‘If We are Going to Include Them We have to do it Before We Die’: Norwegian Seniors’ Views of Including Seniors with Intellectual Disability in Senior Centres

[Points de vue d'adultes vieillissants ayant une déficience intellectuelle à l'égard de leur participation sociale]

Au cours du vieillissement, les adultes ayant une déficience intellectuelle (DI) vivent de nombreux changements susceptibles d'influencer leurs possibilités d'exercer leurs activités quotidiennes et leurs rôles sociaux. Une bonne connaissance de leurs points de vue sur le sujet apparaît cruciale pour mieux adapter l'offre de services à leurs besoins. Cette recherche a pour but de mieux comprendre les points de vue des personnes ayant une DI à l'égard de leurs possibilités de participation sociale à travers l'avancée en âge. Des entrevues individuelles et un atelier participatif ont été réalisés avec des adultes âgés de 40 à 75 ans dans la ville de Québec. L'analyse de leurs propos a permis d'identifier leurs points de vue relatifs à trois thèmes, soit leurs capacités, les possibilités d'exercer leur participation sociale et les soutiens reçus. Pour conclure, des recommandations sont proposées afin que les pratiques soutiennent réellement leur participation sociale à travers l'avancée en âge.

Should inclusion have an expiry date? Older people's attitudes on intellectual disabilities

BACKGROUND

Older people with intellectual disabilities represent a new and neglected population in need of services, yet it may be problematic to include them in generic services without having a clear idea of how elderly people from the general population feel towards them. To the best of our knowledge, this topic has not been addressed quantitatively.

METHOD

Seventy-three participants over 63 years of age (23 females and 50 males) from the general population without an intellectual disability completed two valid measures: the CLAS-MR and the WHOQOL-OLD.

RESULTS

Level of education and quality of life were positively associated with attitudes towards people with intellectual disabilities. Age was negatively associated with knowledge regarding intellectual disability.

CONCLUSIONS

When preparing for the inclusion of older people with intellectual disabilities in generic services, attention should be given to members' level of education, quality of life, and knowledge regarding intellectual disabilities. Sensitivity should be applied to potential tendencies to shelter people with intellectual disabilities.

Participation of People With Impairments in Seniors' Organizations: Conditions and Limitations on Inclusion

BACKGROUND AND OBJECTIVES

While older adults' social participation has attracted sustained attention, the realities faced by seniors with impairments in this area are still understudied. Social representations are formed from socially constructed opinions regarding a given object and have four functions (knowledge, identity, orientation, justification). The purpose of this article is to document the social representations that exist within seniors' organizations regarding participation by older people with impairments.

RESEARCH DESIGN AND METHODS

In this mixed-methods study, an exploratory sequential design was applied. First, a qualitative phase involved meetings with five focus groups to explore how participants would manage difficult situations in which the inclusion of an older person with impairments must be addressed. Second, a quantitative phase consisted of a questionnaire administered to 86 respondents to examine the components of social representations about the participation of older people with impairments.

RESULTS

Results show that, although research participants acknowledge that all seniors have the right to participate, this right confronts a collective identity infused with aging model that demands a youthful, "un-disabled" appearance and activities. In terms of the orientation function, making participation a reality is seen as relying on the efforts of people with impairments, but when there is a failure of inclusiveness, the reasons offered to justify it concern the resources available, rather than possible prejudices.

DISCUSSION AND IMPLICATIONS

Interpretation of the results leads to recommendations for both implementing an inclusion philosophy and practices in seniors' organizations and revisiting the view of impairment in old age as otherness.

Day centres for older people: a systematically conducted scoping review of literature about their benefits, purposes and how they are perceived

With a policy shift towards personalisation of adult social care in England, much attention has focused on individualised support for older people with care needs. This article reports the findings of a scoping review of United Kingdom (UK) and non-UK literature, published in English from 2005-2017, about day centres for older people without dementia and highlights the gaps in evidence. This review, undertaken to inform new empirical research, covered the perceptions, benefits and purposes of day centres. Searches, undertaken in October/November 2014 and updated in August 2017, of electronic databases, libraries, websites, research repositories and journals, identified seventy-seven relevant papers, mostly non-UK. Day centres were found to play a variety of roles for individuals and in care systems. The largest body of evidence concerned social and preventive outcomes. Centre attendance and participation in interventions within them impacted positively on older people's mental health, social contacts, physical function and quality of life. Evidence about outcomes is mainly non-UK. Day centres for older people without dementia are under-researched generally, particularly in the UK. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer, to whom and their wider stakeholders, including family carers, volunteers, staff and professionals who are funding, recommending or referring older people to them.

Choice and control for people ageing with intellectual disability in group homes

BACKGROUND

Many people ageing with intellectual disabilities (ID) age in place in group homes. Participation is a central concept in support and service to people with ID, but age is often a determining factor for participation among this group. Choice and control are dimensions of participation.

AIM

The aim of this article is to explore how choice and control in the everyday life of people ageing with ID is expressed and performed in the group home's semi-private spaces.

MATERIAL AND METHODS

Participant observations and interviews with residents and staff were conducted in four different group homes in Sweden that had older residents.

RESULTS

Four categories were found that can be understood as aspects of choice and control in the group home's semi-private spaces in the everyday life of people ageing with ID. These categories included aspects such as space and object, time and routines, privacy, and a person-centred approach.

CONCLUSION AND SIGNIFICANCE

People ageing with ID are vulnerable when it comes to maintaining choice and control in various situations in the home's semi-private spaces. It is argued that occupational therapists should include this occupational arena in their evaluations and interventions for people ageing with ID.

Transition to retirement and participation in mainstream community groups using active mentoring: a feasibility and outcomes evaluation with a matched comparison group

BACKGROUND

This paper reports on the feasibility and outcomes of a transition to retirement programme for older adults with disability. Without activities and social inclusion, retirees with disability are likely to face inactivity, isolation and loneliness.

METHODS

Matched intervention and comparison groups each consisted of 29 older individuals with disability. There were 42 men and 16 women with a mean age of 55.6 years While attending their individual mainstream community group 1 day per week, intervention group participants received support from community group members trained as mentors. We assessed participants' loneliness, social satisfaction, depression, life events, quality of life, community participation, social contacts, and work hours before and 6 months after joining a community group.

RESULTS

Twenty-five (86%) of the intervention group attended their community group weekly for at least 6 months. They increased their community participation, made an average of four new social contacts and decreased their work hours. Intervention participants were more socially satisfied post-intervention than comparison group members.

CONCLUSIONS

The results demonstrate that participation in mainstream community groups with support from trained mentors is a viable option for developing a retirement lifestyle for older individuals with disability.

Older adults with intellectual disability

PURPOSE OF REVIEW

Improvements in health and social care for people with intellectual disability have led to a dramatic increase in the life expectancy of this population, resulting in a large and growing number of older adults with intellectual disability. They are at risk of age-related mental disorders such as dementia and continue to present with high rates of mental illness.

RECENT FINDINGS

Recent research with older adults with intellectual disability has included physical health issues that may affect mental well being, and biological and clinical features of dementia in people with Down syndrome. Two key clinical trials of memantine and antioxidants for dementia in Down syndrome showed that these treatment options were ineffective in the short term. Other research focussed on environmental and psychosocial issues (including carer issues) and end-of-life care.

SUMMARY

Improved mental well being requires effective management of mental illness and co-morbid physical health problems as well as consideration of environmental and social issues. Biological research has identified potential treatments for age-related decline, which has led to the development of medication trials. Despite disappointing results, two recent medication trials showed that randomized controlled trials are feasible in older people with intellectual disabilities - a group who are often excluded from trials.