Consumer‐Directed Goal Planning in the Delivery of Assistive Technology Services for People who are Ageing with Intellectual Disabilities

Abstract

Background A consumer-directed service-delivery approach to assistive technology and environmental modification intervention was examined with people who were ageing with intellectual disabilities. Material and Methods The intervention was based on a collaborative approach involving consumers, their social supports and service deliverers. Thirty individuals were randomly selected to receive the intervention from a sample of 75 community-dwelling adults. Outcomes related to consumers' and significant others' perceptions of performance and satisfaction with goal attainment were assessed and the consumer-directed goal planning process examined. Results Participants in the intervention group reported significantly higher levels of performance and satisfaction related to goals identified at baseline than participants in the control group. Two broad categories of goals were addressed during the intervention -basic self-care goals and participation ⁄ environmental ⁄ systems level goals. A 98% direct agreement rate between consumer-identified goals and goals addressed by service deliverers was found during the intervention. Of the environmental strategies employed during the intervention, assistive devices and systems level advocacy and action were the two most frequently used across goals. Conclusion Results provide evidence in favour of a consumer-directed approach to assistive technology and environmental modification service delivery for consumers who are ageing with intellectual disabilities.

Choice and control for people ageing with intellectual disability in group homes

“…One example of this is the lack of cognitive assistive devices in semi-private spaces, and how the staff talked about its absence. It is well documented that the use of cognitive assistive devices, such as time aids or communication tools, among people with ID, can be decisive for their participation in everyday life (56)(57), and also for people ageing with this disability (28)(29)(30)58). Keeping older people with ID from getting access to cognitive assistive devices due to their chronological age could be an example of discriminative attitudes among the staff providing or giving access to these devices, often occupational therapists.…”

“…Supportive social environments foster continuity, communion and a sense of coherence (23)(24)(25)(26), and arrangements in the physical environment, such as use of technical devices, can be vital for participation for this group of people (27)(28)(29)(30). Additionally, studies highlight that organisational and institutional factors such as disability policy, attitudes of staff, and societal values are also crucial for participation among older people with ID (23,(31)(32)(33)(34).…”

Delaktig (även) på äldre dar : Åldrande och delaktighet bland personer med intellektuell funktionsnedsättning som bor i gruppbostad

“…En del av det stöd som personer med intellektuell funktionsnedsättning behöver tillgodoses genom tillämpning av LSS (SFS 1993:387), exempelvis i form av boende i gruppbostad eller deltagande i daglig verksamhet. I praktiken kan detta stöd till äldre personer med intellektuell funktionsnedsättning innebära verbal och praktisk guidning, hjälpmedel för den dagliga livsföringen eller andra anpassningar av den fysiska miljön (jfr Hammel, 2000;Hammel, Lai & Heller, 2002;Hammel et al, 2008a;Hutchings, Olsen & Moulton, 2008;Mizra & Hammel, 2009). Kyléns förklaringsmodell (1981;1987), Goffmans stämplingsteori (1963) och den miljörelativa definitionen av begreppet funktionshinder (SOU 1976:20) är betydelsefulla utgångspunkter i denna avhandling.…”

Self-Determination across the Life Span: Issues and Gaps

“…A useful approach in the delivery of such supports is the consumer-directed collaborative goal planning strategy (ATLAS) involving persons with disabilities, their families, and service providers in goal planning. Mirza and Hammel (2009) found that older adults with developmental disabilities participating in the ATLAS intervention reported at follow up higher levels of performance and satisfaction related to goals they had identified. Assistive devices and systems level advocacy and actions were the two most frequently set goals.…”