1
|
Taylor B, Thompson J, Ryan T. 'Moving on' for Adults With a Learning Disability and Their Families: A Constructivist Grounded Theory Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241232360. [PMID: 38437864 DOI: 10.1177/10497323241232360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Ending familial co-residence, termed 'moving on' by participants, is an increasingly relevant life transition for people with a learning disability due to increasing life expectancy and policy developments. Nevertheless, there is an absence of research exploring this transition experience in a United Kingdom (UK) context. This constructivist grounded theory study therefore aimed to explore, conceptualise, and theorise the 'moving on' experiences of adults with a learning disability and their families. This article reports the experiences of five adults with a learning disability and nine family members in England, UK. Narrative interviews and creative storybook methods were used to collect data between April 2015 and May 2016. Constant comparative methods, theoretical sampling, and memo writing were used throughout data collection and analysis. Participants with a learning disability presented personal growth and greater life fulfilment over the course of the transition; they flourished. In parallel, family members relinquished their care responsibilities. Importantly, the iterative and reciprocal relationship between flourishing and relinquishing shows that ongoing family member involvement is crucial during and following relocation. Family members identified factors that potentially inhibit relinquishing: pressure to 'let go', different perceptions of independence between family members and service providers, inadequate future investment, and rapport with professional carers. These novel insights led to the generation of the first known mid-range theory concerning this transition, entitled 'Moving on: flourishing and relinquishing'. Findings will guide future research in this field and facilitate the design of appropriate support for people with a learning disability and their families.
Collapse
Affiliation(s)
- Bethany Taylor
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Health Sciences School, University of Sheffield, Sheffield, UK
| |
Collapse
|
3
|
Mason D, Milner V, Clark L, Kelly E, Pyefinch R, Happé F. Autistic People and Moving Home: A Systematic Review. AUTISM IN ADULTHOOD 2023; 5:236-247. [PMID: 37663439 PMCID: PMC10468557 DOI: 10.1089/aut.2022.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background While many studies have examined where and with whom autistic people live, very few have looked at autistic people's experience of moving home. Choosing where to live, and being able to move residence, could be important for autonomy, and we therefore undertook a systematic review to identify studies about autistic adults' experience of moving home. Methods We entered search terms relevant to autism and moving home into six databases and Google Scholar. After screening the titles and abstracts, we identified a final set of articles and screened the full text. We then checked the reference lists for potentially relevant articles; then, we conducted a search for articles that cited our final set of articles. Three raters assessed each included article for methodological quality. Results The search strategy identified a total of 311 articles (initial search, ancestry searching, articles from other sources). After deduplication, we screened a total of 165 articles for eligibility. A final set of seven articles was identified. Our narrative synthesis of the articles suggests that both autistic people and the relatives of autistic people think living independently is a source of positive personal development. However, autistic people reported that poor employment prospects impacted on their financial independence and hence independent living. Parents highlighted concerns about their offspring's personal care, safety, and the difficulty of navigating the housing system for those autistic people with co-occurring intellectual disability. Conclusions Taken together, our review suggests that autistic people and those who care for them have a positive view of independent living and are aware of the barriers to achieving this. Our review highlights a gap in the understanding of autistic adults' experience of moving home. We briefly describe our ongoing research project [the "Moving (as an) Autistic Person" project] exploring autistic people's experiences of moving house.
Collapse
Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Victoria Milner
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lauren Clark
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Emily Kelly
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebekah Pyefinch
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
5
|
Roos E, Søndenaa E. Improving the transition process to independent living for adolescents with profound intellectual disabilities. Experiences of parents and employees. BMC Health Serv Res 2020; 20:1133. [PMID: 33298053 PMCID: PMC7724626 DOI: 10.1186/s12913-020-05976-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/25/2020] [Indexed: 11/22/2022] Open
Abstract
Background The transition process from the family home to independent living for young adults with profound intellectual disability (PID) becomes delayed. Those families face challenges that exceed those of typical families such as higher objective and subjective burden, more frequent psychological distress and lower social support. The aim of this study was to explore the collaboration process between parents and employees and identify factors that improve the transition with less burden. Methods A descriptive qualitative study was undertaken with 18 persons (9 parents and 9 employees) interviewed individually and in groups. In accordance with the municipality’s guidelines, families with a child with PID should apply for housing, when the child turns 16. The purpose is to ensure interdisciplinary collaboration, information flow and coordinated services according to family’s needs. The main question in the interviews was ‘What was your experience with cooperation in the transition process, and what would you do to improve this process?’ The interviews were analysed with a thematic approach using systematic text condensation. Results The parents experienced a lack of general information about the ‘housing waiting list’, level of services, and the plan for time of moving from the family home, and how to choose where and whom to live with. Parents described an unsustainable burden of care during the waiting period, and a family crisis caused the allocation of an apartment in a group house. Employees shared challenges to meet families’ wishes, as there were too few group homes. They experienced good collaboration with families and said they offered respite care, due to reduce parents’ burden of care. Employees experienced that PID adolescents developed skills, mastery and degrees of independence after completing a residency at the Folk High School. Conclusions To improve the transition process from family home to independent living for young adults with PID, the informants highlighted some factors to reduce the burden of care on families: 1) Systematic follow-up program for families to observe their needs at an early stage; 2) More available group houses; 3) Information about the housing priorities of the services and; 4) Educational preparation programs for families.
Collapse
Affiliation(s)
- Eirik Roos
- Department of Health and Welfare, Municipality of Trondheim, Norway
| | - Erik Søndenaa
- Faculty of Medicine and Health Sciences (MH), Department of Mental Health, Norwegian University of Science and Technology, 7491, Trondheim, Norway. .,Department of Brøset, St. Olavs University Hospital, Trondheim, Norway.
| |
Collapse
|
6
|
Giesbers SAH, Hendriks AHC, Hastings RP, Jahoda A, Tournier T, Embregts PJCM. Social Capital and the Reciprocal Nature of Family Relationships: The Perspective of Individuals With Mild Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:170-185. [PMID: 32357108 DOI: 10.1352/1944-7558-125.3.170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Even though family plays a significant role in the lives of people with intellectual disability, little research has included their own views about their families. This study examined how 138 people with mild intellectual disability describe their family group, with a focus on the reciprocal nature of the emotional support in relationships with family members. Participants reported "significant" family members beyond the nuclear family, and parents were seen as the main provider of support. Only half of participants had a support relationship with siblings and just 13% of participants reported partners. About 30% of support was reciprocal, and reciprocity varied greatly with the types of family connection (e.g., siblings, peers). Implications for future research as well as practice are discussed.
Collapse
Affiliation(s)
- Sanne A H Giesbers
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Alexander H C Hendriks
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Richard P Hastings
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Andrew Jahoda
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Tess Tournier
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Petri J C M Embregts
- Sanne A. H. Giesbers, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and Dichterbij Innovation and Science, Gennep, the Netherlands; Alexander H. C. Hendriks, School of Pedagogical and Educational Science, Faculty of Social Sciences, Radboud University Nijmegen, the Netherlands; Richard P. Hastings, Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia; Andrew Jahoda, Psychological Medicine, University of Glasgow, Glasgow, UK; Tess Tournier, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands and ASVZ, Sliedrecht, the Netherlands; and Petri J. C. M. Embregts, Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, the Netherlands
| |
Collapse
|
8
|
Trip H, Whitehead L, Crowe M, Mirfin-Veitch B, Daffue C. Aging With Intellectual Disabilities in Families: Navigating Ever-Changing Seas-A Theoretical Model. QUALITATIVE HEALTH RESEARCH 2019; 29:1595-1610. [PMID: 31068091 DOI: 10.1177/1049732319845344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Life expectancy is increasing for people with intellectual disability, many of whom live with family. While there has been research about aging and future planning, there is limited evidence about the characteristics of the caregiving relationship. The aim of this study was to examine perspectives of caregiving for older people with intellectual disability and their family. A constructivist grounded theory approach was used, and 19 people with intellectual disability and 28 family members were interviewed. Caregiving was informed by transitions across the life course. Three interrelated concepts, Riding the Waves, Shifting Sands-Changing Tides, and Uncovering Horizons comprise the core components of the theoretical model-Navigating Ever-Changing Seas. This model informs complex, trans-generational relationships that impact decision-making for people with a long-term condition. Applications within health care indicate a need for systems to include individuals and their networks of care in policy, practice, research, and service delivery across the lifespan.
Collapse
Affiliation(s)
| | - Lisa Whitehead
- 1 University of Otago, Christchurch, New Zealand
- 2 Edith Cowan University, Joondalup, WA, Australia
| | - Marie Crowe
- 1 University of Otago, Christchurch, New Zealand
| | - Brigit Mirfin-Veitch
- 1 University of Otago, Christchurch, New Zealand
- 3 Donald Beasley Institute, Dunedin, New Zealand
| | - Chris Daffue
- 4 Canterbury District Health Board, Christchurch, New Zealand
| |
Collapse
|
12
|
Iacono T, Evans E, Davis A, Bhardwaj A, Turner B, Torr J, Trollor JN. Family caring of older adults with intellectual disability and coping according to loci of responsibility. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:170-180. [PMID: 27442688 DOI: 10.1016/j.ridd.2016.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/23/2016] [Accepted: 07/06/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND A complex interplay of factors is evident in the response of family caring for older adults with intellectual disability (ID). The aim of this study was to explore the interaction of these factors. METHODS Quantitative data on health and wellbeing, and coping strategies were obtained for carers and their adult children with ID. Qualitative data were from three focus groups conducted with 19 main family carers. RESULTS Carers varied in their health and wellbeing. Four overarching themes emerged from an initial interpretative phenomenological analysis of the qualitative data: loci of responsibility, impacts of caring and responses to it on health and wellbeing, transitioning care responsibilities, and interrelationships around the caring role. Further interrogation of data according to carers' coping strategies revealed three loci of responsibility, providing a point of convergence that related to carer experiences, plans for transition, and relationships within families. These loci of responsibility were having sole responsibility because there was no-one else, having sole responsibility because no-one could do it better, and sharing responsibility. CONCLUSION The loci of responsibility provide a means to understand carers' appraisal of their role and the degree of control they have over it, and may account for varied coping strategies adopted.
Collapse
Affiliation(s)
- Teresa Iacono
- La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, Australia.
| | - Elizabeth Evans
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Adrian Davis
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Anjali Bhardwaj
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Jennifer Torr
- Centre for Developmental Disability Health Victoria, Monash University, Melbourne, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia; Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| |
Collapse
|