Research in this field is limited. Personal assistance is expensive and difficult to organise, especially in places that do not already have services in place, but its total cost relative to other services is unknown. When implementing new programmes, recipients could be randomly assigned to different forms of assistance (e.g. organised by individual users versus organised through a cooperative). While advocates may support personal assistance for myriad reasons, this review demonstrates that further studies are required to determine which models of assistance are most effective and efficient for particular people.
The Pennsylvania domiciliary care experiment: I. Impact on quality of life.
This paper reports findings concerning the impact on quality of life of a case management focused program of small board and care facilities serving aging, mental health, and mental retardation adult target populations--the Pennsylvania Domiciliary Care Program. Program participants from the counties in which the Domiciliary Care Program was initiated were matched with persons residing in similar counties without the program who were comparable on a large array of characteristics prior to program initiation. Conducted separately by target group, 10-month follow-up assessments provided the basis for determining impact. In general, the effects were positive, particularly with respect to meeting program quality of life goals (providing needed services, improving living conditions, increasing community integration, and reducing institutional days); the effects were more positive for the aging and mental health than for the mentally retarded target populations.