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Article

Deinstitutionalization in Macro Practice  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Article

Life Span: Older Adulthood/Seniors (From Ages 60 to 75)  

Nancy P. Kropf

Although the terms older adult and senior citizen are commonly defined as individuals 60 years and above, later adulthood contains various life-course phases and developmental periods. The young-old, defined as individuals in the age range of 60–75 years, often experience various health, social, and economic transitions. Both the individual and family systems must negotiate some of the changes that accompany the journey into later life. Therefore, this first decade of older adulthood is one that can simultaneously be enjoyable, exciting, demanding, and stressful for aging persons and their families.