Background Individuals with intellectual disabilities (I.D.) who are not accessing any specialist services are a vulnerable group, especially with advancing age. In Ireland, the National Intellectual Disability Database (N.I.D.D.) records the current and future service needs of people with intellectual disabilities, as well as those individuals who are not in receipt of services.

Methods This two-part study firstly used the N.I.D.D. to look at the number and characteristics of those older individuals outside services. Following this, a questionnaire was developed to examine the contact and assessment procedures practised with people who are listed on the N.I.D.D. as not requiring any specialist service.

Results Analysis of the database showed that 7.5% of people on the N.I.D.D. with moderate, severe or profound I.D., over the age of thirty and living at home with family were awaiting, or were not in receipt of specialist services. For these people not accessing any services, the questionnaire responses highlighted poor assessment practices including significant periods of time passing between contacts with the individual and limited contact regarding service planning.

Conclusions Specialist services need to be more pro-active in engaging vulnerable older individuals in services. A standardised approach needs to be developed in the assessment and monitoring of individuals and families refusing services.