Interventions that minimize challenging behavior and disability may make a significant difference to the level of community integration experienced by people with severe TBI.

Objectives:The aim of this article is to describe the characteristics, needs and preferences of people under 50 with an acquired brain injury (ABI) living in residential aged care in Victoria and examine implications for service development.Participants:Sixty-one people under 50 with an ABI living in residential aged care in the state of Victoria.Measures:Care and Needs Scale, Community Integration Questionnaire, Overt Behaviour Scale, Health of the Nation Outcome Scale — ABI Version, Role Checklist, Resident Choice Scale.Results:The younger people with ABI in this study were a diverse group with a complex range of health and support needs that were not being adequately met within residential aged care. Many people (44%) required the highest level of support, indicating they could not be left alone while 26% could be left for part of the day and overnight. Most people (81%) and their support networks indicated they would like to explore moving out from residential aged care into community accommodation settings.Conclusions:This article provides clear direction for the development of services to meet the care needs of this group, to enable them to participate in the life of the community and to pursue a lifestyle of choice.

Objective: To describe the characteristics of people under 60 years of age living in residential aged care in Victoria and to examine the occupational participation of younger residents in aged care facilities by measuring their social contact, participation in recreation and community access. Methods: A survey was sent to the Directors of Nursing at all 803 Commonwealth Department of Health and Aged Care registered aged care facilities in Victoria. Results: The survey had a 78% response rate and information was provided about the characteristics of 330 people under 60 years with high clinical needs residing in aged care facilities. This sample was extremely isolated from peers, with 44% receiving a visit from a friend less often than once per year. Sixteen per cent of residents participated in a recreation activity less than once per month and 21% went outside less than once per month. Of the sample, 34% almost never participated in any community-based activities such as shopping, leisure or visiting friends and family. Conclusion: Over one third of younger people in aged care are effectively excluded from life in our community. Most younger residents are socially isolated and have limited opportunities for recreation. Placement of younger people in aged care facilities is inappropriate, and alternative care models and settings are required.

People with very severe ABI have the potential to increase their level of independence in community-based accommodation settings; a potential that is not fostered in most aged care environments. The findings inform the outcome variables and environmental factors that should be measured in studies of transition from aged care to the community.

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