Does supported living in residential homes improve the quality of life and mental stability of older adults with chronic mental disorder?
OBJECTIVE
Supported living in residential homes for the elderly is an innovative, age-appropriate residential program for older adults with chronic mental disorders. The program involves 1) accommodation in ordinary "elder care" homes; and 2) provision of on-site mental health care by professionals from the local psychiatric hospital. The authors asked whether the program succeeds in improving the patients' quality of life without compromising their mental stability.


METHODS
Patients in 18 supported living programs (N=96) were compared with similar patients in eight psychiatric hospitals (N=78), in a cross-sectional study. Quality of life was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS) and the Manchester Short Assessment of Quality of Life (MANSA). Mental stability was assessed in terms of rehospitalizations, adjustments in medication because of symptom exacerbation, and 6-month prevalence of psychotic symptoms.


RESULTS
After adjustment for patient characteristics, the supported-living participants experienced a significantly lower quality of life than the hospital patients, as indicated by two of the three PGCMS subscales and by the MANSA. Disparities were greatest in the subgroup of patients with psychotic disorders. No significant differences in mental stability were found between the two conditions. Eleven of the 96 supported-living participants had undergone temporary rehospitalization since their entry into the program.


CONCLUSIONS
Supported living in residential homes for elderly persons is an attractive model, but it does not automatically guarantee the participants a better quality of life. Further research is needed to determine which program characteristics can improve results.
Depla
Marja
M
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands. mdepla@trimbos.nl
de Graaf
Ron
R
Heeren
Thea
T
D000368:Aged; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D012111:Residence Characteristics; D012114:Residential Treatment; D012944:Social Support; D011795:Surveys and Questionnaires