Policy briefing

Identifying the needs of older people with learning disabilities

People with learning disabilities are living longer but will have specific health needs

People with learning disabilities are living longer but will have specific health needs


Picture: Alamy

Essential information

People with learning disabilities are now living significantly longer. As they grow older, they have many of the same age-related health and social care needs as other people, but they also face specific challenges associated with their learning disability, according to the National Institute for Health and Care Excellence (NICE).

People with learning disabilities have a poorer health profile than the rest of the population. Many face barriers to accessing care, including not being known to services, difficulties in expressing their needs and undiagnosed sensory impairment. Professionals may have difficulty distinguishing the symptoms of a condition, such as dementia, from those associated with learning disabilities.

NICE adds that managing the needs of older people with learning disabilities can be complex and could create substantial pressures on services.

What’s new?

Improving care and support for adults with learning disabilities as they grow older is the focus of guidance from NICE published in April 2018.

The document covers identifying changing needs, planning for the future, and delivering services including health, social care and housing.

NICE stresses that people growing older with learning disabilities deserve the same care as the rest of the population. It also says that professionals need to be alert to diagnostic overshadowing – when a diagnosis is missed by assuming the signs of a condition, such as dementia, are connected to a patient’s learning disability.

Older people with learning disabilities should have annual health checks and be offered the same routine screening as other people, NICE says.

Major reports have found that a failure of services to take account of the needs of people with learning disabilities and make reasonable adjustments has led to misdiagnosis and, in some cases, premature death.

Implications for nurses

  • Ensure that people growing older with learning disabilities have the same access to care and support as everyone else. 
  • Extend appointment times. Use visual aids and short, clear sentences during consultations and conversations
  • Carry out regular person-centred planning with people growing older with learning disabilities to address their changing needs, wishes and capabilities and promote their independence. This should include planning for the future and transport needs. Involve their family members, carers and advocates as appropriate. 
  • Be aware that people growing older with learning disabilities might have difficulty communicating their health needs. When their needs change, think about whether these changes could be age-related and do not assume they are due to the person's learning disability or pre-existing condition.

Expert comment

Simon Jones, learning disability nurse consultant at Oxford Health NHS Foundation Trust

‘The key message for learning disability nurses is that people with a learning disability are more likely to develop health conditions related to age far earlier than the general population.

'But these same health issues are also more susceptible to being missed due to a range of reasons such as the person’s inability to communicate their distress, diagnostic overshadowing, difficulties in accessing screening programmes – due to lack of awareness or not being able to tolerate invasive tests – and, lastly, just by virtue of having a learning disability and not knowing to get health matters checked out.

'This guidance is vitally important in that it highlights and details these diverse health issues experienced by people as they age – which the Learning Disabilities Mortality Review Programme has noted – has meant that people with a learning disability die 20-30 years earlier than the rest of the population, due mainly to untreated health issues.’

 


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