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Improving service approaches and outcomes for people with complex needs through consultation and involvement
- Authors:
- CLARE Linda, COX Sylvia
- Journal article citation:
- Disability and Society, 18(7), December 2003, pp.935-953.
- Publisher:
- Taylor and Francis
Services have not always catered well for people with complex needs. The term 'complex needs' is used here to signify people who have cognitive impairments and communication difficulties that present major challenges for getting one's views and preferences heard and understood, and/or who may not fit into traditional categories of service provision. Current developments in policy and practice, such as the single shared assessment process, emphasise inclusion through user involvement. There is a danger, however, that people with complex needs will be seen as too difficult to involve, and will therefore remain effectively excluded from the decision-making process and from the opportunity to influence service provision. This article explores the current situation in relation to ensuring genuine involvement for people with complex needs, highlights obstacles to progress and examples of good practice, and identifies future directions for research and practice.
Resident outcomes of Medicaid-funded community residential care
- Authors:
- HEDRICK Susan C., et al
- Journal article citation:
- Gerontologist, 43(4), August 2003, pp.473-482.
- Publisher:
- Oxford University Press
Washington State's initiatives to increase the availability and quality of community residential care presented an opportunity to describe clients entering adult family homes, adult residential care, and assisted living and to identify outcomes of care. We enrolled 349 residents, 243 informal caregivers, and 299 providers in 219 settings. We conducted interviews at enrollment and 12 months later, and we collected data from state databases. The average resident was a 78yearold woman reporting dependence in two of six activities of daily living. Residents in adult family homes demonstrated significantly more disability. Seventy-eight percent of residents survived at the 12-month follow-up. In analyses that controlled for differences at enrollment, residents in the three types of settings were very similar in health outcomes at follow-up. State policies should reflect the wide range of needs of residents seeking care in these settings. Choices among type of setting can be based on the match of needs to individual preferences.