Keeping my place in the community: Achieving successful ageing-in-place for people with intellectual disabilities

Abstract

Introduction: Australian aged‐care and disability service reforms and the advent of National Disability Insurance Scheme have changed the policy and funding landscape from service‐centric to individualised funding. However, there are gaps in policy and practices concerning older people with intellectual disabilities (PwID), whose life expectancy now approximates that of general population. Using Bronfenbrenner's ecological systems framework, the study aimed to define a more viable interface between disability and aged‐care sectors to enable integrated community‐based living.

Methods: i) A survey of health, quality‐of‐life (QoL) and social disparities of PwID (n = 391) and people without lifelong disability (n = 920) across two states; and ii) key informant (KI) semi‐structured interviews, with a sample of policy makers and senior managers in the disability and aged‐care sectors (n = 36).

Results: PwID experience more chronic health conditions than non‐PwID age peers. Social disparities were greater, but mean and median QoL scores were higher for PwID group than their non‐PwID age peers. KI interviews highlighted barriers between disability and aged‐care sectors. Inter‐sectoral silos thwarted coordinated whole‐of‐person operationalisation of policies.

Implications: Ageing‐related needs of PwID must be considered when reforming generic ageing policies and practices. Applying a lifelong perspective would better lead to a seamless transition throughout one's life stages. Practice and policy must focus around co‐design, autonomy and decision making ‐ at the personal, organisational, policy and society levels.

Keywords: Intellectual Disability, Ageing, Disability reforms, Aged‐care services