An exploration of the practice, policy and legislative issues of the specialist area of nursing people with intellectual disability: A scoping review

Abstract

The specialist field of intellectual disability nursing has been subjected to a number of changes since the move towards deinstitutionalisation from the 1970s. Government policies sought to change the nature of the disability workforce from what was labelled as a medicalised approach, towards a more socially oriented model of support. Decades on however, many nurses who specialise in the care of people with intellectual disability are still employed. In Australia, the advent of the National Disability Insurance Scheme offers an apt moment to reflect upon these decades of specialised nursing care as the context of this nursing care will continue to evolve. A review of the published literature was conducted to explore what has shaped the field in the past and how this might inform the future of this speciality area under new policy and service contexts. People with intellectual disability have specific health and support needs that require a specialised workforce. Specialist nurses continue to be needed for people with intellectual disability.

Supporting the needs of people with intellectual and developmental disabilities 1 year into the COVID‐19 pandemic: An international, mixed methods study of nurses' perspectives

“…Due to disparate nonmodifiable genetic and metabolic factors, fully modifiable chronic illnesses, and poor access to and uptake of health prevention (Cooper et al, 2015 ), people with IDD have a higher rate of multiple chronic and complex health conditions than people without IDD, which often require nursing support (Wilson et al, 2020 ). While historically most care of people with IDD took place in the family home, IDD nursing, as a nursing specialty, arose with the institutionalization movement of the first half of the 20th century, as many people with developmental disabilities were segregated away from society in large institutions with nurses delivering and overseeing care (Auberry, 2018 ; Boschma, 2020 ; O'Reilly et al, 2018 ). With the deinstitutionalization movement of the 1960s, most IDD nurses now practice in community settings, where the majority of people with IDD now reside (Auberry, 2018 ; Emerson & Hatton, 2008 ; O'Reilly et al, 2018 ).…”

“…While historically most care of people with IDD took place in the family home, IDD nursing, as a nursing specialty, arose with the institutionalization movement of the first half of the 20th century, as many people with developmental disabilities were segregated away from society in large institutions with nurses delivering and overseeing care (Auberry, 2018 ; Boschma, 2020 ; O'Reilly et al, 2018 ). With the deinstitutionalization movement of the 1960s, most IDD nurses now practice in community settings, where the majority of people with IDD now reside (Auberry, 2018 ; Emerson & Hatton, 2008 ; O'Reilly et al, 2018 ). IDD nurses are now more dispersed and employed in a wide variety of settings, including the private homes of people with IDD and their families, schools, group homes, intermediate care facilities, day habilitation centers, community‐based support centers, the remaining large institutions, etc.…”

Equal access to hospital care for children with learning disabilities and their families: a mixed-methods study

“…Another barrier to the provision of individualised care to children with LD in hospital is the lack of 'nomothetic' 100 knowledge that staff hold about children with LD in general. As reported elsewhere, 56,57 with the exception of paediatricians, undergraduate training in LD is extremely limited, and opportunities for training in the clinical setting are almost non-existent. Hence, we found that in the most part, the knowledge staff developed about children with LD came from experience gained over time.…”

“…The compartmentalisation of nurse training and the movement of medical staff from specialty to specialty were identified as barriers to these professional groups gaining a 'true understanding' of the holistic needs of children with LD. A lack of content on developmental disability in the undergraduate curriculum for both doctors and nurses 56,57 has been expressed elsewhere. More recently, Lewis et al 58 interviewed eight nurses working on an acute admission paediatric ward in a general hospital in Australia, who described that caring for children with LD was in some ways similar to caring for children without LD, in that the goals of keeping them happy and getting them well and back home to normality were the same.…”

Diabetes and people with learning disabilities: issues for policy, practice, and education

“…Learning Disability Liaison Nursing roles have been implemented in many acute hospitals to provide additional support for people with LDs and their families or supporters when attending for assessment, investigations and treatments (MacArthur et al, 2015). Specialist LD health services have been developed in some countries, including the United Kingdom, to provide assessment, treatments, interventions, education and support for people with LDs, their families and carers and other professionals (O'Reilly et al, 2018). People with LDs may require access to LD health services at particular times when they have needs that require specialist care and support.…”