Aging people with intellectual disabilities in need of care: challenges, strategies, and consequences for special housing in Germany

Abstract

Objective While the increasing life expectancy of people with intellectual disabilities is a positive development, it also means that special housing for people with intellectual disabilities has to adapt to meet age-related needs. Method This qualitative study analyzes the decision-making processes of staff in special housing facilities for people with intellectual disabilities in Germany regarding care and housing options as these people age and their care needs increase. Results Drawing on 18 interviews with staff, the study describes the challenges that arise as age-related decline increases and behavioral changes manifest, leading to what we call ‘care boundary’. Using a Grounded Theory approach, the study constructs a theoretical framework of the dynamics between challenges, care boundaries, action strategies, and consequences, especially with regard to the decision of people remaining in special housing or having to move to a nursing home. The study underscores the critical role of staff in navigating these challenges and outlines two primary action strategies: ‘compensating’ adaptations within the existing care context and ‘cooperating’ entailing strategic collaboration with external care providers. Conclusion These insights have implications for the future design of care and support systems for aging individuals with intellectual disabilities in special housing settings and beyond.