The traditional model of long term care services emphasizes a medical approach to meeting needs, often involving unnecessary high cost professionals. The independent living (IL) approach to long term care services vests control of services in the consumer rather than the professional. Many of the services that are widely perceived as “medical” are simply a part of daily life to a person with disabilities. The independent living paradigm supports an integrated life in the community, with personal care workers providing needed assistance in tasks ranging from dressing and bathing to managing breathing devices, feeding tubes and catheters. Tasks that hospitals routinely train family members to perform can also be done in a home setting by other laypersons under the direction of the individual or their family member.