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Oral health and supporting people with intellectual disabilities to get access to dental treatment
Oral health is an important aspect of a person’s overall health and well-being. People with intellectual disabilities have poorer oral health than the general population, so it is essential that service users and their carers are supported to address this. This article provides information for nurses and other healthcare professionals on how to provide evidence-based practice that supports people with intellectual disabilities with their oral healthcare and assists them to access dental services. The authors examine the latest evidence about optimal practice in oral healthcare for people with intellectual disabilities, emphasising the importance of a person-centred approach. The article also discusses the barriers that people with intellectual disabilities experience when accessing dental services and how these barriers can be addressed.
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Biological basis of child health 7: growth, development and the reproductive system
This article is the seventh in a series on the biological basis of child health. It describes early developmental milestones, stages of growth, puberty and the development of the reproductive system. It also outlines the methods used to assess growth and development, and describes conditions that affect growth and development in infants, children and young people. Understanding childhood growth and development is crucial for children’s nurses, who need to be able to identify potential deviations from the norm, since these often reveal underlying conditions that require treatment.
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Management of oxygen therapy for people with intellectual disabilities
People with intellectual disabilities may require oxygen therapy across the lifespan for various reasons. Some of them will require oxygen therapy frequently, such as those who experience recurrent respiratory conditions, while others may require oxygen therapy at times when they become acutely ill or, in certain circumstances, at the end of life. Healthcare professionals and family carers supporting people with intellectual disabilities who require this treatment must have the knowledge, skills and competence to administer it safely and effectively. Oxygen therapy may be administered at times when the individual is distressed and vulnerable, so a person-centred and respectful approach is essential. This article explores the rationale for administering oxygen therapy, outlines the types and equipment that can be used, and explains the measures that nurses can take to support people with intellectual disabilities who are receiving this treatment.
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Focus on asthma 1: the state of care for children and young people in the UK and globally
This is the first in a series of articles on asthma, the most prevalent long-term condition in children with a significant burden of disease. This first article presents an overview of the state of asthma and asthma care in the UK and globally, especially as it relates to children and young people. It considers prevalence, age and sex comparisons, causation, morbidity and mortality rates, cost and the quality of care. It also outlines what children and young people wish for their asthma care.
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Exploring mental health issues in people with an intellectual disability
Mental health concerns are prevalent in regard to those with intellectual disability. There are many reasons for this, some of which may relate to the causation of the person’s intellectual impairment. Other extraneous factors, such as the number of significant life events, may also result in compromised mental health. For many people, however, mental health problems may go untreated, which may relate to difficulties in diagnosis or in ascribing the signs and symptoms to other causes. With increasing numbers of people with an intellectual disability making use of regular community health services, and the reported unfavourable nature of such services, mental health problems may not be addressed. Registered intellectual disability nurses have a crucial role to play in ensuring that the mental health concerns of people with an intellectual disability are identified and addressed in an expeditious manner to achieve maximum well-being. Mental health concerns in people with intellectual disabilities can be difficult to identify due to various factors, including the person’s physical health, behaviour and cognition, and formal and informal carers’ skill deficits and attitudes. Knowledgeable and skilled health professionals must be present in the daily lives of people with an intellectual disability to identify and explore emerging mental health issues, make referrals, implement interventions and monitor outcomes. Registered intellectual disability nurses play a vital role in ensuring that the mental health of people with an intellectual disability is addressed and maximised. This article explores such mental health concerns and, drawing on a brief case study, describes the role of nurses.
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Biological basis of child health 6: development of the skeletal system and orthopaedic conditions
This article is the sixth in a series on the biological basis of child health. It provides an overview of the development of the skeletal system before and after birth, and outlines the potential congenital anomalies that may occur.The article explains the structure and function of the bones before describing the role of the joints, tendons and ligaments. It also outlines the presentation and management of some of the common orthopaedic conditions seen in infants and children, including fractures, osteogenesis imperfecta, scoliosis, juvenile idiopathic arthritis, developmental dysplasia of the hip and achondroplasia.
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Symptom management at the end of life for people with intellectual disabilities
People with intellectual disabilities are living longer while experiencing significant health conditions often resulting in a prolonged period of dying. Symptom management may be complex at end of life and the unique needs of each individual necessitates a person-centred approach.This article discusses several symptoms at end of life including pain, anxiety, agitation, breathlessness and epilepsy, as well as their management strategies, focusing on the last days of life. Healthcare professionals may support people with intellectual disabilities at end of life in a variety of hospital or community settings. Therefore, they need to have the knowledge and skills to provide evidence-based care safely and effectively.Contemporary approaches to ensuring that people with an intellectual disability can self-determine the management of their symptoms and that their circle of support is involved in a meaningful way will be explored, including advanced care planning and shared decision-making. This article presents a biopsychological perspective to end of life care and symptom management, which speaks to a holistic and respectful approach.
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Biological basis of child health 5: development of the respiratory system and elements of respiratory assessment
This article is the fifth in a series on the biological basis of child health. It describes the development of the respiratory system, which starts relatively late in the embryo and continues after birth until the age of seven to eight years. It explains what the developing anatomy of the respiratory system in infants and children means in terms of the conditions that may occur and the precautions required when assessing them. The article provides an overview of the elements of respiratory assessment in infants and children and describes some respiratory conditions seen in these patient groups. It also discusses some of the changes in the care of children with respiratory conditions, which has increasingly moved from hospital into the community and become nurse-led, multidisciplinary and holistic.
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How learning disability nurses can support self-management for people with asthma
Asthma is a long-term condition that requires patient education, support and close monitoring. It is important that individuals are empowered and educated about their asthma and supported to self-manage as appropriate. Self-management is a goal that is recommended as an established and effective approach. However, it can be challenging for many individuals, including those with learning disabilities. Learning disability nurses can support individuals diagnosed with asthma to self-manage the condition and should have the knowledge, skills and competence to do so.
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Percutaneous endoscopic gastrostomy feeding: clinical knowledge and skills for learning disability nurses
People with learning disabilities may require percutaneous endoscopic gastrostomy (PEG) tube feeding to maintain their nutritional status when they have a congenital deformity or severe infection that makes eating and drinking difficult. In addition, people with learning disabilities may have severe dysphagia or medical or surgical conditions throughout their life that make it difficult for them to eat and drink and put them at risk of aspiration and choking. To manage this increasingly common clinical situation learning disability nurses must have the knowledge and skills required to manage patients with a PEG tube safely and effectively.
