Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland

Abstract

Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.

Cardiovascular disease prevalence and risk factors of persons with mental retardation

“…U.S. studies reporting the prevalence of hypertension that included persons with mild to profound MR had lower prevalence rates (10 -23%) than those reporting the prevalence of persons with mild to moderate MR (25-41%) [McDermott et al, 1997;Kapell et al, 1998;Draheim et al, 2002b]. Three research groups reported the prevalence of hypertension to be 1-17% in samples of persons with MR from countries outside the United States [Beange et al, 1995;Cooper, 1998;Barr et al, 1999]. Though the reported prevalence of hypertension varied both among the U.S. reports and the non-U.S reports, it appears that the prevalence of hypertension may be greater in the United States compared to other countries.…”

Health inequalities and people with learning disabilities in the UK

“…One in three adults with learning disabilities and four out of five adults with Down's syndrome have unhealthy teeth and gums, 36 with adults living with families having more untreated decay and poorer oral hygiene and adults living in residential services having more missing teeth.…”

Health of ageing people with intellectual disability and the role of the nurse in Ireland

“…As a result, detection at the asymptomatic stage of disease progression is compromised and there is low usage of health screening (Barr et al, 1999;Sutherland et al, 2002). The RNID has an important role in the detection of health problems in the early stages when clinical signs are least obvious, but intervention are more effective and least expensive.…”

“…However, such capacities cannot be taken for granted in people with intellectual disability as inadequate communication and the fact that they cannot easily articulate their symptoms is one of the major factors contributing to insufficient health care (Cook and Lennox, 2000;Martin et al, 2004). In addition, people with intellectual disability often feel uncomfortable because of the unfamiliarity with physical examinations and various screening procedures, such as blood test and visual/auditory examination, consequently relying on others to understand and represent their needs as well as implement recommendations (Barr et al, 1999;Kerr et al, 2003). Therefore, the responsibility shifts onto trained nurses in intellectual disability (RNIDs) to recognise atypical symptoms such as challenging behaviour that could be indicative of an underlying health problem and support people with an intellectual disability and maintain their health.…”