Abstract:

Purpose of review: The focus of this review is on residential settings for adults with intellectual disabilities. It examines (1) the impact of type and size of settings on organizational features and resident outcomes; (2) the impact of organizational features on resident outcomes; and (3) the interaction of personal and environmental characteristics that promote a higher quality of life for residents with intellectual disabilities. Recent findings: The research reviewed shows that in comparison with institutional settings, community-based residential services generally result in better outcomes for residents when considering adaptive behavior, self-determination, community participation, and social networks. Community services, however, do not necessarily offer quality services as the residences vary widely in their standards. Key features associated with positive outcomes for residents include homelike architectural features, use of assistive technology, organizational policies promoting individualization and person-centered planning, and staff characteristics. Some features, such as high staff-resident ratio, can result in both positive and negative outcomes, depending on the outcome studied and the competence level of the resident. Summary: The studies examined highlights the importance of helping staff to cope with stress relating to their jobs, including dealing with challenging behaviour, and increasing motivation, job satisfaction, and high performance through administrative support and training.