Access to Secondary Healthcare for People with Intellectual Disabilities: A Review of the Literature

Abstract

Background There is growing evidence that people with intellectual disabilities have greater healthcare needs than the general population and that these needs are often unmet. Recently, increasing attention has been drawn to poor care received by people with intellectual disabilities when admitted to hospital. Method A literature search was conducted to identify studies on experiences of secondary healthcare for people with intellectual disabilities. Studies were published between January 1990 and March 2008. Results Thirteen studies were identified. Important influences on the experience of hospital care were: individual factors; the carer's role; the attitudes, knowledge and communicative style of health staff; and the physical environment. A range of recommendations and initiatives have been developed to improve hospital care. Conclusion More research is needed, given that so few studies are published in this area. Initiatives to improve access to secondary healthcare need to be evaluated to inform the development of services.

Hospitalizations of Adults With Intellectual Disability in Academic Medical Centers

“…Attention to improving hospital care may include the need to improve communication and information sharing systems. Backer et al (2009) also indicated the need for improved staff knowledge and attitudes. Health care providers receive little education ahout the health care needs of individuals with ID.…”

“…Access issues included factors related to individuals with ID, such as fear of going to the hospital and communication needs; factors related to the role of caregivers, such as nonrecognition of their knowledge and experience hy hospital staff; the attitudes, knowledge, and communication of hospital staff; and physical environment factors, such as poor layout. Recommendations hased on the integrative review included liaison systems for better coordination of care, improvement of current systems including specific protocols for this population, improvement of staff attitudes and knowledge, improvement of communication and information sharing, and improvements to the physical environment (Backer et al, 2009). The 2001 surgeon general report.…”

“…The differences in outcomes of LOS and complications indicate that the challenges in the health care system are magnified for individuals with ID. Backer, Chapman, and Mitchell (2009) conducted an integrative literature review of research on issues that influence access to acute and hospital care and on evaluation of interventions to improve such access for people with ID. Access issues included factors related to individuals with ID, such as fear of going to the hospital and communication needs; factors related to the role of caregivers, such as nonrecognition of their knowledge and experience hy hospital staff; the attitudes, knowledge, and communication of hospital staff; and physical environment factors, such as poor layout.…”

Identifying the factors affecting the implementation of strategies to promote a safer environment for patients with learning disabilities in NHS hospitals: a mixed-methods study

“…68 There are different models for developing LDLN roles, including posts or teams working in general hospitals; learning disability community teams providing support to people with learning disabilities before, during and after their hospital admission; training hospital nurses to act as a resource ('link nurse') for other hospital staff; and creating city-wide nurse consultant posts to facilitate the provision of co-ordinated care across multisite hospitals. 69 A hospital-based learning disability nurse consultant post has also been described. 70 A national survey of reasonable adjustments made for people with learning disabilities in NHS trusts 36 reported that 55 acute trusts (95%) made use of liaison staff with a specific role in providing health facilitation, such as LDLNs.…”

Training and developing staff in general hospitals: intellectual disability liaison nurses and the RAID model

“…' Understanding the range of communication needs, and development of skills in adapting and using alternative communication -communication is most often cited as an issue (Mencap, 2011;Dinsmore, 2011;Backer et al, 2009;Gibbs et al, 2008), and poor communication poses very significant risks (NPSA, 2004;Read and Johnson, 2012). It can lead to a lack of compliance with care if individuals are not supported to understand (where they are able to).…”