Increasing numbers of people with learning disabilities are living into older adulthood,creating important challenges for services. Greater local understanding of the specific health needs of this population is crucial to influence needs-led service planning. The study used a questionnaire survey to identify people aged over.. who have learning disabilities,covered by a community health trust in England. Specific types of health problems for this older population were identified,along with the sources and types of community supports received and care staff satisfaction with these supports. The most frequently occurring health problems related to psychological/behavioural,incontinence/excretory and circulatory/respiratory needs. Overall general practitioners,followed by community/district nurses,provided the majority of healthcare support. Generally care staff appeared satisfied with the access and quality of health support. There were alarming findings in relation to some areas of health screening. Cervical,breast and testicular examinations were rare. The implications of the study are discussed.
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References
1.
AYLWARD,E. H.,BURT,D. B.,THORPE,L. U.,LAI,F. & DALTON,A. (1997) ‘Diagnosis of Dementia in Individuals with Intellectual Disability’ ,Journal of Intellectual Disability Research41: 152–164 .
2.
BAILEY,N. M. & COOPER,S. A. (1997) ‘The Provision of Specialist Health Services to People with Learning Disabilities in England and Wales’ ,Journal of Intellectual Disability Research41: 52–59 .
3.
BURT,D. B.,LOVELAND,K. A.,CHEN,Y. W.,CHUANG,A.,LEWIS,K. R. & CHERRY,L. (1995) ‘Ageing in Adults with Down’s Syndrome: A Report from a Longitudinal Study’ ,American Journal on Mental Retardation100: 262–270 .
4.
CENTER,J.,BEANGE,H. & MCELDUFF,A. (1998) ‘People with Mental Retardation Have an Increased Incidence of Osteoporosis: A Population Study’ ,American Journal on Mental Retardation103: 19–28 .
5.
COOPER,S. A. (1997) ‘Learning Disabilities and Old Age’ ,Advances in PsychiatricTreatment3: 312–320
6.
COOPER,S. A. (1998) ‘Clinical Study of the Effects of Age on the Physical Health of Adults with Mental Retardation’ ,American Journal of Mental Retardation106: 582–589
7.
DAY,K. (1985) ‘Psychiatric Disorders in the Middle-Aged and Elderly Mental Handicapped’ ,British Journal of Psychiatry147: 660–667
8.
DAY,K. (1993) ‘Mental Health Services for People with Mental Retardation: A Framework for the Future’ ,Journal of Intellectual Disability Research37 (1): 7–16
9.
DAY,K. & JANCAR,J. (1994) ‘Mental and Physical Health and Ageing in Mental Handicap: A Review’ ,Journal of Intellectual Disability Research38: 241–256
10.
DEPARTMENT OF HEALTH (1998) Signposts for Success in Commissioning and Providing Health Services for People with Learning Disabilities. London: Department of Health .
11.
DEPARTMENT OF HEALTH (1999) Facing the Facts: Services for People with Learning Disabilities. London: Department of Health .
12.
DEPARTMENT OF HEALTH (2001a) National Service Framework for Older People. London:Department of Health .
13.
DEPARTMENT OF HEALTH (2001b) Valuing People: A New Strategy for Learning Disability for the 21st Century. White Paper. London: Department of Health .
14.
DINANI,S. & CARPENTER,S. (1990) ‘Down’s Syndrome and Thyroid Disorder’ ,Journal of Mental Deficiency Research34: 187–193
15.
EMERSON,E. (2001) Challenging Behaviour: Analysis and Intervention in People with SevereIntellectual Disabilities,2nd edn. Cambridge: Cambridge University Press .
16.
EVENHUIS,H. (1999) ‘Associated Medical Aspects’,in M. P. JANICKI & A. J. DALTON (eds) Dementia,Ageing,and Intellectual Disabilities: A Handbook. London: Brunner/Mazel .
17.
EVENHUIS,H.,HENDERSON,C. M.,BEANGE,H.,LENNOX,N. & CHICOINE,B. (2000) Healthy Ageing: Adults with Intellectual Disabilities: Physical Health Issues. Geneva: World Health Organization .
18.
FITZGERALD,J. (1998) Services for Older People with Learning Difficulties. London: Joseph Rowntree Foundation .
19.
HOGG,J. & LAMBE,L. (1998) Older People with Learning Disabilities: A Review of the Literature of Residential Services and Family Caregiving. Dundee: White Top Research Unit,University of Dundee .
20.
HOGG,J. & MOSS,S. (1993) ‘Characteristics of Older People with Intellectual Disabilities in England’ ,International Review of Research in Mental Retardation19: 71–96
HOLLAND,A. J. (2000) ‘Ageing and Learning Disability’ ,British Journal of Psychiatry176: 26–31
23.
HOLLAND,A. J.,HON,J.,HUPPERT,F. A.,STEVENS,F. & WATSON,P. (1998) ‘Population Based Study of the Prevalence and Presentation of Dementia in Adults with Down’s Syndrome’ ,British Journal of Psychiatry172: 493–498
24.
HOWELLS,G. (1986) ‘Are the Medical Needs of Mentally Handicapped Adults Being Met?’ ,Journal of the Royal College of General Practitioners36: 449–453
25.
HUTCHINSON,N. J. (1999) ‘Association between Down’s Syndrome and Alzheimer’s Disease: Review of the Literature’ ,Journal of Learning Disabilities for Nursing,Health and Social Care.3 (4): 194–203
26.
JACOBSON,J. W. & HARPER,M. S. (1989) ‘Mental Health Status of Older Persons with Mental Retardation in Residential Settings’ ,Australia and New Zealand Journal of Developmental Disabilities15: 329–336
27.
JANCAR,J. (1998) ‘The Problems of Ageing’,in W. FRASER,D. SINES & M. KERR(eds) Hallas’ The Care of People with Intellectual Disabilities, 9th edn. Oxford: Butterworth Heinemann .
28.
JANICKI,M. P. & DALTON,A. J. (2000) ‘Prevalence of Dementia and Impact on Intellectual Disability Services’ ,Mental Retardation38: 276–288
29.
JANICKI,M. P. & JACOBSON,W. (1986) ‘Generational Trends in Sensory,Physical and Behavioural Abilities among Older Mentally Retarded Persons’ ,American Journal of Mental Deficiency90: 490–500
30.
JANICKI,M. P.,ACKERMAN,L. & JACOBSON,W. (1985) ‘State Developmental Disabilities/Ageing Plans and Planning for an Older Developmentally Disabled Population’ ,Mental Retardation23: 297–301
31.
JANICKI,M. P.,HELLER,T. & SELTZER,G. (1995) Practice Guidelines for the Clinical Assessment and Care Management of Alzheimer and Other Dementias among Adults with Mental Retardation. Washington,DC .
32.
JANICKI,M. P.,DALTON,A. J.,HENDERSON,C. M. & DAVIDSON,P. W. (1999) ‘Mortality and Morbidity among Older Adults with Intellectual Disability: Health Services Considerations’ ,Disability and Rehabilitation21: 284–294
33.
KAPPELL,D.,NIGHTENGALE,D.,RODRIGUEZ,A.,LEE,J. H.,ZIGMAN,W. B. & SCHUPF,N. (1998) ‘Prevalence of Chronic Medical Conditions in Adults with Mental Retardation: Comparison with the General Population’ ,Mental Retardation36: 269–279
34.
MARTIN,D. M.,ROY,A. & WELLS,M. B. (1997) ‘Health Gain through Health Checks: Improving Access to Primary Care for People with Intellectual Disability’ ,Journal of Intellect Disability Research41: 401–408
35.
MONIZ- COOK,E. (2000) The Challenging Behaviour Scale (CBS) for Older People Living in Care Homes. Unpublished.
36.
MOSS,S. & PATEL,P. (1997) ‘Dementia in Older People with Intellectual Disability: Symptoms of Physical and Mental Illness,and Levels of Adaptive Behaviour’ ,Journal of Intellectual Disability Research41: 60–69
37.
MOSS,S.,PATEL,P.,PROSSER,H.,GOLDBERG,D.,SIMPSON,N.,ROWE,S. & LUCCHINO,K. (1993) ‘Psychiatric Morbidity in Older People with Moderate and Severe Learning Disability: Development and Reliability of the Patient Interview (PAS–ADD)’ ,British Journal of Psychiatry163: 471–480
38.
MOSS,S.,EMERSON,E.,KIERNAN,C.,TURNER,S.,HATTON,C. & ALBORZ,A. (2000) ‘Psychiatric Symptoms in Adults with Learning Disability and Challenging Behaviour’ ,British Journal of Psychiatry177: 452–456
39.
OLIVER,C. & HOLLAND,A. J. (1986) ‘Down’s Syndrome and Alzheimer’s Disease: A Review’ ,Psychological Medicine28: 1365–1377
40.
PARRISH,A. A. (1998) ‘Signposts for Success for Learning Disability Services’ ,British Journal of Advanced Nursing.7(4): 185-185
41.
PRASHER,V. P. (1995) ‘Age Specific Prevalence,Thyroid Dysfunction,and Depressive Symptomatology in Adults with Down’s Syndrome and Dementia’ ,International Journal of Geriatric Psychiatry10: 129–135
42.
REISS,S. & SYZSKO,J. (1983) ‘Diagnostic Overshadowing and Professional Experience with Mentally Retarded Persons’ ,American Journal of Mental Deficiency87: 396–402
43.
SCHROJENSTEIN LANTMAN- DE VALK,H. M. VAN,METSEMAKERS,J. F.,SOOMERSTURLINGSM,M. J.,HAVEMAN,M. J. & CREBOLDER,H. F. (1997) ‘People withIntellectual Disability in General Practice: Case Definition and Case Finding’ ,Journal of Intellectual Disability Research41: 373–379
44.
SELTZER,M. B. (1993) ‘Psychological Adjustment in Midlife for Persons with Mental Retardation’,in SUTTON (ed.) Older Adults with Developmental Disabilities,pp. 157–184 Baltimore,MD: Brookes .
45.
SOCIAL SERVICES INSPECTORATE (1998) Moving into the Mainstream: The Report of a National Inspection of Services for Adults with Learning Disabilities. London: Department of Health .
46.
THOMPSON,D. (2002) ‘Growing Older with Learning Disabilities’ ,Journal of Learning Disabilities6 (2): 115–122
47.
THORPE,L. U. (1999) ‘Psychiatric Disorders’,in M. P. JANICKI & A. J. DALTON(eds) Dementia,Ageing,and Intellectual Disabilities: A Handbook. London: Brunner/Mazel .
48.
WALKER,A.,WALKER,C. & RYAN,T. (1996) ‘Older People with Learning Difficulties Leaving Institutional Care: A Case of Double Jeopardy’ ,Ageing and Society16: 125–150
49.
WALKER,C. & WALKER,A. (1998) Uncertain Futures: People with Learning Difficulties and their Ageing Family Carers. London: Pavilion,Joseph Rowntree Foundation .
50.
WALKER,C.,RYAN,T. & WALKER,A. (1996) Fair Shares for All? Disparities in Service Provision for Different Groups of People with Learning Difficulties Living in the Community. London: Pavilion,Joseph Rowntree Foundation .
51.
WILKINSON,H. & JANICKI,M. P. (2002) ‘The Edinburgh Principles with Accompanying Guidelines and Recommendations’ ,Journal of Intellectual Disability Research46: 279–284
52.
WILSON,D. & HARE,A. (1992) ‘Health Care Screening for People with Mental Handicap in the United Kingdom’,in J. ROOSENDAHL (ed.) Mental Retardation and Medical Care,pp. 58–67 Zeist: Uitgeverij Kerkebosch .
