Abstract
Individuals with disabilities and seniors often lack the freedom to choose with whom they live and where they reside. Service options may involve moving consumers to large nursing facilities or other less-preferred settings rather than optimizing environmental supports in their own home or in less restrictive settings. Not only do adults usually enjoy greater choice when they live in their own homes relative to individuals living in congregate care or group home settings but independent and semi-independent settings are also associated with better outcomes and lower costs. Identifying variables that serve as barriers to independent living is especially important given estimates predicting that the numbers of seniors and individuals with disabilities will double in the next 20 years. This doubling will tax an already burdened and costly system of care. The present study queried consumers and other key stakeholders about potential barriers to independent living and their importance. Findings not only revealed a high degree of overlap between identified barriers and their importance ratings within groups but also showed clear differences in potential barriers across the groups assessed (individuals with disabilities and senior citizens).
References
Arcury, T. A., Gelser, W. M., Preisser, J. S., Sherman, J., Spencer, J., & Perin, J. (2005). The effects of geography and spatial behavior on health care utilization among the residents of a rural region. Health Services Research, 40, 135–156. doi:10.1111/j.1475-6773.2005.00346.x.
Baicker, K., Chandra, A., & Skinner, J. S. (2005). Geographic variation in health care and the problem of measuring racial disparities. Perspectives in Biology and Medicine, 48, S42–S53. doi:10.1353/pbm.2005.0020.
Bannerman, D. J., Sheldon, J. B., & Sherman, J. A. (1991). Teaching adults with severe and profound retardation to exit their homes upon hearing the fire alarm. Journal of Applied Behavior Analysis, 24, 571–577. doi:10.1901/jaba.1991.24-571.
Batu, S., Ergenekon, Y., Erbas, D., & Akmanoglu, N. (2004). Teaching pedestrian skills to individuals with developmental disabilities. Journal of Behavioral Education, 13, 147–164. doi:10.1023/B:JOBE.0000037626.13530.96.
Bowes, A. M., & McColgan, G. (2006). Smart technology and community care for older people: innovation in West Lothian Scotland. Edinburgh: Age Concern Scotland.
Burchard, S. N., Hasazi, J. S., Gordon, L. R., & Yoe, J. (1991). An examination of lifestyle and adjustment in three community residential alternatives. Research in Developmental Disabilities, 12(2), 127–142. doi:10.1016/0891-4222(91)90002-A.
Cattermole, M., Jahoda, A., & Markova, I. (1988). Leaving home: the experience of people with a mental handicap. Journal of Mental Deficiency Research, 32, 47–57. doi:10.1111/j.1365-2788.1988.tb01387.x.
Centers for Medicare & Medicaid Services (2010). National Health Expenditure 2010: sponsor highlights. Retrieved April 9, 2012, from www.cms.gov/…Data…/NationalHealthExpendData/…/sponsors.pdf.
DeJong, G., & Branch, L. G. (1982). Predicting the stroke patient’s ability to live independently. Stroke, 13(5), 648–655. doi:10.1161/01.STR.13.5.648.
Developmental Disabilities Assistance and Bill of Rights Act of 2000, S. 1809 (H.R. 4920), 106th Congress.
DiGennaro Reed, F. D., & Reed, D. D. (2013). Field report: HomeLink support technologies at community living opportunities. Behavior Analysis in Practice, 6(1), 80–81.
Dunn, P. A. (1990). The impact of the housing environment upon the ability of disabled people to live independently. Disability, Handicap & Society, 5, 37–52.
Emerson, E., Graham, H., & Hatton, C. (2006). The measurement of poverty and socioeconomic position involving people with intellectual disability. International Review of Research in Mental Retardation, 32, 77–108. doi:10.1016/S0074-7750(06)32003-4.
Frieden, L. (1980). Independent living models. Rehabilitation Literature, 41(7–8), 169–173.
Harrington, C., LeBlanc, A. J., Wood, J., Satten, N. F., & Tonner, M. C. (2002). Met and unmet need for Medicaid home- and community-based services in the states. Journal of Applied Gerontology, 21(4), 484–510. doi:10.1177/073346402237636.
Hazen, M. M., & McCree, S. (2001). Chapter 2: environmental support to assist an older adult with independent living. Journal of Housing for the Elderly, 14(1–2), 27–52. doi:10.1300/J081v14n01_02.
Jungers, C. M. (2010). Leaving home: an examination of late-life relocation among older adults. Journal of Counseling & Development, 88, 416–423. doi:10.1002/j.1556-6678.2010.tb00041.x.
LeBlanc, L. A., Heinicke, M. R., & Baker, J. C. (2012). Expanding the consumer base for behavior-analytic services: meeting the needs of consumers in the 21st century. Behavior Analysis in Practice, 5, 4–14.
Lowe Worobey, J., & Angel, R. J. (1990). Functional capacity and living arrangements of unmarried elderly persons. Journal of Gerontology, 45(3), S95–S101. doi:10.1093/geronj/45.3.S95.
McAneny, B. L. (n.d.). Report on the council on medical service (CMS Report 2-I-09). Retrieved from http://www.ama-assn.org/resources/doc/cms/i09-cms-report2.pdf
Munson, J. C., Morden, N. E., Goodman, D. C., Valle, L. F., & Wennberg, J. E. (2013). The Dartmouth atlas of Medicare prescription drug use. http://www.dartmouthatlas.org/downloads/reports/Prescription_Drug_Atlas_101513.pdf
Stancliffe, R. J., & Keane, R. J. (2000). Outcomes and costs of community living: a matched comparison of group homes and semi-independent living. Journal of Intellectual & Developmental Disability, 25(4), 281–305. doi:10.1080/1366825002001958 4.
Stancliffe, R. J., Lakin, K. C., Larson, S., Engler, J., Taub, S., & Fortune, J. (2011). Choice of living arrangements. Journal of Intellectual Disability Research, 55(8), 746–762. doi:10.1111/j.1365-2788.2010.01336.x.
Taylor, B. A., Hughes, C. E., Richard, E., Hoch, H., & Rodriquez Coello, A. (2004). Teaching teenagers with autism to seek assistance when lost. Journal of Applied Behavior Analysis, 37, 79–82. doi:10.1901/jaba.2004.37-79.
Williams, G. H. (1983). The movement for independent living: an evaluation and critique. Social Science & Medicine, 17, 1003–1010.
Winterling, V., Gast, D. L., Wolery, M., & Farmer, J. A. (1992). Teaching safety skills to high school students with moderate disabilities. Journal of Applied Behavior Analysis, 25, 217–227. doi:10.1901/jaba.1992.25-217.
Wister, A. V. (1985). Living arrangement choices among the elderly. Canadian Journal on Aging, 4(3), 127–145. doi:10.1017/S0714980800015968.
Woolham, J. (2005). Safe at home—the effectiveness of assistive technology in supporting the independence of people with dementia. London: Hawker Publications.
Yeager, K. M. (1996). Independent living: perceptions, realities, and guidelines. Activities, Adaptation, & Aging, 20(2), 1–11. doi:10.1300/J016v20n02_01.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
DiGennaro Reed, F.D., Strouse, M.C., Jenkins, S.R. et al. Barriers to Independent Living for Individuals with Disabilities and Seniors. Behav Analysis Practice 7, 70–77 (2014). https://doi.org/10.1007/s40617-014-0011-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40617-014-0011-6