27/4/1 Seminar ADL, Copenhagen

The situation in The Netherlands

The Dutch care for blind and partially sighted is divided into three large domains:

• care for children, care for multiply handicapped (especially mentally retarded) and residential institutions (mainly for elderly)
• ambulant care for adults
• residential rehabilitatory care for adults.

ADL-therapy or ADL-training is given by:

• independency-therapists of the regional centres (ambulant)
• occupational therapists ("ergotherapists") in the rehabilitation centre (Het Loo Erf, Apeldoorn)
• more or less (incidentally or incorporated in more general training) in the other settings.

The ergotherapists of the rehabilitation centre learn their job in een in-service-setting. They are functioning mainly as specialists.
Most independency-therapists of the regional centres (about 15 centres throughout the country) are ergotherapists (sub-university level), are working as generalists and are educated within the first weeks of their employment by the rehabilitation centre.

Other courses in this field:

• introductory course for all starting employees within this domain. These courses are organized about twice a year by an interinstitutional platform.
• O&M-specialisation course for ergotherapists and other generalists.

The ADL-course is not only covering typical ADL-subjects (strict sense) but also fundamentals of Low Vision, communication (computer and braille) and basic O&M.

The course takes 4 weeks, every week having 5 days (8.30- 17.00 h).
Methods: observation of normal rehabilitation practice, self-experience with blindfold and Low Vision-simulation glasses, instruction of procedures like 10-fingers-blind-typewriting, braille and use of apparatus, visiting the showroom ( devices), theory about emotional processing, psychology (coping), neuropsychology (visuospatial agnosia, alexia, subcortical brain damage) and rehabilitation-theory (deficit model versus process model, strategy choice, coping style, interventions), knowledge about social insurance, clients' organisations, taxes and laws.

The course is obligatory. There are no examinations or individual evaluations. Afterwards the student doesn't get any diploma or something like that (proof of ...). The (colleague-)institutions don't pay for the courses (neither do the students). During the course they stay in a hotel at Apeldoorn or they organize their stay by themselves. The cost of stay and travel is paid for by their employers.

An employer can negotiate about the duration and content of the course in individual cases.

This situation is not felt by us as being satisfying. However, the ex-students and the employers continuously express their gratitude and say that it has been quite useful and pleasant etc. They don't criticize, we do.

Apeldoorn, 10-04-2001

Bill Wouters with help of:
Mariska van de Steege (ergotherapist)
Martin IJsseldijk (O&M-therapist)
Rosa Wassink (ergotherapy-student, stage in Het Loo Erf)

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