Abstract
An increasing number of people with an intellectual disability are living longer and ageing in a residential care service (Johansson et al., 2017). For providers this presents a number of unique challenges in terms how to best support people as their health and age-related support needs change.
The aim of this research was to explore the perspectives of staff working in a residential care service and identify how they anticipated responding to these changing health and age-related support needs. Focus group meetings were held with staff and then a qualitative analysis approach was used, and data generated from the focus groups was subjected to thematic analysis.
The findings from the study were identified under three key themes; challenges of unique and ever evolving support needs, going beneath the surface, and opportunities to prepare, plan and respond. The findings were discussed and reviewed within the context that New Zealand, along with most other developed countries around the world, de-institutionalised the support of people with an intellectual disability (Mansell et al., 2010).
This research identified a number of ways residential service providers can plan and prepare to meet the health and age-related needs of the people they support. These include, acknowledging the tensions that exist between the fact they are an organisation with legal, contractual and moral obligations to keep people safe, yet the reason they exist is to support people's individual autonomy, right to quality of life and community participation. Service providers can work to establish a variety of options in terms of both the age-appropriate homes and the daily activities they provide to support peoples' changing health and age-related needs. Within the service itself, they can provide staff who acts as an 'autonomy advocate' for a person they support on their journey through the various biographical stages of their life. In addition, service providers can support people to have a purpose, meaning and identity. Staff intuition and observations can be recognised and nurtured to support people in an anti-institutional way that recognises when things are working, not working or when someone's health and age-related support needs are changing.
There were a number of limitations in terms of the data from this study not necessarily being representative of the wider sector, due to the small size of this study and the fact that none of the participants in the focus groups identified as Māori. However, this research uncovered some unique perspectives, and a larger study would have the potential to contribute to the ongoing body of work that is informing the transformation of the wider intellectual disability sector (Boxall and Benjamin, 2012).