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Chronic conditions & lack of symptoms | Depression | Psychotic disorders
Mental retardation/developmental disability

A developmental disability is associated with many conditions that originate prior to birth, at birth, or in early adulthood, but the primary disability is intellectual. Developmental disability presents with varying degrees of intellectual deficiency, as well as other physical and/or sensory incapacities and health risks (National Advisory Council on Aging, 2004). As a result of progress achieved in medical science and health care, persons with developmental disabilities now have a life expectancy that extends beyond mid-life.

Older adults with developmental disabilities have the same prevalence of sensory, visual, and auditory impairments as the general older adult population; however, the degree of impairment may be more severe due to preexisting problems or undiagnosed conditions resulting from the older person’s inability to clearly communicate needs. Physical changes that more severely affect older adults with a developmental disability include loss of flexibility, as age-related changes in joint function and bone density combine with their existing mobility problems; in addition, they may be more prone to arthritis at an early age (National Advisory Council on Aging, 2004). Severe physical and sensory impairments coupled with inability to clearly communicate, increase the risk of nonadherence in older adults with developmental disabilities.

Caregivers of developmentally disabled adults play a crucial role in providing emotional, functional, and instrumental support, including managing medications. Two factors have changed the role of caregiving for adults living with developmental disabilities: the deinstitutionalization movement over the past decades, and the increased longevity of developmentally disabled adults. Many parents in their eighties or nineties may find themselves caring for a developmentally disabled “child.” Siblings, usually a sister, may have assumed the primary caregiving role. With this demographic change, adherence messages and support should focus on the caregiver.