Younger adults in long-term care facilities : a review of the literature concerning their characteristics and environmental design, staffing and programming needs

Concern over provision of long-term care for an increasing seniors' population has tended to obscure the fact that younger persons may also require this level of care. This report focuses on the non-geriatric population in long-term care: specifically, on adults between the aged of 20-64. Within this group, the emphasis is on those requiring facility care. While there is general consensus (Ontario Medical Association Committee on Rehabilitation, 1980a and b; Reinecke, 1979; Nichols, 1978) that everything possible should be done to enable younger adult disabled persons to live out their lives in the community, it is recognized that for some individuals with severe congenital or accident-caused disabilities, community living is impossible. Others require periodic admission to an institution in order to continue to live most of the time in the community. Still others enter an institution at the late stages of a progressive deteriorating illness which they and/or their family caregivers can no longer manage in a community setting. For all of these groups, the objective must be to construct institutions that will best meet their physical and psycho-social needs -- that is, that provide the best possible physical care in the least restrictive, most emotionally and intellectually satisfying environment possible.Table of Contents: I INTRODUCTION. II CHARACTERISTICS OF YOUNGER ADULTS IN LONG-TERM CARE FACILITIES: Diagnosis; Age Distribution; Sex and Marital Status; Functional Abilities; Age at Onset of Disability. III ADMISSION CRITERIA AND TURNOVER RATES IN YOUNG DISABLED UNITS: Age; Mental Status and Physical Condition; Turnover Rates; Average Length of Stay. IV GOALS AND OBJECTIVES OF YOUNG DISABLED UNITS. V DESIGN RECOMMENDATIONS: Size of Unit; Location of Unit; Type of Rooms; Other Recommendations. VI STAFFING REQUIREMENTS: Type of Staff Needed; Staff-to-Patient Ratio; Volunteers; Selection and Training. VII THERAPEUTIC PROGRAMS: General Recommendations; Recommendations Concerning Recreational/Leisure Programs; Recommendations Concerning Counselling; a) Educational and occupational; b) Sex; c) Marital and family; d) Counselling aimed at countering resentment and fostering acceptance of disability. VIII DISCUSSION. REFERENCES.