Published online by Cambridge University Press: 19 May 2010
The present generation of older persons with developmental disabilities are survivors. They are also often referred to as pioneers. In effect though, they are persons who have no role models as they and others close to them anticipate the challenges of their later years of life.
For the first time in our nation's history, a significant number of older adults with developmental disabilities (DD) are living in community settings and turning to community-based physicians for care, but information to guide physicians is limited. According to the U.S. Centers for Disease Control and Prevention (CDC):
Developmental disabilities are a diverse group of severe chronic conditions that are due to mental and/or physical impairments. People with developmental disabilities have problems with major life activities such as language, mobility, learning, self-help, and independent living. Developmental disabilities begin anytime during development up to 22 years of age and usually last throughout a person's lifetime.
The CDC statement reflects the federal statutory definition of DD as codified in Public Law 106–402, The Developmental Disabilities Assistance and Bill of Rights Act of 2000. The federal definition notes that most individuals with DD will require special services, supports, and other forms of assistance throughout their lives. Mental retardation, now generally referred to as intellectual disability (ID), autism spectrum disorders, cerebral palsy, hearing loss, and vision impairment are among the most common DD.
In previous generations, only a small proportion of individuals with DD survived into older adulthood and they generally lived in large state institutions where physicians who were removed from mainstream health care systems managed their care.