[3] Residential nursing facilities, also included in this article, may be as large as 100 individuals in 2015, which is no longer the case in fields such as intellectual and developmental disabilities.
There is a considerable variety of different models, sizes and kinds of organizations caring for children and youth who cannot stay with their birth families.
Group homes were revolutionary in that they offered individuals life opportunities to learn to cook and prepare meals (e.g., individuals with severe and even profound disabilities), budget their personal allowance, select photos for their room or album, meet neighbors and "carry out civic duties", go grocery shopping, eat in restaurants, make emergency calls or inquiries, and exercise regularly.
[9][10][11][12][13] Some residents may also have behavioral problems that require a better daily routine, medical assessment for possible health care needs (e.g., pituitary problem, medication adjustment), environmental changes (e.g., different roommates), mental health counseling, specialist or physician consultation, or supervision; government may require a finding of involuntary care (i.e. dangerous to themselves or others) which is a hotly contested and disputed arena.
[15][16] Prior to the 1970s, this function was served by institutions, asylums, poorhouses, and orphanages until long-term services and supports, including group homes were developed in the United States.
[17] Group home residents may be found in workplaces, day services, parks and recreation programs, schools, shopping centers, travel locations, and with family, neighbors, community workers, co-workers, schoolmates and friends.
[20] Similarly, drug, addictions and alcohol programs may be time-limited, and involve residential treatment (e.g., Afrocentric model for 24 women and children, as part of Boston Consortium of Services).
[32] A group home differs from a halfway house, the latter which is one of the most common terms describing community living opportunities in mental health in the 1970s' medical and psychiatric literatures.
Residents are usually encouraged or required to take an active role in the maintenance of the household, such as performing chores or helping to manage a budget.
In 1984, New York's state office in intellectual and developmental disabilities described its service provision in 338 group homes serving 3,249 individuals.
The opening of group homes in neighborhoods is occasionally opposed by residents due to ableist fears that it will lead to a rise in crime and/or a drop in property values.
In the late 1970s, local hearings were conducted in states such as New York, and parents of children with disabilities (e.g., Josephine Scro in the Syracuse Post Standard on June 7, 1979), research experts, agency directors (e.g., Guy Caruso of the Onondaga County Arc, now at Temple University) and community-disability planners (late Bernice Schultz, county planner) spoke with community members to respond to their inquiries.
Specialized therapeutic or treatment group homes are available to meet the needs of children with emotional, intellectual, physical, medical and/or behavioral difficulties.
[41] The term group home is often confused with lock-down treatment centers, which are required to have eyes-on every so often due to behavioral and intellectual disabilities of the children and youth they serve.
In this field, no viable recourse exists for reversing actions by personnel, including professional and medical malpractice, and the most successful programs are viewed as those that result in high compliance.
The nursing facility industry holds the position, often with its affiliated hospitals, that it decides on involuntary treatment of elders, which involves issues such as visitations.
Nursing homes have had a very long history of reviews and complaints including to the federal level of the Government Accountability Office (GAO) in the United States and have been the subject of major reform efforts.
Today, a Red Cross ombudsman may be available in the homes, special needs units may be available to assist in areas such as bathing and eating, and in some cities, short term rehabilitation is provided for seniors at those sites instead of at community locations.
Nursing facilities, unlike the small size standard of the Centers for Disease Control (CDC) for homes for individuals with intellectual disabilities, may have over 100 "institutional clients" on site and is reporting 2–3% restraint use.
An abundance of literature in the 1980s and 1990s described the training needs of personnel,[65][66][67][68] and today new expectations continue to occur as the homes become increasingly health care financed and more self-direction options become available.
[69] Foundational in all helping professions are what are called "critical skill domains", which are congruent with a community support approach (e.g., values clarification, general fluency and flexibility of thought, perception and response, competence in academic content, verbal communications) (Cole & Lacefield, 1978).
[74] In fact, several national research centers in the United States were funded, in part, on the basis of community research studies in community participation [75][76] Education also occurs for special population groups or particular issues or needs; an example are the challenges gay men face in living with chronic illness [77] including HIV-AIDS which may be addressed in supported housing options.
[80] Independent living training has also proved effective in addressing the needs and expectations of individuals who have sensory impairments (e.g., hearing or blindness).
Early organizations provided information on their management and financing to help local communities replicate or begin their own homes and programs.
However, senior services of other kinds, including the senior centers,[89] low cost meals, transportation, Veteran's health services and independent clubs, specialized day care (e.g., day care for older adult policies in Great Britain),[90][91] local case managers, local Offices of the Aging (with Disability coordinators in some locations), and so forth are often available.
The New Politics of Old Age Policy (Robert Hudson, 2005/2010) calls for the government entertaining care credits or generous minimum benefits to assist United States families to juggle paid and unpaid work in today's modernized world.