Care dependence and individual care provision.

The team looked at adults with intellectual disability. They asked which daily-living skills predict how much help each person needs.

They used logistic regression to test dressing, bathing, eating, and other ADL items. Profound ID was also entered as a predictor.

ADL skill level was the strongest sign of care dependence. Adults who could do fewer tasks needed more staff help.

People with profound ID were likely to need total care, but daily-living skills still mattered most.

Bauman et al. (1996) followed the same group for one year. ADL skills dropped after age 60, yet care hours stayed flat until age 70. The 1995 snapshot and the 1996 follow-up agree: ADL predicts need, but aging changes skill faster than support.

Lin et al. (2013) repeated the idea with 480 Taiwanese adults. Severe ID and low education again forecast low ADL scores. The pattern holds across cultures.

Amore et al. (2011) seem to disagree. In 989 older adults, mobility—not ID level—explained ADL scores. The two studies differ in age. For young and middle-aged adults, ID severity drives need; for seniors, mobility becomes the lever you can still train.

When you write an ISP, list each ADL the person can or cannot do. Those lines predict staff minutes better than IQ scores. Target dressing, toileting, and mobility first. Small gains there can shift the care ratio and free time for community goals.