Health conditions and support needs of persons living in residential facilities for adults with intellectual disability in Western Cape Province

Abstract

Background. Intellectual disability (ID) is a relatively high-incidence disability, with an increased risk of poor physical and mental health. Persons with ID also have lifelong support needs that must be met if they are to achieve an acceptable quality of life. Little is known about these health conditions and support needs in the African context. This study examines persons over the age of 18 years with ID in residential facilities in Western Cape Province. Objective. To analyse the health conditions and support needs of persons with ID in Western Cape Province. Method. A survey of residents' health conditions and support needs was conducted in face-to-face interviews with the managers of 37 out of 41 identified facilities. Results and conclusion. The survey comprised 2 098 residents (54% of them female), representing less than 2% of the estimated population of persons with ID in the province. The survey suggests that such persons experience a wide range of health conditions (notably mental health and behavioural issues) but have limited access to general healthcare and rehabilitation services. Furthermore, the daily living supports required for an acceptable quality of life are limited. The findings highlight the need for better health and support provision to persons with ID.

Intellectual disability rights and inclusive citizenship in South Africa: What can a scoping review tell us?

“…The UNCRPD’s Article 8 addresses prejudice and stereotyping, and Articles 29 and 30 pertain to political and social community participation (UN 2007). Yet, safe inclusion of PWID as members of South African communities is yet to be aligned with these principles (McKenzie, McConkey & Adnams 2013b ).…”

“…Unmet service needs of PWID combined with poverty create a dire situation for PWID (Adnams 2010 ; De Vries et al 2013 ; McKenzie et al 2013b ; Saloojee et al 2007 ; Tomlinson et al 2014 ). Nonetheless, there is little evidence of service integration among South Africa’s health, education and social development departments in meeting these needs (Saloojee et al 2007 ), whereas the opportunity costs of informal ID care remain unrecognised (McKenzie et al 2013b ).…”

“…Adults with ID who also have behavioural, physical and mental health difficulties face multiple barriers to accessing necessary services (De Vries et al 2013 ; McKenzie et al 2013b ). Mentally ill PWID may experience marginalisation in an amplified manner by being sequestered as less interesting yet more bothersome members of disabling societies.…”

Where there is no evidence: implementing family interventions from recommendations in the NICE guideline 11 on challenging behaviour in a South African health service for adults with intellectual disability

“…In the last five years, we have seen only two people with ID and behavior that challenges in our service who is employed in the open-labor market. This may be considered against the background of generalized neglect of vocation and occupational opportunities for adults with ID in the Western Cape Province [33]. Lack of vocational training and opportunities: With the exception of the clinic’s Occupational Therapy Day Programme, the limited number of protected employment services as well as skills and development programs do not consider applications for placement if the person presents with significant levels of aggression or self-injurious behavior.…”

Simple ideas that work: Celebrating development in persons with profound intellectual and multiple disabilities

“…Institutional, residential care is not considered best practice – or even good practice – for children and adults with PIMD (Goozner 2013 ; The Presidency, RSA 2002 ; Wang et al 2007 ). It is, however, a reality in South Africa, where some parents cannot cope owing to their employment needs and cannot find other home-based alternatives (Mckenzie, McConkey & Adnams 2013a ); or where, in extreme cases, clients are removed from their families by the courts in the clients’ best interest. While efforts continue to re-integrate as many persons with PIMD in their families and communities as possible, those remaining in institutions have the right to best possible holistic care, stimulation and quality of life in that situation.…”