A rising tide: the increasing age and psychiatric length of stay for individuals with mild intellectual disabilities.
Adults with mild ID now face hospital stays twice as long as before—prepare for extended support needs.
01Research in Context
What this study did
Researchers looked at every NHS admission for intellectual disability from 1998 to 2008.
They tracked age at admission and how long people stayed.
The focus was on adults with mild ID, not severe cases.
What they found
Total ID admissions dropped by half, but patients got older.
The big shock: mild ID stays doubled from 131 to 244 days.
Even as other stays got shorter, mild ID cases needed much more time.
How this fits with other research
Cohen-Almeida et al. (2000) showed adults moving from hospitals to community homes over 20 years.
The new data flips that story: mild ID adults now bounce back into hospitals for longer stays.
Pitchford et al. (2019) adds that older adults with ID have higher readmission risk for some conditions.
Eggleston et al. (2018) explains why: multiple health problems and many meds double death risk in this group.
Together, these papers show ageing adults with mild ID are getting sicker and staying longer.
Why it matters
If you work with adults who have mild ID, plan for longer hospital stays. Build extra transition time into behavior plans. Ask medical teams early about discharge dates. Start discharge planning on day one, not week ten.
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02At a glance
03Original abstract
BACKGROUND: It is unclear whether the substantial decline in number and duration of admissions for patients with intellectual disability (ID) have occurred uniformly over time with respect to age, gender, severity of disability, legal status and location of treatment. METHOD: A retrospective analysis of NHS (National Health Service) admissions for ID and use of NHS ID beds in England between 1998/9 and 2007/8. RESULTS: NHS admissions for ID halved from 37,736 to 18,091, and admissions with a primary diagnosis of ID to beds reduced by 71% from 21,866 to 6420. This reduction was most marked among children with the result that the average age of those admitted increased from 26 years to 36 years. Mean length of stay shortened except for mild ID where it increased from 131 days to 244 days (the median increased from 6 days to 32 days). There was an 18% reduction in the number of patients with ID who were legally detained to NHS facilities but a 170% increase in those to private facilities (from 202 to 545). CONCLUSIONS: The number of patients with ID admitted to NHS facilities, especially children, has fallen dramatically. There has been a marked shift towards legal detentions to private facilities. The most notable finding was the increased duration of admissions for those with mild ID, possibly indicating that substituting mainstream for specialist services for this group has had negative consequences.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01629.x