Assessment & Research

Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ?

Stancliffe et al. (2016) · Research in developmental disabilities 2016
★ The Verdict

Adults with ID understand death less and fear it more than staff, so teach them about it plainly.

✓ Read this if BCBAs running adult day or residential programs.
✗ Skip if Clinicians who only serve young children or non-ID populations.

01Research in Context

01

What this study did

Researchers asked adults with intellectual disability about death. They compared answers to those of disability staff.

The team used a quasi-experimental design. They wanted to see who understood death better and who feared it more.

02

What they found

Adults with ID knew less about death. They had little knowledge of end-of-life planning.

They also feared death more than the staff. The gap was large and significant.

03

How this fits with other research

Cryan et al. (1996) saw the same fear pattern in youths with ID. Kids also showed more and younger-style fears.

Nijs et al. (2016) and Ohan et al. (2015) found large social-cognitive gaps in the same adult group. These studies show reading faces is hard; Faso et al. (2016) show grasping death is hard too.

Haider et al. (2013) mapped worse health and lower screening uptake. Together the papers paint a picture: adults with ID face many unseen risks.

04

Why it matters

You may assume clients do not think about death. This study says they do, and they are scared.

Add simple death-education and future-planning lessons to your adult programs. Use plain words, pictures, and role-play. When you ease fear, you boost self-determination and quality of life.

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Start a 5-minute ‘what happens when’ talk during morning group. Use a simple storyboard to show ‘alive vs. not alive’ and let clients ask questions.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
39
Population
intellectual disability
Finding
negative
Magnitude
large

03Original abstract

BACKGROUND: Adults with intellectual disability (ID) are thought to understand less about death than the general population but there is no available research demonstrating this. Further, the detail of any possible differences in understanding is unknown. METHODS: We compared the responses of 39 adults with mild or moderate ID and 40 disability staff (representing the general population) on (a) understanding the concept of death, (b) knowledge of and self-determination about end-of-life planning, and (c) fear-of-death. RESULTS: We found that adults with ID had a significantly poorer understanding of the concept of death, knew much less about and were less self-determined about end-of-life planning, but reported greater fear-of-death. CONCLUSIONS: We demonstrated, for the first time, the feasibility of assessing end-of-life planning and fear-of-death among adults with ID. The poorer understanding and lower levels of self-determination we found suggest that future research should develop and evaluate interventions to increase understanding and self-determination.

Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2015.11.016