Within Facility Management (FM) the connection between organisation and space is a well-established topic. This study was made in the context of discovery and explored to what extent changes in organisation and space can contribute to the quality of life of intellectually disabled residents with a severe behavioural disorder (hereafter called residents) and a need for low stimulus intensity.In scientific literature the influence of the spatial environment on well-being of this specific group of residents has been described extensively by scholars in psychology. However, the joint optimisation of organisation and space is relatively new in FM and relates to studies on evidence based design and healing environments.This current study explores the relationship between different configurations in organisation and space in real life on one side and aggressive behaviour of two residents on the other. The research design was a longitudinal comparative case study and combined retrospective analysis with analysis of the current situation. The applied methods included document analysis, interview, photography, and walkthrough.Residents were exposed to different degrees of stimulus intensity in different periods. In periods where residents were exposed to a low stimulus intensity in organisation and space a relatively low number of incidents was reported. To be more precise: in periods where residents were exposed to few peer-residents, a custom-made team, a stable team composition, a standard team approach, and many personal spaces less incidents were reported than in periods where residents were often exposed to peer-residents, a group-based team, changes in team composition, no standard team approach, and many group spaces. These preliminary results suggest that a fit between the needs of residents with organisational and spatial designs can improve the well-being of residents. Further research among a larger population of residents should reveal if the current results have more general validity and whether these current findings would also be valid for other care institutes.
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Abstract Background: Although there is little evidence on their efficacy regarding challenging behaviour, antipsychotics are the most used psychotropic drugs in residential intellectually disabled people. Discontinuation is possible for some residential clients with intellectual disabilities. This study aimed to gain insight into support staff's perceptions of discontinuing antipsychotics in residential clients with intellectual disabilities. Method: Four focus groups were conducted in this mixed‐methods study, followed by a survey. Results: A large majority of support staff perceive antipsychotics to be effective in controlling challenging behaviour. Support staff regarded themselves as willing to contribute to the discontinuation of antipsychotics, but were more confident about achieving reductions. Conclusions: The attitude of the majority of support staff towards discontinuation provides a good basis for regularly reviewing antipsychotics use. A reduction plan should include preliminary steps, methods of monitoring and evaluating the process, and establishing measures for dealing with possible crises.
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Background: Intellectual disability (ID) is a developmental disorder that causes considerably below-average intellectual performance and adaptive behaviour. In the context of the present study, families raising a child with ID are reported to experience multiple challenges that appear not to be well documented in Pakistan. Methods and procedures: Pakistan, which was conducted in Karachi, Pakistan, followed participatory action research, in which the researcher and participants examined their existing experiences of informal social support and then created, implemented, and evaluated actions to strengthen this informal social support. A total of five families (n = 25) participated in the study. These participating families comprise parents, siblings, and significant others, i.e., aunts, uncles, and grandparents, living with the child with ID. Families with children with ID were selected through a school for children with ID who are under 12 years old. This qualitative action research was conducted in two distinct parts, i.e., a) exploratory part and b) action part. This paper presents the findings of the first exploratory part of the study. Aim: The exploratory phase aimed to explore and examine the experiences and challenges families may experience with informal social support while caring for a child with an intellectual disability in Karachi, Pakistan. Findings: Parents often sacrifice their personal needs and aspirations for their children, leading to decreased tolerance and anxiety. Lack of communication, support, and assistance from family members is another significant issue. Stigmatisation and discrimination from school, relatives, and friends can cause depression and distress. The study emphasises the need for a unified and coordinated approach to support and care. Religious beliefs, siblings, and close friends provide comfort and well-being. When parents manage to connect with similar families, they have the opportunity to express a collective commitment to caregiving. Conclusion: To strengthen the situation, families propose enhancing intimacy and competency within homes and taking action at the governmental level. Governments must provide appropriate services, such as nurses supporting families, support groups, and religious traditions, to promote acceptance and holistic development for intellectually disabled children.
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