Ireland targets services for those with learning disabilities and their families and carers
Why you should read this article • Mental health concerns in people with intellectual disabilities can be difficult to identify due to various factors, including the person’s physical health, behaviour and cognition, and formal and informal carers’ skill deficits and attitudes • Knowledgeable and skilled health professionals must be present in the daily lives of people with an intellectual disability to identify and explore emerging mental health issues, make referrals, implement interventions and monitor outcomes • Registered intellectual disability nurses play a vital role in ensuring that the mental health of people with an intellectual disability is addressed and maximised Mental health concerns are prevalent in regard to those with intellectual disability. There are many reasons for this, some of which may relate to the causation of the person’s intellectual impairment. Other extraneous factors, such as the number of significant life events, may also result in compromised mental health. For many people, however, mental health problems may go untreated, which may relate to difficulties in diagnosis or in ascribing the signs and symptoms to other causes. With increasing numbers of people with an intellectual disability making use of regular community health services, and the reported unfavourable nature of such services, mental health problems may not be addressed. Registered intellectual disability nurses have a crucial role to play in ensuring that the mental health concerns of people with an intellectual disability are identified and addressed in an expeditious manner to achieve maximum well-being. This article explores such mental health concerns and, drawing on a brief case study, describes the role of nurses.
An evidence-based approach to determine and enable the sleeping needs of people with ID
Continence is regarded as a basic need and many continence problems can be addressed and managed effectively. People with an intellectual disability (ID) are at greater risk of developing urinary incontinence (UI), however action to address their needs is minimal and the quality of care they receive varies despite national care standards and guidelines. This article examines promotion of continence in people with an ID and explores the literature on assessment and management of need. It also discusses the factors ID nurses should consider when meeting the continence needs of people with an ID, including explaining important terms, and assessing and managing UI and continence promotion, as well as their role in providing care and support in a person-centred and inter-professional context.
This article outlines the difficulties that people with severe and profound intellectual and multiple disabilities may have when swallowing. The article explains the prevalence, causes and nature of swallowing difficulties for people with intellectual disabilities and discusses the assessment of swallowing, eating and drinking problems. It also examines management of swallowing problems in this cohort, and uses a case study to consider how to support someone with such difficulties in the context of Orem’s self-care deficit theory. The article concludes with broad recommendations for care.
Background The personal grief of nurses who care for the palliative needs of children with an intellectual disability has rarely been investigated. Method A qualitative descriptive research approach was adopted to identify nurses’ experience of grief and how this is managed following the death of a child in their care. Semi-structured interviews were carried out with eight nurses who had cared for a child with an intellectual disability who had died. Data were analysed using the Newell and Burnard ( 2011 ) pragmatic approach to qualitative data. Ethical approval was granted by University of Dublin, Trinity College and the relevant healthcare provider. Findings The results in relation to four of the identified themes are discussed. The findings demonstrate that nurses have a good understanding of grief, but the way they experience and manage their own grief varies. Conclusion The study, which was carried out in the Republic of Ireland, suggests that disenfranchised grief may be experienced by nurses who have cared for children with an intellectual disability who have died. Nurses may feel helpless because of their limited experience and knowledge, their relationships with family members change after the death of a child, the opportunity to attend a child’s funeral is important for some, while many nurses will try to focus on positives after the death of a child in their care.