Int J Disabil Hum Dev 2010;9(4):263–268 © 2010 by Walter de Gruyter • Berlin • New York. DOI 10.1515/IJDHD.2010.037 Review Aging people with intellectual disability in Israel Eli Carmeli 1 and Joav Merrick 2,3, * 1 Department of Physical Therapy, Sackler Faculty of Medicine, Stanley Steyer School of Health Professions, Tel Aviv University, Ramat Aviv, Israel 2 National Institute of Child Health and Human Development, Health Services, Office of the Medical Director, Division for Mental Retardation, Ministry of Social Affairs and Social Services, Jerusalem, Israel 3 Department of Pediatrics, Kentucky Children’s Hospital, University of Kentucky College of Medicine, Lexington, KY, USA Abstract The proportion of adults with intellectual disability (ID) who are in need of support with various aspects of personal care is already significant at age 40 years. The aim of this study was to learn about the personal, social, and health characteristics of older people with ID in Israel and to examine their needs and the solutions provided. A cross-sectional and nationwide study collected data about people with ID aged 40 years and older. Formal and informal caregivers were interviewed about medi- cal data and about their own characteristics and needs. The percentage of people with severe and profound ID was 29% and among those living with their families 21%, compared with 3% in hostels and small group homes. Differences in age distribution were found in the various housing settings. A sig- nificant correlation was found between the level of intellectual disability and the activities of daily living. As age increased, contact and involvement with family members declined. The use of medical services increased with age in all out-of-home settings. It is possible to compare the differential needs of dif- ferent age groups, which helps us understand the implications of aging for the populations in the various settings. Keywords: aging; intellectual disability; residential care. Introduction As has occurred within the general population, life expectancy for people with intellectual disability (ID) has increased considerably during the past decades with the result that many now reach old age (1, 2). This change has made it necessary to study the needs that arise as people with ID grow older, in order to develop services and solutions to meet needs that change with advancing age (3). Increased life expectancy means that the number of older people with ID is growing appreciably and this changes the age composition in all set- tings caring for this population. The goal of the study commissioned by the Ministry of Social Affairs and Social Services in Israel and conducted by Brookdale Institute (4) was to learn about the personal, social, and health characteristics of older people with ID in Israel and to examine their needs and the solutions provided through services for them and for family caregivers. Methods A cross-sectional and nationwide study collected data about people with ID aged 40 years and older living in out-of-home settings (residential care centers, hostels, and shared homes), and people with ID living with their families and employed in sheltered employment frameworks. Special attention was given to people with Down syndrome, because they have their own particular characteristics and their life expectancy is shorter than other people with ID. The data were collected from several ‘in-house’ sources such as caregivers, physicians, nurses, and informal caregiv- ers (family). Data were also collected, by means of in-depth interviews, from the service providers, managers of the rel- evant frameworks, and policymakers. The goal of the inter- views was to learn from the respondents’ perspectives about the needs of the population, the housing, employment, lei- sure, and health services provided and the extent to which the existing services meet this population’s needs. These in-depth interviews were conducted with 20 key people (4). Altogether, information was obtained on 794 people with ID aged 40 years and older (488 in residential care centers, 126 in sheltered community housing, and 180 living with their families), out of 3729 people with ID aged 40 years and older who received housing and/or employment services from the Ministry of Social Affairs and Social Services in 2004 (approximately 22%). After the data had been collected, three multidisciplinary focus groups were formed from across the nation (4). The focus groups were conducted with a range of profes- sionals, fieldworkers, care staff from social services, and family members in order to discuss the data and clarify the implications of the study with regard to developing solutions. Thus, the focus groups provided opportunities to collect data *Corresponding author: Professor Joav Merrick, MD, MMedSci, DMSc, Medical Director, Health Services, Division for Mental Retardation, Ministry of Social Affairs and Social Services, PO Box 1260, IL-91012 Jerusalem, Israel E-mail: jmerrick@zahav.net.il Received September 1, 2010; accepted September 30, 2010 Brought to you by | Stockholms Universitet Authenticated Download Date | 7/10/15 12:01 PM