1 The Golden Age of Retirement – Creating Inclusive Options for Aging Persons with Intellectual Disabilities

2 Israel Elwyn Founded in 1984 at the initiative of the Municipality of Jerusalem and the Government of Israel, Israel Elwyn (IE) was the first program of Elwyn Inc. (USA) outside the United States. A non-profit organization registered in Israel (Amuta), IE today serves more than 1600 children and adults with special needs -- Israeli and Palestinian alike.

3 Services: Early Intervention ServicesEarly Intervention Services Preschools and Special EducationPreschools and Special Education Residential ServicesResidential Services Supported LivingSupported Living Occupational Training CentersOccupational Training Centers Supported EmploymentSupported Employment Small Business DevelopmentSmall Business Development Vocational Training/Job PlacementVocational Training/Job Placement

4 Distribution of Adult Services in W. Jerusalem

5 The Development of a Retirement Program for Aging Individuals with Special Needs

6 Consumer Driven: About five years ago, Meir, a nearly sixty-year-old man with developmental disabilities in Israel Elwyn ’ s occupational training center approached management with a specialized request. He was tired of working, and asked for the opportunity to retire.

7 Consumer Driven, Con ’ t: His reasoning: It was getting harder and harder to sit for long periods of timeIt was getting harder and harder to sit for long periods of time His ability to concentrate on work became more difficultHis ability to concentrate on work became more difficult The workplace noise bothered himThe workplace noise bothered him In short, he wanted a chance to retire, without giving up the social and recreational benefits he found through work.

8 Meir

9 Needs Assessment: Group Discussions Rehabilitation staff undertook a process of discussions with persons in the occupational training center. The purpose of the interviews was to ascertain if Meir ’ s expressed need was shared by others. Those indicating such a need were encouraged to discuss this with their case manager.

10 Needs Assessment cont ’ d: Individual Discussions Individual Discussions Those individuals who expressed an interest were individually interviewed, during which specific content areas were discussed regarding how the individual sees him or herself in a post-work environment. The individual ’ s needs and preferences were discussed as well as the time, place and content of the proposed retirement program Those individuals who expressed an interest were individually interviewed, during which specific content areas were discussed regarding how the individual sees him or herself in a post-work environment. The individual ’ s needs and preferences were discussed as well as the time, place and content of the proposed retirement program

11 Statistical Analysis: n = 140

12 Statistical Analysis cont ’ d: n = 200

13 Statistical Analysis cont ’ d:

14 Statistical Analysis cont ’ d:

15 Statistical Analysis cont ’ d:

16 Statistical Analysis cont ’ d:

17 An additional factor in developing the program: An unfortunate, but relevant, fact encountered was the resistance of community senior centers to accepting aging individuals with developmental disabilities

18 Theoretical Basis: The project was designed with Heller and Sutton ’ s means of empowerment of the individual with special needs: Self-Advocacy Self determination Decision making Self oriented Problem Solving

19 Program Development – Supported Employees The model that was created for retirees from supported and competitive employment takes into consideration their desire to remain active as before. These individuals generally were not interested in retirement options within the occupational training center. They preferred to be involved in volunteer options at hospitals, day centers, etc.

20 Program Development – Supported Employees – Accommodations 13% of the supported employees are over 50 years-old13% of the supported employees are over 50 years-old These aging individuals with special needs and with intellectual disabilities manifest reduced functioning and productivity, limited concentration ability, difficulties in performing tasks, fatigue and more frequent absences due to health issuesThese aging individuals with special needs and with intellectual disabilities manifest reduced functioning and productivity, limited concentration ability, difficulties in performing tasks, fatigue and more frequent absences due to health issues Main support: modifying vocational expectations from the worker, making new accommodations such as less demanding work hours, simpler work tasks, reduced productivity expectations and physical accommodations at the work placeMain support: modifying vocational expectations from the worker, making new accommodations such as less demanding work hours, simpler work tasks, reduced productivity expectations and physical accommodations at the work place

21 For those workers for whom the accommodations at work were not of value or who wished to discontinue workingFor those workers for whom the accommodations at work were not of value or who wished to discontinue working These aging individuals with special needs and with intellectual disabilities chose to volunteer at community services such as hospitals, senior centers and preschools.These aging individuals with special needs and with intellectual disabilities chose to volunteer at community services such as hospitals, senior centers and preschools. In this way these individuals were able to continue their community involvement and not resort to a more sheltered environmentIn this way these individuals were able to continue their community involvement and not resort to a more sheltered environment Program Development – Supported Employees – Community Service (Volunteering)

22 Program Development – Workshop Retirees For retirees from the workshop, a model was created which approximated community senior center models, but, for now, within the Occupational Training Center

23 Program Development – Retiree Program Creation of a specific retiree group The group included: Preparing the group for the transition Employment of a professional with expertise in the field of seniors Development of meaningful program content which allows for maintaining skills and developing new ones

24 Program Development – Examples of Content: Improving and maintaining interpersonal communication skills Decision making in day-to-day life Activities such as exercise, physical therapy, occupational therapy, Shiatsu, arts and crafts, therapeutic gardening, zootherapy, etc.

25 Photos of the group

26 And:

27 And:

28 Day Description: The retirement program operates 5 days per week, from 9:00 am to 2:00 pm. Each retiree has the right to choose, within this framework, how much time he or she wishes to spend there, and in what activities to participate, according to his needs and abilities.

29 Program structure Morning meetingMorning meeting Different activity opportunitiesDifferent activity opportunities Daily routineDaily routine Modest pensionModest pension StaffStaff

30 A very short film:

31 Program Assessment and Evaluation Feedback forms including collecting specific comments and quantitative resultsFeedback forms including collecting specific comments and quantitative results Intermediate AssessmentIntermediate Assessment Means of future assessment and evaluation: including research and additional feedback mechanismsMeans of future assessment and evaluation: including research and additional feedback mechanisms

32 Future Plans: Opening a community day center Contact with and intake from senior centers in the community Expansion of program to additional geographic locations

33 מרכז יום לגימלאים עם צרכים מיוחדים קרן שלם המוסד לביטוח לאומי עירית ירושלים משרד הרווחה אלווין ישראל רחוב בורוכוב, קרית היובל ירושלים סלמה מילסון ארד אבנר סימוןאדריכלים ומתכנני ערים DAY CENTER FOR RETIRED PEOPLE WITH SPECIAL NEEDS BOROCHOV ST. KIRYAT HA-YOVEL, JERUSALEM Salmah Milson Arad Avner SimonArchitects and Urban Planners

34 מרכז יום לגמלאים 2 תוכנית סביבה- מצב קיים בית כנסת מגורים גן ילדים להריסה חצר

35 מרכז יום לגימלאים 22 מבטים אקסונומטריים

36 Future Plans: Senior Center Located in a residential neighborhood in JerusalemLocated in a residential neighborhood in Jerusalem Interaction with neighbors (e.g. volunteers, coffee shop) – this neighborhood has two “ regular ” senior centers with which we hope to have regular interactionInteraction with neighbors (e.g. volunteers, coffee shop) – this neighborhood has two “ regular ” senior centers with which we hope to have regular interaction 50 seniors to be served there50 seniors to be served there Two stories – higher functioning seniors upstairsTwo stories – higher functioning seniors upstairs Therapy rooms on both floorsTherapy rooms on both floors

37 Problems and issues encountered during program development Government recognition: policies, reimbursement rules – fitting the program into existing funding categories Working with a multitude of government agencies: municipal, government departments for aging and mental retardation as well as the “ National Insur. Inst. ”

38 Problems and issues encountered during program development, cont ’ d: Dilemma: To begin with an integrated program? To insist on referring individuals to an existing senior center? The Integration Paradox: It would seem that the more limited the intellectual and physical functioning of the “ normal ” senior, the less distinctive are the differences with the senior who had a prior intellectual disability. Inclusion here becomes one of individual preference.

39 Problems and issues encountered during program development, cont ’ d: Inclusion as a social process – as with all forms of inclusion, this requires preparation of the environment as well as the individual with special needs The need for dynamic program development – e.g. the stated preference of some retirees to have some vocational element in their day

40 Two short films: At leisure – arts and crafts Sample art work of seniors