Quality of life and living arrangements for people with intellectual disability
| Date | 12 July 2013 |
| DOI | https://doi.org/10.1108/AMHID-03-2013-0027 |
| Published date | 12 July 2013 |
| Pages | 220-231 |
| Author | Marco Bertelli,Luis Salvador‐Carulla,Stefano Lassi,Michele Zappella,Raymond Ceccotto,David Palterer,Johan de Groef,Laura Benni,Paolo Rossi Prodi |
| Subject Matter | Education,Health & social care |
Quality of life and living arrangements for
people with intellectual disability
Marco Bertelli, Luis Salvador-Carulla, Stefano Lassi, Michele Zappella, Raymond Ceccotto,
David Palterer, Johan de Groef, Laura Benni and Paolo Rossi Prodi
Abstract
Purpose – Recent international experiences of community inclusion have produced a major change in
residential care for people with intellectual disability (ID). Assignment and outcome assessment through new
person-centred measures are raising increasing interest; however, the information on quality of life and
accommodation is still limited. This paper aims to provide an overview of the application of quality of life
models and the size of the provision of different living arrangements.
Design/methodology/approach – A systematic mapping of the literature of the last decade was followed
by an expert guided review of the available evidence.
Findings – QoL outcomes measures of living arrangements in people with ID show conceptual and
methodological challenges. The following key topics were identified: individual level: issues related to health
status, behavioural problems and other personal factors (ageing, choice and empowerment); family and
peers; local level: accommodation, architecture and urbanization, and economic aspects (deprivation and
costs); macro level: social participation (community inclusion). The residential solutions that are currently
considered of highest efficiency are small apartments in the community and “cluster centers”.
Originality/value – The level of quality of life is very relevant in the assessment of living arrangements in
people with ID although its assessment still shows significant limitations. Some accommodation typologies
seem more effective than others. New conceptual models of inclusive residential care support the
convenience of a wide range of accommodation alternatives that may fit the individual needs of a highly
heterogeneous population group. A unique residential alternative, albeit optimal from a community care
perspective, may not be adequate for all persons with ID.
Keywords Living arrangement, Housing, Accommodation, Residential care, Quality of life,
Intellectual disability
Paper type Literature review
Introduction
The gradual replacement of large residential institutions for psychiatric patients with smaller
facilities able to promote good community participation represents one of the most important
evolutions of social-health policies of the post-war period (Henckes, 2011; Pycha et al., 2011).
However, more than 30 years after the formal start of the deinstutionalisation process, the
conceptual value of this evolution continues to face difficulties in its implementation, especially
in reference to the mental health of people with intellectual disability (ID) (Mansell, 2006).
The recent United Nations Convention on the Rights of Persons with Disabilities (United
Nations, 2006), dedicated Article 19 to the right to life in a community, specifying that the states
must offer a differentiated range of support services for community life, both domestic and
residential, and prevent isolation or segregation.
Without entering into the specific means of implementation, this article leaves the individual
political authorities at the mercy of the different interpretations of people who support the
operation of various residential models.
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ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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VOL. 7 NO. 4 2013, pp. 220-231, CEmerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-03-2013-00 27
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