Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study.

BACKGROUND: POMONA II was a European Commission public health-funded project. The research questions in this article focus on age-specific differences relating to environmental and lifestyle factors, and the 17 medical conditions measured by the POMONA Checklist of Health Indicators (P15). METHOD: The P15 was completed in a cross-sectional design for a stratified sample of 1,253 adults with ID across 14 European member states. RESULTS: Older people (55+) were more likely to live in larger residential homes. Rates of smoking and use of alcohol were lower than in the general population but were higher with older age. More than 60% of older adults had a sedentary lifestyle. Cataract, hearing disorder, diabetes, hypertension, osteoarthritis/arthrosis, and osteoporosis were positively associated with advancing age; allergies and epilepsy, negatively associated. CONCLUSIONS: Some evidence of health disparities was found for older people with ID, particularly in terms of underdiagnosed or inadequately managed preventable health conditions.

Characteristics, supports, and quality of life of Irish adults with intellectual disability in life-sharing residential communities.

BACKGROUND: Few empirical studies have compared quality and outcomes for residents with intellectual disability across intentional communities such as those organised by the Camphill communities in Ireland. METHOD: Using a multi-element research protocol developed for an earlier large study, data were gathered about the characteristics of N = 29 participants living in life-sharing residences organised by Camphill, management procedures, and outcomes for residents. Comparable data were available for N = 125 adults in group homes or campus residences. RESULTS: Camphill residents reported a smaller size of household, higher staffing ratios, homely living areas, low levels of institutionalised practices such as social distance, reciprocal relationships with houseparents, and well-developed management procedures, as well as less choice, but were not found to be better on a range of other objective measures. CONCLUSION: Although modest in scale, present findings suggest that the value of applying distinctive benefits of life-sharing communities in more typical residential settings for people with intellectual disability should be investigated further to inform current policy debates.

Health indicators and intellectual disability.

PURPOSE OF REVIEW: Health disparities are evident between people with intellectual disabilities and the general population. Despite the potential of indicators for measuring disparities and planning interventions to address inequalities- currently a priority health policy target- few studies have mapped the physical or mental health of people with intellectual disabilities onto the growing territory of health disparities, health information systems and health indicators. This review summarizes recent publications about the role of indicators in gathering optimal health information on behalf of this segment of the population. RECENT FINDINGS: Studies related to measures of the health of people with intellectual disabilities are presented in three sections: information captured in general population surveys; measures of health status of people with intellectual disabilities at country and regional levels; and their use of healthcare systems. The work of the Pomona group of European partners who have devised and applied a set of health indicators specifically for people with intellectual disabilities is presented. SUMMARY: Health indicators yield data to identify health conditions, plan interventions and compare populations or segments of the population. It is suggested that better definitions, measures and surveillance will yield comparable information to inform public health policy and clinical practice.

Communication among nurses and adults with severe and profound intellectual disabilities: predicted and observed strategies.

This study explored communication strategies adopted by staff nurses in a residential centre in Ireland for persons with severe and profound intellectual disabilities. Interactions between staff nurses and service users were video recorded and analysed to determine the frequencies of verbal and non-verbal communication acts. Semi-structured and focus group interviews were carried out with the 10 participating staff nurses. Participants identified staff-related factors, the communicative environment, alternative methods of communication and choice as key elements in communicating with service users. No differences were observed in the frequency of verbal and non-verbal communicative acts. There was a discrepancy between what communicative acts the participants named as their preferred strategies and those observed when they interacted with service users. Most failed to adjust their language to meet service users' needs. The findings suggest that staff nurses do not always adopt optimal strategies in everyday interactions with individuals who use non-verbal communication. Continuing education in communication is recommended.

Ageing and health issues in intellectual disabilities.

PURPOSE OF REVIEW: This review summarizes recent research and evidence-based practice and policy guidelines from 31 articles or books focused on the health of ageing individuals with intellectual disabilities. RECENT FINDINGS: Findings are presented under four headings that correspond to categories of health measures applied in recent EU evidence-based public health documents. Large group studies, notably longitudinal studies, have advanced knowledge of the health-related attributes of the population of older adults with intellectual disabilities and their distinctive health risks, including those linked to aetiologies. Empirical studies applying various research designs and literature reviews presented findings about weight and levels of physical activity, prevalent health problems (e.g. high levels of sensory impairment, risk factors for coronary artery disease) and other aspects of the health status of this population. Efforts to improve assessment methods for dementia continue. Evidence from small group studies in Israel and the USA suggests that interventions to increase physical activity and functioning of older adults may be beneficial. Pharmacological studies consider treatments for dementia as well as widespread prescription of medications to manage challenging behaviours. Health system issues include access to health care, training for health professionals, support for family care givers, end of life care and more cohesive national health policies. SUMMARY: Health-related research in older people with intellectual disabilities has extended our understanding of the characteristics of this population relative to other groups of older individuals and to national populations in terms of health status, determinants of health and priorities for policy and practice.

Retreat and resilience: life experiences of older women with intellectual disabilities.

Older women with intellectual disabilities remain the least studied and understood members of the disability population, and yet they often live well into late adulthood. In this exploratory study we used extensive interviews to examine the demographics, economic and personal safety nets, health, social roles, and well-being of 29 Irish and American older women with intellectual disabilities. Results suggest that these women have very limited resources, social networks, and opportunities. All the women were poor and most lived in group residences, with paid staff as their main allies and careproviders. They reported that their health was good, though it often limited their activities. Despite their societal limitations, these women reported this is the happiest period of their lives.

Health indicators for people with intellectual disabilities: a European perspective.

People with intellectual disabilities make up about 1% of the population of Europe. As trends toward community life advance, they have become more visible and more likely to access generic health systems. Yet evidence suggests that there are striking disparities between the health of this group and that of the general population. Increased longevity means that adults in this group expect to live longer lives and thus to encounter age-related risks for various health conditions. The 'Pomona' project, funded by the EU Health Monitoring Unit, aims to develop a set of health indicators for people with intellectual disabilities. It will build on the work accomplished by the team developing ECHI--European Community Health Indicators. This article outlines the rationale for the project, key elements in its implementation and expected outcomes.