Older adults with lifelong intellectual handicap in New Zealand: prevalence, disabilities and implications for regional health authorities.

AIM: To find and describe the total population of persons in New Zealand born before 1940 with lifelong intellectual disability and to provide health and services data for regional health authorities. METHOD: An intensive community based case finding process identified 197 (19%) people not known to the two major service producers, the public hospitals and New Zealand Society for the Intellectually Handicapped (IHC). Prime caregivers provided information about personal characteristics, health status, and services utilisation and needs. RESULTS: One thousand and sixty-three people with lifelong intellectual disability were identified and surveyed. Forty two percent lived in public hospitals, 7% with family, 13% in rest homes and 38% in community based facilities. The national prevalence was 1.43 with wide regional variation. Prevalence in Southern RHA was 2.34, in Central 1.76, in Midlands 0.70 and in North Health 0.87. The age range was 51 to 88, with 56% aged between 51 and 60 years, 32% between 61 and 70 and 12% over the age of 71 years. Twenty three percent had no major condition, disability or disease, 28% had some unspecified neurological impairment, 4% cerebral palsy, 13% Down's syndrome, 17% epilepsy, 21% musculoskeletal impairment, 14% cardiovascular disease and 25% a psychiatric diagnosis. A significantly higher number of physical disabilities was found in people living in hospitals, including 15 of the 17 blind people and 41 of the 53 people with mobility problems. There was wide variation among RHA areas in demand for therapeutic services, community and social support services. CONCLUSION: Past policies and practices of hospitalization have impacted on the present distribution of the study group. The services system must now accommodate regional differences and characteristics of this population and new demands to achieve goals of community integration.

Report of a national survey of older people with lifelong intellectual handicap in New Zealand.

This paper reports on a national project to investigate the numbers, health status and service needs of people with mental retardation born before 1940. A prevalence of 1.43 per thousand was established nationally, with wide regional variation. Intensive local case finding produced 19% of the study group, not otherwise known to service agencies. In 1990, 42% of the population resided in institutions, 7% with family, 13% in rest homes, and 38% in community-based residential facilities. Of 1063 cases identified, 13% were people with Down's syndrome, 25% were identified as having a psychiatric diagnosis and 17% as having epilepsy, but 23% had no major disability. About 32% had visual problems, 40% had weight problems and 75% received regular medication. Seventy-five per cent have at least occasional contact with their families. The service system is in the process of change as a result of shifts in public policy, responsibility and funding. Personal interview data, reported elsewhere, demonstrated the desire and ability of the people concerned to be included in these decisions. Major needs identified were therapeutic services, medical care, community and recreational services, and support for families. Research areas recommended as priorities are consensus classification and definition of the population, identification of patterns of ageing among different subgroups, and studies of public policy.

Summary of national survey of older people with mental retardation in New Zealand.

The present paper is a summary of a national project to investigate prevalence, health status, and service needs of people with mental retardation born before 1940. In 1990, 42% of this population resided in institutions, 7% with family, 13% in nursing homes, and 38% in community-based residential facilities. Of 1,063 identified, 135 had Down syndrome, 25% had psychiatric diagnosis, 17% had epilepsy, and 23% had no major disability. About 32% had visual problems, 40% had weight problems, and 75% received regular medication. Of this population, 75% had at least occasional contact with their families. Major needs identified were medical care, community, and recreational services.