Quality of life and deinstitutionalisation : an examination of the effects of relocating people with learning disabilities from hospital to life in the community

Abstract

The quality of life for people with learning disabilities was examined for 50 people leaving hospital to live in a range of community residences and for 50 people remaining in hospital. Individuals were followed up for up to 30 months at six monthly intervals. The social validity of quality of life assessment was examined by comparing the importance of a number of service objectives to people with and without learning disabilities. This then informed the development of two measures used to assess aspects of quality of life. A range of measures were employed to address both objective and subjective dimensions of quality of life. Five main areas were identified and examined in two studies - competence and personal growth; health and well-being; quality of care; engagement in activity and staff resident interactions. The issues reflecting some of the difficulties in assessing subjective states of people with learning disabilities are discussed. Overall there was some relatively small changes in the areas of competence and personal growth, quality of care and staff interactions for people moving from hospital to live in the community. The changes tended to occur within six months of moving with little improvement thereafter. In general, there was no change for the people remaining in hospital. Implications for the detailed examination of the effects of deinstitutionalisation are discussed.