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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]

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]

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]

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 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]

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]

Summary Here we explore the enormous implications that independence has for people with intellectual disabilities. After completing the activities, readers will be able to empathise with a client's situation, appreciate [...]

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]

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]

Abstract This article explores the rights-based agenda for social action by intellectual disability nurses working alongside people with intellectual disabilities in Ireland, The author discusses the rights issues raised by [...]

Cognitive behavioural therapy (CBT) has become established as a method for treating psychological disorders experienced by the general population, with considerable evidence available to support its efficacy. However, little research has been conducted into its effectiveness in treating psychological disorders experienced by people with intellectual disabilities. This article explores the various factors involved in the use of CBT for people with intellectual disabilities and how healthcare professionals and the multidisciplinary team have an important role in the CBT process. The input of learning disability nurses is also explored, particularly their vital role in supporting CBT and providing information that is concurrent with an individual's level of understanding. Challenges in the provision of CBT for this population are also examined, for example the prevalence of diagnostic overshadowing, which can make it difficult to distinguish between cognitive impairment and mental health issues in people with intellectual disabilities. [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]

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]

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]

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]

Planning and Support for People with Intellectual Disabilities: Issues for care managers and other professionals Editors: Christine Bigby, Chris Fyffe, Elizabeth Ozanne Publisher: Jessica Kingsley Price: £22.99 Pages: 312 ISBN: [...]

Deinstitutionalization and People with Intellectual Disabilities: In and out of Institutions Editors: Kelley Johnson and Rannveig Traustadottir Publisher: Jessica Kingsley No of pages: 293 Price: £19.95 ISBN: 843101017 There is [...]

People with intellectual disabilities can have various healthcare needs across their lifespan, which may be closely linked to genetic, biological and/or psychosocial factors. As a result, they may require medicines – some of which may be administered intramuscularly – for various clinical reasons, including as part of the treatment of a range of comorbid physical and mental health conditions. Additionally, this population may not fully understand why certain medicines are administered via the intramuscular (IM) route, nor the potential risks that are involved. Some people with intellectual disabilities may find it distressing to receive medicines via this route, and they may depend on others when making decisions in relation to IM injections. Therefore, it is important for nurses to establish a rapport with patients with intellectual disabilities and gain their consent for the procedure. Nurses also require knowledge of the preparation and administration of IM injections to ensure positive health outcomes. This article aims to enhance intellectual disability nurses' knowledge of this procedure, and to explain how they can mitigate the potential physical and psychological effects that IM injections may have for people with intellectual disabilities. [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]

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]

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]

This article presents a literature review that was undertaken to explore the challenges experienced by paid carers when providing palliative care to adults with intellectual disabilities. The outcomes show that providing palliative care to people with intellectual disabilities is fraught with difficulties. Professionals, whether they work in palliative care services or in intellectual disability services, face an array of challenges that limit their ability to provide high-quality care. These challenges include limited experience, difficulties in identifying and managing symptoms, such as pain and distress – partly because of diagnostic overshadowing – and suboptimal coordination of care, collaboration between services and communication with patients. This article outlines some recommendations arising from the literature that may improve the provision of palliative care for people with intellectual disabilities. [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]

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]

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]

Guide to Mental Health for Families and Carers of People with Intellectual Disabilities Authors: Geraldine Holt et al Publishers: Jessica Kingsley Publishers No of Pages: 240 Price: £15.95 ISBN: 1843102773 [...]

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]

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]

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]

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]