Acquiring medical services for individuals with mental retardation in community-based housing facilities.

As a result of deinstitutionalization, individuals with mental retardation (MR) were moved into the community and primary care practices. Residential agency directors now routinely determine health care decisions. Understanding of issues involved in acquiring services and the clinical decision-making experiences of 13 service agency directors representing 1,400 individuals with MR were investigated. This descriptive study with a qualitative exploratory design included structured interviews that were content analyzed. Four themes describe the barriers encountered, which resulted in the delay or denial of appropriate health services. These themes include effects of stigma, knowledge limitations, resource deficits, and inconsistent decision making. Knowledge of these experiences will assist nurses in problem solving and advocating for the holistic competent care of individuals with MR.