The move from a long‐stay learning disabilities hospital to community homes: a comparison of clients’ nutritional status

Abstract

CorrespondenceMrs F. Bryan, Background Adults with learning disabilities have a greater incidence of health problems than the general population. It is now well established that they are a nutritionally vulnerable group with polarized weight distributions.Aim This study was undertaken to investigate the nutritional consequences of the closure of a large learning disabilities hospital and the resettlement of clients in small community homes.Methods The nutritional changes were measured using a locally devised nutrition screening form. This had previously been tested for reliability and validity.Clients were screened in the month prior to their discharge from Stallington Hall and at 1 year post-discharge. The two screening forms for each client were then compared.The screening form assessed risk in three areas: nutritional adequacy, weight and nutrition-related problems.Results A number of significant increases in risk between the two screens were seen. In particular, there was an increase in overall risk relating to food groups, unintentional weight gain and loss and overall risk relating to weight.At the first screen, 70% of the women and 55% of the men were outside the normal weight ranges and by the second screen these percentages had increased to 82% and 60%, respectively. It was not possible to weigh 15% of the study participants at the second screen because suitable scales were not available. ConclusionsThe study confirms the nutritional vulnerability of the participants and highlights a number of adverse nutritional changes. It supports the need for regular screening and dietetic input.

Nutrition and Adults With Intellectual or Developmental Disabilities: Systematic Literature Review Results*

“…Most of the dietary intake studies we reviewed used only a proxy reporter (Bertoli et al, 2006;Braunschweig et al, 2004;Bryan, Allan, & Russell, 2000;Cunningham, Gibney, Kelly, Kevany, & Mulcahy, 1990;Humphries et al, 2004Humphries et al, , 2007Lindeman, 1991;Litchford & Wakefield, 1985;McGuire, Daly, & Smyth, 2007;Mercer & Ekvall, 1992;Molteno, Smit, Mills, & Huskisson, 2000;Razagui, Barlow, Izmeth, & Taylor, 1991;Robertson et al, 2000). The use of proxy reporters for adults with intellectual or developmental disabilities limits the collection of dietary intake data from recalls and records to only those individuals with continuous support (i.e., direct observers) for all food-related needs and no access to food independent of that proxy reporter.…”

“…Two other studies used dietary intake as one of a host of risk factors for CVD and are displayed in Table 5 only. Three studied institutionalized adults (Cunningham et al, 1990;Litchford & Wakefield, 1985;Molteno et al, 2000), 12 studied adults living in community settings (Bertoli et al, 2006;Braunschweig et al, 2004;Draheim et al, 2002aDraheim et al, , 2007Humphries et al, 2007;Humphries, Traci, & Seekins, 2004;Lindeman, 1991;Mann et al, 2006;McGuire et al, 2007;Robertson et al, 2000;Seekins et al, 2005;Stewart et al, 1994), 1 compared a cross-section of samples from the community and from an intermediate care facility (Mercer & Ekvall, 1992), and 1 study assessed dietary intake longitudinally in a sample of adults as they moved from an institution to a community residence (Bryan et al, 2000). Of the communitybased studies, 3 studied dietary intake via menu review (Humphries et al, 2004;Lindeman, 1991;Mercer & Ekvall, 1992), 1 used 7-day food records (Bertoli et al, 2006), 7 used a food frequency questionnaire (Braunschweig et al, 2004;Draheim, 2007;Draheim et al, 2002a;Humphries et al, 2007;McGuire et al, 2007;Robertson et al, 2000;Seekins et al, 2005), and 2 used diet history (Mann et al, 2006;Stewart et al, 1994).…”

Foodwork among people with intellectual disabilities and dietary implications depending on staff involvement

“…This process meant that people with ID were regarded as consumers who were part of their own everyday food provision. As a result, large-scale cooking was phased out and daily cooking became a task for every individual with ID and his/her caregivers (Bryan, Allan, and Russell 2000;Mallander 1999). This also resulted in a shift from meals at set times with limited choice of what to eat (Young 2003) to more individual mealtime arrangements.…”

Feasibility of bioelectrical impedance analysis in persons with severe intellectual and visual disabilities

“…overweight or obesity, or undernutrition (Humphries, Traci, & Seekins, 2009). Prevalence of over-and undernutrition in persons with intellectual disabilities (ID) is estimated at about 30-65% and about 5-20%, respectively (Bryan, Allan, & Russell, 2000;Emerson, 2005;Marshall, McConkey, & Moore, 2003;Robertson et al, 2000;Waninge, van der Weide, Evenhuis, van Wijck, & van der Schans, 2009). However, comprehensive data on over-and undernutrition in persons with SIVD are lacking, because these persons are not accustomed to generally used measurements.…”