Unexpected consequences of deinstitutionalization of the mentally disabled elderly

Goplerud, Eric

doi:10.1007/bf00890695

Cited by 11 publications

(4 citation statements)

References 32 publications

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“…Despite these theories, research on the relation between relocation and cognitive impairment yields inconsistent results. While some studies report greater mortality or morbidity in response to relocation of the cognitively impaired (Friedman et al, 1995;Goplerud, 1979;Kral, Grad, & Berenson, 1968;Lander, Brazill, & Ladrigan, 1997;Markus, Blenkner, Bloom, & Downs, 1972), others fail to produce such findings (Gutman & Herbert, 1976;Ogren & Linn, 1971). For example, Mirotznik and Kamp (2000) investigated the mass transfer of residents from one building to another within the same nursing home to test the hypothesis that cognitively impaired residents are particularly vulnerable to the negative effects of relocation.…”

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confidence: 99%

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

Costlow

Parmelee

2019

Aging & Mental Health

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Objectives-The aims of this study were to explore the effects of relocation stress on depression and anxiety in long-term care residents and to investigate the moderating effect of cognitive status.Methods-The study used an existing dataset collected from nursing home and congregate apartment residents. Self-reported measures of relocation stress, cognitive status, depression, and anxiety were examined. Exploratory analyses examined group differences in depression and anxiety within the full sample (n = 568) and the sample of first-year residents (n = 347). Main analyses were conducted in a subsample of 107 first-year residents who completed the measure of relocation stress.Results-Residents who had moved in the past year reported more anxiety but not depression than longer-term residents, controlling for location and functional status. Within first-year residents, those who endorsed having moved to a less desirable residence reported more depression and anxiety than those who did not. Relocation stress significantly predicted depression but not anxiety in first-year residents. There was no significant effect of cognitive status or the interaction of cognitive status and relocation stress on depression and anxiety. Conclusion-Findingssuggest that cognitively impaired older adults are no more vulnerable to the negative effects of relocation stress than cognitively unimpaired older adults. Relocating within the past year, moving to a less desirable residence, and relocation stress affected depression and anxiety complexly across samples. Relocation stress should be regarded as a risk factor for depression in long-term care residents, regardless of cognitive status, in the first year after relocation.

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confidence: 99%

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

Costlow

Parmelee

2019

Aging & Mental Health

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“…After the closure of public state mental hospitals, these displaced individuals have become part of the growing U.S. aging population and have spent much of their lives on the streets, in and out of family homes and psychiatric hospital wards, locked up in prisons across the country, or contained in privately owned long-term care facilities, such as nursing homes and residential care facilities. 3,5–11 Currently, there are 51,367 licensed residential care facilities (1,233,690 beds) across the nation. (Residential care facilities provide room and board, meals, supervision, custodial care, and health-related services, such as medication management.…”

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confidence: 99%

Welfare State Replacements: Deinstitutionalization, Privatization and the Outsourcing to Immigrant Women Enterprise

Nazareno

2018

Int J Health Serv

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The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population. These immigrant women-owned businesses serve as welfare state replacements, overseeing the health and illness of these individuals by providing housing, custodial care, and medical services after the massive closure of state mental hospitals that occurred between 1955 and 1980. This study explains the onset of these businesses and the challenges that one immigrant group faces as owners, the meanings of care associated with their de facto mental health care enterprises, and the conditions under which they have operated for more than 40 years.

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“…A search of articles in the American Journal of Community Psychology for the last decade (1979-present) reveals no titles on this topic. To be sure, conceptual paradoxes that have implications for human service policies are a favored topic (Ac0sta, 1979;Goplerud, 1979;Lenrow & Cowden, 1980;Mulvey & Hicks, 1982;Rappaport, 1981), but what seem to be missing are discussions of the ambiguities and dilemmas associated with the practice of community psychology. Elias, Dalton, France, and Howe (1984) have noted that there is a gap between academic and applied community psychologists, and the dearth of commentary concerning practical ethical dilemmas may be syrup-tomatic of a more general disinterest in applied matters.…”

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confidence: 99%

Ethical dilemmas in community intervention

Heller¹

1989

American J of Comm Psychol

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Ethics code books provide only general guidelines and are inadequate in resolving explicit ethical dilemmas that frequently occur in community intervention. Ethical choices often reflect personal values as well as professional role proscriptions and are difficult to resolve for a number of reasons. It often is not clear to whom the interventionist should be accountable, or what the long-range impact may be of specific programs that seem to have short-term benefit. Value clashes can occur between consultants and consultees, even when both groups believe that they represent the best interests of vulnerable client groups. Since personal values are important determinants of ethical choices, whenever possible, they should be communicated openly so community groups can understand the interventionist's values before community projects begin. It also is important to share ethical dilemmas with professional colleagues in order to provide community psychologists with constructive feedback from their professional peers, and to help others anticipate similar value conflicts in their own work. These points are illustrated by discussion of the vignettes presented by O'Neill (1989) and by additional examples drawn from my own experience.

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Unexpected consequences of deinstitutionalization of the mentally disabled elderly

Cited by 11 publications

References 32 publications

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

The impact of relocation stress on cognitively impaired and cognitively unimpaired long-term care residents

Welfare State Replacements: Deinstitutionalization, Privatization and the Outsourcing to Immigrant Women Enterprise

Ethical dilemmas in community intervention

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