Employment and attendance in day care centres for people with mild intellectual disabilities - do age, gender, functional level or hospital admissions matter?
Adults with mild ID who lack a functional test on file are mostly shut out of work and day programs—screen and register them.
01Research in Context
What this study did
The team looked at every adult in Norway who has mild intellectual disability. They asked who shows up for work or day programs and who does not.
They checked age, sex, if the person had a functional test on file, and any hospital stays. The data came from big government files, not a small lab.
What they found
Older men with no test on file were the least likely to attend work or day care. People who had both mental-health and medical hospital stays also stayed home more often.
In short, if the system has no record of your needs, you are nearly invisible.
How this fits with other research
Lancioni et al. (2011) saw the same age risk in the Netherlands. Their survey also found older adults with ID missing from community life.
Pitchford et al. (2019) add a twist: older adults with ID return to hospital more for some body systems. Anthony et al. (2020) now show those same hospital stays predict lower day-program use. The two facts link health and service access.
Prigge et al. (2013) warned that mild-ID hospital stays are growing longer. The new data say these longer stays may also pull people out of work routines.
Why it matters
If you serve adults with mild ID, screen for missing functional tests and fill the gap. One quick form can open doors to work, day programs, and better health tracking. Pair this with tight discharge plans after any hospital stay to keep clients from sliding out of services.
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02At a glance
03Original abstract
BACKGROUND: Workforce inclusion is an important political goal in many countries. However, nearly 70% of Norwegians registered with mild intellectual disabilities (IDs) are not registered employed or attending in day care centres. This study investigates the association between age, gender, functional level and hospital admissions with employment or attendance in public financed, community-based day care centres for adults with mild IDs in Norway. METHOD: This study is based on data from a linkage of the national population-based registries from 2013 to 2015: Statistics Norway (SSB), the Norwegian Information System for the Nursing and Care Sector (IPLOS) and the Norwegian Patient Registry (NPR). The sample consisted of 2370 adults registered with a mild ID, receiving disability pension in Norway, aged 18-67 years. Binary and multinomial logistic analyses, adjusted for age, gender, functional level and hospital admissions, were performed. RESULTS: In 2015, 45.7% and 19.6% of the samples aged 20-31 and 52-63 years, respectively, were registered as employed or in day care centres. Participation in day care is a public service registered in IPLOS, which requires registration of functional level, while attendance in employment support is registered in SSB, where functional level is not registered. Compared with people registered with a high functional level, the probability of being employed or in day care centres was lower for people without registration of functional level. People with hospital admissions were less likely to be employed, especially if they had both psychiatric and somatic hospital admissions. People were less likely to attend day care and open employment only if they had a combination of both types of hospital admissions. Attendance in day care centres was less likely for men than women. CONCLUSIONS: Older people with mild ID, without registered functional level (meaning not receiving public community-based services) and with a history of hospital admissions were significantly less likely to be employed or participate in day care centres. The clear association between not being employed or attending day care centres and not having one's functional level registered implies there is a need for increased focus on how to enhance work participation among people with mild IDs who are not within the system of receiving public services.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12709