Athabasca University Essay: Aging Adults and Intellectual Disabilities

This essay delves into the emerging subpopulation of older adults (65+) with intellectual disabilities, examining the multifaceted challenges they encounter. It addresses issues such as declining physical activity, the prevalence of chronic health conditions, and difficulties in accessing healthcare and transportation. The essay reviews relevant literature, including studies on physical activity programs, dementia, and the preparedness of group homes. It further discusses the impact of cognitive decline, communication barriers, and the need for specialized care. The essay also explores the importance of nursing interventions and the need for systemic changes to improve the quality of life for this vulnerable population, including addressing issues of housing, social participation, and healthcare access.

Running head: AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
AGEING ADULT LIVING WITH INTELLECTUAL DISABILITIES
Name of the Student:
Name of the University:
Author’s Note:

1AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
Aging Adult Living with Intellectual Disabilities
Introduction
According to the World Population Prospects: the 2019 Revision, one out of six
people will be over the age of 65 years by 2050 that indicates that 16% of the world
population will belong to the older generation (Un.org, 2020). This is one of the most
prevalent population because it is increasing in number at a drastic manner. Moreover, a sub-
population that is stated to be important for discussion is people above the age of years with
intellectual disability (ID). This is because the burden of mental retardation is more
significant in today’s population and due to advancement in technology and medical science.
One of the significant facts found in 2018 was people belong to age 65 or above had
outnumbered children under five years in a global context. Heller (2017) stated that the
population of adults of 65 years or more with ID is growing in a drastic manner and is
estimated to be 1.4 million by 2030. In North America, 6.5 million people have an
intellectual disability and the number of adults over 65 years old is increasing at a high rate in
the country. Bonder and Dal Bello-Haas (2017) opined that social, environmental, cultural
and development factors are found to have a significant impact on the expression of
behavioural and psychiatric disorders among older adults having ID. The demographic
obligations of the longer life expectancy of old people of more than 65 years with low mental
intelligence and the ageing of this section of people are growing challenges that need to be
addressed. An increasing number of adults over the age of 65 years with ID experience more
health issues than healthy people of the same age. This is because these people have low
mental ability and were supported by someone early however, with age, the dependency level
increased that affected the health and well-being. The aim of the essay is to explore the facet
on the emerging subpopulation of an older adult above the age group 65 years suffering from

2AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
ID. This will specifically address the issues faced by the subpopulation, nursing intervention
and implications on the large system.
Literature Review
According to the study conducted by van Schijndel‐Speet, Evenhuis, van Wijck, van
Montfort and Echteld (2017), the level of physical activity of older people having ID is
observed to be extremely low; thus, their fitness level is invariable beneath the accepted
standard of an older people having normal intelligence level or adults having other physical
issues. Thus, the study intended to understand the impact of physical activity among such
populations. Cluster-Randomized clinical trials were conducted where it was found that there
was a significant effect on muscular strength, physical activities, heart rate, blood pressure,
cognitive function and cholesterol level of the respondents thus, highlighting the importance
of physical programs on the target population. Burke, McCallion, Carroll, Walsh and
McCarron (2017) opined that there was no impact on the body balance, weight, and glucose,
mobility, walking speed, instrumental activities and depression level. Therefore, these
programs have a small effect on the research sample; however, the findings were generalised
in nature. The implementation of evidence-based programs can be recommended for old
adults with ID. The authors Axmon, Björne, Nylander and Ahlström (2018) bring some
information about the background of the problem and it was found that in some cases, people
develop dementia that presents a large number of chronic disability and physical health
issues. The capacity of self-directed activity was low among the elderly people and the
symptoms demonstrated by these people were reduced capacity of enjoying, irritability and
violent behaviour. Thus, it indicates an outlook of the strategic perception of the changes in
differential survival. In a similar study conducted by Bowers, Webber and Bigby (2014)
explore the way the staff of group home in Victoria, Australia, had responded to the needs
and demands of the residents with ID while they develop health conditions related to age. The

3AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
study was conducted on 83 staff for three years in 17 group homes. The use of dimensional
analysis, grounded theory and guided data collection and analysis method was employed. The
findings indicated there is a lack of knowledge with respect to the process of ageing and the
absence of a policy that affected timely diagnosis and prognosis for older people with ID. As
per the findings of Burke, McCallion, Carroll, Walsh and McCarron (2017), there is a risk of
osteoporosis among old people despite if the low level of reports related to doctor’s
diagnosis. Since it is a multifactorial disorder, thus, it offers various kinds of physical
disability due to a reduction in bone density limiting movement. There is a need for raising
the issue of unpreparedness of group home staffs taking care of old people with the ID that is
rooted in a medical model of disability. As per the study of McCausland et al. (2018), elderly
belonging to the age group of more than 65 years or more does not have any medical or
biological evidence to support them in terms of dietary intake. It was found that the quality of
diet and nutrient intake is poor among older adults living in in-group homes. Therefore, it is
important to have educational and policy awareness o improve the prospect of diet among old
people with ID. Axmon, Björne, Nylander and Ahlström (2018) opined that one of the most
significant issues that are faced by subpopulation, older people with an intellectual disability
is transportation, which is important for social participation. Due to limitation, these people
are more prone to loneliness and isolation thus, leading to mental depression and exclusion
among these people. The study conducted by McCausland et al. (2019) specifically targeted
on the old people with ID in Ireland stated that this section depends on other for transporting
from one place to other and used mode, staff-supported transport more frequently that did not
exhibit any longitudinal change. The use of public transportation is secondary in nature and
depend on the level of intellectual in accessing either on an independent or dependent
manner. In another study conducted by AlMutairi et al. (2019), it can be seen that chronic
constipation is an issue among old people of 65 years or more with ID and it has a negative

4AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
impact on the quality of life. This is especially true in the case of older people living in
residential homes because of the exposure to anticholinergic and liquidised or soft food that
includes the use of laxatives. There is a high prevalence of chronic constipation and use of
laxation among the subpopulation and thus, the treatment procedure is stated to be
unsystematic in nature. The need for an evidence-based treatment that will follow the
guidelines is required that will offer effective and quality care to the old people of 65 years
who have an intellectual disability.
Discussion
Older adults above the age of 65 years with ID face a plethora of issues during the
process of ageing. Due to the age factor, these people have difficulties in understanding their
own needs of care and support. One of the concerns aspects in today’s time is the growing
population of old people with ID. Due to this, it poses a burden on the healthcare sectors
resulting in poor addressing of the issue. McCallion et al. (2017) opined that ageing
complicates the life of such people as it involves integrated issues due to the disability as well
as associated factors. O’Dwyer et al. (2018) opined that in most cases, communication issue
becomes critical due to other physical and psychological issues faced at that time. The
cognitive decline among the target population results in the development of various risk
factors such as depression, delusional disorder, affective disorder and anxiety. As the age
increase above 65 years, mobility and access to transport become real-time issues that decline
the quality of life to a large extent. According to O'Dwye et al. (2019), the common health
conditions among old people with ID in dysmenorrhea, allergies, motor deficits, mental
illness, impairment in hearing and vision, otitis media, epilepsy, constipation, oral problems,
sleep disturbance, gastroesophageal reflux disease and others.

5AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
The process of ageing of people above 65 years old with ID is complicated because of
several challenges faced by the individuals during the phase. Due to the age, the immunity of
the body is low as a result; they acquire disease at a faster rate. Moreover, it can be seen that
they are prone to mental distress, psychological impact and another adverse event that has a
profound effect on the mental status, resulting in worsening the condition of intellectual
disability. This hampers the quality of life and increases the risk of developing bipolar
disorder or schizophrenia, especially in the aged population. Another important challenge that
occurs among the subpopulation is the deterioration of health conditions due to lack of
support and inability to conduct daily activities in an appropriate manner.
There is an issue in accessing healthcare services and facilities because the selected
subpopulation is unable to access them independently; they require help and support from
family members, caregivers, or others for access. This is a time-consuming process and since
they have communicational issues, in most cases, delayed or inaccessibility of healthcare
provision are observed. Inadequate provision of care, transportation and medication are issues
that affect the health and well-being of the people.
Some of the older people with intellectual disability live at home with family is taken
care either by close ones or by the carer. However, in some cases, the person exhibits
characteristics that require more specialised care and attention; therefore, they are shifted to
group homes or residential care homes offering formal and informal housing and support
services. The housing and accommodation support that aid the old people with an ID in order
to maintain as well as improve the social networks with the co-residents as they age. Bigby
and Beadle‐Brown (2018) opined that there is a preference for living in large groups and
close association with peers. In addition, active support, use of leadership by staffs and
implementation of policies and practice help in supporting them, vulnerable groups.

6AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
The health status of older people above the age of 65 with ID is stated to be weak in
nature. This is because there is a lack of organised systems for addressing the issue and the
public notion is discriminatory in nature. According to the report of World Health
Organisation (WHO), 2020, older women above the age of 65 years with the disability find
themselves representing a disadvantaged class and over the time, no or fewer efforts are
being made for addressing the needs. Bertelli, Salerno, Rondini, E and Salvador-Carulla
(2017) opined that intellectual disabilities could occur due to genetic, biological, or
environmental factor; however, in some countries, do not identify the disability like mental
illness. The healthcare professionals, most of the time, are unable to recognise the issue faced
by a 65 years old person with ID.
A large section of the old population above 65 years with ID is found to be homeless
(Durbin et al., 2018). The most predominant reason for this fact is a lack of awareness and
inability to handle such people. They exhibit a wide range of reactions that are not normal as
per society and in many developing countries; these people are discriminated as a result of
which they are left alone to deal with the situation. In group homes, they face issues in terms
of housing accommodations because of the growing population of such vulnerable people.
Therefore, there is a lack of accessibility of these resources in the healthcare sectors affecting
the care approach of the above-mentioned group of people.
Nursing intervention, Discussion & suggestions
The role of nurses in order to interventional care to older patients of more than 65
years and suffering from ID is critical. They are responsible for understanding the needs and
demands based on physical, social, medical and psychological aspects with or without the
support of individuals in order to improve the quality of life. Since the subpopulation has the
low mental capability, it can be stated that the people are highly dependent on the caregiver

7AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
or nurse taking care of them. The nurses need to develop a close association with the people
of selected subpopulation as well as family members in order to understand all surrounding
factors and external environment. This will mainly involve gaining knowledge of the
lifestyle, needs and requirements of the people with respect to age and disability-related
factors. The thorough assessment will help in gaining more knowledge and understanding of
the issues faced due to aging and intellectual disability. The development of a care plan based
on the individual’s assessment will be appropriate. Appelgren, Bahtsevani, Persson and
Borglin (2018) opined that nurses played a vital role in changing the current scenario related
to housing and palliative care for the vulnerable group. After reaching the age of 65 year and
low mental IQ level, it is important to understand them in a critical manner. They allow in
offering appropriate resources and support in accessing housing as well as palliative care
because most of the old people above the age of 65 years acquired critical and life-
threatening illnesses. The changes that are required in the healthcare system for supporting
older adults with ID is to focus on the strict implementation of policies and standards.
Talman, Wilder, Stier and Gustafsson (2019) opined that lack of knowledge and skills among
nurses pose challenges in offering help thus, increasing the mortality rate as well as the
inadequate provision of healthcare services. Training and development of the knowledge base
within the system can be useful in enhancing the skills and capacity of nurses in supporting
older adults with ID. The nursing interventions that can be taken for promoting the disabled
old adults are to strengthening the competence level of the nurses and reducing the harm and
risks to the people. This can be done by offering an integrated and comprehensive care
approach that engage the healthcare professionals and family member to provide treatment,
care and support to these people (Smeds-Alenius, Tishelman, Lindqvist, Runesdotter &
McHugh, 2016). In the case of palliative care to the older people having ID, caregivers need
to spend most of the time with the person without perceiving him or her as a burden. This has

8AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
a significant system implication in the healthcare sector that will improve the care delivery
process; thus, limiting the challenges by the system in an appropriate manner. The care
delivery system needs to be given in such a manner that it addresses explicitly social,
physical, mental and other aspects that promoting quality of life. This help in making their
last few years peaceful and happy.
Conclusion
From the essay, it can be concluded by stating older adults of 65 years or more having
an intellectual disability is a vulnerable group and require special attention because they
belong to a critical phase of ageing. Both ageing and disability pose various difficulties for
the person to lead a healthy and normal life. This is because these people belonging to the
subpopulation are unable to conduct activities of daily living; thus, care and support from all
the surrounding members such as family, caregivers, physicians and nurses are required for
supporting them to lead a nearly normal life. The nursing intervention is important in
providing care to them and improving the quality of life to a certain extent to the old people
with ID. Moreover, it is critical to make them feel important, respect and treat them with
dignity, which will help in allowing in passing the last few days with happiness and
contentment.

9AGING ADULT LIVING WITH INTELLECTUAL DISABILITIES
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