Abstract
An important aspect of medical support for people with intellectual and developmental disabilities (IDD) is implementation of medical recommendations, and good practice requires an understanding of the kind of homes adults return to after the office visit or acute care. In the past 50 years, the nation has completely altered its residential models in this area. Where institutions were once common, now they are nearly extinct. Now, as then, most adults who have the label live with relatives. But for some who need non-family residential supports, small, community based, family-like homes are the norm. They are generally staffed in three shifts, and the staff are paraprofessionals with poor to mediocre pay and generally high turnover rates. This chapter explains the changes of the past generation, describes the characteristics of the modern residential support system in the United States, and reports on a national expert opinion survey about the future of residential options for people with IDD. The chapter suggests that modern medical best practice for people with IDD must include knowing about the person’s living situation, as well as vigilance about general well-being.
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References
Larson S, Lakin C, Anderson L, Kwak N, Lee J, Anderson D. Prevalence of mental retardation and/or developmental disabilities: analysis of the 1994/1995 NHIS-D. University of Minnesota, Research and Training Center on Community Living, Institute on Community Integration. MR/DD Data Brief 2000;2(1).
Trent JW. Inventing the feeble mind: a history of mental retardation in the United States. Berkeley: University of California Press; 1994.
Scheerenberger R. A history of mental retardation. Baltimore: Paul H. Brookes; 1983.
Bassuk EL, Gerson S. Deinstitutionalization and mental health services. Sci Am. 1978;238:46–53.
Conroy JW, Bradley VJ. The Pennhurst Longitudinal Study: a report of 5 years of research and analysis. Philadelphia: Temple University Developmental Disabilities Center/UAP, Boston Human Services Research Institute, Pennhurst Study Report PC-85-1; 1985.
Kim S, Larson S, Lakin C. Behavioral outcomes of deinstitutionalization for people with intellectual disability: a review of US studies conducted between 1980 and 1999. J Intellect Dev Disabil. 2001;26(1):15–34.
Conroy JW. The Pennhurst Longitudinal Study: a case study of scientific influence on public policy. In: Downey XX, Conroy JW, editors. A world apart. University Park: Penn State University Press; in press.
Engler JB, Moseley C. Correlates of everyday choice and support-related choice for 8,892 randomly sampled adults with intellectual and developmental disabilities in 19 states. Intellect Dev Disabil. 2012;50(6):486–504.
Brown R, Carlson BL, Dalek S, Foster L, Phillips B, Schore J. Cash and counseling: Improving the lives of medicaid beneficiaries who need personal care or home- and community-based services. Princeton: Mathematica Policy Research; 2007.
Conroy JW. The small ICF/MR program: dimensions of quality and cost. Ment Retard. 1996;34(1):13–26.
O’Brien CL, O’Brien J. The origins of person-centered planning: a community of practice perspective. Atlanta: Responsive Systems Associates; 2000.
Nerney T, Crowley R, Kappel B. An affirmation of community: a revolution of vision and goals. Creating a community to support all people including those with disabilities. Wayne: Center for Self-Determination; 1995.
National Core Indicators. Employment data, phase IX final report. Tualatin: Human Services Research Institute and National Association of State Directors of Developmental Disabilities Services; 2008.
Conroy JW, Irvine R, Ferris CS. Microenterprise options for people with intellectual and developmental disabilities: an outcome evaluation. J Policy Pract Intellect Disabil. 2010;7(4):269–77.
Article 19 of the United Nations Convention on the Rights of Persons with Disabilities. URL:http://www.un.org/disabilities/default.asp?id=259.
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Conroy, J.W., Dale, S.J., McCaffrey, R.P. (2016). Current and Emerging Trends for Residential Supports for Persons with Intellectual and Developmental Disabilities and the Impact of Managed Care Initiatives. In: Rubin, I.L., Merrick, J., Greydanus, D.E., Patel, D.R. (eds) Health Care for People with Intellectual and Developmental Disabilities across the Lifespan. Springer, Cham. https://doi.org/10.1007/978-3-319-18096-0_23
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DOI: https://doi.org/10.1007/978-3-319-18096-0_23
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