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Assessing independence in community living.

Community health professionals are frequently faced with the dilemma of assessing "independence in community living" in individuals with physical limitations. However, the validity of standardized assessment of "independence in community living" continues to be limited. Standardized assessment tools are unable to capture the true meaning of "community living" and "independence" being articulated through the Independent Living Movement by people who have physical limitations. We use examples from our experience with the Community Living Skills Project in Nova Scotia to highlight three limitations of standardized assessment of individuals in light of the Independent Living Movement's interpretation of "independence in community living". Standardized assessments were unable to attend to and integrate the complexities of interactional elements, individual differences and the concept of "independence" as personal control and mutual dependence. We conclude that individual assessment requires tools with greater sophistication than those currently available. This discussion is important since individual assessment guides decisions which have far reaching effects on people's lives and on the demands placed on limited health and social services.