Community Health Care for Adults and Elders with Developmental Disabilities Research and Training A Project of the University Center for Excellence in Developmental Disabilities (UCEDD) funded by the Washington State Developmental Disabilities Council (DDC)
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Promoting Healthy Care for Adults and Elders with Developmental Disabilities

Doug Cook, PhD, Director: Program for Adults and Elders
Center on Human Development and Disabilities (CHDD)
University of Washington, Box 357920 - Seattle WA 98195

DEMOGRAPHICS

• Definition of Developmental Disabilities
• Population Estimates
• Washington State Caseload

DEFINITION OF DEVELOPMENTAL DISABILITIES

• A person who has at least one of the following conditions:
  • Mental Retardation
  • Cerebral Palsy
  • Epilepsy
  • Autism
  • Neurological conditions similar to mental retardation
• Disability must occur before age 18;
• Disability must be expected to continue indefinitely; and
• Disability must result in a substantial impairment

POPULATION ESTIMATES FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES

• Estimates are 1.2% of Total US Population.
• Population is Aging--e.g., Increased Life Expectancy

WASHINGTON STATE CASELOAD:INDIVIDUALS IDENTIFIED BY DIVISION OF DEVELOPMENTAL DISABILITIES (DDD)
Caseload in: 1990 2000 2003
Total: 14,879 28,303 32,004
0-21 years: 5,994 16,187 0-17 yrs: 13,470
22-34 years: 4,426 5,807
35-44 years: 2,292 3,990
45-54 years: 1,145 2,567
55-64 years: 579 1,175 18-64 yrs: 17,775
65+ years: 434 712 759
Unknown: 2 15

POPULATION ESTIMATESof Persons with Developmental Disabilities(BASED ON 1.2% OF TOTAL CENSUS)

• United States-2002 Estimate
  3,460,424 (3 1/2 million)
• Washington State-2002 Estimate
  72,828 (73 thousand)

WHERE DO PEOPLE WITH DEVELOPMENTAL DISABILITIES LIVE?

• Deinstitutionalization began in the 1960’s.
• Few individuals still live in institutional settings where they traditionally received health care.
• Currently, the majority of people with developmental disabilities live in the community.

Institutional LivingResidential Habilitation Centers (RCHs)

Graph showing the number of caseloads ranging from 0 - 3,000 during the years from 1977 to 2003.

Community Living includes family and individual residences, adult family homes and group homes

Graph showing the number of caseloads ranging from 0 - 35,000 during the years from 1990 to 2003.

Community LivingJune 2003

2003 Washington State population estimate residential breakdown

DEVELOPMENTAL DISABILITIES AND AGING

• Adults and Elders with Developmental Disabilities experience many of same changes as general population.
• Generally they need the same information and support.
• Potential differences include:
• Smaller social network and fewer long-term friends
• Fewer skills to maintain or create relationships
• Difficulty identifying and/or expressing sadness or grief
• Less routine and less skilled medical care
• Less angst about “the meaning of life”

Changes include a high incidence of:

A Psychosocial Perspective on Aging

• A psycho-social perspective has four elements:
  • An awareness of our own aging.
  • An awareness of the psychosocial (social, emotional and spiritual) changes that occur with aging.
  • An awareness that we can take better care of ourselves if we make this a priority and we are positively reinforced.
  • An awareness of the experiences of older people with developmental disabilities.

General Psychosocial Changes That Come With Aging

• Social Changes
  • roles and responsibilities change
  • routines can become less varied and less flexible
  • social networks become smaller

General Psychosocial Changes That Come With Aging

• Emotional Changes
  • Family and old friends become more important
  • More acceptance of their lives (or despair)
  • Increased isolation can lead to
  • Increased depression

The Opportunity Of Health Promotion

• Most of the medical and psycho-social issues that come with aging can be prevented, postponed or alleviated through health promotion strategies
• Optimal health has five aspects:
  • A social life that emphasizes interactions among friends, family and community.
  • An intellectual life that emphasizes continued learning, career development and personal achievement.
  • A spiritual life that focuses on hope, love, charity and purpose in life.
  • A physical life that emphasizes fitness, good nutrition,
    medical self care and control of substance abuse.
  • An emotional life that emphasizes good mental health and stress management.

HEALTH PROMOTION STRATEGIES HAVE THE FOLLOWING GOALS

• Promote health and wellness
• Prevent disease
• Postpone further disability

DEFINITION OF HEALTH PROMOTION

The maintenance and enhancement of existing levels of health through the
implementation of effective programs, services and policies.

Updated 02/7/05

Copyright © 2002 by University of Washington. Permission is granted to copy all materials written by the University of Washington for educational, noncommercial purposes provided the source is acknowledged. See Copyright Statement for more information