A qualitative study of the needs of older adults with intellectual disabilities

Views and Experiences of Dementia in People With Intellectual Disabilities: A Systematic Review of Qualitative Research

BACKGROUND

It is important to hear the perspectives of people with intellectual disabilities on dementia. This review aimed to explore views and experiences of dementia from the perspective of people with intellectual disabilities and methodologies enabling people with intellectual disabilities and dementia to participate in qualitative research.

METHODS

Studies were identified in database searches, along with reference and citation searches. Qualitative data were reviewed using thematic synthesis and risk of bias assessed using the Critical Appraisal Skills Programme (2018). Methodologies used to include participants with intellectual disabilities and dementia were reviewed.

RESULTS

Findings from 11 studies, with a total of 47 participants, highlighted loss of ability, relationships and connection associated with dementia, counteracted by support from others, and maintenance of a sense of self through choice, relational connection and competence. A range of methodologies were identified to enable participants with intellectual disabilities and dementia to participate in research.

CONCLUSIONS

This review highlights emerging, albeit demographically limited, qualitative research in this field. It suggests ways to build on this including methodologies to facilitate inclusion of people with intellectual disabilities and dementia in further research.

Good life in old age: Qualitative interviews about ageing with older adults with mild intellectual disability, prior to an educational intervention

BACKGROUND

Knowledge about ageing from the perspective of people with intellectual disability is extremely scarce, which means a lack of evidence-based interventions for healthy ageing adjusted to their needs.

AIM

To investigate how people with intellectual disability experience ageing, prior to an educational intervention.

METHODS

Twenty-six persons with mild intellectual disability, age 42-74 (mean 61.3) were interviewed and the text was analyzed qualitatively.

RESULTS

The main findings are reflected in the themes Live for today - tomorrow you are old and Need of support to enable a meaningful ageing. The participants avoided thinking about ageing, which they associated with retirement, loneliness and social isolation, increased need for help in everyday life, worsening health and death. Meaningful ageing meant continuance of leisure activities and working as long as possible.

CONCLUSIONS

Interventions to prepare people with mild intellectual disability for healthy ageing must take into account these people's loneliness.

Preliminary feasibility study of a cognitive stimulation therapy programme for older adults with an intellectual disability

BACKGROUND

Despite the increased risk for people with an intellectual disability developing dementia, post-diagnostic psychosocial supports such as cognitive stimulation therapy (CST) are not routinely offered and there is limited research examining this intervention with people with intellectual disabilities. The aim of this study was to explore the feasibility of CST for older adults with intellectual disability to support active ageing.

METHODS

Five client participants attended a 14-session CST group and four staff attended a focus group. Reflexive thematic analysis was used to investigate the client and staff narratives.

RESULTS

Three key themes were generated: (1) Brain Health, (2) Connecting with others, and (3) Barriers and Enablers.

CONCLUSION

Findings indicated the suitability of CST as a way of supporting active ageing for older adults with intellectual disability. This study adds to the growing knowledge about service provision for older adults and their changing needs as they age and identifies clinical implications such as staff training to support intervention adherence.

Prioritizing Protecting Oneself Over the COVID-19 Virus Versus Other Health and Social Needs Among Older Adults Living Alone: A Qualitative Study

BACKGROUND AND OBJECTIVES

People aged 65 and older, deemed most "vulnerable" by public health, were targeted by the coronavirus disease 2019 protection measures, which sought to minimize physical contact and social activities. Older adults living alone were particularly affected by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices. This study therefore aimed to understand how protecting oneself over the virus was considered in the prioritization of other health and social needs of older adults living alone during the pandemic.

RESEARCH DESIGN AND METHODS

This study adopted a qualitative design. A total of 17 semistructured interviews were conducted between May 2021 and June 2022 with older adults living alone. All interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis as defined by Braun and Clarke was performed.

RESULTS

Our analysis showed 2 forms of prioritization across 2 themes. This first theme focused on participants who reported prioritizing protecting themselves over the virus by limiting in-person contact and activities. The second theme showed that although several participants reported that protecting themselves over the virus was important to them, the prioritization of this need was not shared by all and, in some cases, evolved over the course of the pandemic.

DISCUSSION AND IMPLICATIONS

Our study demonstrated heterogeneity in the prioritization of older adults needs. Future public health recommendations should consider these variations in the needs and priorities of older adults when determining public health measures.

Social participation in adults with cerebral palsy: a systematic review of the evidence-base

PURPOSE

To identify and synthesise the current evidence on social participation in adults with cerebral palsy (CP).

METHODS

Four databases (PubMed, CINAHL Plus, PsycINFO, Web of Science) were systematically searched between December 2021 and February 2022. Pre-specified eligibility criteria were applied to all identified studies resulting in the inclusion of 16 articles. Data extraction was performed using a standardised tool and quality appraisal was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis approach was taken for data analysis.

RESULTS

The 16 included studies were rated as high (n = 11) and medium quality (n = 5). Numbers of participants included in the studies ranged from 7 to 335. Definitions of social participation were discussed. Common themes were identified: the impact of home and work environments on social participation, the importance of age-appropriate support and interventions, and the impact of limited autonomy on social participation.

CONCLUSIONS

Adults with CP experience limited social participation due to lack of appropriate support in childhood, issues across the lifespan including physical limitations when ageing, and factors such as societal expectations and inaccessible environments which limit opportunities for autonomy. Social participation may be improved by supporting families to provide opportunities in childhood, providing timely interventions, and by enhancing autonomy.

Voices unheard, insights into the lives of people with disabilities: A needs assessment study

BACKGROUND

The phenomenon of disability in society is as ancient as human history itself. Approximately one billion people worldwide experience some form of disability, with a fifth of these individuals facing significant disabilities. Disability affects various life dimensions, including access to health services. This study aimed to identify the needs and challenges encountered by people with disabilities and to propose solutions for these issues.

MATERIALS AND METHODS

This qualitative content analysis research was conducted at Isfahan University of Medical Sciences in 2019. Participants included faculty members from the rehabilitation school, senior students, therapists, disabled individuals, and their families (23 interviews in total). These participants were chosen for their extensive knowledge of the challenges faced by people with disabilities. Semi-structured interviews were conducted, with informed consent obtained before each interview. The interviews were analyzed using the Graneheim and Lundman content analysis method and MAXQDA software. To ensure data accuracy, the criteria of conformability, credibility, dependability, and transferability were applied.

RESULTS

The analysis of the interviews yielded two main categories and 10 subcategories. In the category of disability-related problems, family problems, therapeutic problems, psychological problems, academic problems, and social problems were identified as the most significant. As for solutions, educational solutions, therapeutic solutions, social solutions, research solutions, and solutions for reintegrating patients into normal life were proposed to address the problems faced by disabled individuals.

CONCLUSION

People with disabilities are an integral part of any country's society. To adequately address their therapeutic needs, it is essential to equip our health workers with the knowledge and skills tailored to the specific needs and challenges of disabled individuals.

[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.

Transitions for older people with intellectual disabilities and behaviours that challenge others: A rapid scoping review

BACKGROUND

People with intellectual disabilities and behaviours that challenge others are living longer. This review aimed to explore what is known about the health and social care needs, experiences, service interventions and resources of and for this population as they transition to different care contexts in the UK.

METHOD

A rapid scoping review of published and unpublished literature was conducted based on collaborative working with key stakeholders and using systematic methods of data searching, extraction and analysis.

RESULTS

Consistent social work support, skilled staff, suitable accommodation, creative engagement with individuals and families to plan ahead, and timely access to quality healthcare are all required to promote successful transitions as people age, and to avoid unwanted/inappropriate transitions at points of crisis.

CONCLUSIONS

More research is needed to assess the types of services that this population can and do access as they age, the quality of those services, and the extent to which local commissioners are planning ahead for people with intellectual disabilities and behaviours that challenge others.

Supporting direct support professionals in enabling people with intellectual disabilities to engage in meaningful activities: protocol for the Meaningful Activities 4 All (MA4A) study based on the human-centred design process

INTRODUCTION

Meaningful activities (MA) have a positive impact on identity, well-being, participation and inclusion. Although people with intellectual disabilities (PID) depend on their direct support professionals (DSPs) to engage in MA, the DSPs need support which could enable them to offer more qualitative care and support.

METHODS AND ANALYSIS

To identify DSPs' needs, and to develop a tool/service, an innovative and iterative approach is developed, based on the human-centred design (HCD) process, combined with traditional qualitative and quantitative research methods. In the inspiration phase (needs analysis), in-depth interviews will be conducted in two day care centres in Flanders using an interpretative phenomenological analyses, one with a supply-driven approach and the other with a demand-driven approach, followed by a survey sent to all Flemish day care centres. In the ideation phase, the insights of phase 1 will guide a cocreation process (comprising a World Cafe, brainstorm and prototype sessions) with the DSPs, PID and other stakeholders. In the implementation phase, the solution will be tested in the two day care centres from phase 1 by means of living labs and a realist evaluation. By adopting this protocol, the functionality, quality, usability and acceptance are expected to increase. This protocol adopts all phases of the HCD process and shows the complementarity of HCD with traditional research methods. PID and the DSPs will benefit as the end result is truly grounded in their specific needs and wishes.

ETHICS AND DISSEMINATION

Ethical approval by the Ethics Committee of the University Hospital Ghent, Belgium (reference numbers: B670202042983 and PA2021-091). All participants will sign informed consent forms. Results of this study will be submitted for publication in relevant peer-reviewed journals and will be presented at relevant conferences.