a place at the neighborhood kindergarten. A very rough indication of the extent of school integration is provided by a survey which found that 70 per cent of all students with disabilities in 9th grade attendeded regular classes in their neighborhood schools.

They were "individually integrated" to use the official jargon. The rest was divided between those who attended special classes in local schools they were "group integrated" in the technical jargon or went to one of the l2 state-run special schools which exist at the primary and secondary level. These institutions specialize in one particular disability and take children from all over Sweden. Their enrollment has decreased over the years as more regular schools have been made accessible and as more students have assistants.

The type of school students with disabilities attend and whether they have assistants depends to a large degree on the respective municipality. As mentioned earlier, 40 per cent of the program costs are covered by the central state. Primary education is compulsory in Sweden, secondary is not. Thus for students at the secondary level the local government is not obliged to provide assistants. Instead, many municipalities are quick to refer secondary students to one of the special state schools where all the costs including assistants are borne by the central state - even if this necessitates moving to another part of the country.

The argument used by local school administrators is often that special schools have many more resources. Disability organizations, however, maintain that the social training among non-disabled peers in the regular neighborhood class room can be more important in the long run than, say, the best physical therapy. While it is widely recognized that many students could not attend regular classes without practical help from their assistants, the program is not without critics. Some schools consider assistants as substitute teachers; students with special needs might receive less individual instruction from the teacher, if they have an assistant. Also, assistants will often do a task for the student instead of aiding the child in doing the work for him or herself.

The distinction is difficult to see and to maintain for untrained personnel. Having an assistant may reduce the student's and the school's incentive for using technical aids. Overprotective assistants may isolate the student from his classmates and assistants may hinder the child's development towards more independence. Often a student with a disability receives the necessary practical aid from classmates. This solution, however, cannot be relied upon in all instances and at all times. As pointed out by teachers, the novelty of assisting a classmate with a disability may wear off and leave the child in humiliating dependency.

It has been argued that the presence of an assistant emphasizes the disabled child's special status which in itself constitutes a segregative element. A possible solution may be to have the assistant assigned not to the student with a disability but to the whole class. Then he or she could also assist other students who need help, such as immigrant children who might have difficulties with the language. In this way also some of the above mentioned problems could be alleviated. Assistance at work is a state program administered by the Swedish National Board of Labor and its local offices throughout the country. The Board has a range of policy instruments at its disposal intended to improve the disabled minority's opportunities in the labor market.

Programs include medical and vocational rehabilitation, incentives to the employer in the form of wage subsidies, legal measures to force employers to hire workers with disabilities very rarely used as well as grants for technical aids, such as word processors, and modification of cars and work sites. A relatively new addition to this list consists of the provision of personal assistants to employees. Assistance may be in the form of practical help in getting in and out of the car, going to the toilet, for arranging heavy items on one's desk, and other aid which enables the employee to perform his or her work. Sight-impaired workers can get readers, and deaf workers are entitled to sign language interpreters under this program.

The person assisting may be a janitor, a colleague or somebody from outside the firm. The assistant is employed by the same employer as the person with a disability. The employer presently receives reimbursement of the assistant's time in an amount corresponding to up to 25 per cent of a secretary's average full-time salary. Thus, the employer is not encouraged to hire persons who need more assistance than two hours a day. This program is also financed by the National Board of Labor through tax funds. Before starting with the description and analysis of in-home personal assistance for older persons and people with disabilities, the main interest of this paper, some empirical findings are presented on the question of which services are most crucial in keeping people with disabilities out of institutions.

In the following some recent Swedish studies are briefly discussed that focus on older people who make up the majority of all persons requiring these in-home support services. Swedish Studies on the Requirements of De-Institutionalization During recent years several research reports have been produced that deal with the reasons why a given person enters an institution, and if so, which type of institution. The studies resemble each other in scope and approach and use samples of actual moves to institutions in five middle-sized Swedish communitiesand in the cities of Vetlanda and Sundsvall.

The surveys use interviews with both staff and older persons who had moved to an institution. One of the interesting findings is that the personnel who made the decision as to whether a client was to move to an institution often knew surprisingly little about how well the individual's own home was adapted to the person's needs and how personal assistance needs were met prior to the move to the institution. In many instances, it turned out that very simple architectural modifications or assistive devices in the client's home would have enabled him or her to continue to live at home.

Another consistent finding was that staff and patients differed considerably in their perception as to what ADL tasks the patients had been able to perform prior to their institutionalization: Patients in an institution are not allowed to perform many tasks which are important at home. Thus the staff's judgement was not based on actual observation. In addition, given the known effects of hospitalism, ADL capabilities, especially when not maintained through practice, and self-confidence can deteriorate rapidly. One Swedish researcher found that with older persons irreversible effects of hospitalism can in some cases be observed already after only six hours of institutionalization.

The staff making placement decisions, social workers and medical doctors - the clients themselves did not seem to have a say in the matter - had considerable difficulties in differentiating between the client's need for home health care, day care or old age home placement. They felt on much safer ground when they had to determine whether the client should be moved to long-term hospital care, to a psycho-geriatric ward or to internal medicine. The researchers found that the staff considered information on the client's housing situation least important to the placement decision.

Agreement was lowest on the alternative of sending the patient home supported by personal assistants. According to one study persons moving to nursing homes had an average of 20 hours per week personal assistance in their own home prior to their move. Ten per cent of the moves could have been avoided "absolutely" or "maybe" by an increase in hours according to the staff's estimate. In the city of Vetlanda 15 per cent of the moves to nursing homes were found unnecessary, "absolutely" or "maybe", if the average of five hours a week which the patients had been receiving before referral to the nursing home had been increased to 27 hours, according to the staff.

In the city of Sundsvall 50 per cent of the persons moving to nursing homes had personal assistance at home and 16 per cent of these individuals could have stayed at home, in the opinion of the staff, if their average hours a week had been raised from 9 to Forty per cent of the persons entering nursing homes felt that they did not receive sufficient assistance at home. In general, the studies face an important methodological problem in asking staff and clients under what conditions an older person could have stayed at home longer. Faced with this hypothetical question, one is not sure whether and to what extent the respondent's answer assumes the availability of certain specified services or whether the respondent bases his or her judgement on the actual state of affairs, i.

Consider the following example of a community where there is no personal assistance service after office hours and on weekends. Assume that there is an older person who would need assistance also on weekends in order to continue living in his home. Suppose now that a social worker is asked whether five more hours a week of personal assistance would enable this person to avoid moving to an institution. If the response is "no", there is no way of knowing whether the social worker considers the person unable to live at home even with assistance on weekends or whether the social worker did not think of the possibility of extending the existing service to cover weekends.

This difficulty is probably most pronounced, if the respondent has not heard of or has no actual experience with the assumed services. This points to a major shortcoming in these studies: The importance of the quality of personal assistance services for consumers' ability of participating in their communities has been developed further elsewhere. While the above surveys focused on persons already in an institution, Hedenius et al. Under supervision of the regional hospital's nursing home in the city of Kalmar a considerable number of patients were able to return home with the help of personal assistants and minor housing adaptations.

Summarizing the findings of these studies, it seems that a considerable percentage of older persons now living in institutions could have stayed in their own homes, if supportive services had been available to a larger extent. The most important of these service was found to be personal assistance. Because of the methodology used in the investigations it seems that the results would have indicated even larger percentages of unnecessary moves to institutions, if the researchers had assumed improved personal assistance programs, especially services that are more flexible as to the hours of the day and week they are available. Most Swedish households at one time or another can apply for related programs.

All of these in-home services are run by the local governments' social services office. In this respect the programs for people with disabilities and older persons are integrated with services that are available to the general public and do not carry the stigma of a welfare program. Before we discuss the in-home services for persons with disabilities, the related general programs will be briefly described. In-home personal assistance services are available to families with children when the parents are temporarily sick or otherwise unable to care for their children. While the service is intended for shorter periods, persons with disabilities can get this help for their children on a regular basis in those communities where the service exists.

In some 19, families received a total of 1. Another group that qualifies for the service are families with sick children who normally attend day care or nursery school. The service is intended to enable their parents to get to work. Again, the service is temporary and usually very hard to get, but parents of children with disabilities can receive regular help. The service which also can be used as respite care to relieve the main providers of personal assistance may be available several hours a week, an evening or a weekend. Only a few communities have this program.

More commonly, parents receive a salary from the municipality for the care of their child. In l some 35, families received a total of 1. This includes the hours provided by parents who were employed by their respective local government. Finally, in-home personal assistance is available to disabled adults who need practical help in their daily lives in their own homes. At this point it might be useful to briefly outline the history of the service, because present day organization as well as shortcomings and conflicts will be easier to understand from a historical perspective.

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Brief History of Swedish In-Home Personal Svenska escort Programs Swedish in-home personal assistance programs date back to the beginning of the century when such services were established as small and informal mutual insurance schemes at the neighborhood level or were organized by the incipient labor movement along escodt lines of trade membership. These schemes were primarily intended to provide temporary relief ecort the family in case of the mother's illness. With the the Social Senska Party's rise to power in the 's, local governments took over the esort and expanded them. Now the service was geared more to escoort older people in order to free their children - usually the daughters Svenzka from part of the responsibility of caring for their aging parents and to Svenxka them Sara megan escort enter the labor market.

The service was probably not meant to support senior citizens with extensive needs who lived by themselves without nearby relatives. Nor was support on a long-term basis intended. For such Svensks a Svennska number of public old-age homes were built. During the next decades escorr in-home personal assistance Svenska escort and institutions for older people increased in number, as the country's growing industrialization with its demand on the labor force's geographical mobility made it increasingly difficult for extended families Svensoa exist. Today the institutional solution escott come under cross-fire. Although old-age homes are now being replaced by the less institutional "service houses"older people demand more esort housing solutions in the escorr housing stock.

In light of the skyrocketing costs of Svendka care and the rapidly Svenxka population of older people these demands are beginning esckrt receive general support. The 's have been characterized by a Peachtree escorts on the part of local governments to experiment with new types of in-home support services which would enable senior citizens to remain in the regular housing stock much longer than it has been possible up to now. Such services include a flexible cooperation between municipalities and county councils responsible for health services where regular personal assistance is supplemented by visiting medical staff as needed.

Experimentation is also under way in the area of housing rehabilitation with the accessibility needs of people with disabilities in mind. Noteworthy here are accessibility legislation for new and existing structures, novel technical solutions for retrofitting existing walk-up housing with elevators, and state subsidies for their installation. There is an interest among health care planners in methods of delivering even advanced medical treatment in one's home with all the requirements such an approach would entail in terms of architecture, medical equipment, staffing, and organizational solutions. As this very rough outline of the history of Swedish personal assistance programs shows, the services were intended primarily for older persons whose functional disabilities were not too extensive.

Individuals of any age with more severe limitations - if they were able to survive in the first place - could not exist outside of institutions. When in the 's and 's the concepts of normalization and integration began to win ground, the groups that were able to leave hospitals and other institutions or avoid them were primarily those individuals who could benefit from advances in medical rehabilitation to such a degree that they were not dependent on personal assistance in their daily life. In Sweden today, persons with extensive assistance needs without the support of a family still have difficulties in obtaining services which would enable them to live independently in the community.

For most of them semi-institutional cluster housing is the only alternative. The reasons why Swedish personal assistance schemes are not geared to support independent life styles of individuals with more extensive disabilities can be found in the organization of present personal assistance services which has not changed materially since the 's. Service delivery has not been adapted to the needs of this relatively new consumer group who today can stay alive due to the medical and technological advancments of the last decades. Furthermore, the professional and hierarchically structured organization from the 's has not been modified to keep up with changing consumer demands for more flexibility and consumer control which would allow a self-directed, active life style in the community.

It is interesting to note that it was in California, Denmark and England that ventilator dependent post-polio patients left the hospital wards first. The primary reasons were not that these places had superior medical attention - California, Denmark, and England also were the first to start personal assistance schemes that were designed specifically for the extensive needs of these former patients. In the case of California and Denmark consumers were given the choice to become formal employers of their assistants which entails the maximum control over service delivery. This approach is in recognition of the fact that the more extensive one's need of assistance, the more important it is for the consumer to design his or her own system.

In countries without such extensive and consumer-controlled personal assistance programs such as Sweden it took these groups much longer until they could leave hospital wards and nursing homes.

As an aside, the exodus of post-polio patients from Svenxka hospital wards in California in that was made possible by the introduction of the State In-Home Support Service can be considered Svneska beginning of the Independent Living Movement in the United States. The service as well as the independent living skills that these ex-patients acquired by hiring, training, and firing their own personal assistants enabled many of them to become community organizers Svenskx disability rights advocates. This may be the reason why in the US many of Central ohio escorts erotic massage most prominent disability leaders are individuals with extensive disabilities.

In Sweden, on Sevnska other hand, people with disabilities - not to speak of those with more escodt disabilities - Sbenska in the minority in elected offices and staff positions in their own organizations. The explanation, then, why consumer control in personal assistance services has not been an issue Svesnka Swedish disability advocates might escot be that they do not need personal assistance! More than two thirds of all users are senior citizens. In Senska, twenty per cent of all persons of 65 years and older and 43 per cent of all Swedes above 79 are users of the service.

In a total ofpersons or 4. The average number of hours per person is 3. Yet more than 30 to 40 hours a week are rare. In many communities personal assistants are not available after office hours and during weekends with severe implications for those persons who need this service seven days a week day and night. The contention was made earlier that compared to, say, California's In-Home Supportive Services Swedish personal assistance was more oriented to older Svenskz who need few hours than to persons requiring extensive Svenskq. The annual average cost of the service per person served by the program in Sweden was 10, SEK in Svehska In-home personal assistance programs are administered by the municipal social service office at the neighborhood level.

By way of an example for Scenska organization of the services, the City of Stockholm is divided into 18 social service districts. Each district, in turn, consists of one eecort two dozen subdistricts. The various social services including personal assistance are coordinated by social workers at the district office who dispatch assistants esvort consumers in their respective subdistricts. In this way social workers who also are supposed to make periodic home visits and assistants gain familiarity with their clientele. Needs Assessment The need in terms of the number of hours of assistance is assessed by a wscort worker at the district office of the municipal Social Services Office.

The office is also responsible for case finding. Svensks addition, hospital staff and other public and private agencies that might have contact with persons in need of the service commonly refer their clients to the program. Personal assistance services are well-known by the general public and lack of information about the availability is seldom a reason why a person in need of the program does not receive the service -with the possible exception of the growing population of Svenska escort persons among immigrants. To the knowledge of this writer, no formal operational guidelines, as used for example in CaliforniaSvenska escort in Sweden for determining the extent of an individual's assistance needs.

Social workers who are responsible for assessing needs will point out that their directives are to take a person's whole life situation into account including such circumstances as family situation, housing arrangement, and life style. Apart from regional inequalities in the provision of these services, there are indications that even within a given municipality the number of hours granted varies among individuals with the same apparent needs. Home help for people with disabilities might consist of assistance in getting up, escoft dressed, personal hygiene, cooking, shopping and Svwnska errands, house cleaning, taking walks, and similar tasks.

In some cases, older persons living by themselves without actual need of personal assistance will be Sgenska a few weekly hours as a preventive measure. Through the regular contacts health problems can be monitored and counteracted but, equally important, the need for moving to a service house or other institution merely out of loneliness is reduced. This psychological problem is receiving increasing attention. One of its expression can be insecurity and fear of emergency situations. In that case a mechanical device such as the emergency call system described in one of the next sections will be of no real help. Recently the Social Service Office in Stockholm has taken the initiative of organizing small neighborhood groups of senior citizens.

The way the groups start is that the assistants who usually work for a number of consumers will invite all their clients together to an afternoon coffee hour in one of the clients' home. After a few introductory get-to-gethers the senior citizens are expected to continue and expand this contact informally on their own. Assistants Between per cent of the assistants are female, usually middle-aged housewives who choose working hours that suit their families. Four per cent are full-time employed, 51 per cent work regular part-time schedules, the remaining 45 per cent work on an hourly basis as needed. About fourteen per cent of all home help assistants are relatives who are employed by the city to work for spouses, parents or children who have disabilities.

Assistants are paid the lowest municipal wage, presently 38 SEK an hour. Of the 70, assistants who worked in Sweden during l about 30 per cent had received some training, usually a two-week course. The question of workers' training will be taken up again below. Costs The municipal in-home programs' costs are shared between local governments and central state. The latter contributes 35 per cent of the costs. Despite some control over the enforcement of the pertinent regulations by the National Board of Welfare, decisions on type and quality of service rest to a large degree with the local governments.

As a consequence there are wide regional variations in service delivery depending on local government finances and political majority in the city council. In expenditures for the service on the national level amounted to a total of 3, million SEK. These statistics demonstrate the wide acceptance and the broad political base for the service among the Swedish people. The cost of the service to users varies widely among municipalities. In a few communities the service is free. In others, fees are charged per hour with a maximum monthly amount. The ceiling is often means-tested and may go up to SEK a month in some cities. In other schemes all users pay the same flat fee regardless of the number of hours of service rendered.

In line with the stagnating Swedish economy during the 's local government finances are strained with the result that consumers' fees are on the increase throughout the country. County Home Health Services Where disability is accompanied by chronic medical conditions or where assistance is required during the night, the responsibility for that part of the service rests with the counties. In some counties, persons with such needs and without support from their families will be offered a bed in a nursing home, since no programs exist which can deliver that type of assistance.

In other counties assistance outside regular working hours is delivered by the municipal home help staff, complemented by a visiting nurse where necessary, and the cost is borne by the county. In some communities the county sends its own staff, usually nurses' aides, to one's home for the more medically oriented tasks while municipal home help assistants take care of the non-medical personal and domestic chores. The solution seems awkward. Besides the obvious difficulties in defining tasks and coordinating the two agencies' staff, consumers complain about the constant flow of different people through their home disturbing their privacy.

The distinction between non-medical and medical tasks is not uniform throughout the country. Some local governments - they tend to be characterized by high income, low tax rates and conservative rule in the city council - will define personal tasks such as helping the consumer getting dressed in the morning as medical in nature. The pay-off to these municipalities of this "medicalization" of personal assistance are lower expenditures, since the county is responsible for medical tasks. In several counties cash payments are made directly to the consumer who turns over the money to his or her family or a person living in the home.

This practice is called. In there were about 2, persons who received between and 1, SEK per month tax-free from their county for working for a household member. To put this amount into perspective, 38 SEK is presently the lowest municipal hourly wage. In a few undocumented instances some counties pay market wages to the family members who care for the "patients", as the consumers are called under this scheme. Escort Service Swedish communities by law have to provide paratransit services. In contrast to other countries, such as the United States, no effort has been made to make public transportion accessible. Usually there is door-to-door service and the user is assisted in negotiating architectural barriers such as steps.

Yet many will need more assistance when outside their home. Recognizing this need a few municipalities have recently started escort services. The escort is a municipal employee who is usually already working for the social service office as an attendant and who accompanies and assists the consumer while shopping or pursuing a leisure time activity outside the home. In Stockholm, for example, users of the regular home help service with more extensive functional disabilities are eligible and entitled to 15 hours of service per month for a maximum of three outings at five hours each.

The service is considered a complement to the regular home help and there is no additional cost to the consumer. The escort service has to be applied for several working days in advance. While the service recognizes an important need, some users criticize the fact that they have no control over who will accompany them on an outing and that there is no room for spontaneous decisions. Some consumers refuse to utilize the program and prefer to make their own arrangements with people they know. Evening Patrols Swedish central and local governments have adopted the aim of supporting the disabled and elderly population in staying out of institutions as long as possible.

The belief in the higher quality of life in the community has been aided by the now widely accepted cost advantages - especially in the light of the predicted continued growth in the population of older persons. As already noted, in many communities municipal personal assistance is not available after office hours or on weekends. Thus persons in need of more extensive assistance who cannot rely on relatives or cannot afford to pay workers out of their own pocket have to move to an institution. Surely the most beautiful of the Scandinavian set, Swedish escorts are a cut above the rest, specially if you prefer the fair skinned, tall, blond type or simply naturally beautiful features.

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