[Relocation decisions to nursing homes for older persons with intellectual disability]

Transitioning to long-term care for older adults with intellectual disabilities: A concept analysis

AIM

To undertake a concept analysis of transitioning to long-term care for older adults with intellectual disabilities.

BACKGROUND

Individuals with an intellectual disability are experiencing increased longevity which is associated with an increase in transitions in later life to long-term care. Their experience of later life transitions is likely to be different to the general older population.

METHODOLOGY

Concept Analysis was undertaken using the Walker and Avant framework.

RESULTS

Eight studies met the inclusion criteria. Defining attributes are an older person with intellectual disability; a planned relocation to a long-term care facility; person-centred; and supported decision-making.

CONCLUSION

There is a dearth of empirical evidence and theorisation on this concept. Transitions of this nature have been inadequately informed by the perspective of the older person with an intellectual disability, and future research and practice requires greater efforts to include their voice.

Development and Exploration of Psychometric Properties of the Family Adjustment Questionnaire for Admitting an Older Adult to a Nursing Home (CAFIAR)

Background: Admitting an older adult to a nursing home involves significant adjustment efforts by the family. Our goal was to prepare an assessment instrument for this, given that there was none to date. Method: Participants-134 relatives from different nursing homes in the region of Murcia. Instruments-structured interview for socio-demographic information, satisfaction with the nursing home, well-being and health self-assessment, Radloff's Depression Questionnaire (CES-D), and the first version of CAFIAR. Results: A 15-item instrument with three factors was obtained: Factor 1 (Unease due to admitting an older adult to a nursing home), Factor 2 (Relief), and Factor 3 (Nostalgia and concern for the older adult), in addition to a general adjustment index, with a Cronbach's alpha of 0.74. The general adjustment index and the subscales that demonstrate poor adjustment were significantly correlated with depression and a worse health self-assessment, while the Relief subscale, which indicates better adjustment, was significantly correlated with well-being and a positive health self-assessment. Conclusions: The family adjustment in admitting an older adult to a nursing home questionnaire (CAFIAR) has adequate psychometric properties to assess family adaptation in admitting an older adult to an institution.

[Relocations of older persons with intellectual disability : A quantitative analysis]

BACKGROUND

Relocation from the familiar living environment is a particularly risky transition event for old people with intellectual disability (ID); however, a change of environment has the potential to maintain or improve a person's social participation and self-determination in old age. The research project MUTIG aimed to analyze the frequency and destination of moving home of old persons with ID (≥50 years) in Westphalia for the years 2014 and 2015.

MATERIAL AND METHODS

The investigation was based on a secondary analysis of administrative data of all persons over 50 years who received any kind of social aid for integration from the Regional Association of Westphalia-Lippe. For each individual the address and support arrangements at the beginning and the end of the years 2014 and 2015 were compared.

RESULTS

Approximately 5% of older people with ID changed address per year. People who moved to nursing homes had previously primarily lived in larger institutions or larger community-based group homes. The number of older persons with ID moving into or out of supported living arrangements was approximately equal.

CONCLUSION

Older persons with ID should also be able to move to smaller supported settings and these settings should provide long-lasting living perspectives (aging in place). The pulling effect that nursing homes exert on residents in residential institutions or larger group homes is critically discussed.