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Day service provision for people with intellectual disabilities: a case study mapping 15-year trends in Ireland
- Authors:
- FLEMING Padraic, McGILLOWAY Sinead, BARRY Sarah
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 30(2), 2017, pp.383-394.
- Publisher:
- Wiley
Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery. Methods: National intellectual disability data (1998–2013) were analysed using WINPEPI software and mapped using QGIS Geographic Information System. Results: Statistically significant changes indicated fewer people availing of day services as a proportion of the general population; more males; fewer people aged <35; a doubling in person-centred plans; and an emerging urban/rural divide. Day services did not change substantially and often did not reflect demand. Conclusions: Emergent trends can inform future direction of disability services. Government funds should support individualized models, more adaptive to changing trends. National databases need flexibility to respond to policy and user demands. Future research should focus on day service utilization of younger people and the impact of rurality on service availability, utilization, quality and migration. (Publisher abstract)
Assessment and characteristics of older adults with intellectual disabilities who are not accessing specialist intellectual disability services
- Authors:
- DODD Philip, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(1), January 2009, pp.87-95.
- Publisher:
- Wiley
Individuals with intellectual disabilities (I.D.) who are not accessing any specialist services are a vulnerable group, especially with advancing age. In Ireland, the National Intellectual Disability Database (N.I.D.D.) records the current and future service needs of people with intellectual disabilities, as well as those individuals who are not in receipt of services. This two-part study firstly used the N.I.D.D. to look at the number and characteristics of those older individuals outside services. Following this, a questionnaire was developed to examine the contact and assessment procedures practised with people who are listed on the N.I.D.D. as not requiring any specialist service. Analysis of the database showed that 7.5% of people on the N.I.D.D. with moderate, severe or profound I.D., over the age of thirty and living at home with family were awaiting, or were not in receipt of specialist services. For these people not accessing any services, the questionnaire responses highlighted poor assessment practices including significant periods of time passing between contacts with the individual and limited contact regarding service planning. Specialist services need to be more pro-active in engaging vulnerable older individuals in services. A standardised approach needs to be developed in the assessment and monitoring of individuals and families refusing services.
"With a touch of a button": staff perceptions on integrating technology in an Irish service provider for people with intellectual disabilities
- Authors:
- SIMPLICAN Stacy Clifford, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 31(1), 2018, pp.e130-e139.
- Publisher:
- Wiley
Background: People with intellectual disabilities continue to underutilise technology, in part due to insufficient training. Because support staff professionals provide instructional support, how they perceive integrating new technologies is important for people with intellectual disabilities.Method:The authors conducted a sequential mixed-methods exploratory study (quan→QUAL) including quantitative data from online surveys completed by 46 staff members and qualitative data from five focus groups attended by 39 staff members. Results: Quantitative results show strong support for diverse technologies. In contrast, qualitative results suggest that staff members’ support of technology decreases when they perceive that technology may jeopardise service users’ safety or independence. Conclusions: Although staff members identified increasing independence as the main reason to use new technologies with service users, they also worried that technologies used to increase the social inclusion of service users may pose undue risk and thus may limit their embrace of technology. (Edited publisher abstract)
Value for money? An examination of the relationship between need and cost in intellectual disability services
- Authors:
- CRONIN Jodi, BOURKE Jane
- Journal article citation:
- Health and Social Care in the Community, 25(3), 2017, pp.1227-1236.
- Publisher:
- Wiley
The recent economic crisis along with changing demographic trends has stimulated an increased interest in the value obtained from social care expenditure so as to ensure the sustainability of systems in the future. In Ireland, the Department of Health, further to a recent review of its disability services, committed to a new approach that will reshape and redesign its disability service provision. It specifically outlined a reorganisation of financing services, from a model of prospective block grant funding to a system of individualised budgeting based on an assessment of need. This paper examines the relationship between need, service utilisation and cost for high-cost users of adult intellectual disability residential services in an Irish county under the current model of block grant financing. The analysis reported is based on primary data collected from 68 high-cost users of adult intellectual disability residential services in an Irish county in 2013. Statistical analysis was performed to identify the relationship between need and cost, and also to examine the variations in the cost of support between the service provider organisations. The analysis determined an association between need and cost, with poorer levels of psychological well-being related to higher costs. However, the study found no evident relationship between staff/client ratios, the numbers of staff engaged at the residential units and need. An examination of cost variations between the service provider organisations revealed that agency status; service unit size; client and staff characteristics all contributed to variations in the cost of care. This study supports the development of a national resource allocation framework as being fundamental to the equitable and transparent distribution of scarce resources, as recommended by the Department of Health in Ireland. (Publisher abstract)