The health practices and needs of two samples of older individuals wit
h mental retardation were examined and contrasted over a period of 5 y
ears. Their health status varied markdely, but most had poor health ma
intenance practices, and almost all had difficulty communicating with
health care providers. Those who lived in community residential facili
ties or relatives' homes usually had adequate health care provided for
them, whereas individuals who lived more independently had difficulty
accessing health care. There is a pressing need for health care advoc
acy programs to help prevent chronic disability.