I work for a company that provides supported living services to mentally disabled people. Many such people live in the community. They are provided services according to their needs as determined by a team of people that includes the consumer. The services that are provided can include housekeeping, meals, personal care, etc or can be restricted to transportation and assistance with appointments and shopping. It depends on the level of functioning of the consumer - how independently he/she is capable of living. In some of the homes I oversee, we provide 24/7 services that include total support and supervision; in others, we only provide limited service for a minimal amount of hours a week. (The smallest contracts that I know of are around 3 hours a week.)
Individuals who are more involved behaviorally or medically might live in an ICFMR (Intermediate Care Facility for the Mentally Retarded). Those facilities usually have 24/7 nursing care available and more behavior support and supervision than can be provided in a private home. I don’t have direct experience with an ICFMR but my company has a few in other areas.
Most of the consumers we have are employed at sheltered workshops, which allows them to earn some (usually very little) money. When those consumers reach the age where others are retiring, they are offered the chance to attend a senior program sponsored by the workshop instead of working. I know a charming woman in her 80s who refuses to give up working to go to the senior program, saying that she likes to keep busy and would be too bored. She doesn’t earn much, but she’s happy.
We do have some consumers who work in the community, and those jobs are usually support jobs such as dishwashing or making salads in a restaurant, carry-out in a grocery store, or janitorial work.
Many of our consumers are middle-aged to elderly and the only consumers I’ve known who have died have been younger people who died from causes that strike the general population equally. My company, when we are contracted to help the consumer access medical care (in some cases we are not, when there is family involved who prefer to take care of that themselves), requires that our consumers get annual physicals and dental exams, and we also assist with medical care and medication administration as needed by the consumers.
Sorry for the long post; I live this stuff 24/7 (I’m on-call all the time)!