Self-determination in later life: Insights from the voices of older adults with intellectual disabilities in Chilean context

Abstract

Background: Although disability rights have expanded, ageing continues to impose relational and structural barriers that restrict self-determination among older adults with intellectual disabilities, especially in Latin American contexts. Method: This study explored the experiences of self-determination among older adults with intellectual disabilities living in community settings in Chile. A qualitative, exploratory design was applied. Semi-structured interviews were conducted with 105 participants aged 45–85 years from family homes, day centers, and supported living programs. Data were analysed using reflexive thematic analysis guided by the Theory of Causal Agency. Results: Participants reported highly variable opportunities for daily decision-making. Respectful listening, communicative accessibility, and flexible supports fostered emotional well-being and motivation, while rigid routines, overprotection, and communication barriers constrained autonomy. Conclusions: Self-determination in later life is relationally and structurally mediated. Strengthening individualized, consistent decision-making opportunities is essential to promote dignity, agency, and social inclusion among ageing adults with intellectual disabilities.