Empowering lives: How deinstitutionalization and community living improve the quality of life of individuals with intellectual and developmental disabilities.
Moving to the community only boosts quality of life when staff give adults real choices every single day.
01Research in Context
What this study did
Navas et al. (2025) tracked the adults with intellectual or developmental disabilities. Half moved from large state centers to small community homes. Half stayed in the institutions.
For one year the team measured quality of life with interviews, surveys, and direct observation. They also counted how often each adult made everyday choices—what to eat, wear, or do on Saturday.
What they found
The movers gained large to very-large jumps in quality of life. The stayers saw no change.
More choices drove the gains. When staff let people pick meals, room décor, or daily activities, happiness, friendships, and adaptive skills all rose.
How this fits with other research
Lulinski et al. (2021) warned that some people bounce back to institutions. Their survey showed returns happened when homes were large and lacked mental-health help. Patricia’s new data agree: real choice, not just a new address, keeps people out of institutions.
Vassos et al. (2016) reviewed person-centred planning and saw modest gains in choice-making. Patricia’s study extends that work by showing continuous, real-time choices—not annual plans—create the big quality-of-life leap.
Fortney et al. (2021) found rural areas give adults with IDD fewer doctors and services. Patricia did not test rural life, but her message still applies: after any move, teams must guard against service gaps or the gains may fade.
Why it matters
You can’t just close a state center and call it success. You must build routines where clients pick lunch, music, or bedtime daily. Ask your group-home staff to list five choice points in the next hour. Add one more tomorrow. More choices mean happier, more capable adults—and fewer returns to institutional care.
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02At a glance
03Original abstract
BACKGROUND: The number of people with intellectual and developmental disabilities (IDD) living in residential settings has not changed substantially in recent years in Spain. To change this situation the project "My House: A Life in the Community" aims to promote the transition of individuals with IDD and high support needs into community settings. AIMS: This paper deepens the understanding of the underlying mechanisms responsible for the changes observed in the process of deinstitutionalization. METHODS: A longitudinal study was designed to evaluate the quality of life of individuals with IDD (n = 90) across different environments at two distinct time points: when they were living in an institution and nine months after transitioning to a community-based setting. A comparison group (n = 72) consisting of individuals who remained institutionalized was included to carry out intergroup comparisons. T-tests were used to estimate mean differences both between and within groups. Longitudinal path models were used to investigate the processes underlying the relationships between variables. RESULTS: After transition, movers obtained significantly higher mean scores on all variables with large or very large effect sizes. However, simply moving to a different place was not the factor responsible for the observed improvements: positive changes in quality of life require the constant availability of opportunities to support decision making. IMPLICATIONS: deinstitutionalization will only lead to improvements in quality of life if it favors people's control over their lives. Community living should therefore be understood not as an autonomous life but as a chosen one.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2024.104909