Circle of Homes: group homes for the retarded in Cuyahoga County.
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Adolescent↗
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Clinical need variations of disabled persons residing in group homes.
Group home research has generally entailed comparison of these settings and their residents to institutions and their residents. Group home residents have frequently been treated as a homogeneous cohort of individuals. When group home development began, initial residents--usually individuals recently deinstitutionalized--were probably relatively homogeneous in regard to functional abilities and service needs, and generally similar to other disabled persons living in the community. Today, the residents of one group home may bear little resemblance to those of another. This report presents information about the types of group homes within a state system based upon the characteristics and service needs of 1,050 persons in 118 group homes and questions the role of community mental health centers in addressing certain service needs of group home residents.
Analysis of Variance↗
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↗
Therapeutic use of "prizing" and its effect on self-concept of elderly clients in nursing homes and group homes.
The purpose of this study was to ascertain the effect of nurse high prizing and nurse low prizing during group therapy in changing the self-concept of institutionalized aged persons. The hypothesis tested was that institutionalized aged clients participating in group therapy who receive nurse high prizing will show an increase in self-concept as measured by the Tennessee Self-Concept Scale (TSCS) when compared with those aged clients in the same settings participating in group therapy who receive nurse low prizing or those aged clients constituting the matched control groups. The study used an existing data source generated from the research of Williams and Lindell to conduct a secondary analysis of a variable not previously investigated. Mean difference scores from the posttest total self-concept score and subscales of the TSCS were analyzed in conjunction with the levels of prizing within the experimental and control groups. Using the Scale for Rating Prizing, two nurse raters judged the degree of prizing on 40 randomly extracted video segments. The findings indicated that 47.1% of those subjects who received low prizing decreased in self-concept; 68.4% of those who received high prizing increased in self-concept. No change in self-concept was noted in the control group. Findings were significant at the .0001 level. Investigating the effect of nurse high and low levels of prizing on client self-concept completes the Rogerian trilogy of therapist-offered conditions with this same sample of subjects. Extension of previous studies adds to the ever-growing body of nursing knowledge and increases the certitude, casualty, and generalizability of such investigations.
Aged↗
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↗
Emotional disturbance and substance abuse in youth placed in residential group homes.
Residential group homes are increasingly important components of the system of mental health care for children and adolescents. However, they often do not have sufficient resources to provide active therapeutic programs as a result of their usual missions in serving abandoned or runaway youth. The authors studied 299 youth, ages 12 to 17 years, in five large residential group home programs in South Carolina. The instruments administered were (1) the Center for Epidemiological Survey-Depression Scale (CES-D), (2) a brief substance abuse questionnaire, and (3) questions about socioeconomic status, previous placements, and family relationship variables. A significant percentage scored above conservative clinical cut-off scores for the CES-D (51.7% scored 16 or above and 33.6% scored 23 or above). The youth also had significant levels of substance abuse problems. However, these variables were not predictive of previous multiple out-of-home placements (runaway behavior was predictive). These findings support the importance of addressing the clinical needs of youth in these programs.
Adolescent↗
[Evaluation of group homes for the mentally ill in the county of Copenhagen--1980-1995. A study of a time-limited stay in the group home assessed by the development of the social situation and duration of hospitalization before and after].
INTRODUCTION: We have assessed the diagnostic and social characteristics of residents, who were living in two small group homes during the period, 1 March 1980-1 August 1994. Almost all the 74 residents had a chronic psychotic disease. They had been living in the group homes for at least three months, on average 19 months. MATERIALS AND METHODS: The investigation was made from case notes and hospital records. The social characteristics were obtained from the first stay in a psychiatric ward, from two years before the patient moved into the group home to the time of moving out and 2, 5, and 10 years thereafter. RESULTS AND DISCUSSION: Almost all the patients ended up with clear symptoms of schizophrenia and were receiving a social pension. The average duration of hospitalisation for this group was reduced from one third to one seventh of the time from 2 years before to 10 years after they had left the group homes.
Adult↗
Interactions between group homes and neighbors: neighbor preferences.
Group homes often are in conflict with their neighbors. Consequently, group home administrators tend to minimize contact between group homes and neighbors to reduce conflict. This study examined whether information about group homes and contact between homes and neighbors are related to neighbor problems as well as the preferences of potential neighbors about ways in which to become informed and involved with a group home if one were built in their neighborhood. Neighbors who interacted with residents and staff identified problems with group homes but showed fewer concerns about and had positive attitudes toward group homes generally. Potential neighbors wanted information about group homes entering their neighborhood, and preferred types of contact were associated with positive attitudes toward group homes. Group home administrators should consider neighbors as potential allies to help residents integrate into the community rather than as sources of conflict that must be avoided.
Attitude↗
The relationship between parent-youth interaction and delinquency in group homes.
Interactions between the youths and group home parents in 10 group homes were directly observed during a 2-hour session in each home. These observations were compared to questionnaire measures of the youths' self-reported delinquency while in the group home, and their evaluation of the group home program. The results indicated that over the 10 homes there was a strong inverse correlation between mean self-reported delinquency and the average amount of time youths spent taking to (rs = -.95) and in proximity to (rs = -.81) their group home parents. Talking to group home parents also showed a positive correlation with the youths' evaluation of their group home program. Similar trends were found when the correlations were computed over individual youths, although the magnitudes were reduced. These data may have implications for our understanding of the relationship between parenting behaviors and delinquency, as well as for the improvement of group-home treatment programs.
Adolescent↗
[Group homes and the "not in my back yard" phenomenon (NIMBY)--it happened close to home: a pilot study].
Implementation of group homes often come up against the "Not in My Back Yard" (NIMBY) phenomenon. In order to better understand this phenomenon, this pilot study examines the experience of community residents in three borough where opposition to the implementation of group homes was encountered. Results reveal the underlying reasons for this problem as well as explore the negative impact of the presence of such group homes in the community. Finally, the author concludes that listening to citizens and acknowledging their concerns are essential to developing greater acceptance and a better support towards group homes.
Adolescent↗
Community impact of group homes for mentally ill adults.
The phenomenon of resistance to the establishment of group homes for mentally ill adults is well-documented. The extent to which such homes, once established, do or do not create problems for communities is less clear. The current study examined the impressions of residents of a group home neighborhood one year or more after the establishment of the home. Forty-one residents of group home neighborhoods and thirty-nine residents of control (non-home) neighborhoods responded to a survey about their impressions of how a group home had affected or (for controls) would affect their neighborhoods. More than one fourth of the group home neighbors did not even know that they were living near a home. Those who did know tended to report a negligible impact of the group homes on things such as property values, neighborhood crime, resident safety, and distressing incidents in the community. Most of these residents also indicated that they were satisfied with the group home in their neighborhoods. The actual experience of group home neighbors was far more favorable than what residents of the control neighborhood anticipated, despite lack of differences in demographic characteristics or overall attitudes toward community care of mentally ill persons. Results support the view that the feared consequences of group home establishment in residential neighborhoods do not occur and that such homes may gain reasonable acceptance after they are established.
Activities of Daily Living↗
An analysis of treatment services provided in group homes for adults labeled mentally ill.
Although group homes for adults labeled mentally ill have been the focus of significant attention in deinstitutionalization discussions, substantive research on their operation has been lacking. The present study addresses past limitations by focusing on a well-defined sample of small group homes, with higher staffing levels and in-home treatment provided. Thirty homes were randomly selected; all home residents (N = 253) were studied. Data were collected from case managers, residents, and home staff to assess residents' functioning, services and treatments provided, and the environment of the home. The findings were examined in terms of adequacy and appropriateness of care provided in the home, using accepted guidelines. The results indicated that there are aspects of a homelike environment, emotional support from staff, and skill-development activities within the home. However, an institutional focus still seems prevalent, along with limited rehabilitation and socialization activities. Residents expressed high levels of satisfaction, which may reflect their dislike of the group home alternative, e.g., the state hospital. Policy implications are discussed vis-a-vis current efforts to move away from group homes toward supported housing initiatives.
Activities of Daily Living↗
Behavioral, psychological and physical symptoms in group homes for older adults with dementia.
BACKGROUND: Despite the recent dissemination of group homes in Japan for older adults with dementia, the behavioral and psychological features of the residents remain unknown. To clarify the association of such features with the levels of difficulty encountered by caregivers in coping with these symptoms, we have conducted a survey to compare the frequencies of the symptoms among group homes, nursing homes and a long-term care hospital. METHODS: Five hundred and eighty-six older adults aged 65 years or more were sampled. Data were consecutively collected from questionnaires given to the caregivers. The questionnaire included basic activities of daily living, the Mini-mental State Examination, frequencies of behavioral, psychological and physical symptoms, and the levels of difficulty in coping with the symptoms. RESULTS: In group homes, requests to go home, urinary incontinence and frequent complaining were the most commonly observed symptoms. The symptoms associated with disorientation, anxiety and depression were frequently observed in all three care settings. Most of the symptoms were more frequently observed in group homes than in the other two care settings. However, the levels of difficulty in coping with most of the symptoms were the highest in the long-term care hospital, followed in order by the group homes and nursing homes. In group homes, inappropriate sexual behavior was the symptom creating the most stress for the caregivers, followed by verbal and nonverbal abuse and changeable mood. CONCLUSIONS: The symptomatic traits of residents in group homes were clarified in the present study. These findings could be helpful in considering desirable placement or the improvement of eligible service provision for older adults with dementia in care facilities.
Aged↗
A nutrition survey of and recommendations for individuals with Prader-Willi syndrome who live in group homes.
The purpose of this study was to describe anthropometric data and identify diet-related problems of individuals with Prader-Willi syndrome (PWS) who reside in group homes. A group home is a licensed foster care facility that provides 24-hour care for the developmentally disabled. Questionnaires were sent to dietitians (or the person responsible for nutrition care) of 25 group homes; responses from 18 homes were analyzed. The mean age of residents with PWS was 25 +/- 8.4 years and the mean height was 152.4 +/- 9.7 cm. The mean weight for 19- to 22-year-old men was 75.5 +/- 26.8 kg and that for women of the same age was 74.5 +/- 20 kg. The residents consumed a mean of 1,000 to 1,500 kcal/day. Most of the group homes (n = 16) locked their kitchens at night, and in 12 of the homes stealing and hoarding of food occurred. Pica behavior (eating of nonfoods) was reported in 7 homes. One third of all residents had success in weight loss and were on a maintenance diet, but a major problem was determination of a desirable weight goal. Our key recommendations for dietitians are weigh residents weekly; use the body mass index with prescribed zones for determination of weight goals; monitor change in circumference measurements; follow the guidelines of 7 to 8 kcal/cm of height for weight loss and 10 to 14 kcal/cm of height for weight maintenance; administer 1,000 kcal/day or more and encourage daily aerobic exercise; respect food preferences while adhering to dietary prescriptions; adhere to strict food control procedures; and use nutrition education methods and an interdisciplinary approach for behavior modification.
Adolescent↗
Supporting the free exercise of religion in the group home context.
Ways were delineated in which group home employees can support individuals living in the home in the active expression of faith, both inside and outside the group home environment, and at the same time protect the freedom of others in the home who choose not to be involved in religious activities. After briefly reviewing some assumptions underlying the 1992 AAMR definition of mental retardation and describing the capability of religious expression for individuals with cognitive impairment, we presented several guidelines to assist group home staff members.
Choice Behavior↗
Characteristics of the social environment of small group homes for individuals with severe mental illness.
As part of research into small group homes run by local authorities for those with severe mental illness the characteristics of the social environment was investigated. The ideal and real versions of the Community Oriented Program Environmental Scale (COPES) were administered to residents and staff of small group homes in a county in southern Sweden. Both these groups were also interviewed on their opinions as to the main characteristics that should exist in the social environment in small group homes. High levels of support, order and organization, and program clarity and a low level of anger and aggression distinguished the real social environment according to the residents. Differences between residents' and staff's perceptions were less pronounced than in most other studies, probably owing to a greater level of resident--staff interaction in the home-like milieu. In the interviews both the residents and staff emphasized the importance of social interaction as a major constituent in the social environment of small group homes. The COPES instrument appears to be valid for use in small group homes, although some concern can be raised about two of the subscales, Involvement and Practical Orientation. The social environment, as rated by the residents and staff, was similar to that recommended for psychotic patients and to that proposed as a suitable supportive profile together with low levels of staff control and anger and aggression.
Adult↗
Quality and costs of supported living residences and group homes in the United Kingdom.
Information was collected on 63 adults in supported living residences, 55 adults in small group homes, and 152 adults in large group homes. Results indicated that (a) there were no statistically significant differences in service costs once these had been adjusted to take account of participant characteristics; (b) compared with participants living in small group homes, those in supported living residences had greater choice, participated in more community-based activities, experienced fewer scheduled activities, were more likely to have had their home vandalized, and were considered at greater risk of exploitation; (c) compared with participants living in large group homes, those in small group homes had larger social networks, more people in their social networks who were not staff, not family, and did not have mental retardation. These residents were considered at less risk of abuse.
Adult↗
Prospective study of clinical and social outcome of stay in small group homes for people with mental illness.
BACKGROUND: Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen. METHOD: During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE-10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register. RESULTS: Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration. CONCLUSIONS: A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.
Adult↗