SERVING THE UNDERSERVED
Mary C. Howell
In our society, people who are both mentally retarded and old tend to be poor, helpless, and unpopular. The intent of the Kennedy Aging Project was to pay attention--elegant, sophisticated, and also caring and empathetic attention--to the health and well-being of this relatively small but socially important group of people.
The World Health Organization proposes that health "is both a fundamental human right and a sound social investment. . .Ensuring access to the essentials for a healthy and satisfying life is a basic principle of social justice. . .Closing the health gap between the socially and educationally disadvantaged and the more advantaged in society necessitates a policy that improves access to health-enhancing goods and services, and creates supportive environments. Such a policy would assign high priority to underprivileged and vulnerable groups. 1
We regard this small group of citizens as socially significant precisely because it is doubly underserved: the mental retardation service system has only recently begun to consider the needs of clients who are old, and the "generic" geriatric service system has been inclined to exclude people who are labeled as mentally retarded. Thus, coming to know people who are both old and mentally retarded, understanding and broadcasting their service needs, and providing exemplary services (albeit on a very small scale) can be seen as responding to the call to provide well for citizens who are needy and underserved, and who can represent all who are needy and underserved in society at large.
People with mental retardation who are old are a diverse group. In any group of old people there is an expected diversity that derives from the broadening differences of their various experiences. It is a truism that "we grow more like ourselves" as we mature into old age.
In addition, the various intellectual deficits and physical impairments of those who are labeled as mentally retarded expand the