A study of a move from hospital to community based care for people with a mental handicap

Abstract

This thesis presents findings from a study examining some effects of a move to community based care on a group of 39 residents of Aycliffe Hospital; each person leaving was matched with two people who remained in the hospital. Both groups were studied before and at least 12 months after leaving the hospital. A number of measures were taken that describe the characteristics of the subjects and homes. These include a novel method to describe the location of facilities around the homes. A time budget methodology was used to measure activity outside of the home before subjects left the hospital, this was repeated at follow-up. The time budget consisted of a week long record of each occasion that the person left the home, also recorded were the destination, duration, mode of transport and people accompanying on each trip. At follow-up a novel method was used to gain qualitative and quantitative data concerning subjects' familiarity with their neighbourhood. This involved accompanying the subjects' on walks around their neighbourhoods and required them to identify a standard list of facilities. Further measures at follow-up involved direct time sample observation of activity within the home. Semi-structured interviews were used to establish subjects’ views of the move and of their current pattern of activities. The outcomes for the movers are generally encouraging. Although they loose some independence they do not engage in less activity. They use more unsegregated facilities, and a range of maintenance facilities that not used in the hospital; some use unsegregated work and leisure facilities. Within the home movers have more opportunity for and engage in more domestic and personal behaviour. Of those that gave interviews, more movers than controls indicated that they were satisfied with their new homes, and in comparison with controls few movers would like to live elsewhere.