Dignity or Denial? Decisions Regarding Initiation of Dialysis and Medical Therapy in the Institutionalized Severely Mentally Retarded

Kujdych, Natalia; Lowe, Debbie A.; Sparks, Jared; Dottes, Anita; Crook, Errol D.

doi:10.1097/00000441-200012000-00004

Cited by 13 publications

(5 citation statements)

References 10 publications

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“…Our hospital has no committee to deal with this issue; however, we have not encountered such a case to date. On the other hand, mentally retarded children are often not able to remain quiet or immobile for the 3 – 4 hours required to complete a HD treatment (11,14), and it is also clear that these patients can develop severe peritonitis that might require conversion to temporary HD. Mentally retarded PD patients can be prepared for accepting HD treatment by a graduated approach using play therapists and psychologists.…”

Section: Discussionmentioning

confidence: 99%

Chronic Peritoneal Dialysis in Children with Special Needs or Social Disadvantage or Both: Contraindications are not Always Contraindications

Aksu¹,

Yavaşcan²,

Anıl³

et al. 2012

Perit Dial Int

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Section: Discussionmentioning

confidence: 99%

Chronic Peritoneal Dialysis in Children with Special Needs or Social Disadvantage or Both: Contraindications are not Always Contraindications

Aksu¹,

Yavaşcan²,

Anıl³

et al. 2012

Perit Dial Int

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“…Families may be confronted with formidable challenges when raising a DS child. One major challenge is met by the surrogate when he needs to make medical decisions because of incompetence of the patient to give informed consent [7]. A decision in the best interest of the patient cannot be based exclusively on medical facts considering prognosis and outcome of the treatment.…”

Section: Discussionmentioning

confidence: 99%

A Down Syndrome Patient Treated by Peritoneal Dialysis

Hausmann¹,

Landau

2002

Nephron

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Down syndrome patients are apparently not suited for peritoneal dialysis because of lacking cooperation. We report on an adult Down syndrome patient living in a difficult social environment suffering from ESRD due to posterior urethral valve. Comorbid conditions include decreased left ventricular function, hepatitis B carrier stage and hypothyroidism. The commited mother of the patient treats the patient successfully by peritoneal dialysis for a period of two years without episode of peritonitis.

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“…Different authors provided recommendations on health maintenance for lifespan care of persons with Down syndrome [Bosch, 2003], managing the patient with IDD in the emergency room [Grossman et al, 2000], and ethical considerations in the decision to use or withhold dialysis treatment for persons with IDD [Kujdych et al, 2000]. One of the few studies examining outcomes of physicians using a care procedures checklist with patients with IDD documented significant improvement in care of physical but not mental conditions .…”

Section: Us Recommendationsmentioning

confidence: 99%

Translating policy principles into practice to improve health care access for adults with intellectual disabilities: A research review of the past decade

Krahn

Drum

2007

Ment. Retard. Dev. Disabil. Res. Rev.

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This article extracts principles from two Surgeon General reports, Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation (2002) and Call to Action to Improve the Health and Wellness of Persons with Disabilities (2005), and combines them with the Objectives from Chapter 6 of Healthy People 2010 to create a policy framework. This framework is used to review literature from the past decade on access to health care and health promotion for persons with intellectual and developmental disabilities (IDD). Review of the literature indicates an emerging evidence base for health promotion programs for persons with IDD. Research in health care and health promotion access requires improvements in surveillance and measurement of quality of life, as well as increased participation of persons with IDD and their families in its implementation. While international guidelines for primary health care have been developed for people with IDD, US guidelines are specialty focused and address specific conditions. Despite its recognized importance, there is surprisingly little information on training programs for health care providers to improve care of persons with IDD. Financing of health care continues to threaten access to comprehensive care for persons with IDD, particularly regarding coordination of care and availability of providers who accept Medicaid patients. Community-based sources of health care have been slow to emerge, and there is clear need for assumption of responsibility for providing care to persons with IDD. Future US policy should include consideration of environmental factors in health care access.

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Dignity or Denial? Decisions Regarding Initiation of Dialysis and Medical Therapy in the Institutionalized Severely Mentally Retarded

Cited by 13 publications

References 10 publications

Chronic Peritoneal Dialysis in Children with Special Needs or Social Disadvantage or Both: Contraindications are not Always Contraindications

Chronic Peritoneal Dialysis in Children with Special Needs or Social Disadvantage or Both: Contraindications are not Always Contraindications

A Down Syndrome Patient Treated by Peritoneal Dialysis

Translating policy principles into practice to improve health care access for adults with intellectual disabilities: A research review of the past decade

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