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The extent and nature of need for mealtime support among adults with intellectual disabilities.
- Source :
-
Journal of intellectual disability research : JIDR [J Intellect Disabil Res] 2012 Apr; Vol. 56 (4), pp. 382-401. Date of Electronic Publication: 2011 Oct 12. - Publication Year :
- 2012
-
Abstract
- Background: For many adults with an intellectual disability (ID), mealtimes carry significant health risks. While research and allied clinical guidance has focused mainly on dysphagia, adults with a range of physical and behavioural difficulties require mealtime support to ensure safety and adequate nutrition. The extent of need for and nature of such support within the wider ID population has yet to be reported.<br />Methods: In this study, we have estimated the prevalence of need for mealtime support among people with ID in the UK, using a population of 2230 adults known to specialist ID services (in Cambridgeshire, UK, total population 586,900). In a sample (n = 69, aged 19 to 79 years, with mild to profound ID), we characterised the support provided, using a structured proforma to consult support workers and carers providing mealtime support, and health and social care records.<br />Results: Mealtime support was found to be required by a significant minority of people with ID for complex and varied reasons. Prevalence of need for such support was estimated at 15% of adults known to specialist ID services or 56 per 100,000 total population. Within a sample, support required was found to vary widely in nature (from texture modification or environmental adaptation to enteral feeding) and in overall level (from minimal to full support, dependent on functional skills). Needs had increased over time in almost half (n = 34, 49.3%). Reasons for support included difficulties getting food into the body (n = 56, 82.2%), risky eating and drinking behaviours (n = 31, 44.9%) and slow eating or food refusal (n = 30, 43.5%). These proportions translate into crude estimates of the prevalence of these difficulties within the known ID population of 11.9%, 6.6% and 6.4% respectively. Within the sample of those requiring mealtime support, need for support was reported to be contributed to by the presence of additional disability or illness (e.g. visual impairment, poor dentition and dementia; n = 45, 65.2%) and by psychological or behavioural issues (e.g. challenging behaviour, emotional disturbance; n = 36, 52.2%).<br />Conclusions: These findings not only highlight the need for a multidisciplinary approach to mealtime interventions (paying particular attention to psychological and environmental as well as physical issues), but also signal the daily difficulties faced by carers and paid support workers providing such support and illustrate their potentially crucial role in managing the serious health risks associated with eating and drinking difficulties in this population.<br /> (© 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.)
- Subjects :
- Adult
Aged
Cross-Sectional Studies
Disability Evaluation
England
Enteral Nutrition statistics & numerical data
Feeding and Eating Disorders diagnosis
Feeding and Eating Disorders epidemiology
Female
Food Preferences
Humans
Intellectual Disability diagnosis
Intellectual Disability epidemiology
Male
Mental Disorders diagnosis
Mental Disorders epidemiology
Mental Disorders rehabilitation
Middle Aged
Mobility Limitation
Risk Factors
Young Adult
Feeding Behavior
Feeding Methods
Feeding and Eating Disorders rehabilitation
Intellectual Disability rehabilitation
Needs Assessment statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2788
- Volume :
- 56
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of intellectual disability research : JIDR
- Publication Type :
- Academic Journal
- Accession number :
- 21988217
- Full Text :
- https://doi.org/10.1111/j.1365-2788.2011.01488.x