Residential Characteristics, Social Factors, and Mortality Among Adults With Intellectual Disabilities: Transitions Out of Nursing Homes

Abstract

The present study examined the degree to which residential characteristics and social factors are associated with mortality, after controlling for personal characteristics, among adults with intellectual disabilities who have resided in nursing homes (facilities providing skilled care and related services) at baseline in the Chicago area. Initial assessments were conducted on 330 residents, and 2 follow ups were performed over 10 years. Seventy-one residents had died by the end of the study. The variables examined included personal characteristics of age, gender, intellectual level, health, and adaptive behavior; residential characteristics of type of residence, size of facility, attractiveness of physical environment (cleanliness, conditions, and aesthetic appeal), and diversity of physical environment (personalization of residents' rooms and distinctiveness of all living spaces); and social factors of family involvement and community integration. The results indicated, beyond age, adaptive behavior, and health, that size of residences, residential characteristics, and social factors are related to mortality.

Unlimited Surrounding: A Scoping Review on the Impact of the Built Environment on Health, Behavior, and Quality of Life of Individuals With Intellectual Disabilities in Long-Term Care

“…For example, moving older residents and those with the most severe intellectual disabilities and problem behaviors can lead to poorer health (Bertelli et al, 2013). Hsieh et al (2009) examined the extent to which residential characteristics (and social factors) are associated with mortality in adults with intellectual disabilities who live or have lived in nursing homes and moved to community settings over a 10-year period in the United States. After controlling for personal characteristics, it appears that, among other things, higher diversity of the physical environment (personalization of residents’ rooms and distinctiveness of all living spaces) is associated with lower mortality for these residents, regardless of where they stayed.…”

“…More variety and stimulation, for example, by customizing rooms with personal items and variations in decoration throughout the building, has been found to be associated with more adaptive behavior and integration (Heller et al, 1998). Greater diversity in the physical environment is associated with lower mortality (Hsieh et al, 2009). Greater accessibility of materials (material enrichment) leads to increased participation in household tasks and activities (Felce et al, 1985; Rawlings, 1985).…”

“…Greater diversity in the physical environment is associated with lower mortality (Hsieh et al, 2009). Greater accessibility of materials (material enrichment) leads to increased participation in household tasks and activities (Felce et al, 1985;Rawlings, 1985).…”

Aging in individuals with intellectual and developmental disabilities.

“…Being a member of community groups, building acquaintances, and enjoying time with others can lead to social opportunities and promote the development of relationships (Bigby, 2005). However, many residential settings do not provide enough opportunities for their older residents with IDD to participate in community activities (Hsieh et al, 2009).…”