Co-Designing with Multi-Level Stakeholders as a Universal Design Strategy for Restructuring Long-Term Services and Supports for Persons Aging with Intellectual Disability

This paper presents the methodological framework of an ongoing doctoral research project in Bergamo and Lecco (Italy), aimed at co-designing a care model for aging in place among persons with intellectual disabilities, addressing the structural inadequacy of existing Long-Term Services and Supports. The study combines Ethnographic Case Study methodology with Co-Design Research, structured around the McKinsey 7S Framework as a shared analytical vocabulary across stakeholder levels. A multi-level co-planning approach engages three stakeholder groups (institutional - strategic decision-makers, operational - service coordinators and staff, and experiential - persons with intellectual disabilities) through three methodological tools: Change-Oriented Delphi, Design Thinking Workshops, and Photovoice. The paper argues that this architecture operationalizes all seven Universal Design principles demonstrating that multi-stakeholder co-design, when rigorously adapted for meaningful inclusion, constitutes a UD strategy for rights-based, person-centred LTSS reform.