For some disabled persons one of the biggest obstacles to staying with their families is that they need assistance in their daily lives, for example, with getting up in the morning, getting dressed, going to the toilet, with eating or getting around town. Despite rehabilitation services or assistive devices there will always be persons with disabilities who depend on this type of assistance. Often, a paid worker who comes to the house of the family to provide personal assistance a number of hours a day would be all that is needed in order to keep the disabled family member out of an institution. In some countries subscribing to the idea of the welfare state personal assistance is provided as part of the social insurance scheme in the form of a monthly payment directly to the disabled person who then can employ somebody of his or her choice. Today we know that given proper information, training and support most families would prefer to keep their disabled child or old parent at home.
Personal assistance costs money, but so does running an institution.
Often the institution owns its land and buildings which together represent a significant capital. 3 million Colones or USD 15,000 a year is about 5 times the average salary of the average Costa Rican breadwinner. This annual amount would surely be more than sufficient to enable a family to buy assistive devices such as wheelchairs, to make adaptations to the house such as adding ramps or another room, to provide transportation to the school, pay for other services such as physical therapy and, most importantly, to cover the salaries of one or two workers who would provide the personal assistance.