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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]

Why you should read this article: • To be aware of secondary analysis of data from waves 1 and 3 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) • To appreciate that dementia is highly prevalent in older adults with intellectual disabilities, particularly in those with Down's syndrome • To recognise the need for routine assessment of cognition and adaptive functioning in older adults with intellectual disabilities to increase recognition, identify early symptoms of dementia and plan care accordingly Background: Diagnosing dementia in people with intellectual disabilities can be challenging due to pre-existing cognitive impairment. In this population, functional loss could be an early indicator of dementia, but the relationship between functional loss and dementia is not well understood. This means there is a risk of delayed diagnosis and therefore a delay in care planning. Aim: To identify and compare the prevalence and age distribution of dementia in people with intellectual disabilities, differentiating between those with Down's syndrome and those with an intellectual disability not attributable to Down's syndrome, and to identify and compare functional loss in people with intellectual disabilities who have developed dementia, differentiating between those with Down's syndrome and those with an intellectual disability not attributable to Down's syndrome. Method: This was a secondary analysis of data from waves 1 and 3 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a nationally representative study in Ireland of older adults with intellectual disabilities as they age. Functional loss was determined by participants' level of difficulty with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Results: The prevalence of dementia was higher among participants with Down's syndrome than among those with an intellectual disability not attributable to Down's syndrome, and the age distribution of dementia differed markedly between the two groups. Both groups experienced similar patterns of difficulty with ADLs and IADLs. IADLs posed more difficulty than ADLs, and among ADLs self-care activities posed the most difficulty. Conclusion: It is important to continue to investigate functional loss in older adults with intellectual disability who have developed dementia, as this should lead to earlier assessment and care planning. [ABSTRACT FROM AUTHOR]

Young people with intellectual disabilities are at greater risk of developing mental health issues. However, their mental health needs are often not recognised and therefore remain untreated. This article discusses a case study concerning a young man with a mild intellectual disability and co-existing obsessive-compulsive disorder, which was first identified in adolescence. It describes his experience of accessing appropriate services and interventions, and details the care and support that he received from community-based services, which enabled him to continue living with his family. The case study reveals various issues that are relevant to other young people in similar situations, as well as for service providers and professionals, including intellectual disability nurses. [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]

Why you should read this article: • To be aware that the prevalence of traumatic or adverse life events is high among people with intellectual disabilities • To understand that trauma-informed care is based on the rationale that in healthcare services there is the potential for traumatisation or retraumatisation in people who have been exposed to traumatic events • To recognise what trauma-informed care looks like in intellectual disability services, including the barriers to and enablers of implementation Traumatic events are associated with actual or threatened risk to life, serious injury or sexual violence. The prevalence of traumatic events is particularly high among people with intellectual disability. Trauma-informed care is an important yet unresearched area in intellectual disability services. This article outlines the principles of trauma-informed care and considers how these can be applied in practice to people with an intellectual disability. The authors discuss the limited literature on the implementation of trauma-informed care in intellectual disability services, which is primarily drawn from case studies or non-empirical research. The article includes two examples of trauma-informed care implemented in intellectual disability settings and outlines areas for future research. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities want meaningful relationships, which could mean friendship or intimacy. Nurses and other professionals can support children and young people with intellectual disabilities to understand sexuality as well as promoting friendships and safe relationships. However, best practice guidelines are needed to promote consistency in practice that meets their distinct needs. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the clinical aspects of venesection • To increase your awareness of how to make venesection a positive experience for service users • 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 learning disabilities face challenges in accessing healthcare services, particularly testing, screening and monitoring, which means that common conditions are often missed. Like anyone, people with learning disabilities develop conditions that require diagnosis, assessment and monitoring through the laboratory analysis of blood samples, so learning disability nurses need to be skilled at performing venesection. Obtaining informed consent and preparing the person psychologically and emotionally for the procedure is as important to its success as getting the clinical aspects right. This article discusses venesection in people with learning disabilities, explaining how nurses can support them before, during and after the procedure and describing a step-by-step approach to performing venesection in a person with a learning disability. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the discrimination experienced by people with a learning disability who cross-dress • To learn techniques to support people with learning disabilities who want to cross-dress • To familiarise yourself with gender issues in the context of people with learning disabilities People with a learning disability who identify as lesbian, gay, bisexual, transgender, queer or as a cross-dresser can experience multiple layers of discrimination and experience numerous challenges in having their needs met. This article describes a group that was set up to support five men with learning disabilities who wanted to cross-dress. The aim of the group – called Being Me – was to offer the men support, education and empowerment. The article includes case studies to illustrate the men's experiences of being part of the support group. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that people with learning disabilities and a long-term health condition are at risk of avoidable and premature death • To identify how a combination of reflective practice and the introduction of a virtual nurse-led clinic improved health outcomes for a patient with a learning disability and uncontrolled epilepsy • To understand how reflection can enhance your practice This article presents a reflection on a case study by a hospital liaison nurse for patients with learning disabilities. The case study details the care of a patient with a learning disability and uncontrolled epilepsy who was at risk of premature and avoidable death. Following frequent hospital episodes, reasonable adjustments to the patient's care and support needs were essential. An integrated approach was adopted through the setting up of a nurse-led virtual clinic to monitor and coordinate care for patients with learning disabilities and long-term conditions. The clinic was instrumental in improving patient safety and optimising health outcomes. [ABSTRACT FROM AUTHOR]

There is evidence that people with learning disabilities, particularly those with behaviour that challenges, are prescribed psychotropics even when they do not have a mental health condition. The STOMP programme was launched in 2016 in England and Wales with the aim of reducing the use of psychotropics in adults with learning disabilities and/or autism. This article describes how the STOMP programme was implemented in a community learning disability service for adults at Cheshire and Wirral Partnership NHS Foundation Trust. The article briefly discusses the overuse of psychotropics in people with learning disabilities and describes the local service's strategy to reduce its clients' use of psychotropics, highlighting some of the beneficial effects this had on clients' quality of life. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the need to reduce the use of restrictive practices • To increase your knowledge of applying a human rights-based approach to the use of restrictive practices • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) In 2021 the Welsh Government launched a new framework for reducing the use of restrictive practices in childcare, education, health and social care settings. A series of reports and guidelines have stressed the importance of ensuring that restrictive practices, if used at all, respect people's human rights. Human rights that are particularly relevant in this context include the right to not be subjected to inhuman or degrading treatment, the right to have one's autonomy and physical and psychological integrity respected, and the right to not be discriminated against in the application of the Human Rights Act 1998. This article explores how applying a human rights-based approach can support learning disability nurses to consider the legal and ethical aspects of restrictive practices, use a person-centred approach that respects service users' dignity and autonomy, and recognise their role in reducing the use of restrictive practices. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the vulnerability of people with learning disabilities to coronavirus disease 2019 (COVID-19) • To find out about COVID-19-related deaths in patients with learning disabilities at one hospital • To enhance your awareness of the need to obtain more clinical awareness of the needs of the learning disability population There is evidence that people with learning disabilities are more vulnerable to coronavirus disease 2019 (COVID-19) than the general population, but there is a need to understand better how COVID-19 has affected that patient group. This article details a retrospective comparison study exploring the response of one acute hospital to COVID-19 in the learning disability population. A wide range of data were collected for the period between March 2020 and March 2021 about patients with learning disabilities, including admissions and deaths, do not attempt cardiopulmonary resuscitation (DNACPR) orders, ceilings of care and input from the learning disabilities acute liaison team. Data from the five years preceding the study were also collected. These data were compared with data about the general population, in the hospital and nationally. The data show that there had been no significant increase in the number of deaths of people with learning disabilities at the hospital during the first 13 months of the pandemic. However, this could be because fewer people attended hospital and more died in the community. Wider and more in-depth investigation is needed to understand the factors that may increase the risk of COVID-19-related death for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware that transitions from child to adult services are often challenging • To identify the importance of early transition planning for successful outcomes • To recognise that young people's views, preferences and wishes should be reflected in transition plans Transition to adult services for young people with learning disabilities and complex needs should be a purposeful and planned process that begins at the age of 14. However, it is often fraught with challenges. This article explores the story of a young person's transition from child to adult services. It shares the lessons learned and how a collaborative, person-centred approach can result in positive outcomes for young people with autism, learning disabilities and complex needs. Recommendations are made for good practice in person-centred transition planning. Although the article explores one family's experiences, the recommendations are applicable to learning disability practice in developing improved pathways for transition for young people with complex needs. [ABSTRACT FROM AUTHOR]

'It's never too late to start over in life, because I didn't come into learning disability nursing until I was nearly 40. Our first son was born with Down syndrome in 2000 and at the time I was working as a research scientist in the pharmaceutical industry. [ABSTRACT FROM AUTHOR]

Over the past two decades person-centred planning has been used to support people with learning disabilities to fulfil their personal aspirations. This has been backed up by national policies that have adopted the principles of person-centredness. However, widespread barriers to the implementation of person-centred planning for people with learning disabilities have been reported and the literature suggests that implementing person-centred planning is particularly challenging for people with more complex needs. This article discusses the findings of a literature review that explored the barriers and facilitators to the implementation of person-centred planning for people with learning disabilities and complex needs and their carers. The article identifies barriers such as limited funding and resources, challenges in accessing services and communication difficulties. It also describes initiatives that appear to have successfully engaged service users and their carers in person-centred planning. Further research is needed into the long-term effects of person-centred planning for people with learning disabilities and complex needs, notably to measure its effectiveness in enhancing their quality of life, while strategies to enable them to engage in person-centred planning need to be developed. [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]

The evidence is becoming ever clearer that the COVID-19 pandemic has had a devastating effect on the mental health of children. Data from NHS Digital show the number of children with a probable mental health disorder rose from one in nine in 2017 to one in six in 2021. [ABSTRACT FROM AUTHOR]

Attending healthcare appointments can be challenging for people with learning disabilities, prompting anxiety that can keep them away. [ABSTRACT FROM AUTHOR]

Intimate and sexual relationships are an important part of life for most people and that includes those with a learning disability. Research indicates that many people with a learning disability have the same aspirations for loving relationships as those without, and that a safe and happy sexual relationship can be a positive experience, improving confidence and well-being. [ABSTRACT FROM AUTHOR]

The government has published the first-ever Women's Health Strategy for England to tackle the gender health gap. It is a ten-year plan that aims to address the obstacles faced by women when accessing healthcare and improve health outcomes for all women. [ABSTRACT FROM AUTHOR]

Numbers of learning disability nurses have fallen by 32% in England over the past decade. This has a damaging effect on the care of people with learning disabilities and/or autism, and for the most vulnerable – those who are inpatients in mental health hospitals – the risks are particularly high. [ABSTRACT FROM AUTHOR]

Diagnostic overshadowing is not a new concept for learning disability nurses, but the impact it has on people with Down syndrome is not always fully understood by many healthcare professionals and the public. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand that active listening is a fundamental skill that underpins effective communication with people with intellectual disabilities • To appreciate that listening to the perspectives of people with severe or profound intellectual disabilities is crucial to providing person-centred care • To reflect on how contextual factors such as physical environment and your role in that environment can affect your ability to actively listen to people with intellectual disabilities This article presents a literature review that explored communication partners' experiences of listening or attending to people with severe or profound intellectual disabilities during interactions. Findings suggest that the context in which the interaction takes place, and the role of the communication partner, influences the structure of the interaction. Additionally, an optimal balance between communication partner sensitivity to the person's communication behaviours, and knowledge of the person, is valuable when listening to and attempting to understand what the person is expressing. The authors make recommendations for research, practice and education to support and develop the evidence base and practice in this area of learning disability nursing. [ABSTRACT FROM AUTHOR]

Guidance has been issued to help people navigate a newly operational law on the use of force in mental health units in England. [ABSTRACT FROM AUTHOR]

All nurses in England can now access the Oliver McGowan mandatory training programme following a long campaign to improve the care for people with a learning disability and/or autism. [ABSTRACT FROM AUTHOR]

Gerard Wainwright (pictured), from St Anne's Community Services, West Yorkshire, led the Unsafe Swallow Project to address the high number of people with learning disabilities who die because of aspiration pneumonia caused by swallowing difficulties. [ABSTRACT FROM AUTHOR]

Learning disability nursing is under 'great threat' and more needs to be done to recruit and retain nurses in the sector, a leading academic has suggested. [ABSTRACT FROM AUTHOR]

Strikes, staff shortages and low morale are dominating the headlines, and for good reason. But amid the gloom there was another familiar call – more needs to be done to increase the number of people choosing learning disability nursing as a career. Now where have we heard that before? [ABSTRACT FROM AUTHOR]

The Learning Disability Mortality Review (LeDeR) programme aims to improve healthcare for people with a learning disability and those with autism. LeDeR, which was started in 2017, is funded by NHS England and NHS Improvement and has three aims: » Improve care. » Reduce health inequalities. » Reduce early deaths. [ABSTRACT FROM AUTHOR]

What can I do to be ready for placement?: This is a question I am asked a lot, particularly by students in their first year preparing to face different placement areas. I can still distinctly remember my first placements and how conscious I was of trying to make a good impression– I was being assessed after all. I would carry a notebook around with me and make notes on anything and everything I thought was useful, particularly questions I wasn't sure of the answer to. [ABSTRACT FROM AUTHOR]

If you are looking for inspiration to develop your nursing career and improve patient care, then look no further than this year's Learning Disability Practice webinar on innovation. [ABSTRACT FROM AUTHOR]

If good communication is more to do with listening than talking, we need to be open to hearing others in different ways. [ABSTRACT FROM AUTHOR]

Many of you will be supporting people with learning disabilities who will, for some aspects of their lives, have restrictions placed on them. [ABSTRACT FROM AUTHOR]

What is billed as the biggest shake-up in the NHS for a decade in England will come into force next month. Integrated care systems (ICSs) are designed to pool resources between health and local councils, involve voluntary and third sector organisations and encourage more partnership working. [ABSTRACT FROM AUTHOR]

Only one in three NHS trusts in England is fully complying with a legally-binding standard to help people with learning disabilities and sensory impairments access healthcare, according to data from Healthwatch England. [ABSTRACT FROM AUTHOR]

Compulsory training for all NHS health and social care staff in understanding the needs of people with learning disabilities and autism has moved a step closer to being enshrined in law. This is fantastic news. [ABSTRACT FROM AUTHOR]

It is widely accepted that having equality and diversity in healthcare provision is important. Indeed, it is seen as a major part of the solution to the challenges facing the health service – the theory being that the more diverse the workforce, the more talented and innovative those teams will be. [ABSTRACT FROM AUTHOR]

Rationale and key points: Why you should read this article: • To increase your awareness of the challenges of diagnosing constipation in people with learning disabilities • To understand the potential consequences, for people with learning disabilities, of untreated constipation • To revisit the assessments required to diagnose constipation in a person with a learning disability accurately. Constipation is a common health condition that, if not recognised and treated, can have major adverse effects on people’s health and well-being. People with learning disabilities have been shown to have a shorter life expectancy than the general population. Leading causes of premature death in this population group are respiratory disease, cardiovascular disease and gastrointestinal disorders including constipation. Yet, with timely assessments and appropriate interventions, constipation can be prevented or treated. • Consequences of constipation include increased laxative use, frequent hospital admissions and readmissions, suboptimal health outcomes and premature death. • The signs and symptoms of constipation can be challenging to ascertain in people with learning disabilities due notably to communication difficulties and diagnostic overshadowing. • Accurately diagnosing constipation in a person with a learning disability who shows behaviour of concern involves comprehensive and thorough assessments of their physical and mental health, behaviour, medicines and environment. Reflective activity: ‘How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting the accurate diagnosis of constipation in a person with a learning disability who shows behaviour of concern. • How you could use this information to educate nursing students or colleagues to support the accurate diagnosis of constipation in a person with a learning disability who shows behaviour of concern. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the challenges that may be involved in undertaking mental health assessments of people with learning disabilities • To identify appropriate communication skills, strategies and approaches that can be used when conducting mental health assessments of people with learning disabilities • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Mental health issues are not only more prevalent in people with learning disabilities compared with the general population, but they are also more challenging to assess and diagnose. Reasons for this may include the communication issues and cognitive impairments often experienced by people with learning disabilities. This article describes some of the challenges that nurses and other healthcare professionals may encounter when assessing mental health issues in people with learning disabilities. It provides practical advice on how to conduct an effective mental health assessment and outlines a range of communication strategies that can be used to overcome any issues that occur. [ABSTRACT FROM AUTHOR]

People with learning disabilities are more likely than the general population to develop type 2 diabetes, but are less likely to receive appropriate care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the challenges in breaking bad news to people with learning disabilities • To consider various tools that you could use in your practice to break bad news • 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) Breaking bad news is a challenging aspect of healthcare professionals' roles in any setting. In learning disability settings, specific challenges compound the difficulty of this task. For example, a person who has cognitive difficulties may not understand an abstract concept such as death; the person's family may be concerned that hearing bad news will be too distressing for them; or the healthcare professional may be reluctant to talk about death because of their own beliefs and values. This article discusses the barriers related to breaking bad news to people with learning disabilities. It also describes several tools – generic and specific to the learning disability field – which healthcare professionals can use to inform and improve their practice in this area. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware of communication challenges often experienced by people with learning disabilities • To recognise how communication challenges for people with learning disabilities may be compounded by the growing use of digital technology • To consider various communication strategies and tools that you could use to support people with learning disabilities Healthcare provision relies on effective communication, since this can enable information to be shared, develop therapeutic relationships and improve health outcomes. However, many people with learning disabilities experience significant issues with expressive and receptive communication, and these issues are likely to be compounded by the growing use of digital technology. This article outlines factors that affect communication for people with learning disabilities during healthcare encounters, including communication challenges they may experience in relation to accessing health information and using digital technology. The article also explores strategies and tools nurses can implement to address these challenges and ensure effective communication with individuals. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the principles of forensic risk assessment • To recognise the benefits of, and the different evidence-based approaches to, forensic risk assessment • To increase your understanding of risk formulation and the development of a tailored risk management plan. While forensic healthcare is a highly specialised area of clinical practice, many learning disability nurses will, over the course of their careers, be required to provide care to people who have had contact with the criminal justice system. Robust risk assessment and risk management systems are central to ensuring the well-being and safety of people with learning disabilities who have forensic needs. Although the core assessment skills required to undertake forensic risk assessments are embedded in nurses’ skill set, learning disability nurses need to develop their knowledge and understanding of how to apply these skills in forensic practice. This article explores the principles of forensic risk assessments and the elements of the forensic risk assessment process as a foundation to risk formulation. The author uses a fictitious case study to illustrate forensic risk assessment, risk formulation and the development of a tailored risk management plan. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of the causes of, and risk factors for, obesity in people with learning disabilities • To acknowledge the importance of nutrition as a key controllable factor in preventing long-term conditions • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Obesity is a major global concern and is more common among people with learning disabilities than in the general population. If unmanaged, obesity can lead or contribute to various long-term health conditions, such as type 2 diabetes, cardiovascular disease and cancer. People with learning disabilities often rely on support staff, families and carers to meet their individual nutritional needs, but care teams and families may lack adequate knowledge of public health recommendations about healthy diet and optimal nutrition. More needs to be done to enhance the diet, and subsequently improve the health outcomes, of people with learning disabilities. This article provides an overview of obesity in people with learning disabilities, including contributing factors, associated health conditions and nutritional considerations. It also details recommendations for nurses to promote a healthy diet and support positive dietary behaviour change in this population. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of education, reasonable adjustments and medication reviews in supporting optimal medicines adherence in people with learning disabilities • To enhance your awareness of factors that contribute to suboptimal medicines adherence in people with learning disabilities • To acknowledge the importance of involving family or carers in supporting medicines adherence. Rationale and key points: People with learning disabilities often have long-term conditions that require the regular use of medicines. Medicines adherence can be particularly challenging in this population and support with taking medicines is often not provided in a way that meets people’s needs. Suboptimal medicines adherence can negatively affect the health outcomes of people with learning disabilities, which are already poorer than those of the general population. • Achieving optimal medicines adherence among people with learning disabilities requires a multi-component strategy that includes education, reasonable adjustments and medication reviews. • Factors that cause and/or contribute to suboptimal medicines adherence among people with learning disabilities include burdensome medicine regimens, medicines prescribed in unsuitable forms, overmedication and overprescribing, lack of medication reviews, lack of reasonable adjustments, suboptimal communication from healthcare professionals and suboptimal care coordination. • Family and carers are often those who administer medicines, so it is crucial to involve, educate and support them about the person’s medicine regimen so that they can help ensure the medicines are taken as prescribed. Reflective activity: ‘How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting a person with a learning disability to take their medicines as prescribed. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take to support a person with a learning disability to take their medicines as prescribed. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To develop your knowledge of rare epilepsy syndromes • To enhance your understanding of the association between epilepsy and learning disability • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Epilepsy is more prevalent in people with learning disabilities than in the general population and there are a number of rare epilepsy syndromes closely associated with learning disability. These syndromes are challenging to manage, notably because seizures are often refractory, the risk of status epilepticus is high and comorbidities are usually present. People with a rare epilepsy syndrome need high levels of specialist support throughout their lives. Such syndromes are rare, but professionals who care for people with learning disabilities are likely to encounter them at some point in their career. Improved knowledge and understanding of rare epilepsy syndromes can assist learning disability nurses to provide adequate information, care and support to service users, family members and paid carers as well as to other healthcare professionals. This article explains the association between epilepsy and learning disability, describes rare epilepsy syndromes and explores the goals of treatment, additional treatment options and challenges of management. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the need to proactively address the barriers to accessing healthcare that people with learning disabilities may experience • To learn about the development of a desensitisation programme for people with learning disabilities and a fear of needles to support them to receive the coronavirus disease 2019 (COVID-19) vaccine • To consider interventions that you could implement in your practice to support people with learning disabilities to access healthcare interventions. Many people with learning disabilities have a fear of needles and as a result they find receiving injections and vaccinations challenging. Therefore, community learning disability nurses and positive behaviour support practitioners developed a desensitisation programme with the aim of supporting people with learning disabilities who had a needle phobia to receive coronavirus disease 2019 (COVID-19) vaccines. Additionally, reasonable adjustments were made for five individuals who did not have a fear of needles but required a home visit with familiar healthcare professionals who they felt comfortable with. Of the 24 people who engaged in the desensitisation programme, 88% (n=21) received all doses of the COVID-19 vaccine, while 80% (n=4) of five people who were provided with reasonable adjustments received all doses of the COVID-19 vaccine. This article discusses how and why the desensitisation programme was developed, what worked well, the challenges encountered and other areas where the approaches used could be implemented to support people with learning disabilities with accessing other healthcare interventions. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise how you can assist general practice staff in caring for people with learning disabilities • To reflect on your role in supporting people with learning disabilities to attend general practice appointments • 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 learning disabilities have poorer health outcomes and are at increased risk of premature death compared with the general population. It is crucial that they attend routine annual health checks and screening appointments in primary care, but there are many barriers preventing them from doing so and accessing adequate care provision. As a result, they are likely to experience delays in diagnosis and treatment for undetected health conditions. This article identifies some of the barriers to effective service provision for people with learning disabilities in primary care. It describes how learning disability nurses and learning disability support workers can assist staff in primary care to improve the experiences of people with learning disabilities when attending healthcare appointments such as annual health checks, blood tests, cancer screening and other routine investigations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the health and well-being benefits of physical activity for people with learning disabilities • To learn about the principles of behaviour change theories and how they can be used to promote physical activity in people with learning disabilities • To recognise the areas to consider when implementing physical activity interventions for people with learning disabilities. The health and well-being benefits of physical activity are well documented, but it has been identified that many adults with learning disabilities engage in low levels of activity. Behaviour change theories can explain the facilitators of and barriers to healthy behaviours and can result in more effective interventions. This article outlines two of the most commonly used behaviour change theories: the transtheoretical model and social cognitive theory. Using a fictional case study, it explores how these two theories can be applied by health and social care staff to enhance physical activity levels in adults with learning disabilities. The author discusses the importance of considering readiness to change, robust social support mechanisms and inclusive environments. [ABSTRACT FROM AUTHOR]