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| Living the Good Life: Supporting Adults with Disabilities in the Community |
| Sunday, May 30, 2004 |
| 3:00 PM–4:20 PM |
| Back Bay A |
| Area: DDA/OBM; Domain: Applied Research |
| Chair: Alan E. Harchik (May Institute) |
| Abstract: Learning Objectives
Participants will learn the components of providing comprehensive treatment to adults with complicated behavioral and psychiatric histories.
Participants will learn the various models of the Teaching Family Model and how they have been adapted to support individuals with developmental disabilities.
Participants will learn a specific method to address challenging overnight, sleep, and supervision issues to better support individuals with developmental disabilities. |
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| Success in the Community for Adults with Dual Diagnoses |
| GORDON SMITH (May Institute), Thomas J. Harvey (May Institute), Amy E. Clark (May Institute), Tamara Musto (May Institute), Alan E. Harchik (May Institute) |
| Abstract: Individuals with the dual diagnoses of mental retardation and a psychiatric disorder require specialized supports and services if they are to live successfully in typical community neighborhoods. In this presentation, we will describe the components of a comprehensive system for this population. The components include individualized plans for reducing problem behaviors, skill training to increase competencies, specialized psychiatry services, opportunities for decision making, and availability of a pleasant residence, a paying job, and trained staff. We will present data in multiple baseline format across three cases. In each case, the individual exhibited frequent serious aggression, self-injury, screaming, medication refusal, and/or suicidal comments and actions. Following implementation of the comprehensive program, behaviors reduced to safe levels (typically zero). |
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| Living the Good Life: Comparing Residential Outcomes Across Four Different Models |
| DIANE BANNERMAN JURACEK (Community Living Opportunities, Inc.), Jamie Price (Community Living Opportunities, Inc.), Holly M. Sweeney (Community Living Opportunities, Inc.), Michael C. Strouse (Community Living Opportunities, Inc.), James A. Sherman (University of Kansas), Jan B. Sheldon (University of Kansas), Cheryl Dyer (Community Living Opportunities, Inc.) |
| Abstract: In this presentation, the outcomes of four residential models for people with developmental disabilities will be compared. The residential models are: (1) group homes serving eight people with shift staffing, (2) Apartments serving three people with shift staffing, (3) Family Teaching duplexes or homes serving three to four people with a couple living adjacent and providing teaching/support, and (4) Extended Family Teaching homes serving one to three people in a family or single person’s private home. Measures used to compare the residential models included Quality of Life ratings, Home Certification scores, staff turnover and stability data, and parent satisfaction ratings. On almost all measures, the Family Teaching and Extended Family Teaching models outperformed the more traditional models. For example, group home staff turnover for 2002 was 43.5%, whereas turnover for Family Teaching homes was 14.8%. Further, average certification ratings (based on a 6-point scale, where "6" is "very satisfied) for group homes were "4" (slightly satisfied), whereas ratings for Family Teaching models averaged above a "5" (satisfied). Independent observations conducted on 10 % of certification surveys showed that raters were in agreement 82% of the time. |
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| Living the Good Life: A Retrospective Analysis of Quality of Life for People with Developmental Disabilities Across Residential Models |
| JAMIE D. PRICE (Community Living Opportunities, Inc.), Holly M. Sweeney (Community Living Opportunities, Inc.), Diane Bannerman Juracek (Community Living Opportunities, Inc.), Michael C. Strouse (Community Living Opportunities, Inc.), James A. Sherman (University of Kansas), Jan B. Sheldon (University of Kansas) |
| Abstract: In pursuit of a positive quality of life, community service providers have retooled residential models in a variety of ways ranging from large bed facilities to single person living arrangements. Community Living Opportunities has evaluated quality of life indicators across time and residential service models. In this presentation, we will review case studies of individuals with severe and multiple disabilities who have lived in a variety of service models. We will review variables we believe were significant in the improvement of their quality of life. Over ten years of data show that smaller family-supported models (Family Teaching Model) and a model in which a person lives in a family’s home (Extended Family Teaching) resulted in increased consumer satisfaction and decreases in dangerous maladaptive behaviors and use of restrictive procedures such as psychotropic medications and restraint. To illustrate, frequency of theft of potentially harmful substances for one person decreased from an annual high of 134 occurrences to zero occurrences. Average frequency per year of aggression and property destruction for one person decreased from an average of 6742 per year to an average of 2971 per year. Independent observer reliability was obtained on approximately 5% of the data and was over 85%. |
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| Good Night Irene: Using Security and Behavioral Technology to Provide Low Cost Night Support for Persons with Severe Disabilities Living in the Community |
| MICHAEL C. STROUSE (Community Living Opportunities, Inc.), Jennifer Richer (Community Living Opportunities, Inc.), Lewis Walton (Community Living Opportunities, Inc.), Boone Bradley (Community Living Opportunities, Inc.), Jan B. Sheldon (University of Kansas), James A. Sherman (University of Kansas) |
| Abstract: Many persons with significant disabilities require night monitoring support, which means that someone must stay awake or be paid to sleep at night in a community home, just in case. The cost of up-at-night or sleeping employees who are compensated according to wage and hour guidelines is high. Further, excessive turnover (exceeding 100%), a low pool of available night talent, and low wages can produce poor quality and threats to safety.
CLO has developed and tested security/video technology, security industry practices, and behavioral technology to significantly reduce night monitoring costs and better ensure safety. Low/no light video surveillance technology combined with sensor and other technology allows CLO to centrally monitor about 30 community homes across three cities spanning 150 miles in Kansas. This technology allows central night monitoring staff to watch remote locations; speak and interact with persons served; alert emergency supports such as fire and police; and dispatch mobile staff or Family-Teachers to provide help.
Data will show a 70% to 80% decrease in night staffing costs and reductions in agency-wide turnover. System integrity data; back-up system strategies; the frequency and nature of up-at-night behavior; and the role of behavioral technology to produce good sleeping habits will be described. |
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