Quality of Life Experienced by Persons with Mental Retardation in Various Residential Settings

Article excerpt

There have been numerous calls for applying quality of life measurement concepts in assessing the rehabilitation outcome of persons with physical disabilities (e.g., Anderson, 1982; Freed, 1984; Kottke, 1982), and others have begun exploring their applicability in assessing mental retardation (Schalock, Keith, Hoffman, & Karan, 1989) and mental illness interventions (Blau, 1977; Fabian, 1990). The growing concern regarding quality of life stems from a variety of disability-related issues (Brown, 1988). However, the overriding appeal of quality of life assessment is that it is conceptually consistent with the holistic orientation of rehabilitation. Despite attractiveness of the measurement concept, there are a number of problems that must be addressed before its potential utility can be realized (Fabian, 1991). These include further clarification of the quality of life construct, development of appropriate measures to use with persons with disabilities, and gaining a better understanding of how quality of life assessment can be fitted into the rehabilitation evaluation process.

Calls for development and utilization of quality of life assessment approaches have been especially widespread within the mental retardation field. Continuing debate has followed the movement toward deinstitutionalization of persons who are mentally retarded (Alexander, Huganir, & Zigler, 1985). To a large extent, the debate centers around questions such as whether the numerous alternative living environments enhance life quality, which settings can maximize the life quality for individuals functioning at different levels, and whether traditional institutional settings can be altered to the extent that their environment is more supportive of life quality for some individuals than the alternatives (Walker, 1988).

It has been suggested that quality of life is likely to become the issue of the 1990's, superseding normalization, deinstitutionalization, and community adjustment issues (Schalock, Keith, Hoffman, & Karan, 1989). This view is consistent with that of Landesman (1986), who earlier identified quality of life and personal life satisfaction as the new buzz words in the field of mental retardation. At the same time, Landesman urged the American Association on Mental Deficiency to take leadership in developing the means by which to measure those qualities. Moreover, Walker (1988) indicated that care needed to be exercised in attempting to define quality of life from the standpoint of the mentally retarded population. She emphasized that consideration be given not only factors such as where these individuals are living and working, but their ability to make decisions and have choices within their life.

The need to develop effective, meaningful quality of life assessment tools and methods provided the impetus for implementing a multi-faceted study centered on assessing the quality of life supported by a regional service system in South Carolina for its citizens with mental retardation. A primary objective was to assess the quality of life of persons with mental retardation residing in a variety of residential settings used for placement.

The study was also designed to explore the feasibility and utility of an assessment strategy or methodology designed to address a number of the needs expressed by authorities in the field. In that respect, the stvategy followed a multidimensional quality of life assessment model similar to that described by Lawton (1991). Lawton's model rests on utilization of intra-personal and socio-normative criteria in assessing the person-environment system of individuals, with the resulting assessment considered to reflect on life quality. The model was based on three assumptions. First, there are unique, internal standards and evaluations of life generated within individuals that are not totally represented by external elements. This aspect or domain is commonly referred to as the perceived or subjective domain of quality of life. …