Self-Care & Independent Living Skills for Individuals with Intellectual Disabilities

By Kara Welsh, Personal Supports Program Director, Bello Machre 

Independent living skills are crucial for people with intellectual and developmental disabilities to live full, independent, and rich lives. Such skills lead to better physical and mental health, stronger relationships, and more community involvement.

Independent Living Skills for People with Intellectual Disabilities

Independent living skills – such as meal preparation, personal hygiene, money management, household organization, and transportation – are essential for living a fulfilling and rich life. For people living with developmental and intellectual disabilities, independent living skills are particularly important, allowing them to gain control over their daily lives and make decisions for themselves. 
Independent living skills improve physical and mental health, empower people to develop strong relationships, and help them integrate into the community. Many individuals with intellectual disabilities continue working on such skills well into adulthood, often building on skills they began developing in early intervention programs and through school-based special education services. This blog provides a roadmap for supporting adults with intellectual and developmental disabilities in learning and maintaining independent living skills.

Starting with the Person-Centered Plan (PCP)

The Person-Centered Plan (PCP) serves as a starting point for adults who are working on independent living skills. Revised annually, the PCP is centered on the individual, focusing on their unique wants, needs, and passions to guide the process and build meaningful goals. Bello Machre’s initial PCP meeting, an essential part of our admissions process, is a collaborative session involving the individual, their Coordinator of Community Services (CCS), the Bello Machre Services Director, and any other requested attendees, including family and loved ones. 

During this meeting, Bello Machre staff review and discuss important information, set meaningful goals, and create or revise the PCP. Independent living skills are woven into the PCP, ensuring individuals with intellectual and developmental disabilities receive the personalized support they deserve.

Independent Living Skills Checklist

In creating or revising the PCP, Bello Machre works with individuals and their families on a comprehensive abilities and needs checklist. Examples of skills on the checklist include:

• Food and nutrition – Eating finger foods, using utensils, understanding basic nutrition.
• Hygiene – Toileting, showering/bathing, brushing teeth, dressing appropriately.
• Employment – Pursuing a career or volunteering in the community. 
• Social and communication – Expressing basic needs, requesting help, understanding others, using phone/device to communicate.
• Transportation and navigation – Knowing home address and directions home, understanding location of favorite places, getting to and from work, appointments, and recreational activities.
• Gross and fine motor skills – Walking independently or with support, balancing, riding bike, picking up small objects, manipulating buttons and zippers, opening jars and containers.
• Financial management – Basic budgeting, using debit/credit card or cash responsibly, saving money.
• Time management – Punctuality, completing tasks, waking up with alarm, planning daily activities.

Health management – Making routine appointments, following medical advice/treatment plans, reporting symptoms, managing chronic medical issues.

How Self-Care Factors into Independent Living Skills

• Many people include self-care skills as part of their PCP. Self-care includes hygiene (toileting, bathing, brushing teeth), grooming (hair, skin, nail care), dressing (selecting appropriate clothes, putting on and taking off clothes), personal health (medications, basic health monitoring), sleep, and nutrition.
• For someone who needs support toileting, we might take them to the bathroom every two hours for consistency’s sake. Or, if they need support with getting ready, we will assist with dressing, brushing teeth, and more.

Meeting at Home and in the Community

After compiling this list, we meet with individuals at home with their families to better understand their strengths and where they might need support. We speak with them and their families, observing and assessing critical home-based skills such as answering the door, using the bathroom independently, preparing a snack or meal, and getting around the house. During this meeting, we’ll also discuss long-term goals. For example, if the person wants to get married or live by themselves one day, we might recommend they strengthen skills such as laundry, dishes, cleaning, and meal prep.

Then, our program director meets with the person one-on-one outside the home to gauge their interests and abilities. They might go to the mall, which offers excellent insight into community-based skills. For example, can they get around the mall? Find their favorite stores? Communicate with store associates? Leave a preferred activity? Complete a non-preferred activity? Order and pay for lunch? 

After these home and community-based assessments are done, we finalize the PCP and get started!

The Importance of Breaking Down Independent Living Skills into Manageable Steps

Breaking down skills into manageable steps, along with consistency and repetition, are key to success. Bello Machre Direct Support Professionals (DSPs) are trained to show individuals first, before completing a task. For example, when washing one dish, the DSP will break that task down into all its individual steps, and then see if the individual wants to try. If the person needs support, our DSP might do hand-over-hand work or have them help with whatever step they can, such as drying the dish in their lap. We also make it fun by building in rewards, such as getting ice cream or doing a fun activity, once a task is completed.

Because Bello Machre DSPs are with the individuals in our services eight hours a day, they become very familiar with their strengths and opportunity areas, maintaining consistent schedules and activities to help build skills. An example is brushing teeth at the same time each morning and evening or making a healthy snack every afternoon at 3pm.
Our staff also focuses on repetition of skills throughout our clients’ lives. For example, during the pandemic, a client with Down Syndrome lost many skills in which she had previously shown full competency. We worked with her to rebuild those skills and now repeat them regularly to ensure she maintains them. Similar to learning a language or an instrument, if you don’t use skills, you lose them.

Common obstacles to acquiring independent living skills

Some individuals deal with behavioral challenges that impede progress in skills development. Others do better when their families are not present. Similarly, some families build routines in which the parents or another loved one regularly performs a particular task for an individual. In such cases, Bello Machre staff trains parents and families on best practices for helping their loved ones develop independent living skills.

Assessing Progress Toward Goals

Our staff assesses progress toward attaining independent living skills after every shift. They track goals and care, including which skills were worked on that day, whether they were completed, and whether the person refused to do them. This is important. If we see a pattern of refusal, we might need to modify the way we are teaching the skill or modify the goal itself.

Difference in Independent Skills for Age Ranges and Specific Conditions

Children and teens are primarily served by early intervention programs and school-based special education services to achieve independent living skills. After adolescents transition into adulthood, Bello Machre supports adults and seniors to build upon those and create goals for developing new skills to support a new phase of life.

A common misconception is that people living with certain disabilities must work on the same independent living skills. Some commonalities do exist – for example, people living with Cerebral Palsy might require support with large motor skills, and people with Autism might require support with sensory-stimulating activities. However, each individual is unique, and there is a broad spectrum of skills that they might want to pursue. The PCP is key in creating person-driven goals so individuals can learn and master the skills they desire. 

Independent living skills are essential for people with intellectual and developmental disabilities to thrive, live on their own, and develop personal relationships. Bello Machre is committed to helping people develop such skills and achieve meaningful goals that ignite personal growth and foster a genuine quality of life.