Medical needs of people with intellectual disability require regular reassessment, and the provision of client‐ and carer‐held reports

Abstract

Background Previous work has indicated a wide range of unmet medical health needs in people with intellectual disability (ID). Methods A profile of recorded medical needs was produced for  people with ID through a detailed search of individual medical and nursing case records. Specialist optometric and audiological assessments were offered, and reports were provided in technical and plain English terms. A Health Watch project delivered folders with copies of the plain English reports to  individuals and carers. Results The case record review indicated a wide range of medical disorders; however, exact diagnoses and counselling regarding underlying neurological conditions were seldom recorded. Assessed levels of hearing and vision loss were much greater than had

A cascade of disparities: Health and health care access for people with intellectual disabilities

“…Lewis et al [2002] reported 54% of their California sample to be overweight or obese, while Kerr et al [2003] reported only 22% of the UK residential sample as overweight. In the California study, there was a greater risk for obesity for individuals living at home (67%) or with family or friends (57%) compared with those living in a group residence (47%).…”

“…In both the Kerr et al [2003] and Lewis et al [2002] studies, a much larger proportion of study participants were receiving antipsychotic or antidepressant medications than had a psychiatric diagnosis in their chart. In the United Kingdom [Halstead et al, 2000], community-dwelling persons with ID who saw community clinicians received less frequent primary care than people in residences, with behavioral disturbance and severe disability predicting more contact with primary care.…”

“…A number of organizations and authors have made recommendations to address the health needs of people with disabilities [Beange, 1996;Cook and Lennox, 2000;Scottish Executive Health Department, 2000;Beacock, 2001;WHO, 2001;Cooper, 2003;Kerr et al, 2003]. The recommendations vary by country and disciplinary perspective, but most can be summarized into five categories of recommendations that address the cascade of disparities leading to poor health outcomes of people with ID as presented in Table 3.…”

Vision and oral health needs of individuals with intellectual disability

“…The article concludes with recommendations to improve the vision and oral health of individuals with between the ages of 45 and 64 years and 7% of those over 65 years in the general U.S. population have been reported to have vision problems, Kapell et al [1998], studying New York residents, found that 9 to 16% of 45 to 64 year olds with ID and 17 to 50% of 65 to 74 year olds with ID had vision problems. Other studies have reported that 18 to 99% of 50ϩ year olds with ID have vision problems [Day, 1987, Moss, 1991Evenhuis, 1995;van Schrojenstein Lantman-de Valk et al, 1997;Janicki and Dalton, 1998;Evenhuis et al, 2001b;Warburg, 2001b;Janicki et al, 2002;Kerr et al, 2003;van Splunder et al, 2003avan Splunder et al, , 2004.…”

“…Similarly, while the overall population prevalence of strabismus outside the United States ranges from Ͻ1 to 10%, international researchers found the prevalence of strabismus among individuals with ID to range from 4 to 45% (Table 1) [Lyle et al, 1972;Bankes, 1974;Woodruff, 1977;Woodruff et al, 1980;Levy, 1984;Jacobson, 1988;Aitchison et al, 1990;Hestnes et al, 1991;McCulloch et al, 1996;Buch et al, 2001;van Splunder et al, 2003avan Splunder et al, , 2003bvan Splunder et al, , 2004Woodhouse et al, 2003]. The prevalence of cataracts (opacity of the lens of the eye, the capsule, or both) and keratoconus (swelling and scarring of the cornea) among individuals with ID also has been reported to be much higher than that in the general population (Table 1) [Lawson and Schoofs, 1971;Bankes, 1974;Markovits, 1975;Woodruff, 1977;Jaeger, 1980;NCHS, 1983;Levy, 1984;Kennedy et al, 1986;Day, 1987;Jacobson, 1988;Aitchison et al, 1990;Hestnes et al, 1991;Sacks et al, 1991;Evenhuis, 1995;Maino et al, 1996;McCulloch et al, 1996;Warburg, 2001b;Friedman et al, 2002;Congdon et al, 2003;Foran et al, 2003;Kerr et al, 2003;…”