CHAPTER 11 Providing Care for Older People with Learning Disabilities Eleni Hatzidimitriadou and Alisoun Milne OVERVIEW Changes in lifestyle, improvements in care and better access to medical treatment have resulted in increased longevity among people with learning disabilities. Despite wider recognition of this ‘new’ older population by policy-makers and service providers, the needs arising from the cumulative challenges of ageing with a learning disability have yet to be fully understood and addressed. In this chapter, the authors explore the care implications of growing older with a learning disability, offer an overview of the main age-related needs and discuss the service context of their care. They also highlight the needs of family carers. The key challenges facing service provision are also explored and a number of recommendations made, focusing particularly on the development of effective and safe intimate and personal care. INTRODUCTION Old age has only recently been conceptualised as a distinctive life stage for people with learning disabilities. Enhanced longevity is a consequence of changes in lifestyle, improvements in care and better access to medical treatment (Herr and Weber 1999; Tinker 1997; Victor 1997). For the learning disabled population as a whole, life expectancy has increased from 20 years in 1930 to 70–74 years in 1990 (Foundation for People with Learning Disabilities 2002). The greatest increase has been among people with mild learning and physical disabilities – mainly women (McDonald 2002). Life expectancy of people with Down’s Syndrome has increased spectacularly with over 40 per cent now 160