Now What? Intellectual and Developmental Disabilities


Older adults with intellectual and developmental disabilities can present clinicians, families, and caregivers with unique challenges related to appropriate assessment, treatment, and care. Providers need to develop the skills and sensitivity necessary to effectively treat these individuals. Adults with developmental disabilities are living longer with more meaningful lives. Within the past decade, advancements in medicine and public policy changes have provided clinicians with an opportunity to play a pivotal role in promoting, managing, and delivering care that supports a high quality of life for older adults with intellectual and developmental disabilities (ID/DD).

Many health care providers, people with disabilities, families, and caregivers are unfamiliar with the latest information about the age-related health issues that affect people with ID/DD. A need exists not only for more research in this area but also for disseminating information and for improved preventive strategies across the life span for adults with ID/DD. These strategies include targeted health education programs, appropriate screening, and community health promotion programs.

The number of adults with ID/DD aged 60 and older is projected to nearly double from 641,860 in 2000 to 1.2 million by 2030.  Adults with ID/DD are more likely to develop chronic health conditions at younger ages than other adults because of biological factors related to syndromes and associated developmental disabilities, limited access to adequate health care, and lifestyle and environmental issues. These adults experience higher rates of obesity, sedentary behaviors, and poor nutritional habits compared with the general population.

Panel of Experts

Dr. Anna Fisher serves as the Hillcrest Health Services health, quality, and nursing services education expert. She is responsible for the implementation of educational and quality improvement programs following the identification of clinical needs, competency exams, and supporting the need for high quality of care for diverse business lines that include assisted living, memory support, adult day services, home health care, palliative, hospice, post-acute, and skilled nursing care. 

Dr. Fisher is also an adjunct professor in the College of Arts and Sciences at Bellevue University and teaches in the Masters-Health Administration Program. She was awarded the prestigious Maenner Award for Professorship of the Year in 2012. In 2015, she received the APEX Award for Excellence in Health & Medical Writing by Nursing 2015, for an article she co-authored entitled, "Best Practices for Engaging Patients with Dementia."

Dr. Fisher is co-producer of the NET Connects series, Now What?, about elder care and dementia. The program series received a 2014 Nebraska Broadcasters Association Silver Award in the Service to Community category and a 2012 Nebraska Broadcasters Association Bronze Award of Excellence in the category of Service to Community.

Dr. Fisher is currently President of the Consortium of Dementia Alternatives and Vice President of the Montessori International School of the Plains. She is a certified dementia practitioner, licensed nurse, and holds an undergraduate degree in human resources, graduate degree in business management, and a doctorate in health administration.

 


Dr. Sarah Smith has an ambulatory Med-Peds practice at the Nebraska Medicine - Fontenelle location. She joined the Med-Peds faculty in 2014 and also staffs a resident clinic at this location. Dr. Smith graduated medical school from University of Nebraska Medical Center and completed her residency training in the combined Med-Peds training program at Tulane University in New Orleans, LA, where she also served as Med-Peds chief resident. Dr. Smith is board certified in both Internal Medicine and Pediatrics and is active in Maintenance of Certification in both disciplines.

Her interests included primary and preventive care for both children and adults, chronic disease management, and adolescent health. Dr. Smith is particularly interested in developing a Transition Clinic for young adults with special healthcare needs and is working closely with her other Med-Peds faculty, residents, specialists from several disciplines and advocacy groups to best develop this program.


Debbie Herbel currently serves as the ENCOR Agency Executive Director, Omaha’s largest and oldest program for people with developmental disabilities. She attended Missouri State University in Springfield, MO, receiving a Bachelor’s of Science degree in Psychology and a Secondary Education Degree specializing in Social Sciences. She attended Pittsburg State University in Pittsburg, KS, to obtain a Master’s in Health Care Administration.

Debbie has worked in a variety of positions working with people with disabilities, including 12 years with the State of Nebraska. Some of the responsibilities with the State included supervising the Aged and Disabled waiver, the Developmental Disability program, and the medically handicapped children’s program. She has worked as the Administrator for the State of Nebraska’s only private intermediate care facilities and Administrator of the State’s only private school tailored for students with autism located in Axtell, NE. Debbie has personal experience as a caregiver. At one time, she had a license for an adult family home where people with developmental disabilities live in her home.  One of the ladies who lived with them for 10 years had a diagnosis of Down Syndrome, and the last year she lived with them, was diagnosed with Alzheimer’s Disease.  They continued to care for her until the care became greater than they were able to manage. She subsequently moved into a care facility where she lived for another nine months and passed away. 


Terry Streetman is the Public Policy Manager for the Alzheimer’s Association Nebraska Chapter. He develops and executes the chapter’s lobbying and advocacy strategies at the state and federal level. Previously, Terry served as a Development Specialist for the chapter, coordinating fundraising events in Omaha, Lincoln, and statewide. Terry also serves as a board member for the ENCOR Foundation and is a member of the inaugural cohort of the Young Nonprofit Professionals Network of Greater Omaha Rising Leaders Institute.

Prior to joining the Alzheimer’s Association Nebraska Chapter, Terry served as Communications & Public Policy Manager for Michigan Nonprofit Association. He has also served on the board of the Alzheimer’s Association Michigan Great Lakes Chapter, co-founded the Young Professional Alzheimer’s Advocates of Lansing, and was a Young Alumni Council member and a Regional Alumni Network Coordinator for Bowling Green State University.

Terry is a proud alumnus of Bowling Green State University, graduating in 2009 with a Bachelor of Fine Arts in creative writing and a marketing minor and was named a 10 Under 10 Alumni Award honoree in 2017 for his achievements after graduating.


Janet Miller received a Master’s degree in Sociology and a Masters Certification in Applied Gerontology from the University of Nebraska at Omaha. The focus of both of her degrees was on persons with intellectual and developmental disabilities. She is an Affiliated Trainer in a dementia care curriculum offered through the National Task Group, part of the American Academy of Developmental Medicine and Dentistry (AADMD).  Janet is employed by the Munroe-Meyer Institute/University of Nebraska Medical Center.

Janet’s professional career has been directed in the field of developmental disabilities since the birth of her daughter, Jennifer, age 41, with Down syndrome who passed away from early onset Alzheimer’s disease in 2018.  Her present focus is dementia awareness as it relates to individuals with developmental disabilities.