An increasing number of people with intellectual disability (ID) are reaching older ages today although they experience more health problems than the older population without ID. Leaders in intellectual disability services can greatly influence the conditions for a healthy ageing, and the aim of the present study was to explore healthy ageing in this group from the perspective of the leaders. Interviews with 20 leaders were subjected to qualitative content analysis. The findings gave rise to the overall theme ageing in dependence, which emerged from the following six categories: Supporting self-determination; Inaccessible activities after retirement; Signs of decline; Increased and specific needs for support and care; A non-question of gender; Aspects concerning the end of life and death. A prerequisite for healthy ageing in the case of people with ID is, according to the leaders, that they can live the life according to their preferences and make independent choices whilst at the same time receiving adequate support. With the shrinking of their social network after retirement, they become increasingly dependent on staff and leaders in the group home, who need to know what healthy ageing implies.
Aims
To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care.
Design
National survey study with cross‐sectional design.
Methods
Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied.
Results
The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.
The present study evaluated a multidisciplinary structured day-care programme in patients with rheumatoid arthritis of less than 2 years (n = 41) and more than 2 years disease duration (n = 46). During the 3 week intervention, outcome measures reflecting disability (HAQ, SOFI), the patient's perception of disease and pain (VAS for patient's global assessment and pain), Ritchie articular index (RAI), a 44 swollen joint count, and overall disease activity (DAS) improved significantly in the group as a whole. The improvements remained significant after 15 weeks and were of a similar magnitude in the patient groups with short and long disease duration. At week 3 and 15, the ACR and the EULAR criteria for individual response, for the total study group was fulfilled by 28% and 26%, and 36% and 52% respectively. Evaluation of a subgroup 6 weeks prior to admission indicated that the outcome measures were stable at the time of the intervention. Furthermore, administration of intraarticular glucocorticosteroids (GC) could only partly explain the observed improvement. This uncontrolled observational study supports that a multidisciplinary day-care rehabilitation program is beneficial and feasible for patients with rheumatoid arthritis of both short and long duration.
This article investigates the need and sources of knowledge among LSS administrators in Sweden (i.e. social workers handling service and support for individuals with disability according to the Swedish Disability Act [LSS]). Changing and challenging working conditions and issues concerning professional status warrant the aim. A questionnaire distributed via gatekeepers in a number of municipalities demonstrated that knowledge about ‘disability’, ‘law’, ‘ethics’ and ‘augmentative and alternative communication’ was rated highly. This result is particularly interesting given that many social work education programmes do not have compulsory courses in disability. Colleagues appear to be relied upon as essential sources of support and knowledge, but the knowledge sharing seems unorganised. Findings are discussed in relation to communities of practice (CoP) and shows that, due to the lack of essential knowledge from formal education and the strong dependence on colleagues, a locally developed praxis might be established. Inadequate theoretical and research-based knowledge, together with this local praxis knowledge, may result in the LSS administrators’ work becoming inadequate. A specialist education in disability studies is proposed as a prerequisite for being employed as an LSS administrator, and the inclusion of a theoretical and scientific framework in the regular CoP interaction is also recommended.
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