Quality of life and living arrangements for people with intellectual disability

Purpose: Recent international experiences of community inclusion have produced a major change in residential care for people with intellectual disability (ID). Assignment and outcome assessment through new person-centred measures are raising increasing interest; however, the information on quality of life and accommodation is still limited. This paper aims to provide an overview of the application of quality of life models and the size of the provision of different living arrangements. Design/methodology/approach: A systematic mapping of the literature of the last decade was followed by an expert guided review of the available evidence. Findings: QoL outcomes measures of living arrangements in people with ID show conceptual and methodological challenges. The following key topics were identified: individual level: issues related to health status, behavioural problems and other personal factors (ageing, choice and empowerment); family and peers; local level: accommodation, architecture and urbanization, and economic aspects (deprivation and costs); macro level: social participation (community inclusion). The residential solutions that are currently considered of highest efficiency are small apartments in the community and "cluster centers". Originality/value: The level of quality of life is very relevant in the assessment of living arrangements in people with ID although its assessment still shows significant limitations. Some accommodation typologies seem more effective than others. New conceptual models of inclusive residential care support the convenience of a wide range of accommodation alternatives that may fit the individual needs of a highly heterogeneous population group. A unique residential alternative, albeit optimal from a community care perspective, may not be adequate for all persons with ID.