Deinstitutionalization and Quality of Life of Individuals With Intellectual Disability: A Review of the International Literature

Abstract

The policy of deinstitutionalization was based on the proposition that quality of life (QoL) of individuals with intellectual disabilities (ID) will improve as a result of being moved from institutions to community‐based care settings. The aim of this literature review was to evaluate whether this assumption has become a reality now that the social policy of deinstitutionalization has progressed in many countries across the globe. A total of 15 studies were examined that assessed QoL as an outcome of community living following deinstitutionalization. Results indicated that relocation had a general positive impact on life quality of participants. However, many of the studies found that improvements were most prominent shortly after the move and plateaued after a year. Also, participants continued to have low levels of community integration. There was some evidence that healthcare needs might not be adequately met in the community. The role of service providers was indicated as vital in the continued development of participants' life quality. Common limitations of the studies reviewed included lack of subjective assessments of QoL and limited use of standardized measures of QoL. The authors note that the directions for future research should include examining whether QoL outcomes after deinstitutionalization are affected by level of ID and age of participants. Overall, additional empirical research is needed to identify the factors that are critical in enhancing QoL of participants in community‐based care following deinstitutionalization.

Public Attitudes Toward People With Intellectual Disabilities After Viewing Olympic or Paralympic Performance

“…Increased engagement in social activities generally indicates a higher quality of life and increased well-being (Verdonschot, De Witte, Reichrath, Buntinx, & Curfs, 2009), which is highly relevant for people with ID, as they tend to have a lower quality of life than other groups in society (Chowdhury & Benson, 2011). In addition, given that people with ID are a population vulnerable to low selfesteem and psychological disorders, contributed to by perceived negative attitudes (Campbell, 2009;Dagnan & Waring, 2004), increasing inclusion and reducing discrimination through promoting positive attitudes seems a potentially fruitful avenue for intervention.…”

Evaluating quality of life in adults with profound learning difficulties resettled from hospital to supported living in the community

“…The risks associated with resettlement were not apparent at this stage but would merit further auditing over a longer period. Whilst all the domains showed improvement, the relatively smaller improvement for social relationships suggests the need for further study, and this reflects the findings summarized in Chowdhury and Benson (2011) in which the community relationships had showed least improvement after resettlement.…”

“…This approach has integrated a number of data streams to provide a distinctively comprehensive evaluation of the resettlement compared with other reported evaluations (Chowdhury and Benson, 2011). The research combined a relatively objective audit with qualitative descriptions and questionnaire surveys of stakeholder views.…”

“…In the most recently published review, Chowdhury and Benson (2011) found that relocation had a generally positive impact on the QofL of service users. However, many of the studies identified that improvements were most prominent shortly after the move and plateaued after a year.…”

Educational policies and practical implications for children with intellectual disability in Republic of Macedonia

“…A research conducted by Chowdhury and Benson (2011) showed that relocation of persons with intellectual disabilities from large institutions to non-residential setting has a general positive impact of the quality of life of the persons with ID although the improvements were most prominent in the first year and they plateaued after a year. Brown, Mac-Adam Crisp, Wang and Iarocci (2006) suggest that there is a need to both identify and provide measures of care and support that would enable families to function at an optimum level within their home and community, so they may experience a quality life similar to that of families without a child with a disability.…”