Being a pioneer: a qualitative study of moving into individualised housing from the perspective of adults with neurological disability
J. Douglas A B , D. Winkler A B , K. D’Cruz A B * , S. Oliver A B , S. Liddicoat A B , J. Naismith A and D. Wakim AA
B
Abstract
Despite a move towards individualised models of housing and support for people with disability, there is limited research to inform best practice with people with neurological disability. This study was undertaken to better understand the experience of moving into individualised housing from the perspective of people living with neurological disability.
Ten adults with neurological disability (acquired brain injury = 3; cerebral palsy = 4; muscular atrophy = 1; muscular dystrophy = 1; multiple sclerosis = 1) undertook semi-structured interviews at two time points (pre-move and 6–24 months post-move). Interviews explored participants’ quality of life, community participation, social connection and support use. Transcripts from 20 interviews were analysed using constructivist grounded theory methods. Analysis moved through a process of data-driven, open and focused coding; identification of emergent themes; and relations between them using the method of constant comparison.
Two key themes emerged. Participants’ lives pre-move were described as ‘not a good fit’ with experiences of social isolation, lack of autonomy and limited housing choices. In contrast, life post-move was characterised as ‘moving in the right direction’ with experiences of new responsibilities, building a support team and making a home. Transition between the two environments was a challenging period of adjustment in which participants felt like a pioneer navigating new opportunities and responsibilities.
The findings highlight the value of moving into and living in individualised housing, contributing much needed research evidence from the perspective of people with disability. The move into individualised housing was identified as a transition experience that necessitates the development of transition-specific policy and support models to better prepare and support people during this transition.
Keywords: autonomy, individualised housing, independence, lived experience, neurological disability, qualitative, support, transition.
References
Australian Government (2020a) National Disability Insurance Scheme Act 2013 (Compilation No. 18). (Australian Government: Canberra, ACT, Australia) Available at https://www.legislation.gov.au/Details/C2023C00345
Australian Government (2020b) National Disability Insurance Scheme (Specialist Disability Accommodation) Rules 2020. (Australian Government: Canberra, ACT, Australia) Available at https://www.legislation.gov.au/Details/F2020L00769
Australian Government Department of Social Services (n.d.) Specialist Disability Accommodation. Retrieved from https://blcw.dss.gov.au/grow/specialist-disability-accommodation
Callaway L, Tregloan K, Moore L, Bould E (2021) Audit of advertised housing and support vacancies for people with disabilities in Australia. Australian Journal of Social Issues 56(1), 94-113.
| Crossref | Google Scholar |
Chen L, Xiao LD, Chamberlain D (2020) An integrative review: challenges and opportunities for stroke survivors and caregivers in hospital to home transition care. Journal of Advanced Nursing 76(9), 2253-2265.
| Crossref | Google Scholar | PubMed |
Connellan J (2015) Commentary on Housing for People with Intellectual Disabilities and the National Disability Insurance Scheme Reforms (Wiesel, 2015). Research and Practice in Intellectual and Developmental Disabilities 2(1), 56-59.
| Crossref | Google Scholar |
Douglas J, Winkler D, Oliver S, Liddicoat S, D’Cruz K (2023) Moving into new housing designed for people with disability: preliminary evaluation of outcomes. Disability and Rehabilitation 45, 1370-1378.
| Crossref | Google Scholar | PubMed |
Fisher KR, Parker S, Purcal C (2009) Measuring the effectiveness of new approaches to housing support policy for persons with disabilities. Australian Journal of Public Administration 68(3), 319-332.
| Crossref | Google Scholar |
Harkes MA, Brown M, Horsburgh D (2014) Self Directed Support and people with learning disabilities: a review of the published research evidence. British Journal of Learning Disabilities 42(2), 87-101.
| Crossref | Google Scholar |
Haslam C, Haslam SA, Jetten J, Cruwys T, Steffens NK (2021) Life Change, Social Identity and Health. Annual Review of Psychology 72, 635-661.
| Crossref | Google Scholar | PubMed |
Hennink MM, Kaiser BN, Marconi VC (2017) Code saturation versus meaning saturation: how many interviews are enough? Qualitative Health Research 27(4), 591-608.
| Crossref | Google Scholar | PubMed |
Mansell J, Beadle-Brown J (2009) Dispersed or clustered housing for adults with intellectual disability: a systematic review. Journal of Intellectual & Developmental Disability 34(4), 313-323.
| Crossref | Google Scholar | PubMed |
Mansell J, Beadle-Brown J, Bigby C (2013) Implementation of active support in Victoria, Australia: An exploratory study. Journal of intellectual & Developmental Disability 38(1), 48-58.
| Crossref | Google Scholar | PubMed |
Marlow E, Walker N (2015) Does supported living work for people with severe intellectual disabilities. Advances in Mental Health and Intellectual Disabilities 9(6), 338-351.
| Crossref | Google Scholar |
McColl MA, Davies D, Carlson P, Johnston J, Harrick L, Minnes P, Shue K (1999) Transitions to independent living after ABI. Brain Injury 13(5), 311-330.
| Crossref | Google Scholar |
McConkey R, Kelly F, Craig S, Keogh F (2018) Irish persons with intellectual disability moving from family care to residential accommodation in a period of austerity. Journal of Applied Research in Intellectual Disabilities 31(5), 833-839.
| Crossref | Google Scholar | PubMed |
Oliver S, Gosden-Kaye EZ, Winkler D, Douglas JM (2022) The outcomes of individualized housing for people with disability and complex needs: a scoping review. In Disability and Rehabilitation 44, 1141-1155.
| Crossref | Google Scholar | PubMed |
Paterson B, Scott‐Findlay S (2002) Criticalissues in interviewing people with traumatic brain injury. Qualitative Health Research 12(3), 399-409.
| Crossref | Google Scholar |
Salmon N, Garcia Iriarte E, Donohoe B, Murray L, Singleton G, Barrett M, Dillon M (2019) Our Homes: An inclusive study about what moving house is like for people with intellectual disabilities in Ireland. British Journal of Learning Disabilities 47(1), 19-28.
| Crossref | Google Scholar |
Sloan S, Callaway L, Winkler D, McKinley K, Ziino C (2012) Accommodation outcomes and transitions following community-based intervention for individuals with acquired brain injury. Brain Impairment 13(1), 24-43.
| Crossref | Google Scholar |
Spicker P (2013) Personalisation falls short. British Journal of Social Work 43(7), 1259-1275.
| Crossref | Google Scholar |
Taleporos G, Craig D, Brown M, McNamara C, Forbes S (2013) ‘Housing and support for younger people with disabilities transitioning to independent living: elements for success in the design and implementation of Disability Care Australia, a National Disability Insurance Scheme.’ (Youth Disability Advocacy Service: Melbourne, Vic.)
Tichá R, Hewitt A, Nord D, Larson S (2013) System and individual outcomes and their predictors in services and support for people with IDD. Intellectual & Developmental Disabilities 50(6), 486-504.
| Crossref | Google Scholar |
Topping M, Douglas J, Winkler D (2021) General Considerations for Conducting Online Qualitative Research and Practice Implications for Interviewing People with Acquired Brain Injury. International Journal of Qualitative Methods 20, 160940692110196.
| Crossref | Google Scholar |
Topping M, Douglas JM, Winkler D (2022) Factors that influence the quality of paid support for adults with acquired neurological disability: scoping review and thematic synthesis. Disability and Rehabilitation 44, 2482-2499.
| Crossref | Google Scholar | PubMed |
Turner BJ, Fleming JM, Ownsworth TL, Cornwell PL (2008) The transition from hospital to home for individuals with acquired brain injury: A literature review and research recommendations. Disability and Rehabilitation 30(16), 1153-1176.
| Crossref | Google Scholar | PubMed |
Turner BJ, Fleming J, Ownsworth T, Cornwell P (2011) Perceived service and support needs during transition from hospital to home following acquired brain injury. Disability and Rehabilitation 33(10), 818-829.
| Crossref | Google Scholar | PubMed |
Tøssebro J (2016) Scandinavian disability policy: From deinstitutionalisation to non-discrimination and beyond. Alter 10(2), 111-123.
| Crossref | Google Scholar |
UN General Assembly (2007) Convention on the Rights of Persons with Disabilities: resolution adopted by the General Assembly. Available at https://social.desa.un.org/issues/disability/crpd/convention-on-the-rights-of-persons-with-disabilities-crpd
Wiesel I (2011) Allocating Homes for People with Intellectual Disability: Needs, Mix and Choice. Social Policy and Administration 45(3), 280-298.
| Crossref | Google Scholar |
Wiesel I (2015) Housing for People with Intellectual Disabilities and the National Disability Insurance Scheme Reforms. Research and Practice in Intellectual and Developmental Disabilities 2(1), 45-55.
| Crossref | Google Scholar |
Wright CJ, Colley J, Kendall E (2020) Exploring the efficacy of housing alternatives for adults with an acquired brain or spinal injury: A systematic review. Brain Impairment 21(2), 125-153.
| Crossref | Google Scholar |