Living Arrangement Options

This chapter outlines some of the key issues and research evidence regarding residential living options for older individuals who have intellectual or developmental disabilities (IDD). The United Nation’s Convention on the Rights of Persons with Disabilities defends the right of individuals with disabilities to choose where and with whom they live, on an equal basis with others. For many, especially those with intellectual and developmental disabilities (IDD) who are ageing, challenges abound in exercising this right. The growing life expectancy experienced by this population has not been supported by clear policies on residential supports for ageing individuals. Internationally, no clear consensus has emerged on whether age-related needs of older individuals with IDD should be addressed by the disability sector, the ageing sector, or both. A lack of clarity is also evident in whether ageing in place, endorsed in many international charters for the general population, is an appropriate and feasible policy for those who have IDD. The ageing in place concept is complicated for older individuals with IDD as notions of ‘home’ have different application within the disability field, for example, living with ageing parents within the family home or living in multiple housing options provided by state or third sector organisations. Some providers support a policy of ‘in place progression’ where individuals with significant age-related needs, typically late-stage dementia, are moved to specialised environments supported by trained staff. More controversial is the policy of ‘referral out’ where individuals are moved to mainstream aged care, also termed senior/older persons or nursing home care. The atypical profile of older persons with IDD presenting at these facilities, combined with evidence of lower quality outcomes and lower cost suggests that ageing in place should be the preferred option.