Grief experiences of older Chilean adults with intellectual disabilities: “It still hurts inside”

BACKGROUND: Although death and grief are universal experiences, older adults with intellectual disabilities have historically been excluded from mourning, due to assumptions about their capacity. This study explores how they experience and express grief after the loss of close individuals. METHOD: Based on qualitative data from semi-structured interviews with 92 older adults with mild to moderate intellectual disabilities residing in long-term care facilities in Chile, a reflexive thematic analysis was conducted to identify key themes. RESULTS: Five main themes emerged: emotional awareness of loss; diverse expressions of grief; disenfranchised mourning; environmental and relational disruptions; and the role of supports. Participants demonstrated symbolic, somatic, and relational ways of processing grief, despite structural and communicative barriers. CONCLUSION: Findings underscore the need to recognise and support the grieving processes of older adults with intellectual disabilities through inclusive practices, communicative supports, and accessible rituals that honour their emotional and relational needs.