Alison B. Miller

Impact of a consumer-directed family support program on adults with developmental disabilities and their family caregivers

In the current study we examined the impact offamily support programs for adults with developmental disabilities. Results of the study indicated that participants had fewer unmet needs and used more services than the control group. Participant caregivers were more satisfied with the services their relative received, experienced greater self-efficacy, and were less likely to desire an out-of-home placement than the control group. Participants with developmental disabilities experienced increases in community integration and monthly wage.

Later-Life Planning: Promoting Knowledge of Options and Choice-Making.

The effectiveness of a person-centered later-life planning training program designed to teach older adults (N = 60) with mental retardation about later-life planning issues and increase their participation in choice-making was examined. Using quantitative data analyses, we assessed the impact of the program on intervention and control groups. Results indicated that the intervention group gained more knowledge of concepts in the curriculum and made more choices over time than did the control group. The wide variety of goals that participants set were examined through qualitative analyses; 87% of the participants met or partially met their goals. Information on the supports and barriers to meeting goals is provided.

Adults with mental retardation as supports to their parents : Effects on parental caregiving appraisal

This study was conducted to determine whether support provided to caregivers by their adult children with mental retardation would influence caregiving appraisals. We also examined how severity of disability of the adult child, personal and social resources of the caregiver, and amount of caregiver assistance to the adult with mental retardation influenced caregiving appraisals. Using surveys and interviews we collected information from 80 primary caregivers on caregiving burden and satisfaction and six predictors of burden and satisfaction. Findings indicate that greater support from the adult child to the caregiver resulted in greater satisfaction and less burden. Adaptive and maladaptive behaviors and caregiving assistance all predicted caregiving satisfaction but only maladaptive behaviors predicted caregiving burden.

Understanding dignity in the lives of homeless persons.

The current investigation is a planned, systematic study of dignity as critical to understanding the experience of homelessness and improving services and programs for the homeless. Specifically, we conducted a thematic content analysis of interviews with 24 homeless men and women to identify their perception of specific environmental events that validate and invalidate dignity. In addition, we explored the impact that these events have on homeless persons. Eight types of events were identified that sustain dignity such as being cared for by staff and having resources available to meet basic needs. Eight types of events were found that undermine dignity, such as being yelled at or insulted by staff persons and having staff use rules in an excessive and arbitrary way. Two outcomes followed the sustenance of dignity including increased self-worth and motivation to exit homelessness. Three outcomes followed the undermining of dignity including anger, depression, and feelings of worthlessness. The results suggest that dignity is an important variable to consider in understanding the experience of homelessness. Policies and programs that support validating the dignity of homeless persons are encouraged.

Eight-year follow-up of the impact of environmental characteristics on well-being of adults with developmental disabilities.

The impact of environmental features of residences on adaptive behavior, community integration, and health of adults with mental retardation over an 8-year period was examined. Environmental features included residence type, size, choice-making opportunities, physical attractiveness, and family involvement. We assessed 186 residents who initially lived in nursing homes. At the 8-year follow-up, 133 had moved to community-based residential settings. Findings indicated that residents who moved to community settings had higher levels of adaptive behavior and community integration than residents who remained in nursing homes. A more attractive physical environment and greater opportunity for choice-making were associated with higher levels of adaptive behavior at follow-up. Greater opportunity to make choices and family involvement were associated with higher levels of community integration.