Elder Abuse and Older Adults with Intellectual and Developmental Disabilities
Photo: Borya, Creative Commons
“Disability” is a word frequently associated with aging. Many adults age without developing significant physical or cognitive disabilities; however, most older adults do experience changes in their functional capacities. In a society that prizes independence and idolizes the idea of being able bodied (having reasonable vision, hearing, physical mobility, and cognitive function), a fear of losing one’s capacities, of becoming disabled, is an important component of ageism.[1]
Stigma around disability transcends aging. Children and adults of all ages who live with disabilities are routinely subjected to increased rates of bullying, discrimination, and violence compared to people without disabilities.[2] Additionally, people with disabilities often have worse health outcomes and are more likely to fall into a low-income threshold. [3] A great deal of the advocacy to address these disparities is driven by people with intellectual and developmental disabilities (IDD) and their families.
Definitions vary by agency, organization and researcher, but as federally defined, IDD are “chronic impairments that occur before age 22 that may affect functional abilities in matters of self-care, learning, mobility, language, economic self-sufficiency, capacity for independent living, and other everyday skills.”[4] Some causes of these impairments include genetic conditions, pregnancy complications, and physical and/or brain trauma experienced during childhood or adolescence. While disability service providers have developed programs to address the trauma of abuse and exploitation for younger victims with IDD, more needs to be done for older adults with IDD.
Why does this matter for elder abuse professionals?
As noted in the American Association on Intellectual and Developmental Disability’s (AAIDD) Position Statement on Aging, “disability-based organizations have historically not planned for the challenges faced by older people with intellectual and/or developmental disabilities and are not prepared to address these unique needs, including providing education and training on mitigating the risk of elder abuse and neglect for a potentially more vulnerable population of older people.”[5]
The absence of such programming is not a simple oversight. Historically, individuals with IDD did not survive into old age. Advances in medical knowledge, improved access to healthcare and other services, and advocacy supporting community-based care for people with IDD has changed that; an estimated 523,000 to 1 million people with IDD are now 60 years and older.[6] AAIDD also notes that this service gap is two-sided: “many community-based services for senior citizens are not prepared to meet the special needs of older adults with intellectual and/or developmental disabilities,”[7] leaving this population particularly underserved and at-risk.
What can we do? Here are actions elder justice professionals can take to better serve older adults with IDD who are at risk of being abused:
- Deepen collaborations between the disability and aging communities in all states and localities. Aging and Disability Resource Centers (ADRCs) are federally funded programs designed to help communities better respond to the needs of older adults and individuals with disabilities looking for long-term services and supports (e.g., help at home, nursing home placement, benefits enrollment). Each state has developed its own version of the program (in New York, the ADRC is known as New York Connects and is run jointly by the State Office for the Aging and the State Department of Public Health). ADRCs offer natural opportunities for increased collaborations among the disability and aging communities.
- Provide training for Office of Persons with Developmental Disabilities (OPWDD) workers and vice-versa to help professionals in both worlds better identify risk factors for abuse in vulnerable populations. In New York, individuals with IDD are served by the OPDWW system and OPWDD staff members occasionally attend NYC Elder Abuse Center Multidisciplinary Team meetings when a person involved in an MDT case is (or potentially could become) a OPWDD client. Experts suggest that many people aging with IDD may not yet be part of the disability supports service system.[8]
The aging and disability networks have an incredible amount of common ground that is ripe for collaborations. Above all, efforts should be made by elder abuse professionals to establish relationships and begin conversations with those who serve people with IDD.
What do you think your community could do to better ensure older adults with IDD have access to elder abuse services? Are there ways that we, as a united field, can strengthen our responses to serving older adults with IDD? Please share your thoughts in the below comments section.
By David Lachs, NYCEAC 2016 Risk and Resiliency Internship Project Intern, who is currently an undergraduate student at New York University (NYU).
Edited by Sarah Dion, formerly NYCEAC’s Program Assistant, who is currently a first year medical student at the University of Cincinnati College of Medicine.
[1] This fear relates to both how ageism is perpetrated against others and against ourselves; we not only fear the notion of others becoming more dependent, we fear the potential of our future selves experiencing physical or mental decline.
[2] Arc PDF about discrimination and violence.
[3] The poorer health outcomes of individuals with disabilities in some cases are tied to the underlying conditions of their disability. However, increased rates of poverty, worse access to health care, limited research on the development and treatment of diseases in people with disabilities and a tendency for healthcare providers to dismiss health complications as inevitable or as a result of a person’s disability are all aggravating factors that could be targeted for improvement.
[4] Ansello, O’Neill JEAN 2010
[5] https://aaidd.org/news-policy/policy/position-statements/aging#.WSJAVRMrKRs
[6] Hammel and Nochajski 2000; Fujiura, 2002; Janicki & Ansello, 2000.
[7] https://aaidd.org/news-policy/policy/position-statements/aging#.WSJAVRMrKRs
[8] From Ansello, O’Neill JEAN 2010, which discusses “invisible elders” who have never engaged with the disability supports system, potentially because their families feared institutionalization or further marginalization by becoming associated with a formal system.
