ABSTRACT
Considerable attention has been paid in the literature to the topics of mortality and prevalence. Such statistics permit us to estimate the size of the service population, and to make projections of future changes. With regard to the population of elderly people, whether handicapped or non-handicapped, it is clear that any changes in the near future are going to be in the direction of increasing numbers rather than reductions. As Jacobson, Sutton and Janicki (1985) point out, increases in the size of the service population present potential crises for human service systems. Increases in the absolute size of the elderly population will require a corresponding increase in the allocation of resources, and it is essential that such changes are made in time to meet the needs. In this respect, changes in the allocation of resources to older people with mental handicap deserve particular attention. At the present time, about 90 per cent of older people with mental handicap live in institutions of one sort or another. This compares with a figure of about 5 per cent for non-handicapped people (Blake, 1981). Institutional care is expensive, so it is not surprising that service providers are anxious to shift the burden of care onto the community where possible, which usually means the client’s immediate family (Finch and Groves, 1980; Walker, 1981). For people with mental handicap, this shift to community care is a relatively new phenomenon. The novelty of this process, coupled with the fact that a large proportion of people with mental handicap are now surviving to old age, presents considerable uncertainty for the level of future service provision. What is clear, however, is that the number of elderly clients is increasing, and that this group of people probably represents a population who are particularly vulnerable to institutional admission or readmission due to the impact of functional impairments related to the process of ageing (Jacobson et al., 1985). It is thus vitally important to make the best possible projections of client numbers and predicted longevity.
