title: Knowing, planning for and fearing death: Do adults with intellectual disability and disability staff differ?
abstract: BACKGROUND
  Adults with intellectual disability (ID) are thought to understand less about death than the general population but there is no available research demonstrating this. Further, the detail of any possible differences in understanding is unknown.
  
  
  METHODS
  We compared the responses of 39 adults with mild or moderate ID and 40 disability staff (representing the general population) on (a) understanding the concept of death, (b) knowledge of and self-determination about end-of-life planning, and (c) fear-of-death.
  
  
  RESULTS
  We found that adults with ID had a significantly poorer understanding of the concept of death, knew much less about and were less self-determined about end-of-life planning, but reported greater fear-of-death.
  
  
  CONCLUSIONS
  We demonstrated, for the first time, the feasibility of assessing end-of-life planning and fear-of-death among adults with ID. The poorer understanding and lower levels of self-determination we found suggest that future research should develop and evaluate interventions to increase understanding and self-determination.
authors.affiliation: The University of Sydney, Centre for Disability Research and Policy, Australia. Electronic address: roger.stancliffe@sydney.edu.au.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Stancliffe
authors.affiliation: The University of Sydney, Centre for Disability Research and Policy, Australia. Electronic address: michele.wiese@sydney.edu.au.
authors.forename: Michele Y
authors.initials: MY
authors.lastname: Wiese
authors.affiliation: School of Nursing and Midwifery, Keele University, UK. Electronic address: s.c.read@keele.ac.uk.
authors.forename: Sue
authors.initials: S
authors.lastname: Read
authors.affiliation: Sunshine, Sydney, Australia. Electronic address: gailjeltes@sunshinelgd.org.au.
authors.forename: Gail
authors.initials: G
authors.lastname: Jeltes
authors.affiliation: HammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, Australia; The University of Sydney, Northern Clinical School, Sydney, Australia. Electronic address: josephine.clayton@sydney.edu.au.
authors.forename: Josephine M
authors.initials: JM
authors.lastname: Clayton
mesh_terms: D000328:Adult; D032722:Advance Care Planning; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D016022:Case-Control Studies; D032882:Comprehension; D005239:Fear; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013727:Terminal Care
keywords: Death; End-of-life; Fear-of-death; Intellectual disability; Planning; Staff