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People with intellectual disabilities are living longer while experiencing significant health conditions often resulting in a prolonged period of dying. Symptom management may be complex at end of life and the unique needs of each individual necessitates a person-centred approach. This article discusses several symptoms at end of life including pain, anxiety, agitation, breathlessness and epilepsy, as well as their management strategies, focusing on the last days of life. Healthcare professionals may support people with intellectual disabilities at end of life in a variety of hospital or community settings. Therefore, they need to have the knowledge and skills to provide evidence-based care safely and effectively. Contemporary approaches to ensuring that people with an intellectual disability can self-determine the management of their symptoms and that their circle of support is involved in a meaningful way will be explored, including advanced care planning and shared decision-making. This article presents a biopsychological perspective to end of life care and symptom management, which speaks to a holistic and respectful approach. [ABSTRACT FROM AUTHOR]

The population of people with intellectual disabilities -- this is the international term used to describe a learning disability -- is increasing and ageing, and many require frequent access to healthcare services for assessment, treatment and care. The European Disability Strategy 2010-2020 identifies the need to reduce the barriers to healthcare for people with disabilities, to improve their quality of life and reduce preventable mortality. Part of this policy focuses on the education and preparation of future practitioners. The European Union (EU) Erasmus Plus programme is an opportunity to bring together educators and students, to share learning and develop an understanding of the needs of people with intellectual disabilities. This article gives an overview of the programme, policies and practices relating to care of people with intellectual disabilities in four EU member states -- Scotland, England, Norway and Romania. It also identifies ways in which access to services for this population can be improved through education, workforce and services in an EU context. [ABSTRACT FROM AUTHOR]

This article describes a public engagement project on bereavement involving people with intellectual disabilities. The project was a practical application of research findings related to discussing death, dying and bereavement with people with intellectual disabilities. The project involved working with people with intellectual disabilities, staff from organisations that support them, and nursing and design students to make artificial lilies that could be illuminated for an interactive art installation. The site for the art installation was the Grassmarket area of Edinburgh, Scotland, where lilies were provided to members of the general public. The public participated in the installation by writing a message to someone who had died, then planting the lily in the garden as a means of remembrance. Through the development and implementation of the project, the authors identified that there was a desire among people with intellectual disabilities to discuss issues of loss and grief. This project also enabled people with intellectual disabilities to be part of a community of remembrance. [ABSTRACT FROM AUTHOR]

Constipation is a common condition that can have significant adverse effects on people's psychological well-being and quality of life. Chronic constipation is associated with various burdensome symptoms and may lead to serious health issues, such as faecal impaction and bowel obstruction. People with intellectual disabilities may be at increased risk of constipation for several reasons, including side effects of medicines, suboptimal diet and limited mobility. This article outlines the causes and risk factors that can lead to constipation in people with intellectual disabilities. It discusses the prevention, assessment and management of this condition, emphasising the need for a holistic, integrated and person-centred approach. The article also uses a fictional case study to illustrate how such an approach could be applied in practice and to demonstrate the role of nurses in addressing constipation in people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To improve your knowledge of the barriers that people with intellectual disabilities experience when accessing dental services • To understand how to support people with intellectual disabilities with their oral healthcare • To familiarise yourself with latest evidence about optimal practice in oral healthcare for people with intellectual disabilities Oral health is an important aspect of a person's overall health and well-being. People with intellectual disabilities have poorer oral health than the general population, so it is essential that service users and their carers are supported to address this. This article provides information for nurses and other healthcare professionals on how to provide evidence-based practice that supports people with intellectual disabilities with their oral healthcare and assists them to access dental services. The authors examine the latest evidence about optimal practice in oral healthcare for people with intellectual disabilities, emphasising the importance of a person-centred approach. The article also discusses the barriers that people with intellectual disabilities experience when accessing dental services and how these barriers can be addressed. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand when to administer oxygen therapy to people with intellectual disabilities • To learn about the different types of oxygen therapy and their indications for use • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) People with intellectual disabilities may require oxygen therapy across the lifespan for various reasons. Some of them will require oxygen therapy frequently, such as those who experience recurrent respiratory conditions, while others may require oxygen therapy at times when they become acutely ill or, in certain circumstances, at the end of life. Healthcare professionals and family carers supporting people with intellectual disabilities who require this treatment must have the knowledge, skills and competence to administer it safely and effectively. Oxygen therapy may be administered at times when the individual is distressed and vulnerable, so a person-centred and respectful approach is essential. This article explores the rationale for administering oxygen therapy, outlines the types and equipment that can be used, and explains the measures that nurses can take to support people with intellectual disabilities who are [ABSTRACT FROM AUTHOR]

The Research Active Programme (RAP) was designed to enable adults with intellectual disabilities to learn about the purposes and process of research. This article introduces RAP's content and draws on the experiences of 14 RAP students, three facilitators and two research assistants to present a critique of the programme's eight weekly sessions. It also makes recommendations to enrich the learning experience of students during future versions of the programme. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities have greater health needs than the general population, however they also experience greater inequality in accessing healthcare. Registered intellectual disability nurses (RNIDs) have a primary role in supporting these patients to access adequate healthcare and experience optimal health. Asthma affects many people with intellectual disabilities. This article gives an overview of the condition and discusses RNIDs' role in supporting people to manage their own condition. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware that social inclusion for people with intellectual and development al disabilities (IDD) is a focus of welfare policies and legislation in many countries • To recognise that the implementation of policy and legislation for people with IDD is the shared responsibility of governments, and health, education and social care professionals • To identify shared learning among students in health, education and social care programmes as one means of achieving social inclusion for people with IDD Policies for people with disabilities, and specifically those with intellectual and developmental disabilities (IDD), have undergone significant changes during the past three decades. Many people with IDD experience social exclusion, which has significant implications for the individual, their family and wider society. Today the focus is on accessing universal services, care and support in the community to facilitate social inclusion. Professions and professionals in health, education and social services implement social inclusion policy in the field of IDD. However, there is a lack of coherence between the policy intentions of social inclusion and the realities of professional practice. Educational collaborations involving academics, students and practitioners from the professions working with people who have IDD provide an opportunity for shared learning. These collaborations support the development of knowledge and understanding, and the barriers that need to be addressed to achieve social inclusion for people with IDD. [ABSTRACT FROM AUTHOR]

People with an intellectual disability who aspire to further education, and who seek employment on their transition to adulthood, need access to a range of supports, for independence, personal and educational development, and collaborative transitioning. This article discusses the importance of family care, service provision, employment, influential past policies and future strategic developments within an Irish context, and how collaboration between all key stakeholders is essential for effective transitioning for people with an intellectual disability. [ABSTRACT FROM AUTHOR]

Background There are few available tools for screening and assessing mental distress in people with intellectual disabilities. Method Comparison of the Clinical Outcomes in Routine Evaluation: Learning Disabilities (CORE-LD) tool with other psychometrically robust but more specific measures. Results Scores derived from CORE-LD correlate with those of established measures that have been adapted for use with people with learning disabilities. Conclusions As a tool for measuring mental health problems and levels of distress, CORE-LD is as valid as established tools for measuring anxiety, depression and self-esteem. [ABSTRACT FROM AUTHOR]

People with intellectual disability, until recently, had notably earlier mortality rates than the general population, but many are now living into their fifties, sixties and beyond. Many older people with intellectual disabilities lose the ability to perform activities of daily living, which is termed 'mobility decline', and this has implications for service planners and intellectual disability nurses (RNIDs), who must provide appropriately designed services, and ensure they are equipped to meet the needs of this ageing population. This article highlights the importance of the role of RNIDs in assessing mobility, as part of the holistic assessment of older adults with intellectual disability, and describes a variety of resources practitioners can use. [ABSTRACT FROM AUTHOR]

A growing body of literature documents multiple morbidities and multiple medication use among older people with intellectual disabilities. In Ireland in 2012,8.6% of all medication-related adverse events were reported from the disability sector. To determine the level of medication use in a long term care centre that was home to 129 older people, the on-site pharmacist performed a base line audit. Results showed that 31,614 oral solid form medications (tablets/capsules) were administered in 28 days with an average of 1,129 administered per day. There was also widespread use of other medication forms, such as liquids, patches and eye drops. Although medication administration may seem to be a 'simple' nursing task, the combination of multiple medication use and medical complexity in this population means that it is often more complicated than fully realised by the staff involved in the process. Pharmacists who serve older people who have intellectual disabilities need to be aware of, and sensitive to, the unique medication needs and vulnerabilities of this population. Medication use is a major therapeutic intervention in this population and it is important that all nursing, medical and pharmacy personnel, service provider management and policy makers are aware of the complexity of the medication use process. [ABSTRACT FROM AUTHOR]

Sleep is an essential activity of daily living that is often overlooked in approaches to caring for people with intellectual disabilities (IDs). Poor sleep, insomnia or disrupted sleep can have wide-ranging effects on the health and well-being of people with ID resulting in many adverse consequences. This article outlines the main challenges that people with ID may have initiating and sustaining sleep, explains the nature, prevalence and causes of sleeping problems they experience and discusses a variety of assessments of sleeping issues. It also examines sleep maintenance, management and sleep hygiene approaches to support this cohort using a person-centred nursing care plan and concludes with some suggestions for sleep maintenance and hygiene. Good sleep hygiene should form a central element of caring for people with ID and this article offers suggestions about care planning approaches to enable good quality sleep experiences for people with ID. [ABSTRACT FROM AUTHOR]

It's a chilling scenario: a young man with autism is in prison. He is approached by another inmate and asked to keep some drugs for him. The other inmate tells him that the prison officers are happy for him to take drugs, but that he prefers someone else to look after them. The young man with autism takes this request at face value – he's happy to help, but then the drugs are found in his cell... [ABSTRACT FROM AUTHOR]

Increased life expectancy allied to increasing numbers of people with learning disabilities living in the community means that more people with learning disabilities are having their health needs met in acute general medical services. In the context of a person-centred approach, this article examines the potential problems that may arise in all healthcare settings which pose barriers to effective healthcare delivery. These include perceptions and attitudes of healthcare staff, issues of consent and communication. It proceeds to outline solutions that enable these barriers to be overcome. Such solutions centre around addressing communication difficulties and issues of consent as well as developing the education of healthcare professionals. It concludes with a case study that explains how the theoretical principles may be applied sensitively in a practice situation. [ABSTRACT FROM AUTHOR]

The insertion of an indwelling urethral catheter is a considered, invasive intervention that places the patient in a position of increased vulnerability. It requires the nurse to have the knowledge, skills and understanding to prepare and perform the procedure while supporting the patient. Such a procedure may evoke a range of emotions and responses in a person with a learning disability. It is important that nurses address the needs of the individual and tailor the care to their needs in a sensitive and respectful manner. [ABSTRACT FROM AUTHOR]

Aim People with an intellectual disability generally have poorer emotion recognition than their typically developing peers, but there is limited research on how this might be influenced by processing style. This study aimed to explore this. Methods Children with an intellectual disability (n=45) and without (n=57) an intellectual disability completed an emotion recognition naming task and a processing style task. A path mediation model was used to evaluate whether having an intellectual disability predicted poorer emotion recognition and if this was mediated by a local processing style. Results While children with an intellectual disability were significantly less accurate at emotion recognition, having a local processing preference was not a significant factor. Conclusion The findings may help nurses involved in developing, delivering and evaluating interventions to improve the emotion recognition of people with an intellectual disability. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effect of a 12-week mindfulness-based stress reduction (MBSR) course adapted for people with an intellectual disability (ID). Methods Ten participants with ID completed measures of well-being and understanding of the concepts of mindfulness before and after the course, provided information about additional practice and gave feedback on the perceived benefits of the course. Findings No significant difference was found between mean well-being or understanding scores before and after the course. A significant relationship was found between additional practice and post-course well-being scores. Perceived benefits of mindfulness included reduced stress, increased self-control and confidence. Conclusion MBSR may be effective for people with ID but the benefits may not always be reflected in changes in questionnaire scores. The amount of practice of mindfulness exercises may be an important component of increasing well-being. [ABSTRACT FROM AUTHOR]

Healthcare professionals who support people who require an inhaler or nebuliser need to know how to use the devices, monitor and assess patients' inhaler techniques effectively. Often, people have inadequate inhaler techniques, which can lead to poor management of their respiratory condition, increased signs and symptoms, reduced quality of life and increased use of primary/secondary care services and treatment costs. This article explains how to use inhalers and nebulisers appropriately and considers some of the challenges for children and adults with a learning disability. It also describes some devices and assessment tools, and explores assessment/review methods to help ensure people use their inhalers/nebulisers successfully. [ABSTRACT FROM AUTHOR]

This study offers evidence that co-production and the delivery of person-centred care are good for staff. The researchers surveyed 466 professionals who care for people with profound learning disabilities in residential and day settings. [ABSTRACT FROM AUTHOR]

Aim To investigate the views of people with a learning disability on their experiences of the community team for people with a learning disability (CTPLD ) that is designed to meet their health and social care needs. Method Two focus groups were held with people who have learning disabilities. A flip chart with photographs of the CTPLD members, pictures and vignettes about how people use the team's services and a semi-structured interview schedule were used to ask participants about which healthcare professionals they had seen, what they had found helpful about the CTPLD and ideas for changes to the service. Findings Participants identified positive areas of practice as well as areas for improvement. Participants reflected on their relationship with the team as well as individual professionals. Conclusion The involvement of people with learning disabilities in the planning and development of the services that they receive should be an important focus for organisations. Participants' suggestions enable the team members to improve the services they provide to people with a learning disability. [ABSTRACT FROM AUTHOR]

Background Behaviours of concern restrict opportunities and choices for some people with learning disabilities and autism spectrum conditions and often lead to potentially harmful, restrictive and costly interventions. Immediate interventions, for example de-escalation, to manage behaviours of concern are required to complement behaviour support plans which may take some time to be effective. Low arousal is one de-escalation approach, which is attuned to the needs of people with learning disabilities. A low arousal approach relies on a change in the beliefs, emotional responses, opinions about the cause of the behaviour and practices of direct support staff. Aim To explore the internal consistency and concurrent validity of the Staff Perceptions of Challenging Behaviour Questionnaire (SPCBQ) -- a measure of low arousal. Method A cross-sectional survey of direct support staff included measures of mindfulness, the belief that people can control behaviours of concern (attribution of controllability), self-efficacy and a measure of physical and non-physical interventions used to manage behaviours of concern. Results Staff attitudes to low arousal approaches were associated positively with mindfulness and associated negatively with attribution of controllability. Staff perceptions were not associated with self-efficacy. One form of restrictive intervention was used less by staff who showed more positive attitudes to low arousal approaches. The staff perceptions measure showed weak internal consistency. Conclusion Further development of the SPCBQ, as a measure of low arousal approaches, has the potential to support interventions and understanding of staff practice that limit the use of restrictive approaches. [ABSTRACT FROM AUTHOR]

Keratoconus is a potentially sight-threatening condition in which the cornea distorts and becomes fragile, and without treatment can lead to severe visual impairment. The condition is much more common in people with Down's syndrome and likely to be more common in people with other types of learning disability. Since the advent of a new treatment, corneal cross-linkage, which is only applicable in the early stages of the condition, early diagnosis has become imperative. However, people with learning disabilities are less likely to complain of poor vision and more likely to have poor vision and astigmatism which can mask early changes, so keratoconus can be missed. It is essential that those caring for and supporting people with a learning disability appreciate the risk of keratoconus and ensure that clients have regular and appropriate eye examinations from the age of ten years. When keratoconus is diagnosed it is important to discuss treatment options and for carers to understand the effects of the condition to minimise sight loss and maximise quality of life. [ABSTRACT FROM AUTHOR]

Strengthening the Commitment, the Modernising Learning Disabilities Nursing Review, highlighted the importance of learning disability nurses providing support across the lifespan. This article describes an activity undertaken at the Living the Commitment Conference in Cardiff in November 2016, at which delegates were asked to identify the roles of learning disability nurses at different lifespan stages. The article examines the responses, which were thematically analysed, and highlights a range of support, some of which is provided across all lifespan stages, and some at specific periods. Responses also identified new and emerging roles across a range of settings, and the importance of influencing policy and commissioning of services. It is not possible to determine whether these roles are fulfilled across the UK, and the article recommends scoping these roles, and using the findings to inform development of learning disability nursing practice, education and research. [ABSTRACT FROM AUTHOR]

This article explores the lived experiences of five nursing students who participated in the Erasmus+ programme, an initiative -- funded by the European Union -- which aims to support projects that enhance, modernise and innovate education and training in Europe. The project discussed here focused on meeting the needs of children and young people with complex intellectual and developmental disabilities. The students, from across Europe, were from a variety of disciplines, including nursing, education and social education. [ABSTRACT FROM AUTHOR]

Physical intervention techniques must continue to be refined and developed to ensure they are safe and fit for purpose. However, it could be argued that innovation in this area has plateaued, partly because training providers build their business around fixed techniques, which leads to stasis. Further, the drive to eliminate restrictive practices has placed a focus on prevention of physical restraint and physical intervention, rather than evolution of the techniques. This article considers martial arts, the origin of most physical restraint techniques, and examines how they have been modernised, using Christensen's failure framework, to instigate critical debate about how physical intervention techniques need to improve. [ABSTRACT FROM AUTHOR]

Sleep problems in children with learning disabilities are common and affect their health and learning, and the health and well-being of their parents and carers. The use of melatonin in this population is growing, but research on its efficacy and safety is conflicting. This article discusses the role of learning disability nurses in supporting children with learning disabilities wit h sleep problems, describes the prevalence and relevance of sleep issues, introduces some behavioural interventions and gives an overview of the use of melatonin. [ABSTRACT FROM AUTHOR]

Visual impairments are common in people with learning disabilities, but identification, treatment and care can be difficult. Learning disabilities health professionals who have been trained as vision champions can ensure that the vision needs of their clients are being supported and met. This service evaluation aimed to learn about post-training outcomes for vision champions in their work teams and for their clients with learning disabilities. Vision champion training was delivered to ten community learning disabilities healthcare professionals and, three months later, training outcomes were evaluated with qualitative interviews. Vision champion training increased the professionals' confidence and efficacy in their abilities to assess and meet the vision needs of their clients with learning disabilities. The training enabled the professionals to create more vision-friendly environments for their clients. The champion role can be effective in meeting the health needs of clients. Further development of the champion role and its evaluation are recommended. [ABSTRACT FROM AUTHOR]

Background The Research Active Programme (RAP) was an eight-week group-based research training programme designed to promote disability rights in research by providing opportunities for people with intellectual disabilities to become co-researchers. This article presents an evaluation of the effectiveness of the RAP from the perspectives of 14 students. Methods Data collection involved individual pre- and post-programme interviews and weekly post-session group feedback with all 14 RAP students. Interviews were transcribed and analysed. Results Students' interests, abilities and learning styles were identified and used alongside continual feedback to guide the curriculum design. Students' perspectives are presented under four domains: foundations to learning, responsive curriculum development, content learning and complementary learning. Conclusions From the students' perspectives, the RAP was a worthwhile investment for them. Participating in the programme provided access to a wider social network in a third-level educational environment and created opportunities for lifelong learners interested in becoming co-researchers. [ABSTRACT FROM AUTHOR]

This article describes one learning disability nurse's experience of being seconded to work on a research project in a university setting. The nurse Tracey Rose and her academic manager Irene Tuffrey-Wijne argue that the benefits of such a secondment go beyond the obvious advantages for the nurse, who gained research skills. The delivery of evidence-based care and support is enhanced when learning disability nurses are engaged in research. Creating opportunities for a secondment can support nurses' career progression and may also help promote staff retention. For the academic partner, a close link with clinical practice can keep the research grounded and help to clarify the impact of research on practice. The authors also discuss the challenges in making this type of secondment work. [ABSTRACT FROM AUTHOR]

There has been a move in children's services to encourage greater participation by children themselves in how those services are designed and run. This is equally important in services used by those who find it difficult to express their views, yet children with complex needs appear to have less involvement in their care than other groups. Encouraging children with intellectual disabilities to express their views requires creativity, and this article describes the development and use of the child-friendly questionnaire, which uses various methods to support children in communicating their emotions and provide feedback about the service they have received. [ABSTRACT FROM AUTHOR]

Purple Patch Arts is an organisation based in Bradford, West Yorkshire. It works with adults and children to provide innovative education using the creative arts. In 2014, it was awarded a grant from the Heritage Lottery Fund to undertake a project that would uncover the social history of learning disabilities and record it in a way that was accessible to a range of target audiences. This article describes the process that was followed and some of the challenges that ensued. [ABSTRACT FROM AUTHOR]

Raising a child with a profound learning disability and complex health and behavioural problems can be very difficult at times. However, when this is coupled with being a learning disability nurse, it brings about its own unique challenges. In this article I describe what life is like having Nia, and the emotions involved in being her mum and being a nurse. I also discuss the particular difficulties faced by parents of individuals who have a dual diagnosis of Down's syndrome and autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Aim To examine whether there is a relationship between the temperament and character of university students and their attitude towards people with disabilities. Methods The study investigated the views of nursing students in their second year of university who had elected to take a course on disability. Questionnaires were distributed to 100 people and 81 filled in the forms completely, 75 of whom (92.6%) were women. The study data were collected in January 2014. Data were analysed using the Temperament and Character Inventory (TCI) and Attitudes Toward Disabled Persons (ATDP) scale. Results The mean attitude score of the students was 68.77 ± 12.71 (min: 39, max: 102). The correlation between the mean scores for the ATDP scale and the subdimensions of the TCI was evaluated. A significant correlation was determined between positive attitudes towards people with disabilities and the reward dependence dimension and the sentimentality sub-scale of reward dependence. Conclusion A relationship was determined between reward dependence and positive attitudes towards people with disabilities. People high in reward dependence are compassionate, sensitive, dependent on others' approval and sociable. Education to improve nursing students' attitudes towards disabled people and their social communication skills should be incorporated into nurse training. Future studies should investigate the effects of temperament and character on attitudes, as well as sociodemographic factors. Sample groups should be selected from a range of social groups to see if nursing students who will be caring for people with disabilities have a more positive attitude towards them. [ABSTRACT FROM AUTHOR]

The University of East Anglia has announced it is closing its learning disability undergraduate degree programme. This comes after similar moves by other institutions in recent years, including London South Bank University. [ABSTRACT FROM AUTHOR]

Research indicates that aspirate pneumonia as a result of dysphagia can be one of the leading causes for episodes of hospitalisation among people with intellectual disabilities (Glover and Evison 2013). Likewise, numerous studies have identified the risk factors for individuals and ascertained the strategies required to manage swallowing disorders and minimise the risks (Wright and Howseman 2013). Yet, several types of medication have been identified in the British National Formulary as having a high-risk effect on the process of swallowing, which may often be overlooked. Furthermore, the problems associated with polypharmacy indicate that adverse drug reactions can be implicated and linked to unplanned hospital admissions (Payne et al 2014). This article highlights the need for health professionals and care providers to reduce the potential risks and side effects that prescription medications can have in relation to swallowing dysfunction in people with intellectual disabilities and who are diagnosed with long-term conditions. [ABSTRACT FROM AUTHOR]

This article describes a project in which people with intellectual disabilities, their families and care staff were taught how to collaborate in the improvement of services. After forming teams, and with the support of academic supervisors and service-based mentors, they undertook a university module based on co-operative learning about services. The process was found to be effective in translating legislation and policy into practice, and was appreciated by those who took part. [ABSTRACT FROM AUTHOR]

According to the 2012 UK census, 6.6% of the population of London have a South Asian background. As this article explains, attitudes to, and care of, people with learning disabilities in this population often depend on its members' beliefs about health and abilities to communicate with practitioners. Care can also be affected by prejudice and misconceptions among service providers. In the South Asian community, people with learning disabilities are often isolated and stigmatised, and many families have feelings of shame or guilt, that lead to delays in presentation, diagnoses and care provision. The article concludes by suggesting that employment of liaison workers from South Asian backgrounds could help families seek assistance and services, and ensure that their children with learning disabilities develop the social skills they need to cope with adult life in the UK. [ABSTRACT FROM AUTHOR]

This article reports on a self-assessment audit of a clinical nurse specialist in health promotion and intellectual disability care. The audit addresses the core concepts of the role as laid down by the National Council for the Professional Development of Nursing and Midwifery in Ireland, the results of a strengths, weaknesses, opportunities and threats analysis, and planned improvements to the role. [ABSTRACT FROM AUTHOR]

Children and young people with learning disabilities are over-represented among perpetrators and victims of sexual offences. This article describes how a group approach was adopted for a series of complex and risky referrals of adolescents with learning disabilities and harmful sexual behaviours. The approach draws on a version of the Sex Offender Treatment South East Collaborative: Intellectual Disabilities, a treatment protocol for adults with learning disabilities, that has been adapted for teenagers. Successful aspects of the approach include the use of visual resources and multi-sensory activities, which led to improvements in sexual knowledge, and social and emotional skills. Areas that still need development include appropriate assessments for formulation and outcome measurement, and multi-agency commissioning and support for this vulnerable group. [ABSTRACT FROM AUTHOR]

The Confidential Inquiry into Premature Deaths of People with Learning Disabilities reviewed the deaths over a two-year period of all people with learning disabilities living in five primary care trusts. It aimed to identify good practice in the care of people with learning disabilities, and to contribute to learning and recommendations about what might have been done differently. This article presents a case study about end-of-life planning and palliative care. It discusses how a multidisciplinary team collaborated to support an individual with a terminal condition. Examples are given of the good practice recognised by the confidential inquiry investigation and learning points arising from the case are highlighted. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that people with intellectual disabilities are over-represented in homeless populations, but services may not recognise their intellectual disabilities • To read about the short-term impact of screening with the Learning Disability Screening Questionnaire (LDSQ) on people known to a homeless service • To be aware that use of the LDSQ to identify people with intellectual disabilities in homeless services may lead to positive healthcare outcomes, such as annual health checks. Background: Research suggests that people with intellectual disabilities are over-represented in homeless populations, but services may not recognise their intellectual disability. Aim: To explore the short-term impact of screening with the Learning Disability Screening Questionnaire (LDSQ) on seven people known to a homeless service in England. These participants had been found to have intellectual and adaptive functioning in the intellectual disability range in a larger study of the use of the LDSQ in homeless services. Method: The LDSQ impact questionnaire was used to evaluate participants’ views on the benefits and drawbacks of screening with the LDSQ. Changes in participants’ health status were also explored. Findings: There appeared to be many benefits of using the LDSQ and few drawbacks. Six of the seven participants had been placed on the GP learning disability register following participation in the larger study, of whom four had received an annual health check and two had received new treatment. Conclusion: Using the LDSQ in a homeless service appears to be beneficial for people with intellectual disabilities who are homeless and can lead to positive healthcare outcomes. [ABSTRACT FROM AUTHOR]

This article describes the role of Mingle, a support group for people with learning disabilities who identify as lesbian, gay, transgender or bisexual. The service was reviewed, with members, three years after it was launched; its main value seems simple, that it is a safe place to be different. [ABSTRACT FROM AUTHOR]

This article examines the theoretical approaches to understanding and managing individuals with a learning disability who display behaviours that challenge. The authors explain how drawing on these approaches can help professionals from different disciplines to provide effective, patient-centred care. [ABSTRACT FROM AUTHOR]

Safeguarding is an important role for learning disability nurses and other professionals. Their clients have increased vulnerability for many reasons, requiring nurses to be constantly watchful. Empowerment of service users and improved access to advocacy are positive ways of protecting them from abuse. Nurses need to be able to understand these responsibilities, as well as thresholds of abuse, the potential need to whistleblow, their own protection from subsequent repercussions and what can be done at an organisational level to safeguard people with learning disabilities. [ABSTRACT FROM AUTHOR]

This article reviews the prevalence and treatment of comorbid conditions (personality disorders) in individuals with learning disabilities. It is based on a new clinical services model under the direction of the author at a secure hospital facility. The overarching framework of the programme is drawn from cognitive behaviour therapy, interpersonal theory and developments in attachment theory. The author describes the work of a forensic learning disability personality disorder service that has been specially created to diagnose patients and to improve the standards of care and treatment they receive. Personality disorders can be reliably diagnosed in individuals with learning disabilities, yet comparatively little is known about the interaction between personality disorders and learning disabilities, and most importantly of all, how to best treat these coexisting conditions. [ABSTRACT FROM AUTHOR]

The article focuses on the development of an integrated care pathway (ICP) to assess the capacity of people with learning disabilities to make decisions about medical treatment. The issue of capacity to consent in decision making arose when the Mental Capacity Act 2005 came into force. Developing an ICP brings together professionals to produce a document that will produce good practice guidelines. Some of them find the paperwork arduous whereas others find it helpful.

The article discusses the principles involved in the changes in the Mental Capacity Act in Great Britain. Those who lack capacity, whether permanently, temporarily or in relation to some or all decisions should be protected by this law. The most significant changes in the law are the introduction of substituted decision-making by the appointment of a lasting power of attorney or court deputy and the requirement for an independent mental capacity advocate to be appointed in certain situations.

The article reports on the intent of the British government regarding the improvement of the health services among people with learning disabilities in Great Britain. The government has carried out the principles for such objective in its Valuing People White Paper. For this reason, the concept of health facilitation has been proposed in order to reduce the health inequalities and to improve the health services for people having mental disabilities.