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.

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.