Satisfaction and Sense of Well Being Among Medicaid ICF/MR and HCBS Recipients in Six States

Abstract

Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's neighborhood, feeling happy, feeling that staff are nice and polite, and liking one's home and work/day program. Loneliness was the most widespread problem, and there were also small percentages of people who reported negative views in other areas. Few differences were evident by HCBS and ICF/MR status. The findings document consistent benefits of residential support provided in very small settings-with choices of where and with whom to live-and to individuals living with family.

Correlates of Everyday Choice and Support-Related Choice for 8,892 Randomly Sampled Adults with Intellectual and Developmental Disabilities in 19 States

“…Like the previous study, this difference existed at each level of intellectual disability. We bave sbown elsewbere tbat people wbo cbose wbere and witb wbom tbey live experienced a range of more positive lifestyle outcomes (Stancliffe, Lakin, Taub, Chiri, & Byun, 2009). In addition to having little support-related choice, the absence of key cboices about wbere and witb wbom to live may bave consequences sucb as increased loneliness, decreased liking of one's bome, and decreased reported bappiness.…”

Comparison of community residential supports on measures of information & planning; access to & delivery of supports; choice & control; community connections; satisfaction; and, overall perception of outcomes

“…Concerns included ‘the possible lack of support’ from staff, potential boredom because of living alone and issues of safety. Stancliffe et al . (2009) compared self‐reported levels of satisfaction and sense of well‐being in a sample of 1885 across community‐based services and intermediate care facilities in six US states reporting consistent benefits of small settings with choice of where and with whom to live and for individuals living with families.…”

Choice of living arrangements

“…Gardner & Carran (2005) found an association between the personal outcome ‘People chose where and with whom to live’ and several other important individual outcomes such as ‘People are safe’ and ‘People are free from abuse and neglect’. Stancliffe et al . (2009) reported that individuals with greater choice of living companions and of where to live had better outcomes in four of six areas examined: loneliness (only for choice of whom to live with), feeling happy, home staff are nice, and liking home (the other two areas showed no significant differences).…”

“…For example, choosing between several group homes may provide genuine choice about where to live, but no meaningful choice of housemates. Stancliffe et al . (2009) reported only a modest correlation between choice of living companions and choice of where to live ( r s = 0.42, P < 0.001).…”