The potential for active mentoring to support the transition into retirement for older adults with a lifelong disability

Supporting Social Inclusion in Neighbourhoods of Adults with Intellectual Disabilities: Service Providers' Practice Experiences

Deinstitutionalisation has increased the likelihood of adults with intellectual disabilities residing in neighbourhoods either in staff-supported accommodation or in their family home. However, it raises the question of whether national policies on disability have translated into practice actions by service providers that result in positive social inclusion outcomes for individuals. This study examined the practice initiatives supporting social inclusion in neighbourhoods in specialist state-funded service providers for adults with intellectual disabilities. Using a mixed methods design, CEOs/service leaders of 40 organisations completed an online survey. Follow-up interviews were completed with a randomised sample. Shifting towards new service models and strategic links with mainstream organisations were most often mentioned as furthering social inclusion goals. A wide range of service initiatives were reported, with positive outcomes alongside a range of challenges. Service providers play an important role in providing individualised supports that foster local engagement. However, the service context is complex and service leaders have reported many challenges that may impede progress on social inclusion.

Stress and social isolation, and its relationship to cardiovascular risk in young adults with intellectual disability

PURPOSE

Stress produces many physiological changes, some of which may contribute to the development of cardiovascular disease (CVD). Individuals with intellectual disability (ID) are exposed to multiple and stressful challenges everyday which may put them at increased cardiovascular risk. This current study aimed to establish whether adults with ID experience higher levels of subjective stress and encounter different stressors (including social isolation) than the general population, and whether there is a relationship between stress and cardiometabolic profile in this population.

METHODS

Adults with ID (n = 35) aged 18-45 years completed the Subjective Stress Survey, and underwent a physiological assessment to measure blood pressure, metabolic profile and subclinical CVD risk factors, and were compared to a control group (n = 29). Multiple regression was used to investigate whether cardiometabolic parameters were predicative of SSS scores.

RESULTS

Findings showed adults with ID have higher perceived stress levels (total score ID: 21.3 ± 11.4 vs control: 13.9 ± 9.0, p = 0.006), which is elicited by unique stressors, when compared to people without ID. Stress was strongly associated with increased social isolation (r = -0.38, p = 0.002) and with obesity in females with mild ID (r = 0.72). Regression showed that arterial stiffness was predictive of total SSS score (p = 0.038).

CONCLUSIONS

Adults with ID aged 18-45 years report higher levels of perceived stress when compared to people without ID.Implications for RehabilitationReducing stress in this young population may prevent development of arterial stiffness, and consequently lower the risk of cardiometabolic morbidity and mortality.There are unique targets for stress management in young adults with intellectual disability, including supporting decision-making and improving self-efficacy.Improving community integration and reducing social isolation may decrease perceived stress in young adults with intellectual disability.

Australians with intellectual disability share their experiences of retirement from mainstream employment

BACKGROUND

As part of a larger study exploring the transition to retirement for people with intellectual disability from a working life in mainstream employment, this paper reports on retirement from the perspective of those who have already retired.

METHOD

Semi-structured interviews were undertaken with five Australian retirees with intellectual disability. Data were analysed using grounded theory methodology. Employment service records provided background information on participants' employment and supports.

RESULTS

Retirement occurred as the solution to ongoing problems primarily related to health. Retirement decisions were made in conjunction with family and support staff, with participants reporting varying levels of self-determination in the process, and mixed feelings about their retirement. None of the participants were participating in mainstream community groups in retirement.

CONCLUSIONS

There is a need for retirement preparation for this emerging population to support self-determination in retirement-related decisions including individualized training to facilitate independent participation in mainstream social activities in retirement.

"Just one of the guys" An application of the Occupational Wellbeing framework to graduates of a Men's Shed Program for young unemployed adult males with intellectual disability

INTRODUCTION

Conceptualisation of occupation requires understanding of subjective wellbeing and experiences of occupation. Opportunities for participation in productivity activities, such as employment, may be limited for people with intellectual disability (ID). An occupational wellbeing framework was recently re-imagined to focus on the subjective meaning of a person's occupational life rather than occupational performance. This study analysed experiences and possible benefits to occupational wellbeing of young adult men with ID in an intergenerational mentoring program based on Australian Men's Sheds using this revised occupational wellbeing framework.

METHODS

A qualitative approach was used to gather individual semi-structured interviews at the end of an intergenerational mentoring program to explore occupational wellbeing experiences. Eight individual mentees and five parents of mentees (n = 13) from the different Men's Sheds sites agreed to participate in an individual interview about their experiences of the program. All mentees were male aged between 17 and 24 years. Family members included four female mothers and one male father. Data were highlighted, selected and deductively coded using content analysis according to the five occupational wellbeing domains of the framework.

RESULTS

Mentees reflected upon their experience with their mentor, the program, activities and environment of the Men's Shed. Findings were organised in relation to each of the five domains of occupational wellbeing, including contentment, competence, belonging, identity and autonomy. Experiences of mentees and their family members reflected the positive impact of participation on each domain and occupational wellbeing, including opportunities for socialisation outside of the program, mastery of skills and knowledge and validation of belief in self.

CONCLUSION

Mentees involved in an intergenerational mentoring program in Australian Men's Sheds report benefits of participation in activities that foster and increase occupational wellbeing experiences. The experience of such domains should be considered when attempting to understand the quality of life and function for people with disabilities.

Older male mentors: Outcomes and perspectives of an intergenerational mentoring program for young adult males with intellectual disability

ISSUE ADDRESSED

Intergenerational mentoring is emerging as a way to provide meaningful engagement and improve wellbeing for older adults in retirement. However, there is little, if any, Australian research concerning the benefits for older mentors involved in such mentoring. This study aims to investigate the experiences of older male mentors involved in an intergenerational mentoring program with young men with intellectual disability and identify any benefits to physical and mental health and generativity.

METHODS

This study used a mixed methods concurrent triangulation design. Quantitative outcomes data were collected pre and postintervention using the SF-36 and Loyola Generativity Scale. Qualitative data were collected using a single-interview approach. Mentors and mentees took part in a 6-month mentoring program based in Australian Men's Sheds.

RESULTS

No significant changes were seen in physical health and generativity. Investigation of mental health scores revealed a significant improvement in scores on the mental health subscale. Qualitative analysis revealed the main theme as "Learning together through a relational and practical routine" and four sub-themes.

CONCLUSION

Men's Shed intergenerational mentoring programs present an environment for older, retired men to express generativity, improve their mental health and bond with younger generations.So what? The potential wellbeing implications for older men through intergenerational mentoring should form the basis of future research and intervention.

Parents with intellectual disabilities and their perspective of peer support: "It depends on how they give it"

BACKGROUND

Parents with intellectual disabilities face particular challenges, such as lack of sufficient support with their parenting. Peers can be an important source of support for parents in the general population; however, there is a limited knowledge about peer support for parents with intellectual disabilities. The aim of this study was to explore experiences of parents with intellectual disabilities with social support with a focus on the role of peers.

METHOD

Twenty-six parents with intellectual disabilities in New South Wales, Australia, took part in a semi-structured interview.

RESULTS

The inductive content analysis of data revealed three main themes; this article reports on one of them-Developing interdependence.

CONCLUSIONS

The source of support was less important than the way support was offered. Parents valued support offered by someone who respected them as a person and parent, and was interested in what they wanted and needed.

Active Interest Mentorship for Soon-to-Retire People: A Self-Sustaining Retirement Preparation Program

Retirement is a major life transition that often leads to maladjustments and mental health hazards. In this study, we developed an innovative retirement preparation program, the Active Interest Mentorship Scheme (AIMS), which utilized active interest development as a positive entry point through which to engage soon-to-retire people. Each retiree received a 1-year mentorship 6 months before retirement. Adopting a quasi-experimental design, the study aimed to evaluate the efficacy of the AIMS in protecting retirees' well-being. The well-being status of 161 retirees was assessed at 4-month intervals. Measures included self-esteem, life satisfaction, positive affect, depression, anxiety, and somatic symptoms. Serial trend analysis revealed a general improvement in well-being at 4 months after mentorship, followed by a mark reversion in some variables at 2 months after retirement. Upon completion of the program, participants generally returned to a level of well-being that was comparable with or better than preretirement levels. The first 2 months after retirement appeared to be the most distressing. The findings support the efficacy, as well as feasibility of the innovative retirement preparation program.

Transition to retirement and participation in mainstream community groups using active mentoring: a feasibility and outcomes evaluation with a matched comparison group

BACKGROUND

This paper reports on the feasibility and outcomes of a transition to retirement programme for older adults with disability. Without activities and social inclusion, retirees with disability are likely to face inactivity, isolation and loneliness.

METHODS

Matched intervention and comparison groups each consisted of 29 older individuals with disability. There were 42 men and 16 women with a mean age of 55.6 years While attending their individual mainstream community group 1 day per week, intervention group participants received support from community group members trained as mentors. We assessed participants' loneliness, social satisfaction, depression, life events, quality of life, community participation, social contacts, and work hours before and 6 months after joining a community group.

RESULTS

Twenty-five (86%) of the intervention group attended their community group weekly for at least 6 months. They increased their community participation, made an average of four new social contacts and decreased their work hours. Intervention participants were more socially satisfied post-intervention than comparison group members.

CONCLUSIONS

The results demonstrate that participation in mainstream community groups with support from trained mentors is a viable option for developing a retirement lifestyle for older individuals with disability.

Responsiveness to self-report questions about loneliness: a comparison of mainstream and intellectual disability-specific instruments

BACKGROUND

We compared responsiveness to two self-report assessments of loneliness: the UCLA Loneliness Scale (UCLALS) designed for the general community, and the Modified Worker Loneliness Questionnaire (MWLQ) designed for people with intellectual disability (ID).

METHODS

Participants were 56 older adults with disability - 40 individuals with ID and 16 without ID. They were individually assessed on the MWLQ and the UCLALS. The difficulty of the items in both scales was evaluated in relation to readability, features of question wording, question length and response format.

RESULTS

The UCLALS was more difficult than the MWLQ on each of the difficulty dimensions assessed. There was significantly greater responsiveness to the MWLQ than the UCLALS, especially among people with ID.

CONCLUSIONS

To enable as many people with ID as possible express their views on loneliness, the ID-specific MWLQ is a much better choice. However, this choice comes at the cost of ready comparison to loneliness data for the general community, which is available for widely used assessments such as the UCLALS.

Mentoring at Men's Sheds: an international survey about a community approach to health and well-being

Men's Sheds are named within the Australian and Irish National Male Health Policies as an exemplar of male health and well-being and offer a range of formal and informal mentoring to counter the known consequences of social exclusion. The study aimed to report on whether Men's Sheds undertake mentoring programmes, and if so, who is being mentored; are mentors being trained, and if so by whom; and the perceived effectiveness of the mentoring programme. Furthermore, the study aimed to explore associations between sheds with a mentoring programme and factors that reflect an inclusive and a health-focused environment. All known Men's Sheds were invited to participate in the survey; of those, 324 (42.8%) Men's Sheds in Australia and 59 (48.0%) International sheds participated in the study between April and August 2012. Overall, 39.2% (n = 127) of Australian sheds and 23.7% (n = 14) of International sheds undertook formal mentoring. Youth was the most common group being mentored in both Australia (60.6%; n = 77) and Internationally (71.4%; n = 10). Over half of Australian shed co-ordinators rated their mentoring programme as moderately effective (52.8%; n = 67) and over a third as highly effective (36.2%; n = 46), while half of International shed co-ordinators rated theirs as highly effective (50.0%; n = 7). The findings from this paper support the notion that a large number of Men's Sheds offer formal mentoring programmes targeting a range of disadvantaged sub-populations, thus supporting social inclusion. Inter-generational mentoring is the most frequently occurring type of mentoring programme. While training mentors occurs at some sheds, the efficacy of this training and programme outcomes are unknown. A typology of shed types appears to be emerging based on a divergence of sheds with a more utilitarian focus and sheds that appear to embrace a health and well-being focus.

Engagement in retirement: an evaluation of the effect of Active Mentoring on engagement of older adults with intellectual disability in mainstream community groups

BACKGROUND

As adults with intellectual disability age, retirement options need to be explored. One option is to attend a mainstream community group for retirees. Support within these groups could come from group members who are trained to act as mentors for the older adults with intellectual disability. This research evaluated a support training programme, Active Mentoring, which combines elements of Active Support and Co-worker Training.

METHOD

Three older women with intellectual disability participated in a non-concurrent multiple baseline design. Effect size analyses (Percentage of Non-overlapping Data) were used to evaluate observational data.

RESULTS

Active Mentoring was effective in increasing most types of engagement in activities, but there was no observed effect for social engagement. Mentor help also increased.

CONCLUSION

Active Mentoring was effective in eliciting support from mentors, and in increasing activity engagement of older adults with intellectual disability in mainstream community groups.

Mentors' experiences of using the Active Mentoring model to support older adults with intellectual disability to participate in community groups

BACKGROUND

Social inclusion is a widely acknowledged goal; who is best positioned to provide support and how support is delivered are key questions. Using Active Mentoring training, members of community groups mentored a person with intellectual disability and supported their inclusion in that group.

METHODS

Interviews with 14 mentors explored their experiences of supporting a previously unknown person with intellectual disability to participate in their community group.

FINDINGS

The core theme was No Different From Us. Mentors saw beyond the disability, they valued others, were community leaders, and had intrinsic qualities. With some basic orientation to the task, mentors were able to support the inclusion of their mentee in the group.

CONCLUSION

Community members are willing to support people with intellectual disability to join their community groups. The Active Mentoring training is one way of harnessing the goodwill of community groups and their members to include people with intellectual disability to participate on an individual basis in community groups.

Social inclusion and community participation of individuals with intellectual/developmental disabilities

As more individuals with intellectual/developmental disabilities are physically included in community life, in schools, neighborhoods, jobs, recreation, and congregations, the challenge of going beyond physical inclusion to true social inclusion becomes more apparent. This article summarizes the status of the research about community participation and social inclusion, summarizes some debates and points of contention, notes emerging research issues, and highlights needed areas of research. It is clear that most research on these topics has been conducted with individuals who are in paid formal services, and there are great needs for understanding the community participation of individuals who live on their own or with their families, as well as researching social inclusion by focusing on the attitudes and experiences of community members themselves, not just individuals with disabilities and paid providers.

Masculinity theory in applied research with men and boys with intellectual disability

Researchers in intellectual disability have had limited theoretical engagement with mainstream theories of masculinity. In this article, the authors consider what mainstream theories of masculinity may offer to applied research on, and hence to therapeutic interventions with, men and boys with intellectual disability. An example from one research project that explored male sexual health illustrates how using masculinity theory provided greater insight into gendered data. Finally, we discuss the following five topics to illustrate how researchers might use theories of masculinity: (a) fathering, (b) male physical expression, (c) sexual expression, (d) men's health, and (e) underweight and obesity. Theories of masculinity offer an additional framework to analyze and conceptualize gendered data; we challenge researchers to engage with this body of work.

Disconnected expectations: staff, family, and supported employee perspectives about retirement

BACKGROUND

Australia has few policies to support the transition of older people with intellectual disability from employment to retirement. This study aimed to identify the possibilities and barriers to retirement for older employees in supported employment services.

METHOD

Five distinct participant groups discussed retirement in 6 separate focus group interviews: staff from disability accommodation (7) and employment services (7), members of mainstream activity programs for older people (4), family members (5), and supported employees (2 groups of 6 people).

RESULTS

Participants perceived retirement as a risk to the well-being and participation of employees. Participants were pessimistic about the availability of necessary support in retirement. The need for additional resources and skills was identified, but the utility of inclusion strategies was not recognised. Continued segregation through specialist programs or adaptation of existing employment programs was the most commonly suggested retirement option by staff and family members.

CONCLUSION

Perceptions did not reflect the current policy imperatives of social participation. This poses an additional obstacle to conceptualising, planning, and supporting quality of life for older people with intellectual disability.