Intellectual disability and ageing: ecological perspectives from recent research.

Hogg (1997) looked at every recent paper on adults with intellectual disability who are growing old. The author wrote a narrative review. He argued that single-factor models miss the big picture. Instead, he said, we should view ageing through an ecological lens. That means we map the person, the family, the service system, and policy all at once.

The paper did not test one program. It found that family carers sit at the center of the ecological web. When carers age or step back, supports can collapse. The review says multi-level assessment is the only way to plan ahead.

Llewellyn et al. (2010) later surveyed older parent-carers in Australia. Their data back the ecological claim: carers rely on their own coping and rarely ask for help. Berkovits et al. (2014) gave us a tool that fits inside the model. A 51-item frailty index predicts how much care an adult with ID will need three years later. Heald et al. (2020) showed the danger of ignoring system-level factors. Older cancer patients with ID saw specialists half as often and died at home more than in hospital. Kim et al. (2025) moved the same ecological frame into research itself. They show how to include adults with ID as study partners by adjusting supports at every level.

If you serve adults with ID who are 50-plus, stop running single-domain assessments. Add a frailty screen, interview the carer, and check service gaps before crisis hits. Map all levels in one plan. That is the ecological move from narrative to action.