Challenges in Care and Service Provision for Older Adults with Intellectual Disabilities and Complex Age-Related Conditions in Ireland

BackgroundPeople with intellectual disabilities are living longer and are increasingly diverse, with health and care needs that are varied and complex. Without changes to funding, services have found it difficult to respond to needs and wishes.MethodA descriptive mixed methods design study, data were collected through questionnaire, focus groups and individual interviews from intellectual disability service managers, direct care staff and older people with intellectual disabilities and family members.ResultsContinued reticence on the part of some community healthcare providers to treat people with intellectual disability was noted. Although some service innovations were noted, housing, staffing levels, staff mix and the timely provision of equipment were all reported to impact the ability of services to respond to changing needs. Current per-capita funding practices were reported as unresponsive to growing age-related complexity and fundamentally unsustainable.ConclusionsThe health inequalities experienced by people with intellectual disabilities are compounded as they age with complex age-related health needs. There is an urgent need for revision of the service model in Ireland and instigation of flexible and responsive approaches to funding. More people with intellectual disabilities are living into old age and may experience age related ill health.In this study, we interviewed older people with intellectual disability, family members and staff and managers in intellectual disability services. We also surveyed staff from the services.We found that there is a concern that as people with intellectual disability age and have different health and social needs, the way that services are provided and staffed may no longer suit the needs of the individuals.Most intellectual disability services are now based in the community and most staff are social care rather than healthcare staff and may not have the skills and experience to provide care to older adults with healthcare needs. Accommodation in the community may not be suitable for older adults with healthcare needs.A new model of care and different model of funding intellectual disability services is needed to meet the needs of older people with intellectual disability.