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Quality of Life Indicators

Quality of Life Indicators
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At APSI, we advocate for our clients to have the best quality of life. We believe that “quality of life” looks like:

  • Increasing inclusion,

  • Providing a wide variety of opportunities,

  • Raising the bar to maximize the potential of our clients and the services they receive, and

  • Ensuring individuals have control over their lives.


We also believe that “quality of life” means decreasing isolation and minimizing sameness—whether that’s constraining all individuals within the same limited experiences or thinking that an individual’s life should be the same forever. We know that “quality of life” looks different for each person based on their desires, preferences, and needs, and may change over time for each person.


Quality of life can be promoted in every area of a person’s life. We believe that there are minimum standards below which an individual does not experience high quality of life, and that there are ambitious goals toward which we can strive in order to continually improve a person’s quality of life. The quality indicators described here are intended to expand beyond minimum standards and point toward more ambitious goals.


With these principles as a guide, APSI is developing standards of advocacy to promote quality of life for each of our clients. The standards of advocacy will address how APSI’s services will improve an individual’s quality of life, how APSI will advocate for other services to support an individual’s quality of life, and the systemic policies that APSI advocate for to ensure that APSI clients across Ohio can have the best quality of life.


  • Being included in discussions about their lives—especially team meetings.

    • Options and support to participate in discussions about their lives and advocate for themselves.

    • Actively exercising choice about topics that are discussed.

    • Being listened to and heard.

    • People talking directly to the individual—not just about them to others—and respecting the individual’s input.

    • A large network of supporters—not just paid professionals—who value their input and listen to them.

  • Not being limited to their current communication abilities—others explore ways to enhance communication skills and methods for effective two-way communication.

    • Having access to technology that can support their communication.

  • Respecting the privacy of an individual’s information.

Advocacy & Engagement

  • Being involved in decisions about themselves—even if they have a guardian.

    • Making every decision they are capable of making.

    • Receiving the resources they need to make and participate in decisions.

    • Teams working together to help an individual build their decision-making and self-advocacy skills toward the goal of the individual making safe and appropriate decisions.

    • Teams working toward the individual’s goals.

  • Only having a guardian if they absolutely need one—and all decision-making supports are the least restrictive option that meets their needs.

    • Robust education and supports for alternatives to guardianship, including supported decision-making.

  • Opportunities to participate in self-advocacy groups and other activities that build self-advocacy skills—including training others (with and without disabilities) and sharing their perspective.

    • Access to information—in plain language, about a broad range of topics—about what is happening in the world so they can decide how they want to engage with those issues (voting, advocacy, dialogue, etc.).

  • Supporters actively exposing individuals to options and opportunities beyond the standard service model.

    • The chance to grow and expand their limits.

  • Experiencing dignity of risk—where they are accountable for their decisions but do not experience greater consequences than people without disabilities.

    • Risks are assessed individually and accurately.

  • Making decisions that involve reasonable risk—including different levels of risk at different life stages.

Responsibility & Leadership

  • Acknowledging and respecting individuals’ human, civil, and legal rights.

    • Access to the resources and supports they need to experience the rights and opportunities enjoyed by people without disabilities.

    • Teams discuss with individuals their rights, responsibilities, potential consequences, and the outcomes of their decisions.

  • Access to information about their right to vote and assistance to vote when needed.

  • Opportunities for leadership and growth in their areas of interest.

    • Opportunities to join groups or committees that address issues that matter to them.

Safety & Security

  • Feeling safe in all of their environments.

    • Team members seek to thoroughly understand the individual’s history, conditions, trauma, and unique circumstances and how these factors impact their support needs (including behavior supports, environment, and sensory needs) to help them feel safe and secure.

    • Control over their environment to the greatest extent possible.

    • Effective safety plans in all of their environments—and staff have the skills required to implement those plans.

    • Receiving training on safety skills to the extent of their abilities.

  • Not being isolated.

    • People they trust—people they can talk to when there is a problem who will actively work to support them and notice when something is wrong or when something changes—and contact information and contact methods for these people.

  • No fear of asking for help or acknowledging that something is wrong—they won’t experience consequences for asking for help.

    • Asking for and getting emotional support is normalized.

  • Needs are appropriately assessed, and services are based on those needs.

    • Supports are flexible as an individual’s needs fluctuate or cycle based on their environment, life stages, mental health, or other life changes—and services are not the same forever.

    • Access to technology and other sensory supports to meet their needs.

    • Enough staff to meet identified needs and provide high-quality services.

    • A variety of supervision levels available within a single environment and tailored to provide needed supports for each individual while maximizing the independence and privacy of each individual.

    • Supervision levels specifically and clearly tied to precise needs and expected interventions, and services available at the needed supervision level.

  • Individuals are supported through the least restrictive measures that are appropriate to their needs, and court orders are only sought when no other effective measures are available.

    • Alternatives to restrictive measures are thoroughly explored, such as environmental changes and other positive behavior supports.

    • Restrictive measures are reassessed frequently by properly credentialed professionals for continued necessity.

  • Opportunities for periods and places of privacy (being unobserved).

Social & Spirituality

  • Respecting individuals’ unique backgrounds, cultures, faiths, and interests.

  • Regular engagement and inclusion in their communities.

    • Access to public spaces and cultural experiences.

    • Opportunities to explore different activities to find what they enjoy and to participate in the activities they prefer.

    • Opportunities to serve in the community.

  • Supported in developing and continuing healthy family relationships.

    • Interacting with people other than paid staff.

    • Having someone to celebrate holidays and birthdays with.

    • Supported in understanding and navigating their relationships (family, friends, partners, coworkers, community members, staff, supporters, etc.).

    • Initiate contact and relationships.

    • Choosing to live in proximity to the people they care about—decisions about where they live factor in who they want to be near.

  • Choosing to engage in romantic relationships—and having privacy to do so—when they are capable of consenting.

    • Access to education about sex and relationships that is appropriate to their age and developmental stage.

Daily Life & Employment

  • Making daily decisions within their capabilities and seeking their opinion or preference even when they cannot make the decision.

  • Receiving the educational services they are entitled to up to age 22 and the higher education opportunities that they want to pursue.

    • Support to get their GED if they did not earn a high school diploma and want their GED.

    • Access to lifelong learning opportunities (higher education, certificate, conferences, trainings, etc).

  • A wide range of options in the community for employment, day programs, and community involvement.

    • Choices about how to spend their day that are appropriate to their life stage, abilities, and preferences—including the choice to retire and choices about post-retirement activities.

    • Teams creatively identify opportunities that match an individual’s skill set and interests to maximize their success.

  • Individuals who want to work are supported with appropriate assessments, skill-building, and obtaining a job.

    • Opportunities for community employment and skill-building to prepare for community employment even if previous attempts have not been successful.

    • Exploring new jobs or opportunities, changing jobs when they prefer, and getting the right supports in their jobs.

    • Working the hours they want to work—both the number of hours and the hours of the day.

  • The team is aware of the individual’s financial resources so they can be maximized.

    • Obtaining and maintaining all benefits they are eligible for.

    • Receiving benefits analysis and counseling if they are employed or exploring employment so they can maximize their income and benefits.

    • Basic needs are covered, and other money is spent how the person wants to spend it—involved in budgeting and deciding how money is spent.

      • Spending their disposable income as they desire.

    • Supported for managing their funds, covering needs and wants to the greatest extent possible.

    • Developing money management skills and understanding of money, even if they currently have a payee or guardian of the estate.

Community Living

  • Connecting with neighbors and other community members.

  • Safe, reliable, affordable, accessible transportation.

    • Timely transportation to get where they need to go when they need to go.

    • On-demand transportation to activities they want to attend.

    • Choosing their mode of transportation from the available options.

  • Strong influence over where and with whom they live.

    • If an individual’s living situation is less than ideal, the team continually looks for and advocates for improvements or changes.

    • Teams give significant weight to compatibility of housemates.

    • A private bedroom, or having a roommate in a shared bedroom is totally within their discretion.

  • Personal items in their homes, including spaces outside of their bedroom—the entirety of the home reflects their personal interests and preferences.

Healthy Living

  • Timely treatment for physical and mental health needs, including access to counseling services.

    • Healthcare is accessible, and individuals are valued as human beings by their healthcare providers.

    • Healthcare providers ensure effective communication with individuals based on their communication methods and cognitive abilities.

    • Timely preventative care and treatment and follow-up for identified conditions, including access to appropriate specialists and providers with relevant expertise and understanding.

    • Access to PRN medications when needed, including minor pain management and mental health treatment.

    • Support for understanding and managing their chronic conditions.

  • Education about wellness choices (activity levels, hygiene, health habits) and support for making healthy choices.

    • Gym memberships, adult sports, and other wellness activities.

    • Opportunities to experience nature.

  • Access to a wide variety of healthy food, but also choices about what to eat.

    • Support for developing food-related skills, such as shopping and preparing meals.

    • Specialty diets are followed and adaptive equipment is available, with staff trained on those needs.

    • Individuals and staff are educated with effective communication about personal dietary needs.

    • Diet textures are clearly defined and staff are appropriately trained.

  • End-of-life decisions are conducted in a way that values all lives and tries to understand what the person wants for themselves.


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