Supported Accommodation for People With Intellectual Disabilities and Quality of Life: An Overview

Abstract

This article presents the findings of a review of evidence related to quality of life in models of supported accommodation for adults with intellectual disabilities identified in English-speaking nation deinstitutionalization and postdeinstitutionalization studies. An international literature-based investigation of research published between 1995 and 2005 in English-language peer-reviewed academic journals was conducted to: (1) review the outcome of deinstitutionalization and postinstitutionalization studies; (2) examine instruments used to measure outcomes for individuals; and (3) compare costs and benefits associated with different models of supported accommodation. In the deinstitutionalization studies, there was consistent evidence of greater choice and self-determination, participation in social networks or relationships and community-based activities, and personal satisfaction in community-based settings. Postdeinstitutionalization studies provided consistent evidence for greater choice, self-determination, and participation in community-based activities in smaller settings, but no evidence for greater physical health or material well-being, and little evidence for a relationship between type of setting and employment. Future research is needed to meet methodological challenges identified here, to investigate the apparent failure of smaller residences to improve residents’ well-being and to study systematically factors not directly addressed in the studies under review: poverty and income, organizational culture, and geographical variation.