Intellectual Disability in Health and Social Care

Stacey Atkinson, Joanne Lay, Su McAnelly, Malcolm Richardson

• Publisher: Routledge
• Year: 2014
• ISBN:
  9781317818922
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Many practitioners within health and social care come into contact with people with intellectual disabilities and want to work in ways that are beneficial to them by making reasonable adjustments in order to meet clients' needs and expectations. Yet the health and wellbeing of people with learning disabilities continues to be a neglected area, where unnecessary suffering and premature deaths continue to prevail.

This text provides a comprehensive insight into intellectual disability healthcare. It is aimed at those who are training in the field of intellectual disability nursing and also untrained practitioners who work in both health and social care settings. Divided into five sections, it explores how a wide range of biological, health, psychological and social barriers impact upon people with learning disability, and includes:

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• Six guiding principles used to adjust, plan and develop meaningful and accessible health and social services

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• Assessment, screening and diagnosis of intellectual disability across the life course

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• Addressing lifelong health needs

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• Psychological and psychotherapeutic issues, including sexuality, behavioural and mental health needs, bereavement, and ethical concerns.

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• The changing professional roles and models of meeting the needs of people with intellectual and learning disabilities.

Intellectual Disability in Health and Social Care provides a wide-ranging overview of what learning disability professionals' roles are and provides insight into what health and social care practitioners might do to assist someone with intellectual disabilities when specific needs arise.

Part
I

The six guiding principles

We have a duty to challenge ourselves and each other on behalf of our patients.

(DH, 2013)

This statement was made in the Foreword to Patients First and Foremost: The Initial Government Response to the Mid-Staffordshire NHS Foundation Trust Public Inquiry in 2013 as a result of the Francis Inquiry (2012), reporting on poor quality and neglectful care in Britain in the twenty-first century. Many of the shocking revelations were attributed to a lack of consideration by professionals of the needs of vulnerable clients and patients.

Many people with intellectual or learning disabilities are vulnerable and inarticulate in the presence of professionals and service providers (DH, 2012). Their carers may also struggle to present their needs accurately. As a result, this client group who suffer from greater health needs than the general population often experience inappropriate treatment, ineffective care and consequently even poorer health (Emerson and Baines, 2010).

Part I introduces the six guiding principles which can be used to adjust, plan and develop meaningful and assessable health and social services for adults and children with intellectual/learning disabilities. These principles have been developed from the personal experiences of life (both living with disability and also living alongside those with disabilities), the professional experience of caring, and the empirical research of the contributors.

These six principles are integrated within the philosophy and content of this book and the contributors believe them to be at the forefront when considering how best to meet the needs of people with intellectual or learning disabilities. We aim to enable you to consider these principles in your own actions and in those of others in your daily contacts with your clients and patients.

The six guiding principles presented and chapters in Part I are:

Chapter 1 Guiding principle 1: Ensuring dignity and respect

Chapter 2 Guiding principle 2: The importance of providing accessible information for people with learning disabilities

Chapter 3 Guiding principle 3: Providing equal access to services for people with learning disabilities

Chapter 4 Guiding principle 4: Personal and professional development through education and training

Chapter 5 Guiding principle 5: Adapting your skills: thinking outside the box

Chapter 6 Guiding principle 6: Delivering quality to people with learning disabilities

References

DH (Department of Health) (2012) Transforming Care: A National Response to Winterbourne View Hospital, London: Department of Health.

DH (Department of Health) (2013) Patients First and Foremost: The Initial Government Response to the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: Department of Health.

Emerson, E. and Baines, S. (2010) Health Inequalities and People with Learning Disabilities in the UK. Available at: www.improvinghealthandlives.org.uk.

Francis, R. (2013) Mid Staffordshire NHS Foundation Trust Public Inquiry. Available at: www.midstaffspublicinquiry.com/report.

1

Guiding principle 1: Ensuring dignity and respect Su McAnelly and Dorothy Matthews

Learning outcomes

After reading this chapter you will be able to:

•identify and consider your own skills and abilities in caring for all people

•consider ways in which dignity and respect can be assured within good health and social care practice

•apply the principles of holism to working with people with learning disabilities.

Introduction

Every life deserves a certain amount of dignity, no matter how poor or damaged the shell that carries it.

(Bragg 1998).

This chapter gives an introduction to the overall guiding principles and is intended to enable you to think and develop ideas about your own development needs. The section offers reader activity boxes which are designed to provoke ideas and discussion around the complexities of working with people with learning disabilities who have health and social needs. In addition, the chapter refers to a case study featuring a real scenario based upon a person with a learning disability. Additional reference material and fast fact boxes offer further reading or access to on-line materials, fact sheets and reports.

This chapter looks at the many issues and complexities of working with people who are vulnerable. The reflection that you will be asked to undertake in it will be based upon the values and attitudes you have towards other people in general, but you may become more acutely aware of these beliefs as you come to deal with more challenging situations.

The chapter focuses upon a case story about a man named Colin and covers the following topics:

•human drives

•motivations

•dignity

•respect

•confusion and misunderstandings.

Human drives

As human beings, our behaviour is influenced by many things; our environment, our social relationships, our biological make-up and also our internal drives. For many people, internal drives relate to psychological motivations, emotional histories or even genetic precedents. However, it is perhaps most important for health and social care workers to attempt to understand the reasons for their own behaviour towards others and vice versa.

Abraham Maslow (1943) is most famously known for a set of universal ideas which have been used as a framework to explain the inter-relationships between our motivations to meet our various unsatisfied needs. Figure 1.1 explains his theory that humans are driven to satisfy their most basic needs in hierarchical order. This theory helps us understand that human drives are based upon many variants and that we are all striving for similar human goals but with differing degrees of success.

Figure 1.1 Maslow’s hierarchy of needs

Source: Maslow (1943).

Physiological needs

The drives to meet our basic physical survival are considered the strongest and the most obvious. A threat to these needs, which include the human need to eat and to stay warm, will probably override the need for friendship or learning, for example.

Safety needs

When physical needs are being met, Maslow argues that a desire to be safe and secure follows. These needs may consist of personal safety, financial safety, health and well-being. These drives are complex and are dependent upon the person’s perceived situation. For many vulnerable people, these drives are the most complex and can result in psychological problems such as post-traumatic illness and phobias.

Love and belonging

When a person begins to feel physiologically sound and perceives their situation as safe, the most compelling drive may be to be loved and to be cherished. The need for love and friendship can be overwhelmed by isolation or incarceration during events such as hospital stays or severe rejection.

Esteem

All humans have a need to be respected and recognised for their own worth. The search for esteem and belonging can be on two levels: first, to be happy with one’s image of oneself, and, second, to be well received by others. It is believed by Maslow that the former (being happy with one’s self) is essential to becoming recognised by others. The strong desire for recognition leads people to aim for previously unobtainable goals, For example, to be famous, to be a winner or to be known more widely.

Self-actualisation

As a relatively comfortable human being, the desire turns to meeting an additional need; to be what you want to be or be the ideal! To reach your full potential. This desire to mee...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• List of tables
• Notes on contributors
• Note on terms
• Introduction
• Part I: The six guiding principles
• Part II: Assessment, screening and diagnosis
• Part III: Health throughout life
• Part IV: Psychological and psychotherapeutic interventions
• Part V: Changing roles
• Index