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

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.