Clinical update

Dignity in healthcare for people with learning disabilities

The RCN’s latest edition of its guidance Dignity in Health Care for People with Learning Disabilities features contributions from an expert panel of people with learning disabilities, alongside examples of good practice

The RCN’s latest edition of its guidance Dignity in Health Care for People with Learning Disabilities features contributions from an expert panel of people with learning disabilities, alongside examples of good practice


Picture: Roy Mehta

Essential facts

According to the British Institute of Learning Disabilities, an estimated 2% of the population in England has a learning disability. The charity Mencap defines learning disability as reduced intellectual ability and difficulty with everyday activities. While always lifelong, learning disabilities may be mild, moderate or severe, but given the right level of support for their needs, most people are able to lead an independent life. However, people with a learning disability are likely to have worse physical and mental health than those without, says Mencap. They also have increased health needs compared with the wider population.

What’s new

In December 2017 the RCN produced a third edition of its guidance Dignity in Health Care for People with Learning Disabilities. The document features contributions from an expert panel of people with learning disabilities, alongside examples of good practice.

Risk factors

While mortality rates have improved over recent decades, people with a learning disability are still likely to die younger than others, with an average age of 65 for men and 63 for women, compared with 78 for men and 83 for women generally. According to NHS England, people with a learning disability are four times more likely than the general population to die of something that could have been prevented.

The leading cause of death for those with a learning disability is respiratory disease. They are also more likely to develop mental health problems – in particular, schizophrenia has three times the average prevalence – alongside some cancers, diabetes, coronary heart disease and gastro-intestinal problems. About one-third have epilepsy.

How you can help your patient

All healthcare professionals have a role to play in promoting the health of people with learning disabilities, says the RCN. Practical tips include booking double appointments to give them extra time to communicate their needs in a relaxed and less hurried way, while helping to alleviate anxieties.

Expert comment

RCN learning disability nursing forum chair Simon Jones

‘This publication is essential reading for everyone working within health care, especially at a time when services are over-stretched and understaffed, with dignity often the first casualty.

‘Dignity is important when caring for anyone, but especially so for patients with a learning disability. They will have individual and different needs and can struggle to communicate these, often relying on support from others. But this means it can be all too easy to fall into the trap of directing communication and attention to a person’s carer, rather than interacting with them directly.

‘I’ve seen people being treated more like an object than a person, not due to malice but a lack of understanding of how to interact. In contrast, carers can sometimes feel disregarded, but they know the patient very well, so utilising them as a resource is also important.’


Find out more

RCN Dignity in health care for people with learning disabilities (2017)

Mencap

British Institute of Learning Disabilities

Improving Health and Lives: Learning Disability Observatory

RCNi articles

Promoting the independence of people with intellectual disabilities (Learning Disability Practice, 2010)

Dignity, humanity and equality: Principle of Nursing Practice A (Nursing Standard, 2011) 

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