The Role of Assistive Technology in the Lives of Former Long-term Nursing Home Residents

Despite legislative reforms addressing institutionalized living, people with disabilities transitioning from long-term nursing home residence to the community are not guaranteed successful outcomes. Assistive technology (AT) has been recognized as a tool that contributes to increased participation and quality of life of people with disabilities and, therefore, holds potential as a key contributor to community living. However, the lack of outcome studies examining factors that impact quality of life and participation among former long-term nursing home residents is particularly detrimental for AT users because misidentification of the factors influencing community living puts this population at risk for re-institutionalization. The purpose of this study was to bring forth the viewpoints and experiences of AT users who have moved from nursing homes to the community under Illinois’ Colbert Consent Decree to better understand the factors that facilitate and/or impede participation and quality of life within the context of community living. This study utilized an explanatory sequential mixed method design where quantitative survey results were explained by qualitative semi-structured interviews. Quantitative data collection was conducted using two standardized instruments: 1) the Impact on Participation and Autonomy and 2) the World Health Organization Quality of Life Brief form and the Disabilities module. A convenience sample of 347 Colbert class members who received AT between January 2015 and May 2020, from the UIC Assistive Technology Unit were invited to participate in the study, resulting in a total of 41 survey respondents. Fourteen purposively selected individuals participated in the interviews. Quantitative results demonstrated that physical health perceptions, environmental satisfaction, transportation quantity, disability quantity, and inclusion were significantly associated with participation and quality of life outcomes. Qualitative findings highlighted the correlation between participation and quality of life; described the importance of individual-level factors, activities with meaningful outcomes, AT, and context (i.e., environment, resources, and positive relationships) in influencing participation and quality of life; and identified person-centered transition planning and respect of lived experience as cornerstones to long-term community living and well-being. Results of this study can inform future scholarship, practice, and policy towards improving the community living outcomes of former long-term nursing home residents using AT.