Environmental characteristics of nursing homes and community-based settings, and the well-being of adults with intellectual disability

The present study examined whether characteristics of the environment of nu rsing homes and community-based residential settings are associated with th e adaptive behaviour, health and community integration of adults with intel lectual disability living in those settings. The specific characteristics o f the environment were type of facility, size, level of residential involve ment in policymaking, and the degree of variety and stimulation of the phys ical environment The study assessed 249 residents with intellectual disabil ity over a 3-year period who lived in nursing homes at baseline. At follow- up, 50 of the residents had moved to community-based facilities while 199 o f the residents remained in nursing homes. The results indicated that type, size and characteristics of the environment were related to the level of a daptive behaviour and community integration at follow-up. Residents living in community-based settings had better health and greater levels of communi ty integration than residents living in nursing homes. Residents living in smaller facilities had greater adaptive behaviour at follow-up than residen ts living in larger facilities. More variety and stimulation in the residen tial physical environment was associated with greater adaptive behaviour am ong residents at follow-up. Residential facilities that permitted greater r esident involvement in policy-making, and had greater variety and stimulati on in their physical environment were associated with greater levels of com munity integration among their residents at follow-up.