TitleFactors influencing functional ability among community-dwelling adults with developmental disabilities
NameHutchings, Barbara Lynn (author), Zippay, Allison (chair), Dickson, Donald (internal member), Johnson, Yvonne (internal member), Turner, Carol (outside member), Axelrod, David (outside member), Rutgers University, Graduate School - New Brunswick,
Developmentally disabled older people--Home care
DescriptionAdults with developmental disabilities are increasingly reaching old age in significant numbers while living in community-based, non-institutional settings. The overlay of cognitive and physical age-related impairments onto existing intellectual and physical disabilities, a paucity of informal social relationships, and a limited education and low income levels place this generation at risk for premature behavioral limitations and dependency. The purpose of this study was to explore the relationships between individual functional ability in the performance of typical self-care and household activities, personal expectations of competency, and the physical and social environment of the home to better understand how these factors contribute to both the autonomy and dependency of people aging with developmental disabilities. This study hypothesized that physiological impairment, the built environment, and personal expectations would be among the factors impacting individual functional ability level. Using a combination of qualitative and quantitative methods, this study gathered data from adults with developmental disabilities through individual in-person interviews and self-care/household task observations conducted in the participants' homes. A small sample of the consumers' direct care staff were also interviewed. Results from the study revealed that both levels of participation and competency in the performance of self-care activities varied widely. Physical impairments, and particularly severe mobility impairments, had a stronger impact on functional ability than the cognitive impairments of the participants. Those who used wheelchairs for all mobility both reported and were observed to have very limited person-environment fit. Settings that offered a higher degree of supervision were also more likely to physically support a wide range of activities. Ninety percent of the interview participants expected to perform less well than they did during the task observation assessment. Qualitative data revealed that participants valued privacy, safety and a physically and socially supportive environment. These data also suggested factors that may have inhibited functional ability, such as an over-concern with the risks involved in participation, low perceptions of ability, and staffs' habitual caregiving behaviors. Methods of encouraging and fostering independence and autonomy in the home are discussed. Behavioral methods included having high expectations of consumers, encouraging consumers to attempt tasks that they previously may have considered too challenging, and supporting consumers to take calculated risks in order to develop judgment and increase skills. Environmental methods included providing supportive physical environments, modified to meet individual needs, and appropriate and timely home maintenance.
NoteIncludes bibliographical references
Noteby Barbara Lynn Hutchings
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.