Circle of Homes: group homes for the retarded in Cuyahoga County.
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Adolescent↗
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Clinical need variations of disabled persons residing in group homes.
Group home research has generally entailed comparison of these settings and their residents to institutions and their residents. Group home residents have frequently been treated as a homogeneous cohort of individuals. When group home development began, initial residents--usually individuals recently deinstitutionalized--were probably relatively homogeneous in regard to functional abilities and service needs, and generally similar to other disabled persons living in the community. Today, the residents of one group home may bear little resemblance to those of another. This report presents information about the types of group homes within a state system based upon the characteristics and service needs of 1,050 persons in 118 group homes and questions the role of community mental health centers in addressing certain service needs of group home residents.
Analysis of Variance↗
Placement practices in specialized foster homes and small group homes for persons with mental retardation.
Resident functional and personal characteristics (e.g., gender, race, age, and level of mental retardation), placement histories, and projected placements of a nationally representative sample of 336 persons with mental retardation living in a total of 181 small, specialized foster care homes and group homes with 6 or fewer residents were compared. In addition, the extent to which resident characteristics differentiate between persons placed in specialized foster care homes or small group homes was assessed. Results indicate that there are some differences in resident characteristics across facility type, including communication and toileting skills, age, and mobility. Overall, results showed that small foster and group homes successfully serve a variety of people and that placement generally lasts for several years.
Activities of Daily Living↗
Therapeutic use of "prizing" and its effect on self-concept of elderly clients in nursing homes and group homes.
The purpose of this study was to ascertain the effect of nurse high prizing and nurse low prizing during group therapy in changing the self-concept of institutionalized aged persons. The hypothesis tested was that institutionalized aged clients participating in group therapy who receive nurse high prizing will show an increase in self-concept as measured by the Tennessee Self-Concept Scale (TSCS) when compared with those aged clients in the same settings participating in group therapy who receive nurse low prizing or those aged clients constituting the matched control groups. The study used an existing data source generated from the research of Williams and Lindell to conduct a secondary analysis of a variable not previously investigated. Mean difference scores from the posttest total self-concept score and subscales of the TSCS were analyzed in conjunction with the levels of prizing within the experimental and control groups. Using the Scale for Rating Prizing, two nurse raters judged the degree of prizing on 40 randomly extracted video segments. The findings indicated that 47.1% of those subjects who received low prizing decreased in self-concept; 68.4% of those who received high prizing increased in self-concept. No change in self-concept was noted in the control group. Findings were significant at the .0001 level. Investigating the effect of nurse high and low levels of prizing on client self-concept completes the Rogerian trilogy of therapist-offered conditions with this same sample of subjects. Extension of previous studies adds to the ever-growing body of nursing knowledge and increases the certitude, casualty, and generalizability of such investigations.
Aged↗
Personal characteristics and competence of people with mental retardation living in foster homes and small group homes.
In this 1986-1987 study, the demographic and diagnostic characteristics, problem behaviors, self-care skills, community living skills, domestic expectations, and program goals for personal competence of 336 persons with mental retardation living in a national sample of 181 foster care and small group care settings with 6 or fewer residents was assessed. The findings indicated relatively more severe cognitive impairment among persons in small ICFs-MR, less severe cognitive impairment and fewer functional limitations among non-ICF-MR group home residents, and more functional limitations among residents in foster homes. Neighborhood integration was relatively high for foster home residents, but there were fewer expectations for their development of home and community living skills. Implications for future research and program development in small, community-based residential settings were discussed.
Activities of Daily Living↗
Emotional disturbance and substance abuse in youth placed in residential group homes.
Residential group homes are increasingly important components of the system of mental health care for children and adolescents. However, they often do not have sufficient resources to provide active therapeutic programs as a result of their usual missions in serving abandoned or runaway youth. The authors studied 299 youth, ages 12 to 17 years, in five large residential group home programs in South Carolina. The instruments administered were (1) the Center for Epidemiological Survey-Depression Scale (CES-D), (2) a brief substance abuse questionnaire, and (3) questions about socioeconomic status, previous placements, and family relationship variables. A significant percentage scored above conservative clinical cut-off scores for the CES-D (51.7% scored 16 or above and 33.6% scored 23 or above). The youth also had significant levels of substance abuse problems. However, these variables were not predictive of previous multiple out-of-home placements (runaway behavior was predictive). These findings support the importance of addressing the clinical needs of youth in these programs.
Adolescent↗
Interactions between group homes and neighbors: neighbor preferences.
Group homes often are in conflict with their neighbors. Consequently, group home administrators tend to minimize contact between group homes and neighbors to reduce conflict. This study examined whether information about group homes and contact between homes and neighbors are related to neighbor problems as well as the preferences of potential neighbors about ways in which to become informed and involved with a group home if one were built in their neighborhood. Neighbors who interacted with residents and staff identified problems with group homes but showed fewer concerns about and had positive attitudes toward group homes generally. Potential neighbors wanted information about group homes entering their neighborhood, and preferred types of contact were associated with positive attitudes toward group homes. Group home administrators should consider neighbors as potential allies to help residents integrate into the community rather than as sources of conflict that must be avoided.
Attitude↗
The relationship between parent-youth interaction and delinquency in group homes.
Interactions between the youths and group home parents in 10 group homes were directly observed during a 2-hour session in each home. These observations were compared to questionnaire measures of the youths' self-reported delinquency while in the group home, and their evaluation of the group home program. The results indicated that over the 10 homes there was a strong inverse correlation between mean self-reported delinquency and the average amount of time youths spent taking to (rs = -.95) and in proximity to (rs = -.81) their group home parents. Talking to group home parents also showed a positive correlation with the youths' evaluation of their group home program. Similar trends were found when the correlations were computed over individual youths, although the magnitudes were reduced. These data may have implications for our understanding of the relationship between parenting behaviors and delinquency, as well as for the improvement of group-home treatment programs.
Adolescent↗
Community impact of group homes for mentally ill adults.
The phenomenon of resistance to the establishment of group homes for mentally ill adults is well-documented. The extent to which such homes, once established, do or do not create problems for communities is less clear. The current study examined the impressions of residents of a group home neighborhood one year or more after the establishment of the home. Forty-one residents of group home neighborhoods and thirty-nine residents of control (non-home) neighborhoods responded to a survey about their impressions of how a group home had affected or (for controls) would affect their neighborhoods. More than one fourth of the group home neighbors did not even know that they were living near a home. Those who did know tended to report a negligible impact of the group homes on things such as property values, neighborhood crime, resident safety, and distressing incidents in the community. Most of these residents also indicated that they were satisfied with the group home in their neighborhoods. The actual experience of group home neighbors was far more favorable than what residents of the control neighborhood anticipated, despite lack of differences in demographic characteristics or overall attitudes toward community care of mentally ill persons. Results support the view that the feared consequences of group home establishment in residential neighborhoods do not occur and that such homes may gain reasonable acceptance after they are established.
Activities of Daily Living↗
An analysis of treatment services provided in group homes for adults labeled mentally ill.
Although group homes for adults labeled mentally ill have been the focus of significant attention in deinstitutionalization discussions, substantive research on their operation has been lacking. The present study addresses past limitations by focusing on a well-defined sample of small group homes, with higher staffing levels and in-home treatment provided. Thirty homes were randomly selected; all home residents (N = 253) were studied. Data were collected from case managers, residents, and home staff to assess residents' functioning, services and treatments provided, and the environment of the home. The findings were examined in terms of adequacy and appropriateness of care provided in the home, using accepted guidelines. The results indicated that there are aspects of a homelike environment, emotional support from staff, and skill-development activities within the home. However, an institutional focus still seems prevalent, along with limited rehabilitation and socialization activities. Residents expressed high levels of satisfaction, which may reflect their dislike of the group home alternative, e.g., the state hospital. Policy implications are discussed vis-a-vis current efforts to move away from group homes toward supported housing initiatives.
Activities of Daily Living↗
A nutrition survey of and recommendations for individuals with Prader-Willi syndrome who live in group homes.
The purpose of this study was to describe anthropometric data and identify diet-related problems of individuals with Prader-Willi syndrome (PWS) who reside in group homes. A group home is a licensed foster care facility that provides 24-hour care for the developmentally disabled. Questionnaires were sent to dietitians (or the person responsible for nutrition care) of 25 group homes; responses from 18 homes were analyzed. The mean age of residents with PWS was 25 +/- 8.4 years and the mean height was 152.4 +/- 9.7 cm. The mean weight for 19- to 22-year-old men was 75.5 +/- 26.8 kg and that for women of the same age was 74.5 +/- 20 kg. The residents consumed a mean of 1,000 to 1,500 kcal/day. Most of the group homes (n = 16) locked their kitchens at night, and in 12 of the homes stealing and hoarding of food occurred. Pica behavior (eating of nonfoods) was reported in 7 homes. One third of all residents had success in weight loss and were on a maintenance diet, but a major problem was determination of a desirable weight goal. Our key recommendations for dietitians are weigh residents weekly; use the body mass index with prescribed zones for determination of weight goals; monitor change in circumference measurements; follow the guidelines of 7 to 8 kcal/cm of height for weight loss and 10 to 14 kcal/cm of height for weight maintenance; administer 1,000 kcal/day or more and encourage daily aerobic exercise; respect food preferences while adhering to dietary prescriptions; adhere to strict food control procedures; and use nutrition education methods and an interdisciplinary approach for behavior modification.
Adolescent↗
Supporting the free exercise of religion in the group home context.
Ways were delineated in which group home employees can support individuals living in the home in the active expression of faith, both inside and outside the group home environment, and at the same time protect the freedom of others in the home who choose not to be involved in religious activities. After briefly reviewing some assumptions underlying the 1992 AAMR definition of mental retardation and describing the capability of religious expression for individuals with cognitive impairment, we presented several guidelines to assist group home staff members.
Choice Behavior↗
Prospective study of clinical and social outcome of stay in small group homes for people with mental illness.
BACKGROUND: Small group homes operating according to the principles of supported housing have, during the past five years, become a cornerstone of the housing services for the long-term mentally ill in Copenhagen. METHOD: During a 2.5-year period, 47 long-term mentally ill persons were examined at the time of entry to a group home programme. Residents' psychopathology, social integration, mastery and quality of life were measured by structured interviews, including the Present State Examination (PSE-10); and their social functioning was recorded by interview with the staff. Forty-four of the residents were re-examined at follow-up after a mean of 1.1 years using the same instruments. Data on hospitalisation were obtained through the Danish Psychiatric Case Register. RESULTS: Eighty-three per cent of the residents remained in the programme during the first year. They showed a significant improvement in subjective quality of life, PSE total score, social integration, functioning and hospitalisation index. The number of reciprocal supportive contacts in the social network increased. Lower baseline PSE total score was associated with adherence to the programme, and the improvement in quality of life during their stay was predicted by reduction in symptoms and improvement in social integration. CONCLUSIONS: A rehabilitation strategy of supplementing standard psychiatric treatment with a programme of small supportive group homes improves the quality of life, psychosocial functioning and community tenure of the long-term mentally ill.
Adult↗
Gaining community support for group homes.
Data from a telephone survey of New Jersey group home providers, contracting with the State Division of Mental Retardation and Mental Health and Hospitals, evidence the assertions that providers who follow a standard public relations policy, arrange to meet with municipal officials, inform neighbors before moving-in, use local contacts, and invite the community to an open house generally enjoy greater support for their group home programs. In the medium to long run, neighbors who choose to become involved in the group home location effort (often because of concern if not opposition) generally offer more support.
Community-Institutional Relations↗
Neighbors' perceptions of group homes.
Neighbors often presume that group homes (GHs) have negative effects on their neighborhoods, but it is rather unclear how often GHs actually have adverse effects. Neighbors of GHs and a matched set of people who did not live near GH were interviewed. Neighbors of GHs were asked about their experiences with the specific GH near them, while "non-neighbors" were asked similar questions about their expectations of what it would be like to live near a GH. For both negative (e.g., noise, traffic) and positive effects (e.g., leaning about disabilities) of GHs, non-neighbors expected GHs would have a much greater impact on them than what was actually reported by neighbors. This research supports prior findings that expectations of negative effects are much greater than what is actually experienced by neighbors. It also suggests that GH operators might wish to capitalize on the positive expectations that may be over-shadowed by the more commonly voiced negative expectations.
Adult↗
Evaluation of environmental support in group homes for persons with mental retardation.
Types of environmental support provided to adults with mental retardation in group homes after transfer from a large state institution were compared. Substantial differences in the functioning of the group homes were found even though the service structure was held constant. Community adjustment was compared for matched groups of residents of the group homes. Differences in community adjustment occurred for residents in group homes with significantly different functional features. The findings indicate that resident outcome was generated by the interaction of several factors in combination. Both structural and functional features of facilities must be considered in any evaluation of the effectiveness of community programs.
Adult↗
Ongoing consultation as a method of improving performance of staff members in a group home.
A model of ongoing consultation was implemented in a community group home for 8 adults with severe and profound mental retardation. Two consultants, highly experienced in working with people with mental retardation and in the procedures used in group homes, taught staff members to use a token reinforcement system, to engage the adults in a variety of activities, and to improve the content and style of the staff members' interactions with the adults. The consultants taught skills to 9 staff members through brief mini-workshops, direct observation of the staff members' use of the skills during regular activities in the group home, and individual verbal feedback regarding a staff member's performance of the skills. Evaluation of the ongoing consultation process by the 2 consultants showed it to be effective in improving the performance of the staff members and in changing the behaviors of the adults who lived in the home. Continued implementation of the process, however, appeared to be necessary for the behavior changes of staff members to be maintained at high levels.
Adolescent↗
Affiliation and friendship of mentally retarded residents in group homes.
The social behavior of 208 mentally retarded residents in 18 group homes was observed and analyzed in terms of their (a) informal grouping behavior, (b) affiliation, and (c) intense social relationships ("friendships"). Moderately to mildly retarded residents engaged in "social" types of behavior in groups (primarily dyads) and "neutral" types of behavior when alone. In contrast, profoundly retarded residents did not behave differently when others were present, although they did display social types of behavior. Residents' affiliative behavior was not as related to personal characteristics (sex and intelligence) as it was to (a) size of the group home, (b) average intelligence of the residents in the home, (c) sex ratio in the home, and (d) homogeneity of the residents' backgrounds. Although residents in large homes affiliated more extensively with others, intense relationships were as likely in large as in small homes. Sixteen intense friendships were identified and described. In total, the results support the view that the group home environment can influence residents' affiliation and friendship.
Adult↗