Discuss how the needs of the elderly learning disabled can be met.

• the population is getting older as a whole
• implications for the provision of healthcare
• in old age, there are a number of age-related cognitive changes:
• drop in performance IQ
• decision-making skills decline
• information retrieval is impaired
• questions whether people with learning disability are particularly prone to age-related problems
• life-expectancy has increased in the last 100 years
• in normal adults, it is approximately 75 years
• the life-expectancy of Down's syndrome 100 years ago was less than 10 years, now it is closer to 50 years
• life-expectancy is shorter for those with more severe learning disability

• needs, predictably, depend on where on the spectrum the person is
• as a group, functional ability improves in later life due to differential mortality rates leading to a shorter life expectancy for people with more severe LD (and Down's syndrome)
• predictions about future needs are difficult due to the potential cohort effects of improved childhood survival and changes in education, etc. (1971 Education Act)

Patel et al (1993):

• used PAS-ADD
• patients aged 50 years or over
• 12% had psychiatric disorder (mainly depression and anxiety)
• 12% had dementia
• special case of dementia:
• if lives are undemanding, then functional decline may go unnoticed
• any changes may get attributed to the learning disability
• personality and behaviour changes in association with evidence of a functional change are probably the most important features

• without work there can be no retirement - lack of life stages in the learning disability population
• there is a consequent failure to recognise and plan for 'retirement' and to provide the necessary change in lifestyle
• death of friends, carers, and family members puts added stresses on the person
• also the potential for loss of knowledge about the past experiences of the person with LD
• use of life story books
• bereavement can be associated with significant behavioural and emotional changes, which may go unrecognised, or be attributed to the learning disability

1. the social care environment should be responsive to the changing needs and social circumstances of later life
2. establishment of links with other services for older people, e.g. day hospitals
3. availability of health professionals familiar with age-related health problems, and also age-related psychiatric problems, such as dementia
4. acknowledgement of the emotional needs of people with learning disability
5. support for carers
6. retaining knowledge of their past and families