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Disability Services (disability + services)
Kinds of Disability Services Selected AbstractsMainstream In-Patient Mental Health Care for People with Intellectual Disabilities: Service User, Carer and Provider ExperiencesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2010Ben Donner Background, Government guidelines promote the use of mainstream mental health services for people with intellectual disabilities whenever possible. However, little is known about the experiences of people with intellectual disabilities who use such services. Materials and Methods, Face-to-face interviews with service users, carers and community nurses were completed and analysed on a case by case basis using interpretative phenomenological analysis. The results were followed up in focus groups with service providers. Results, Positive aspects included the provision of respite, particularly for carers, and good basic care. These were outweighed by a perception of the admission as disempowering and lacking in flexible treatment provision. Accessing help emerged as a major problem, as well as the prospect of staff neglecting the specific needs of people with intellectual disabilities. Conclusions, While there were some indications of improvements in line with recent policies and guidance, mainstream services seem a long way off realizing aims of easy accessibility, person-centred practices and active partnership with intellectual disability services. [source] Residential Provision for Adult Persons with Intellectual Disabilities in IrelandJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2007Fiona Mulvany Background, The type of accommodation provided for persons with an intellectual disability is a major indicator of the social policy for this client group. This is likely to vary within and across countries; hence the importance of undertaking national and international comparisons. Estimations of future need are also required to assist service planning. Method, A database of all persons in receipt of intellectual disability services has been operating in the Republic of Ireland since 1995. In Northern Ireland, regional databases were used to provide similar information. Results, Around 10 000 people live in some form of residential provision: 56% in special settings, 35% in ordinary housing and 9% in hospitals. Most residents were classed as having ,severe' disabilities and were aged over 35 years. There were marked differences in the amount and type of provision provided in the two parts of the island. This was also mirrored in differences across health service areas within each country. The demand for future places was greater in Northern Ireland. Conclusions, A planning target of 3.5 places per 1000 adult population is proposed although substantial investments in services is required to achieve this. Longitudinal surveys are an important way of monitoring the impact of new policy initiatives. [source] A Communication Training Programme for Residential Staff Working with Adults with Challenging Behaviour: Pilot Data on Intervention EffectsJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2007Andy Smidt Background, Challenging behaviour often serves a communicative function. It therefore stands to reason that the residential staff working in developmental disability services require training to foster appropriate communicative interactions with adults with challenging behaviour. Method, Eighteen members of staff working in three residential services participated in a 4 week communication training programme. The programme focused on staff attitudes to and beliefs about challenging behaviour, communicative interactions between staff and residents and working as a team. Objective measurements were made of the effects of the training programme on staff use of augmentative and alternative communication, praise and use of inappropriate language in a multiple-baseline design across three organizations. Changes in the rate of challenging behaviours among the residents were also evaluated. Results, As staff's use of AAC and praise increased, and inappropriate language decreased, there was some concomitant decrease in residents' levels of challenging behaviour; however, these results were not sustained in the long-term. Conclusion, This pilot data suggest that an approach to staff training based on modifying attitudes and beliefs is potentially beneficial to both staff and residents. [source] The Social Networks of People with Intellectual Disability Living in the Community 12 Years after Resettlement from Long-Stay HospitalsJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2006Rachel Forrester-Jones Background, The social inclusion of people with intellectual disabilities presents a major challenge to services. As part of a 12-year follow up of people resettled from long-stay hospitals, the size of 213 individuals' social networks and the types of social support they received were investigated, as viewed by people with intellectual disabilities themselves. The types of support received in four different kinds of community accommodation were compared. Method, Individuals were interviewed and their social support networks mapped using a Social Network Guide developed for the study. Descriptive statistics were generated and comparisons made using generalized linear modelling. Results, The sample comprised 117 men (average age 51 years) and 96 women (average age 56 years). All but seven were White British, 92% were single and they had in general, mild to moderate intellectual disabilities. The average network size was 22 members (range 3,51). The mean density was 0.5. A quarter of all network members were other service users with intellectual disabilities and a further 43% were staff. Only a third of the members were unrelated to learning disability services. In general, the main providers of both emotional and practical support were staff, although these relationships were less likely to be described as reciprocal. Other people with intellectual disabilities were the second most frequent providers of all types of support. People in small group homes, hostels and supported accommodation were significantly more likely to report close and companiable relationships than those in residential and nursing homes, but they also reported a greater proportion of critical behaviour. Conclusions, The social networks revealed in this study are considerably larger than those of previous studies which have relied on staff reports, but findings about the generally limited social integration of people with intellectual disabilities are similar. A clearer policy and practice focus on the desirability of a range of different social contexts from which to derive potentially supportive network members is required so that people do not remain segregated in one area of life. [source] Investigating Sexual Abuse: Findings of a 15-Year Longitudinal StudyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2005Bob McCormack Background, There is a lack of longitudinal large-scale studies of sexual abuse in intellectual disability services. Such studies offer opportunities to examine patterns in disclosure, investigation and outcomes, and to report on incidence and trends. Methods, All allegations of sexual abuse (n = 250) involving service users as victims or perpetrators of sexual abuse over a 15-year period in a large Irish community-based service were analysed based on the data extracted from extensive contemporaneous case notes. Results, Victims or families were the most common concern raisers of abuse. Following multidisciplinary investigation, almost half (47%) of all allegations of sexual abuse were confirmed (n = 118). In confirmed episodes, more than half the perpetrators were adolescents and adults with intellectual disabilities, while almost a quarter were relatives. The most common type of abuse was sexual touch, although 31% of episodes involved penetration or attempted penetration. The most common location was the family home, followed by the day service and public places. A notable feature was the variation in the incidence of abuse over the study period, largely caused by episodes of multiple abuse. Conclusions, The incidence of confirmed episodes of sexual abuse of adults with intellectual disabilities may be higher than previously estimated. There is an urgent need for statutory guidelines, which require reporting of adult abuse, and provide protection for bona fide whistle blowers, similar to existing child protection legislation. [source] Parents of Children with Intellectual Disabilities: Their Expectations and Experience of Genetic CounsellingJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2003Owen Barr Background, Following the birth of a child, parents and other family members have to adapt to their new circumstances. This process takes time and can become more complex when the child is suspected or diagnosed as having intellectual disabilities. When a child has a disability, parents often seek answers as to the origin and nature of the condition as part of the adaptation process. For some parents, this will result in genetic investigations and could lead to the provision of personal genetics about the child and parents. Materials and methods, This paper reports a mixed-method project that combined questionnaires prior to and interviews after an appointment with a geneticist. The project sought to identify the expectations and experience of parents who had a child referred to specialist genetics services. Results and conclusions, The findings identify that parents felt largely unprepared for their appointment and reported feelings of failing to maximize the opportunity present. The need for more effective liaison between specialist regional and local primary care and learning disability services is also highlighted. Parents made practical suggestions relevant to all the above services about how they could be better supported at this difficult stage in the adaptation process. [source] Physical Interventions with People with Intellectual Disabilities: Staff Training and Policy FrameworksJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2003Glynis Murphy Background, Physical intervention or restraint with people who have intellectual disabilities is sometimes necessary, even though it is known to present dangers to both staff and service users (some service users have died as a result of restraint). Aims, This study aims to investigate the extent to which staff in intellectual disability services were trained in the use of physical interventions or restraint. Their views of a recent policy framework on physical interventions were also sought. Methods, There were three groups of participants: (i) group 1 included staff who had attended conferences on the Policy Framework (the conference sample); (ii) group 2 included staff from two geographical areas (the geographical sample); (iii) group 3 included staff in specialist assessment and treatment services (the SpAT sample). All participants were sent a questionnaire asking them about their training in (and use of) physical intervention methods and their opinions on the policy document. Results, There were at least 12 different types of training recorded, including a number of varieties of Control and Restraint (C&R). By no means did all the senior staff did have training in physical intervention methods. The degree of training varied with the sample and the type of training varied with the employing organization. Most participants in group 1 were very positive about the BILD & NAS Policy Framework but few staff in groups 2 and 3 had read the document. About two-thirds of the participants said their services had (or were developing) a written policy on physical interventions. Conclusions, There remained a clear need for further training in physical interventions and evidence on which the effectiveness of different methods of physical interventions could be judged. [source] Forensic Risk Assessment in Intellectual Disabilities: The Evidence Base and Current Practice in One English RegionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 4 2000Stephen Turner The growing interest in forensic risk assessment in intellectual disability services reflects the perception that deinstitutionalization has exposed more people to a greater risk of offending. However, ,risk' and the related idea of ,dangerousness' are problematic concepts because of connotations of dichotomous definition, stability and predictability. Assessment instruments in mainstream forensic psychiatry often combine actuarial and clinical data, and increasingly stress the dynamic nature of risk as well as the importance of situational and accidental triggers. Despite this increasing sophistication of research in mainstream forensic psychiatry, the ability to predict future offending behaviour remains very limited. Furthermore, actuarial predictors developed in studies of psychiatric or prison populations may not be valid for individuals with intellectual disabilities. Offending behaviour among people with intellectual disabilities is also hard to circumscribe because it often does not invoke full legal process or even reporting to the police. In order to discover how such problems were reflected in practice, a survey of providers in the North-west Region of England was undertaken. Seventy out of 106 providers identified as possibly relevant to this inquiry responded to a short postal questionnaire. Twenty-nine (42%) respondents , mainly in the statutory sector , reported operating a risk assessment policy relating to offending. The number of risk assessments completed in the previous year varied from none to ,several hundred'. Providers reported three main kinds of problems: (1) resources or service configuration; (2) interagency or interdisciplinary cooperation or coordination; and (3) issues relating to the effectiveness, design and content of assessment. [source] Family Carers of Adult Persons with Intellectual Disabilities on the Island of IrelandJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 2 2006Steve Barron Abstract, Many families provide lifelong support to their relative with an intellectual disability. However, relatively little information is available for national populations on the characteristics of the people for whom these families care and the supports they receive or need. A database of all persons in receipt of intellectual disability services has been operating in the Republic of Ireland since 1995 and records details of those living with family carers. In Northern Ireland, regional databases provide similar information. Using both sources, data were obtained on over 12,500 people living with family carers; half of whom lived with two parents, around 30% with a lone parent, and just under 20% with another relative. More people in Northern Ireland were identified as living with family carers, which was attributed mainly to less available residential alternatives. Only a minority of carers received respite breaks and domiciliary supports although higher proportions required them. The authors conclude that family care arrangements have received relatively little attention within government policy making, and hence service provision has been largely reactive. Future research should focus on the changing needs of carers over time and how they can be better supported in their role. [source] Technology for independence: a community-based resource center,BEHAVIORAL SCIENCES & THE LAW, Issue 1 2003Peter Blanck Ph.D. Despite the prominence of the disability civil rights model,with its values of inclusion and empowerment,the majority of social and policy research conducted to date has not sufficiently included the perspective of persons with disabilities in the research process and as uniquely qualified researchers themselves. This article describes a new project, "Technology for Independence: A Community-Based Resource Center" (CBRC). Over a five-year period, the CBRC will attempt to enhance community and consumer-directed disability organizations to design, implement, and disseminate research that promotes access to and use of assistive technology (AT). The CBRC will use strategies such as leadership training, participatory action research, technical assistance, web- assisted training, and annual symposia. A primary goal of the CBRC is to increase the capacity of community organizations to conduct research on AT that is scientifically rigorous and relevant to disability services, policy, and law. Copyright © 2003 John Wiley & Sons, Ltd. [source] Inclusion or control? commissioning and contracting services for people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 4 2006Liam Concannon Accessible summary ,,The rise of new public management has seen the role of the social worker becoming increasingly administrative and less about face to face contact with service users. ,,When commissioning managers seek to help people with learning disabilities plan their services, who actually makes the decisions? ,,Direct payments are proposed as the answer for people with learning disabilities to take the lead, but is this a real shift in power from managers to service users? This paper examines what commissioning and contracting means for people with learning disabilities. It asks if the voices of service users are heard when it comes to planning their services and, more significantly, are their choices respected and acted upon by commissioners? The government believes the introduction of direct payments will change the way social care is administered, by placing both the decision-making and funding, firmly in the hands of people with learning disabilities. However, the question remains as to how far this can be successful, considering the complicated administration and financial processes involved. The paper explores new ground in terms of research by investigates the effects that new public management, in the form of commissioning and contracting, has on the lives of people with learning disabilities. It looks at the relationship between the service user, care manager and commissioner, and asks whether management structures help individuals or actually create further barriers to participation and inclusion. Summary This paper seeks to critically assess the impact made by the introduction of commissioning and contracting as a new culture of social care in learning disability services. It offers an evaluation of the growth in importance of the user as consumer. Does the commissioning and the contract process give users with learning disabilities a greater influence over their services and ultimately their lives? It is suggested that far from empowering people with learning disabilities to have a say in the services they want, the emerging culture of business contracts and new public management transfers power firmly back into the hands of professionals making the decisions. Social work practice is changing in response to major shifts in social trends and at the behest of market values. Traditional models are being rejected and the challenge for social work is to adapt itself to operate within a competency based paradigm. The paper argues that at the centre of this new culture is a government use of a system of performance management that successfully drives down cost. Thus there remain contradictions between the adoption of a mixed economy of care; services planning; consumerism; resource constraints; and the communication difficulties experienced by many people with learning disabilities. [source] Time to make up your mind: why choosing is difficultBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 1 2003John Harris Summary For many years, the promotion of choice has been a core objective for virtually every service provider working to support people with learning disability. This is confirmed by the 2001 English White Paper Valuing People, A New Strategy for Learning Disability for the 21st Century, which describes choice as one of four key principles at the heart of the UK Government's proposals, and the 2000 review of learning disability services commissioned by the Scottish Executive, People Like Us, which places a similarly high priority on the creation of choice. The present paper gives an overview of our current understanding of the concept of choice. It concludes that our aspirations to promote choice for people with learning disability are undermined by conceptual confusion about the meaning of choice, inappropriate methods for helping people to make choices and an absence of applied research to guide practice in service settings. This review is designed to establish a conceptual framework for examining choice and empowerment for people with learning disability, and to describe the implications for future research and practice. [source] Discussing the menopause with women with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 1 2003Michelle McCarthy Summary Traditionally, little attention has been paid to the menopause as it affects women with learning disabilities. Consequently, older women with learning disabilities have rarely been adequately prepared for, or supported through, what for most women is a significant ,change of life'. None of the existing literature focuses on the women's perspectives, but rather, looks at menopause from a medical angle, in particular focusing on the timing of onset. The research study described in the present paper is an attempt to gain some insights into the ways in which women with learning disabilities perceive the menopause. The main informants were women with learning disabilities themselves, but also general practitioners, staff in learning disability services and parents who still cared for their middle-aged daughters at home. The research project also involved the non-disabled researchers working alongside two groups of women with learning disabilities, who acted as advisors and consultants to the project, and who were paid for their time. [source] | ||||||||||