We examined whether broad factors assessing dimensions of personal competency and community participation could be used to discriminate between people with mental retardation who were living in small group homes and small foster homes. Using a large national sample and multiple discriminant analysis procedures, we found that personal competencies were least important in distinguishing on the basis of setting between people living in the two types of residential placements. Primary differences emerged in factors assessing extent of community participation, family relationships, and recreation/leisure integration. Implications for policy and future research were presented and discussed.

Activities of Daily Living↗

PubMed1993

Personal characteristics and competence of people with mental retardation living in foster homes and small group homes.

In this 1986-1987 study, the demographic and diagnostic characteristics, problem behaviors, self-care skills, community living skills, domestic expectations, and program goals for personal competence of 336 persons with mental retardation living in a national sample of 181 foster care and small group care settings with 6 or fewer residents was assessed. The findings indicated relatively more severe cognitive impairment among persons in small ICFs-MR, less severe cognitive impairment and fewer functional limitations among non-ICF-MR group home residents, and more functional limitations among residents in foster homes. Neighborhood integration was relatively high for foster home residents, but there were fewer expectations for their development of home and community living skills. Implications for future research and program development in small, community-based residential settings were discussed.

Activities of Daily Living↗

PubMed1992

Components of personal competence and community integration for persons with mental retardation in small residential programs.

This study identifies components of personal competence and community adjustment in a national sample of persons with mental retardation living in residential facilities of six or fewer residents. Factor analysis of 65 variables yielded an 8 principal component solution that accounted for approximately half the total variance in the observed variables (49%). The eight identified components of personal competence and community adjustment were labeled (1) Self Care and Functional Personal Living Skills, (2) Community Living Skills, (3) Home Living Skills, (4) Problem Behavior, (5) Community Training Goals and Objectives, (6) Recreation/Leisure Activity, (7) Family Contact/Relationships, and (8) Community Assimilation and Acceptance. The implications of reducing potentially hundreds of indicators of personal competence and community adjustment into relatively few broad internally consistent composite constructs are discussed.

Activities of Daily Living↗

PubMed1992

Direct-care staff stability in a national sample of small group homes.

In this national study of direct-care staff members working in 101 small (6 or fewer residents) community homes, we examined staff stability in terms of turnover, staff members' perceptions of turnover problems, and their intentions to remain a careprovider. The annual turnover rate for the facilities sampled was 57.0%. Staff members indicated that they planned to remain a care provider for an average of 5.4 years (SD = 5.9). One multiple regression analysis revealed two variables that accounted for 7% of the variability in facility turnover rates. Another multiple regression analysis revealed three employee and five employer variables that accounted for 53% of the variability in intended length of stay for individual staff members. The findings confirm the importance of individual staff member characteristics to staff members' stability.

Adult↗

PubMed1992

Social integration of older persons with mental retardation in residential facilities.

The findings from a study of the social integration of a national sample of 370 older persons with mental retardation were reviewed. Individuals were selected from a national sample of all facilities owned, operated, or licensed by developmental disabilities agencies having one or more persons 63 years of age or older with mental retardation (N = 235). Facilities included foster care, small group homes (3 to 15 residents), large private facilities, and large state-operated facilities. Information was obtained on resident activities and relations considered to be indicators of social integration through extensive questionnaires completed by primary caregivers. Comparisons of the differences in community integration among residents living in different types of residential facilities were presented. The relative contribution of individual and facility characteristics to the social integration of older persons with mental retardation was explored with hierarchical multiple regression analysis.

Activities of Daily Living↗

PubMed1992

Placement practices in specialized foster homes and small group homes for persons with mental retardation.

Resident functional and personal characteristics (e.g., gender, race, age, and level of mental retardation), placement histories, and projected placements of a nationally representative sample of 336 persons with mental retardation living in a total of 181 small, specialized foster care homes and group homes with 6 or fewer residents were compared. In addition, the extent to which resident characteristics differentiate between persons placed in specialized foster care homes or small group homes was assessed. Results indicate that there are some differences in resident characteristics across facility type, including communication and toileting skills, age, and mobility. Overall, results showed that small foster and group homes successfully serve a variety of people and that placement generally lasts for several years.

Activities of Daily Living↗

PubMed1991

Programs and services received by older persons with mental retardation.

Findings from a study of the programs and services received by a national sample of older persons with mental retardation were reviewed. Individuals were selected from a national sample of all facilities owned, operated, or licensed by developmental disabilities agencies having one or more persons 63 years of age or older with mental retardation. Facilities included foster care, small group homes, large private facilities, and state-operated facilities. One or two residents per facility were studied. A total of 370 individuals in 235 facilities were surveyed (10% of all eligible facilities). Comprehensive information on resident characteristics, day program participation, and services received was gathered through extensive questionnaire and telephone interviews of primary careproviders and directors of the day programs attended by individuals in the resident sample. Differences in programs and services received were presented by facility type.

Aged↗

PubMed1991

Persons with mental retardation in nursing homes in 1977 and 1985.

Findings from the 1977 and 1985 National Nursing Home Surveys with respect to residents with mental retardation were compared. The single most notable finding was that very little changed over the 8-year period. The size of the mentally retarded population changed little (remaining at an estimated 40,500), the characteristics of the population remained essentially the same, and the services received by residents with mental retardation in 1985 remained at essentially the same low levels as those found in 1977. Implications of the findings as they relate to the initiative begun with the passage of P.L. 100-203 in 1987 and the forthcoming regulations to guide its implementation were discussed.

Activities of Daily Living↗

PubMed1990

Medicaid-financed residential care for persons with mental retardation.

Two sources of Medicaid support for persons with mental retardation and related conditions (MR/RC) are examined, the intermediate care facility for the mentally retarded (ICF/MR) program and the home and community-based services (HCBS) waiver. Results indicate that Medicaid support through the ICF/MR program has shown little recent growth in terms of number of persons served, although expenditures continue to increase. Medicaid's HCBS waiver is being used increasingly by States to support residential placement because of its greater flexibility and more individualized approach relative to ICF/MR care. Use of Medicaid to finance care for persons with MR/RC varies considerably across States.

Community Mental Health Services↗

PubMed1990

Longitudinal change and interstate variability in the size of residential facilities for persons with mental retardation.

Changes in the size and type of operation of residential facilities for persons with mental retardation in the United States over the past 2 decades were discussed and current (June 30, 1988) interstate variability in residential services along these same dimensions examined. Considerable progress was noted nationally in securing relatively small, community-based residential opportunities for persons with mental retardation. However, this progress has not been uniformly realized in all states or for all types of facilities. Standards for federal policy that would make the official national commitment to community-based services more consistent among all the states were considered.

Health Facility Size↗

PubMed1989

Movement of developmentally disabled individuals among out-of-home residential facilities.

This paper reported on the movement of a large (N = 2271) probability sample of the nation's residents of public (PRF) and community (CRF) residential facilities for developmentally disabled children and adults. Estimates placed the national population at 217,410 in all facilities--73,709 in CRFs and 143,701 in PRFs--in the fall of 1978, when the sample was selected, although extrapolation from subsequent surveys suggest that the CRF numbers should be about 100,000. In the winter of 1979 direct care staff and administrators completed detailed information about each resident sampled, about themselves, and about their facilities. In 1980 they were asked if their residents had moved exactly one year later. Most residents (91%) had not moved; 1.3% had died; and about 8.5% had moved. Most moves featured greater integration into the community. Multivariate analyses indicated very little difference between moved and unmoved residents. Among moved subjects, three dimensions accounted for 62% of the common variance in placement status: (a) ability, (b) age, and (c) autonomy.

Adolescent↗

PubMed1989

Permanency planning for children and youth: out-of-home placement decisions.

This article advocates the extension of "permanency planning" in out-of-home placements to include those children and youth with developmental disabilities. It discusses permanency planning and notes its promise in improving the opportunities of all children and youth to grow up in a stable family environment. There is a need for major initiatives in this area: 78% of children and youth with developmental disabilities who are placed in long-term care have no such protections. Though some states currently operate programs according to the principles of permanency planning, significant changes in existing federal policy are recommended to require permanency planning in federally supported out-of-home care for all children, including those with severe disabilities.

Adolescent↗

PubMed1989

Longitudinal patterns in ICF-MR utilization, 1977-1986.

The development of the ICF-MR program and the issue to which the ICF-MR program was intended to respond was briefly reviewed. National and state-by state statistics on changing patterns and interstate variations in use of ICF-MR services as of June 30, 1977, June 30, 1982, and June 30, 1986 were presented and ICF-MR problems and issues were discussed within the context of the evolving system of long-term care.

Humans↗

PubMed1986

Classification of residential facilities for individuals with mental retardation.

Explore the source record for details and available documents.

Data Collection↗