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How deinstitutionalisation of adults with learning disabilities affects quality of life

Movement to community settings associated with improved sense of well-being and independent decision-making

Movement to community settings associated with improved sense of well-being and independent decision-making


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There has been movement internationally in recent years, based on human rights-based approaches and national policies, to reduce reliance on institutional-based models of care and support.

This was a systematic review of literature about the effects of deinstitutionalisation and associated changes in quality of life for adults with learning disabilities. Papers originated from Australia, New Zealand, Ireland and the UK.

Quantitative and qualitative findings found consistently that deinstitutionalisation was associated with improved quality of life. Quantitative data established that quality of life gains were sustained and continued at one-year follow-up.

Housemate compatibility

Movement to less institutional, community settings was associated with an improved sense of well-being, freedom and independent decision-making. Careful consideration of ‘housemate compatibility’ before a move was also associated with higher-quality daily living experiences.

The findings highlighted that additional support may be required to ensure that people have the opportunity to experience quality of life gains associated with greater social connectedness and integration into wider communities.

The review team noted that subpopulations with additional needs, or who require high levels of support, are less well considered in the available literature. Nonetheless they appear to show similar benefits to their counterparts, with fewer additional needs.


Reference

McCarron M, Lombard-Vance R, Murphy E et al (2019) Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review. BMJ Open


Dave Atkinson is an independent nurse consultant

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