Exploring Choice, Home and Health Service Utilisation For People Ageing With An Intellectual Disability During A Time Of Housing Relocation And Transition

摘要

The study aims to understand if and how older people with an intellectual disability are involved in the decision to change place of residence, the relationship between this choice opportunity and choice in other areas of life and how both choice and moving impact on health service utilisation.National policy promotes the closure of congregated living for people with ID. For people who live with family, longer life expectancy presents different challenges in preparing for later life living arrangements. This context provides strong rationale for current study.The research design consists of three main elements; (i) a content analysis of relevant health and housing policies; (ii) a systematic review of healthcare utilisation models; and (iii) quantitative analysis of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA)The data analysis showed three types of moves made by IDS-TILDA participants – more restrictive, more community based and lateral moves (which represented the majority). The main drivers for change differed by type of move but the predominant stakeholder in these decisions was the ID service provider.In conclusion, the duality of home and health for people with ID was evidenced across the various elements of the analysis with the quantitative analysis demonstrating that people with ID continue to be excluded from decisions on major life events and transition points such as moving home, and that regardless of type of living arrangement and type of moves made by movers, that many older people with ID continue to have choice for everyday and key life decisions made by someone else. This has implications for future health and housing policy and the need for complementarity in policy development and implementation.