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Learning Disability

Learning Disability. Ann Sanders GP West Bar Surgery ann.sanders@tiscali.co.uk. What will I cover?. Definition of learning disability Morbidity and mortality Deficits in care Common medical problems Practicalities Attitudes Communication challenges Capacity.

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Learning Disability

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  1. Learning Disability Ann Sanders GP West Bar Surgery ann.sanders@tiscali.co.uk

  2. What will I cover? • Definition of learning disability • Morbidity and mortality • Deficits in care • Common medical problems • Practicalities • Attitudes • Communication challenges • Capacity

  3. What is the definition of Learning Disability? • “Significantly reduced ability to • Understand new and complex information • Learn new skills • Cope independently” • Starting <18yrs • IQ 70 often used as cut off

  4. Morbidity and mortality • 2.5 times more medical problems than patients without learning disability • 30% epilepsy, 30% visual impairment, 30% hearing impairment • Significantly reduced life expectancy

  5. Deficits in care 1 • Untreated, yet treatable medical conditions (e.g. eczema, constipation) • Untreated health issues relevant to known condition (e.g. tfts in Downs syndrome)

  6. Deficits in Care 2 • Lack of health promotion (e.g. diet, exercise) • “Diagnostic overshadowing”

  7. Common medical problems 1 • Complex epilepsy • Multiple medications • GI – reflux, helicobacter, constipation • Orthopaedic – joint contractures

  8. Common Medical Problems 2 • Chest infection, aspiration • Obesity, unhealthy lifestyles • Psychological & social – challenging behaviours, anxiety, depression, abuse, dementia

  9. “Valuing People”, 2001 government white paper Introduction of LES/DES – practice register and annual Cardiff health check Health Action Plans Who? How? Where? Practicalities

  10. Case part 1

  11. Conclusions: • Presentation is never straight forward • Always consider • Physical (e.g. GO reflux) • Psychological (e.g. anxiety) • Social (e.g. change in carers)

  12. Case part 2

  13. Attitudes • Personal experience • Fear • Paternalism • Prejudice • Equity

  14. Communication challenges • Intellectual impairment • Visual impairment • Hearing impairment • Interaction with parents/carers

  15. Communication essentials • Time, • Patience, • Commitment & continuity of care • Patient centeredness.

  16. Capacity • Mental Capacity Act • Patients with learning disability are likely to lack capacity • How should decisions be made?

  17. Personal experience: • Cardiff check cumbersome but useful • Mental health neglected • Positive feedback from patients and carers • Good opportunity for health promotion • ‘New’ diagnoses made – major (melanoma) and minor (hay fever) approx 20% cases • £50-£100 per check

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