Journal articles on the topic 'People with mental disabilities Residential care Victoria'
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Bigby, C., R. Webber, B. Bowers, and B. McKenzie-Green. "A survey of people with intellectual disabilities living in residential aged care facilities in Victoria." Journal of Intellectual Disability Research 52, no. 5 (May 2008): 404–14. http://dx.doi.org/10.1111/j.1365-2788.2007.01040.x.
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Lennox, Nicholas, and Robert Chaplin. "The Psychiatric Care of People with Intellectual Disabilities: The Perceptions of Consultant Psychiatrists in Victoria." Australian & New Zealand Journal of Psychiatry 30, no. 6 (December 1996): 774–80. http://dx.doi.org/10.3109/00048679609065044.
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Objective: This study was undertaken to establish the perceptions of psychiatrists regarding the care of people with intellectual disabilities. Method: A 28-item self-administered questionnaire was developed, piloted and sent on two occasions to 467 psychiatrists who receive the newsletter of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists. The questionnaire incorporated a Likert scale to document the opinions of the respondents. Results: A response rate of 51.1 % was achieved. The respondents indicated that, in their opinion, people with intellectual disabilities receive a poor standard of care in the inpatient and community setting. To improve this situation, the following strategies were recommended: the development of improved liaison between services; improved training for all personnel who provide services to people with intellectual disabilities; the development of greater resources; and support for professionals working in the area. The study also indicates that there is a core group of very interested psychiatrists who are currently practising and that people with intellectual disabilities are accessing private psychiatric services. In addition, the results suggest that diagnostic overshadowing is not a major barrier to psychiatric assessment, and that disorders which were presumed to be commonly overlooked by doctors (such as depression) are in fact frequently being diagnosed. Conclusions: Despite some positive findings, the majority of psychiatrists who responded held major concerns about the situation of people with intellectual disabilities. To improve the care provided to these people, it is recommended that these concerns are addressed by the psychiatric profession and responsible government departments in conjunction with university departments of psychiatry.
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Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.
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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.
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Hatton, Chris. "Living arrangements of adults with learning disabilities across the UK." Tizard Learning Disability Review 22, no. 1 (January 3, 2017): 43–50. http://dx.doi.org/10.1108/tldr-11-2016-0040.
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Purpose The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland. Design/methodology/approach National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use. Findings There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK. Social implications Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences. Originality/value This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.
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Wicki, Monika T. "Physical and mental health of older people with disabilities in residential homes in Switzerland." SAGE Open Medicine 9 (January 2021): 205031212110005. http://dx.doi.org/10.1177/20503121211000530.
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Objectives: People with disabilities are underserved in terms of health care and prevention, and special health conditions exist among older people with intellectual disabilities. The Swiss Health Survey only covers people over the age of 15 years living in private households. Therefore, this study aims to assess the health status of older persons living in residential facilities for adults with disabilities. Methods: A cross-sectional survey with written questionnaires was conducted in six cantons in Switzerland to capture context factors and the physical health status of persons aged between 50 and 65 years in residential homes in Switzerland. The survey collected data on physical and mental health from 241 persons aged 50–65 years living in residential homes for people with disabilities. This was compared with data from the 2012 Swiss Health Survey comprising a sample of 2261 persons of the same age with chronic morbidities living in their own apartments. Results: Regarding their health, 94.1% of the survey respondents rated it as being very good, good or moderate. Although higher limitations on activities of daily living, higher levels of psychological distress and lower energy and vitality were reported by all respondents, a lower level of health issues was assessed than in the sample of persons with chronic morbidities living in their own apartment. Conclusion: Low energy and vitality, high limitations on activities of daily living, high psychological distress, high obesity rates and the assessment of health issues and pain should be specifically addressed in residential homes for people with disabilities.
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Iemmi, Valentina, Martin Knapp, Caroline Reid, Catherine Sholl, Monique Ferdinand, Ariane Buescher, and Marija Trachtenberg. "Positive behavioural support for children and adolescents with learning disabilities and behaviour that challenges: an initial exploration of service use and costs." Tizard Learning Disability Review 21, no. 4 (October 3, 2016): 169–80. http://dx.doi.org/10.1108/tldr-03-2015-0013.
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Purpose Positive behavioural support has been considered as a valuable alternative to residential care for children and adolescents with learning disabilities and behaviour that challenges. While recent evidence suggests it has a positive impact on behaviour and carer ability to cope, there is little evidence of its economic costs or benefits. The paper aims to discuss this issue. Design/methodology/approach An exploratory cross-sectional study was conducted to evaluate the cost of providing positive behavioural support to ten children and adolescents with learning disabilities and behaviour that challenges living in the community in Ealing, West London. Comparison was also made with the cost estimate of possible alternative support packages for children and adolescents with learning disabilities and behaviour that challenges in the UK, as obtained through a Delphi exercise. Findings Total cost of services per child was £1,454 per week for young people supported short-term, and £1,402 supported long-term. Children and adolescents were making use of a range of social care, education and health services. Over the full sample, half of the total cost was accounted for by education services. The Delphi exercise estimated the weekly cost of residential-based care as more expensive than the cost of community-based care for children and adolescents with learning disabilities and behaviour that challenges. At the end of the ITSBS, all ten children and adolescents initially at risk of imminent residential placement were living in the community with less service-intensive and less expensive support. This suggests that avoiding residential-based care could reduce costs in the long term. Originality/value Positive behavioural support has potential to support people with learning disabilities and behaviour that challenges in the community, leading to potential cost advantages. However, this is a small study and more robust research is needed.
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Hatton, Chris. "Social care for adults with learning disabilities in England: trends over time." Tizard Learning Disability Review 24, no. 2 (April 1, 2019): 94–100. http://dx.doi.org/10.1108/tldr-02-2019-0003.
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Purpose The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England. Design/methodology/approach Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities. Findings In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing. Social implications While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care. Originality/value This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.
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Marlow, Elizabeth, and Nina Walker. "Does supported living work for people with severe intellectual disabilities?" Advances in Mental Health and Intellectual Disabilities 9, no. 6 (November 2, 2015): 338–51. http://dx.doi.org/10.1108/amhid-02-2015-0006.
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Purpose – The purpose of this paper is to look at whether a move to a supported living model of care from traditional residential group homes could improve the quality of life for those with a severe intellectual disability and other challenging needs. Design/methodology/approach – Six men with severe intellectual disabilities moved from two residential homes into new-build individual flats. Their quality of life was measured using a battery of assessments looking at; environment, relationships, community participation, interactions, mood interest and pleasure, activities, physical health and challenging behaviour. These measures were taken before the move, immediately after and six months after the move. The views of staff and family carers were also assessed at each stage. Findings – The move had a positive effect on the tenants in that it caused an improvement in their mood and a decrease in their challenging behaviours. Further improvements could be made in the tenant’s quality of life by introducing more activities. The initial concerns of family members about the move decreased over time. However staff found the changes to their working practices stressful. Research limitations/implications – The study was a small scale one because of the small number of tenants. The tenants were unable to express their own views because of their limited communication abilities so a combination of direct observation and indirect measures were used. Practical implications – In the light of the Winterbourne view report by Stephen Bubb this study looks at the impact on quality of life of a move to supported living for a group of people with complex and challenging needs who might otherwise be placed in an out of borough placement similar to Winterbourne view. Social implications – The study also looks at the impact of such a move on the family members of the individuals and on the staff who had to change their working practices to adapt to both a new working environment and model of care. Originality/value – This study also looks at the impact of a model of supported living for people with severe intellectual disabilities and complex needs rather than those with mild intellectual disabilities. This is particularly important in the post Winterbourne view climate when the authors need to look carefully at positive alternative models of care for these individuals.
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Thayer, N., S. White, J. Islam, W. Jones, S. Kenzie, and R. Kullu. "Evaluation of a collaborative pharmacy service initiative for people with intellectual disabilities in residential care homes." International Journal of Pharmacy Practice 29, Supplement_1 (March 26, 2021): i44—i45. http://dx.doi.org/10.1093/ijpp/riab015.054.
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Abstract Introduction People with Intellectual Disabilities (ID) often have complex care needs and increased likelihood of premature death.1 The NHS has committed to improving the use of psychotropic medicines in people with ID with the Stopping the Over-Medication of People with Learning Disabilities (STOMP) programme.2 In the Wirral a cross-sector, collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmaceutical care reviews for ID care home residents, which included an evaluation of the initiative. Aim This study aimed to determine the number and type of pharmacists’ interventions and GP recommendations in this service initiative. Methods Pharmacists provided pharmaceutical care reviews for ID care home residents using a framework and where applicable made interventions or recommendations to residents’ GPs or consultant psychiatrist. The framework was devised by the lead Consultant, Mental Health Trust lead pharmacist and Local Pharmaceutical Committee representatives to align with national ID priorities.1 Pharmacists were recruited via expressions of interest and direct recruitment by the mental health trust. Using anonymised, aggregated, Clinical Commissioning Group data, an Oversight Group divided all ID care homes in the locality into two groups: homes with residents with low psychotropic medicines use were primarily assigned to community pharmacists, whilst those with higher psychotropic use were assigned to the specialist mental health pharmacist. Pharmacists contacted care home managers and arranged reviews with all residents, sharing learnings in weekly reviews. Community pharmacists identified residents who would benefit from specialist mental health pharmacist review and referred them. Data collected included patient demographic details, medication history, results of assessments completed and interventions/recommendations. Following institutional ethical approval, this data was downloaded from PharmOutcomes into Microsoft Excel and personally identifiable data removed. The data underwent descriptive statistical analysis in SPSS, including frequency counting interventions by type. Results The pharmacists conducted reviews with 160 residents (76 by community pharmacists and 84 by the specialist mental health pharmacist) from November 2019 – May 2020, reflecting all residents in visited care homes. These residents were prescribed 1207 medicines, 74% were prescribed 5 or more medicines (i.e. polypharmacy) and 507 interventions or recommendations were made, averaging 3.3 per resident. Table 1 shows that the highest proportion (30.4%) of these were public health related, whilst changing and stopping medicines accounted for 17.9% and 12.8% respectively. The majority (63%) of interventions made by community pharmacists were public health related, whilst those made by the mental health specialist pharmacist most frequently concerned changing medicines (25%), stopping medicines (18%), and blood monitoring (13%). Conclusion The study findings indicate a high level of polypharmacy among the ID residents and a high number of interventions / recommendations were needed to improve care, in line with national priorities.1,2 The small scale of the study is acknowledged, and further research is warranted. However, the findings suggest that this service model may be an effective use of the respective skill sets of the pharmacists involved and suitable for wider adoption, with community pharmacists focusing on holistic care and specialist mental health making specialist medicines interventions. References 1. University of Bristol Norah Fry Centre for Learning Disability Studies. The Learning Disability Mortality Review (LeDeR) Programme Annual Report 2018. Available at: https://www.hqip.org.uk/wp-content/uploads/2019/05/LeDeR-Annual-Report-Final-21-May-2019.pdf (last accessed 12/10/20). 2. NHS England. Stopping over medication of people with a learning disability, autism or both (STOMP). https://www.england.nhs.uk/learning-disabilities/improving-health/stomp/ (last accessed 12/10/20).
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Carmeli, Eli, Carmit Cahana, and Joav Merrick. "The Assimilation of Assistive Technology in Residential Care Centers for People with Intellectual Disabilities." Scientific World JOURNAL 4 (2004): 178–85. http://dx.doi.org/10.1100/tsw.2004.16.
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People with intellectual disability (ID) require special support in order to achieve independence in their daily life. Persons with ID are less exposed to assistive technology, although studies have shown that the availability of aids afford an opportunity to reach independence and cooperation. The aim of this study was to examine the nature of the relationship between involvement of the physiotherapy (PT) team and the degree to which assistive technology was used. A questionnaire was sent to all PTs employed at all 54 residential care centers for persons with ID of the Division for Mental Retardation at the Ministry of Social Affairs in Israel. A significantly positive correlation was found between the degree of involvement of the PT and the utilization of assistive technology. The study results may be summarized by stating that PTs demonstrated a great deal of involvement, particularly in relation to the extent of their work in the residential care centers. PT's awareness of the importance was indicated as the major reason to use assistive technology.
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Sequeira, Heather, Patricia Howlin, and Shiela Hollins. "Psychological disturbance associated with sexual abuse in people with learning disabilities." British Journal of Psychiatry 183, no. 5 (November 2003): 451–56. http://dx.doi.org/10.1192/bjp.183.5.451.
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BackgroundThe association between sexual abuse, mental health and behavioural problems in people with learning disabilities has not previously been examined in a controlled study.AimsTo identify symptoms of psychological disturbance in adults with and without a confirmed history of sexual abuse.MethodThe study used a matched (1:1) case–control design comparing 54 adults who had experienced sexual abuse with 54 adults with no reported history of abuse. The two groups were selected from a community population of adults with learning disabilities living in residential care, and compared for selected psychiatric diagnoses and for scores on measures of disturbed behaviour.ResultsSexual abuse was associated with increased rates of mental illness and behavioural problems, and with symptoms of post-traumatic stress. Psychological reactions to abuse were similar to those observed in the general population, but with the addition of stereotypical behaviour. The more serious the abuse, the more severe the symptoms that were reported.ConclusionsThe study provides the first evidence from a controlled study that sexual abuse is associated with a higher incidence of psychiatric and behavioural disorder in people with learning disabilities.
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Lennox, Nicholas, and Robert Chaplin. "The Psychiatric Care of People with Intellectual Disabilities: The Perceptions of Trainee Psychiatrists and Psychiatric Medical Officers." Australian & New Zealand Journal of Psychiatry 29, no. 4 (December 1995): 632–37. http://dx.doi.org/10.3109/00048679509064978.
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Objective: The main aim of this study was to document the perceptions of trainee psychiatrists and psychiatric medical officers regarding the psychiatric care of people with intellectual disabilities. Method: A 28-item self-administered questionnaire was developed by the investigators and pretested on eight psychiatrists and psychiatric trainees. A revised version of the questionnaire was then sent to 128 psychiatric trainees and 27 medical officers working in the public psychiatric services in Victoria. 116 questionnaires were returned, and the responses analysed. Results: The results indicate a high degree of interest in the psychiatry of intellectual disability, however this was tempered by a feeling that the respondents and their senior colleagues are inadequately trained. The respondents expressed major concerns regarding the care of people with dual disabilities in the hospital and community setting, and significant support for the development of specialised units and subspecialisation within psychiatry. The major concerns which were identified would in part explain why 30% of the respondents felt that they would prefer not to treat people with an intellectual disability and a psychiatric disorder. Conclusion: We can only support the assertion made by the Burdekin Report [12] that “there is an urgent need for academic research, increased clinical expertise and substantial increased resources in the much neglected area of dual disability.”
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Niemeijer, Alistair R., Brenda J. M. Frederiks, Ingrid I. Riphagen, Johan Legemaate, Jan A. Eefsting, and Cees M. P. M. Hertogh. "Ethical and practical concerns of surveillance technologies in residential care for people with dementia or intellectual disabilities: an overview of the literature." International Psychogeriatrics 22, no. 7 (March 4, 2010): 1129–42. http://dx.doi.org/10.1017/s1041610210000037.
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ABSTRACTBackground:Technology has emerged as a potential solution to alleviate some of the pressures on an already overburdened care system, thereby meeting the growing needs of an expanding population of seriously cognitively impaired people. However, questions arise as to what extent technologies are already being used in residential care and how ethically and practically acceptable this use would be.Methods:A systematic literature review was conducted to explore what is known on the moral and practical acceptability of surveillance technologies in residential care for people with dementia or intellectual disabilities, and to set forth the state of the debate.Results:A total of 79 papers met the inclusion criteria. The findings show that application and use of surveillance technologies in residential care for vulnerable people generates considerable ethical debate. This ethical debate centers not so much around the effects of technology, but rather around the moral acceptability of those effects, especially when a conflict arises between the interests of the institution and the interests of the resident. However, the majority of articles lack in depth analysis.Furthermore, there are notable cultural differences between the European literature and American literature whereby in Britain there seems to be more ethical debate than in America. Overall however, there is little attention for the resident perspective.Conclusion:No ethical consensus has yet been reached, underlining the need for clear(er) policies. More research is thus recommended to determine ethical and practical viability of surveillance technologies whereby research should be specifically focused on the resident perspective.
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Wistow, Gerald, Margaret Perkins, Martin Knapp, Annette Bauer, and Eva-Maria Bonin. "Circles of Support and personalization." Journal of Intellectual Disabilities 20, no. 2 (March 22, 2016): 194–207. http://dx.doi.org/10.1177/1744629516637997.
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Circles of Support aim to enable people with learning disabilities (and others) to live full lives as part of their communities. As part of a wider study of the economic case for community capacity building conducted from 2012 to 2014, we conducted a mixed methods study of five Circles in North West England. Members of these Circles were supporting adults with moderate to profound learning disabilities and provided accounts of success in enabling the core member to live more independent lives with improved social care outcomes within cost envelopes that appeared to be less than more traditional types of support. The Circles also reported success in harnessing community resources to promote social inclusion and improve well-being. This very small-scale study can only offer tentative evidence but does appear to justify more rigorous research into the potential of Circles to secure cost-effective means of providing support to people with learning disabilities than the alternative, which in most cases would have been a long-term residential care placement.
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Hunter, Rachael. "Evaluating the costs and cost-effectiveness of interventions for people with learning disabilities and behaviour that challenges: the need to improve the evidence base." Tizard Learning Disability Review 21, no. 4 (October 3, 2016): 181–85. http://dx.doi.org/10.1108/tldr-06-2016-0016.
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Purpose The purpose of this paper is to provide a commentary on the challenges associated with evaluating the costs and cost-effectiveness of interventions for people with learning disabilities and behaviour that challenges. Design/methodology/approach The paper is a commentary on a range of evidence relating to the findings of “Positive behavioural support for children and adolescents with learning disabilities: an initial exploration of service and costs”. Specific attention is paid to gaps in the literature and the evidence base for the cost of care for people with learning disabilities and behaviour that challenges. Findings Recommendations for person-centred support and increased use of behavioural and psychological interventions for people with learning disabilities and behaviour that challenges are based on limited evidence. The literature is particularly sparse in relation to the cost implications for service providers or informal carers of implementing such interventions and the question of whether they reduce costs through preventing residential placements and long-term inpatient admissions. Originality/value More high-quality research is required in the area of behavioural and psychological interventions for people with learning disabilities and behaviour that challenges. Trials in this area should include high-quality economic evaluations including budget impact analysis to provide information on the cost implications for different government agencies and cost-effectiveness analysis incorporating impact on quality of life.
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Tsiantis, J., A. Perakis, P. Kordoutis, G. Kolaitis, and V. Zacharias. "The Leros PIKPA Asylum. Deinstitutionalisation and Rehabilitation Project." British Journal of Psychiatry 167, S28 (July 1995): 10–45. http://dx.doi.org/10.1192/s0007125000298176.
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A three-year deinstitutionalisation and rehabilitation pilot intervention project was implemented at Leros PIKPA for people with severe learning disabilities. Initial conditions at the asylum were appalling. Residents suffered severe deprivation, extreme institutionalisation, and violation of basic human rights. Intervention involved professionals from different disciplines, and involved residents, their families, care staff, the institution, and the local community. As a result, resident care and adaptive behaviour has started to improve. Communication between residents and families has increased. Owing to training and sensitisation, care staff's poor resident-management practices and negative attitudes toward disabled people have changed. Living and hygienic conditions have been upgraded and building renovation is under way. Asylum administration and the local community have been sensitised to residents' needs. Eleven residents have moved to the project's pilot community home in Athens; two others now live with foster families. The results suggest that deinstitutionalisation and rehabilitation can be successfully initiated even in residential institutions of the severest kind.
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Barry, Sandra, Lucy Knox, and Jacinta M. Douglas. "“Time's Up”: The Experience of Entering Residential Aged Care for Young People with Acquired Neurological Disorders and Their Families." Brain Impairment 20, no. 1 (September 13, 2018): 37–48. http://dx.doi.org/10.1017/brimp.2018.13.
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Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.
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Kim, Jinsook, and Jennifer A. Gray. "Effect of Online Palliative Care Training on Knowledge and Self-Efficacy of Direct Care Workers." Intellectual and Developmental Disabilities 59, no. 5 (September 22, 2021): 392–404. http://dx.doi.org/10.1352/1934-9556-59.5.392.
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Abstract We evaluated the effectiveness of an online training on palliative care knowledge and self-efficacy among staff working with people with intellectual and developmental disabilities (IDD) using a one-group pretest-posttest design. Staff from four nonprofit residential and day services organizations in a U.S. Midwestern state participated. Among 132 staff who completed a baseline assessment, a 2-hour online training, and a posttest, 98 staff completed a 1-month follow-up survey. Palliative care knowledge was assessed before and after the training, and palliative care self-efficacy, at baseline and 1-month follow-up. We used linear regression to identify the factors that influence the effect of the training on main outcomes. Overall palliative care knowledge and self-efficacy significantly improved while higher education and longer work tenure enhanced training effectiveness.
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Yong, Phooi Ling, Faizah Mas'ud, and How Kee Ling. "Reflexivity: Doing Research with Women in a Mental health Care Facility." Asian Social Work Journal 4, no. 4 (October 7, 2019): 19–29. http://dx.doi.org/10.47405/aswj.v4i4.106.
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Reflexivity has been recognised as a crucial strategy in the knowledge generating process and applied in qualitative research to legitimate, validate and question research practices and representation, as well as evaluating the quality of qualitative research. Reflexivity in the social work literature have impacted in research and practice. However, the effect of researcher’s perspectives on the data collection and interpretation process by using reflexivity has not been examined in the mental health research in Malaysia. Thus, this paper aims to explore the role of methodological reflexivity in a qualitative research with Chinese women with mental health problems in a residential care setting in Malaysia. The researcher’s and participants’ interaction and experiences, as well as emotional context during interviews that affect the data interpretation and data collection process are discussed. Greater understanding on their experiences in the care centre has been generated by focusing on these women as an “abled-body” rather than people with disabilities. Recognition of the researcher’s feelings and experiences have enriched the research method and analysis, as well as informing the practice for social workers, health practitioners, and students who work with women with mental health problems.
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McConkey, Roy, Fionnola Kelly, Hasheem Mannan, and Sarah Craig. "Moving From Family Care to Residential and Supported Accommodation: National, Longitudinal Study of People With Intellectual Disabilities." American Journal on Intellectual and Developmental Disabilities 116, no. 4 (April 1, 2011): 305–14. http://dx.doi.org/10.1352/1944-7558-116.4.305.
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Abstract A cohort of nearly 11,000 persons was traced over 8 years to determine those who had moved from family care and those who had remained. The majority (85%) continued to live with families, and, for two thirds (67%), no future move was deemed necessary. The 2 main predictors of moving were as follows: A need had been previously recorded and the family had used out-of-home respite services during the 8 years. However, just one quarter of those identified as needing to move had done so in the 8 years. Conversely, no prior indication of need had been recorded for two thirds of people who had moved in this period. The complexities of assessing need and equitably meeting demands are discussed.
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Mitra, Ipsita, and Regi Alexander. "Out-of-area placements: implications of psychiatric services in learning disability." Psychiatric Bulletin 27, no. 10 (October 2003): 382–85. http://dx.doi.org/10.1192/pb.27.10.382.
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Aims and MethodWith an absence of appropriate residential services, people with learning disabilities are often placed outside their local areas and there is regularly no dialogue between the relevant health authorities prior to a placement being made. This survey from Leicestershire explored this issue by focusing on the catchment area covered by one consultant psychiatrist. Practice standards were formulated and compliance with these was examined.ResultsA total of 29 patients were identified as ‘out-of-area’ placements. They had high psychiatric morbidity, exhibited significant degrees of aggression and needed a high level of professional input. The suggested practice standards were met by less than 10%.Clinical ImplicationsIn parts of the country where a large number of ‘specialist’ residential homes have opened, there has been an unplanned increase in the workload of local learning disability/ mental health services. This can compromise patient care and there is an urgent need for health authorities to address this issue.
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Lulinski, Amie, and Tamar Heller. "Community Capacity to Provide Mental/Behavioral Health Services for People With IDD Transitioning From State-Operated Developmental Centers." Intellectual and Developmental Disabilities 59, no. 3 (May 24, 2021): 224–38. http://dx.doi.org/10.1352/1934-9556-59.3.224.
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Abstract The study's aim was to explore the capacity of community-based providers of residential supports and services to support people with intellectual and developmental disabilities who transitioned out of state-operated institutions into community-based settings. Receiving agency survey results from 65 agencies and individual-level variables of 2,499 people who had transitioned from an institution to a community-based setting indicated that people who returned to an institution post-transition tended to be younger, have a higher IQ score, were more likely to have a psychiatric diagnosis, tended to have shorter previous lengths of stay at an institution, transitioned to larger settings, and received services from an agency receiving behavioral health technical assistance as compared to those who remained in their transition settings.
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Cohen, Y. "Seven years after ratification of the UNCRPD: Are there any advances for patients with mental health conditions?" European Psychiatry 33, S1 (March 2016): S39—S40. http://dx.doi.org/10.1016/j.eurpsy.2016.01.884.
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The Convention on the Rights of Persons with Disabilities (CRPD) is the first highest international legally-binding standard which aims to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, including those with mental health conditions, and to promote respect for their inherent dignity. The CRPD embodies a ‘paradigm shift’, from the charitable and the medical approaches to disability to one, which is firmly rooted in human rights. It provides a clear path towards non-discrimination, full and effective participation and inclusion in society, respect for difference and acceptance of persons with disabilities as part of human diversity and humanity, equality of opportunity and accessibility just to name a few.States which have signed the CRPD have an obligation to respect, protect and fulfil the internationally agreed upon set of standards guaranteed to all people included in the Convention. However, even in signatory states, violations often occur behind “closed or open doors” and go unreported and consequently unprevented. The growing number of people with mental health conditions in the world has further contributed to a level of attention paid to quality and human rights conditions in both outpatient and inpatient facilities, which has never been greater. Persons with mental health conditions need both de jure human rights protection and de facto human rights practices.Seven years after the CRPD came into force the care available in many mental health facilities around Europe is still not only of poor quality but in many instances hinders recovery. The level of knowledge and understanding by staff of the rights of people with mental disabilities is very poor. It is still common for people to be locked away or to be chained to their beds, unable to move. Inhuman and degrading treatment is common, and people in facilities are often stripped of their dignity and treated with contempt. Violations are not restricted to inpatient and residential facilities; many people seeking care from outpatient and community care services are disempowered and also experience extensive restrictions to their basic human rights.In the wider community, many people with mental disabilities are still denied many basic rights that most people take for granted. For example, they are denied opportunities to live where they choose, marry, have families, attend school and seek employment. There is a commonly held, yet false, assumption that people with mental health conditions lack the capacity to assume responsibility, manage their affairs and make decisions about their lives. These misconceptions contribute to the ongoing marginalization, disenfranchisement and invisibility of this group of people in their communities.One of the underlying reasons it is difficult to move through the obstacles to fully embrace the CRPD, is that discrimination continues to affect people with mental health conditions on many levels. Changing laws is only a partial solution. We have to change the ways that we relate to each other at every level, and to offer people information and tools to make the transition to a more equitable social reality.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Rusakovskaya, O., and E. Volodenkova. "The system of institutional care for children with developmental disabilities in Russia: problems and current results of reforming." European Psychiatry 65, S1 (June 2022): S424—S425. http://dx.doi.org/10.1192/j.eurpsy.2022.1077.
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Introduction As part of the full-sized personal examination of persons, living in residential facilities for mentally disabled people (Kekelidze, 2020) 621 children, living in 3 asylums “for children with mental retardation” of Krasnoyarsk region were examined. In 134 cases diagnosis “Moderate or severe mental retardation” wasn’t confirmed. In 2020 a full examination of 47 children with non-confirmed diagnoses was carried out in one of the asylums. Objectives The main purpose of this investigation is to present the results of this full examination and sum up the main problems of the system of institutional care for children with intellectual and developmental disabilities in Russia. Methods Clinical and psychological examination, Wechsler Intelligence Scale for Children (WISC-II), analysis of pedagogical characteristics. Results Figure 1 presents the results of cluster analysis of WISC-II. In 37 cases diagnoses were reversed to Mild intellectual disability. In one case – 10 y.o. boy - to developmental delay through social-pedagogic neglect. In the beginning of 2021 32 children were transferred to boarding schools with educational programme for children with mild intellectual disabilities. 13 children adapted to new developmental and educational conditions relatively successfully, 4 children – unsuccessfully and were returned to the first institute. Conclusions The success of adaptation did not depend on IQ, but on the age of the child and the severity of emotional and behavioral disorders, as well as on the willingness of the institution to provide personalized assistance to the child. The results identify the main problems of the system of institutional care for children with developmental disabilities in Russia. Disclosure No significant relationships.
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McConkey, Roy, Jayne McConaghie, Owen Barr, and Paul Roberts. "Views of family carers to the future accommodation and support needs of their relatives with intellectual disabilities." Irish Journal of Psychological Medicine 23, no. 4 (December 2006): 140–44. http://dx.doi.org/10.1017/s0790966700009940.
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AbstractObjectives: The demand for places in supported accommodation is likely to rise due to the increasing longevity of people with intellectual disabilities and as their parents become unavailable or unable to care for them. However few attempts have been made to ascertain carer's views on alternative accommodation.Method: Four studies were undertaken in Northern Ireland to ascertain carer's views using three different methods. In all, 387 carers participated with the response being greatest for individual interviews conducted in the family home and least for self-completed questionnaires and attendance at group meetings.Results: The majority of carers envisaged the person continuing to be cared for within the family. The most commonly chosen out-of-home provision was in residential or nursing homes, living with support in a house of their own and in homes for small groups of people. Few carers chose living with another family. However only small numbers of carers envisaged alternative provision being needed in the next two years and few had made any plans for alternative living arrangements.Conclusions: The implications for service planning are noted, primarily the need for individual reviews of future needs through person-centred planning; improved information to carers about various residential options and their differential benefits, along with more services aimed at improving the quality of life of people living with family carers. These need to be underpinned by a commitment of statutory agencies to partnership working with family carers. The implications for mental health services are noted.
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Reid, Caroline, Catherine Sholl, and Nick Gore. "Seeking to prevent residential care for young people with intellectual disabilities and challenging behaviour: examples and early outcomes from the Ealing ITSBS." Tizard Learning Disability Review 18, no. 4 (October 14, 2013): 171–78. http://dx.doi.org/10.1108/tldr-01-2013-0003.
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Peña-Salazar, Carlos, Francesc Arrufat, Abel Fontanet, Josep Font, Silvia Mas, Pere Roura-Poch, and Josep Manel Santos. "The role of mental health and challenging behaviour in the quality of life in people with intellectual disabilities in Spain." Advances in Mental Health and Intellectual Disabilities 12, no. 1 (January 2, 2018): 34–43. http://dx.doi.org/10.1108/amhid-06-2017-0022.
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Purpose The purpose of this paper is to determine the relation between quality of life (QoL), mental illness, challenging behaviour and institutionalisation in an adult population with intellectual disabilities (ID). Design/methodology/approach The study assessed the QoL and its conditioning factors in 142 subjects with different degrees of ID. The GENCAT and Quality of Life in Late Stage Dementia scale were used to evaluate QoL, the Psychiatric Assessment Schedule for Adults with Developmental Disability and Diagnostic Assessment for the Severely Handicapped-II scale to assess mental illness and the Inventory for Client and aetiology Planning scale to assess challenging behaviour. Findings Individuals who live in residential care homes were found to have significantly impaired QoL (<0.001). Individuals with challenging behaviour presented significantly lower QoL, regardless of ID aethiology and degree, while psychiatric disorders did not seem to have a direct influence on individual QoL. Originality/value This paper provides new insight into the importance of challenging behaviour and psychiatric disorders in the QoL of individuals with ID.
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Mitra, Ipsita, and Regi Alexander. "Out-of-area placements: implications of psychiatric services in learning disability." Psychiatric Bulletin 27, no. 10 (October 2003): 382–85. http://dx.doi.org/10.1017/s0955603600003172.
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Aims and Method With an absence of appropriate residential services, people with learning disabilities are often placed outside their local areas and there is regularly no dialogue between the relevant health authorities prior to a placement being made. This survey from Leicestershire explored this issue by focusing on the catchment area covered by one consultant psychiatrist. Practice standards were formulated and compliance with these was examined. Results A total of 29 patients were identified as ‘out-of-area’ placements. They had high psychiatric morbidity, exhibited significant degrees of aggression and needed a high level of professional input. The suggested practice standards were met by less than 10%. Clinical Implications In parts of the country where a large number of ‘specialist’ residential homes have opened, there has been an unplanned increase in the workload of local learning disability/ mental health services. This can compromise patient care and there is an urgent need for health authorities to address this issue.
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Modi, Kiran, Gurneet Kalra, Leena Prasad, and Najeebullah Babrakzai. "COVID, Its Impact on the Mental Health of Caregivers in Childcare Institutions of South Asian Countries and Their Coping Techniques: Analysis of the Caregivers in Childcare Institutions Using Data from Seven South Asian Countries." Institutionalised Children Explorations and Beyond 8, no. 2 (August 29, 2021): 223–48. http://dx.doi.org/10.1177/23493003211033062.
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Widely across the globe, COVID has placed massive strain on various parameters of life, including child protection, health, education and economic systems. Apart from these visible threats, this situation has an ongoing devastating impact on the mental health and psychological well-being of people. The word of the law enforces care and support for children with disadvantages, disabilities and vulnerabilities on caregivers, Managers and Staff, managing Alternative Care programmes, but the spirit of such child protection laws also underlines the importance of caring for caregivers, especially in childcare institutions (CCIs). The well-being of the caregivers is the cornerstone of every well-functioning childcare institution and other residential care spaces. This article is designed to document the mental health status of caregivers (residential staff staying with children), in residential care spaces in the COVID times and to determine how the new stresses impacted them and the coping patterns they acquired in current situation; across different countries of South Asia, including Afghanistan, Bangladesh, India, Maldives, Nepal, Pakistan and Sri Lanka. This exploratory rapid assessment project aimed to reach out to the registered childcare homes/ institutions, across the South Asian region, with the help of different NGOs, as well as Government mechanisms. The data was collected through purposive sampling and analysed quantitatively where the sample included the selected caregivers of participating CCIs across these nations. This study aimed to synthesize the responses of caregivers across the region; develop an analysis, which may help authorities to rethink, reform and strengthen the current practices, in order to develop approach-centred strategies for improving the well-being of caregivers as this has a direct bearing on the well-being of children in their care. Since the start of the COVID pandemic, for the residential caregivers, the access to external resources, including physical support from professional staff, has become restricted to bare minimum, due to lockdown and quarantine measures. Any interventions to prevent, treat and mitigate the effects of COVID among caregivers needed to be taken at the ground level by the care team management.
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Clare, Isabel C. H., Kelly A. Wade, Nadine Ranke, Sarah Whitson, Alison Lillywhite, Elizabeth Jones, SallyAnne Broughton, Adam Wagner, and Anthony J. Holland. "Specialist community teams for adults with learning disabilities: referrals to a countywide service in England." Tizard Learning Disability Review 24, no. 2 (April 1, 2019): 41–49. http://dx.doi.org/10.1108/tldr-05-2018-0015.
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Purpose While “generic” community teams for adults with learning disabilities (CTs) are well-established in the UK, very little recent evidence is available about any aspect of their work. As part of a larger project about the role, structure and functioning of CTs, the purpose of this paper is to provide data about referrals. Design/methodology/approach Over three months, the authors obtained data about 270 consecutive new referrals to five CTs in a countywide integrated health (NHS) and care management (local authority) service. Findings The 270 referrals related to 255 individuals, mainly already service users, with almost a third (30 per cent, n=204) described as people with severe or profound disabilities. Consistent with the reported living arrangements (residential accommodation or with one or more family members (87 per cent, n=270)), referrals were most often made by social care staff, General Practitioners or carers. The referrals related to a wide range of issues including mental health and/or behavioural needs, physical health and skills, and independence. The major group, however, were requests about a person’s entitlement to specialist learning disability services and/or reviews of an existing social care package. Research limitations/implications The focus on new referrals and the exclusion of intra-team referrals mean that the data are not representative of a CT’s caseload and cannot be used as a basis for resourcing. Nevertheless, the findings emphasise the heterogeneity of the population, and the long-term and varied nature of their needs, meaning that CTs require access to a range of expertise and, often, an inter-agency approach. The implications for service design are considered. Originality/value This is the first empirical study of referrals to specialist integrated (health and care management) community learning disabilities teams in England.
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Chikwava, Fadzai, Melissa O’Donnell, Anna Ferrante, Eduwin Pakpahan, and Reinie Cordier. "Patterns of homelessness and housing instability and the relationship with mental health disorders among young people transitioning from out-of-home care: Retrospective cohort study using linked administrative data." PLOS ONE 17, no. 9 (September 2, 2022): e0274196. http://dx.doi.org/10.1371/journal.pone.0274196.
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Objectives The study examined the relationship between mental health, homelessness and housing instability among young people aged 15–18 years old who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia with follow-up to 2018. We determined the various mental health disorders and other predictors that were associated with different levels of homelessness risk, including identifying the impact of dual diagnosis of mental health and substance use disorder on homelessness. Methodology Using retrospective de-identified linked administrative data from various government departments we identified various dimensions of homelessness which were mapped from the European Topology of Homelessness (ETHOS) framework and associated mental health variables which were determined from the WHO ICD-10 codes. We used ordered logistic regression and Poisson regression analysis to estimate the impact of homelessness and housing instability respectively. Results A total homelessness prevalence of 60% was determined in the care-leaving population. After adjustment, high risk of homelessness was associated with dual diagnosis of mental health and substance use disorder, intentional self-harm, anxiety, psychotic disorders, assault and maltreatment, history of involvement with the justice system, substance use prior to leaving care, residential and home-based OHC placement and a history of staying in public housing. Conclusions There is clearly a need for policy makers and service providers to work together to find effective housing pathways and integrated health services for this heterogeneous group of vulnerable young people with complex health and social needs. Future research should determine longitudinally the bidirectional relationship between mental health disorders and homelessness.
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Bertelli, Marco O., Michele Rossi, Niccolò Varrucciu, Annamaria Bianco, Daniela Scuticchio, Chiara Del Furia, Serafino Buono, and Margherita Tanzarella. "Relationship between psychiatric disorders and adaptive functioning in adults with intellectual disabilities." Advances in Mental Health and Intellectual Disabilities 10, no. 1 (January 4, 2016): 92–101. http://dx.doi.org/10.1108/amhid-08-2015-0038.
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Purpose – Though the very high prevalence of psychiatric disorders (PD) in people with intellectual disability (PwID), the impact of these disorders on adaptive functioning has been minimally investigated. The few contributions present in the literature focussed on children, adolescents, and individual with autism spectrum disorders (ASD). There are no studies concerning the evaluation of any kind of impact on individual skills. Comparison studies between PD and organic disorders, including neurological disorders (ND), was also underexplored. The purpose of this paper is to assess the impact of the presence of a PD on the adaptive functioning of adults with intellectual disability (ID). Design/methodology/approach – In total, 107 adults with ID living in residential facilities or attending day care centers in Tuscany were consecutively assessed with the Psychiatric Instrument for the Intellectually Disabled Adult (SPAID-G), the Diagnostic Manual-Intellectual Disability (DM-ID) criteria, and the Vineland Adaptive Behavior Scales (VABS). The scores were statistically compared and results were controlled for level of ID and other background variables. Findings – The presence of a PD resulted to have a significant negative impact on individual adaptive skills. Participants with PD scored significantly lower than those without PD in communication and socialization areas of VABS. Participants with ND scored significantly lower than people without ND in daily living and motor skills. The average scores of participants with only PD and those of participants with PD and ND showed no significant differences. Significant differences were found between participants with only ND and participants with ND and PD in the interpersonal relationship subscale. Originality/value – As far as the best knowledge, this is the first study on the evaluation of the impact of any kind of PD on the abilities of PwID. This paper suggests that the presence of a PD seems to have a relevant negative impact on functioning of PwID higher than that of ND, particularly in communication and socialization skills.
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Worthington, Rachel, Chris Patterson, and Neel Halder. "Working with intellectually disabled autistic individuals – a qualitative study using repertory grids." Journal of Intellectual Disabilities and Offending Behaviour 9, no. 1 (March 12, 2018): 22–31. http://dx.doi.org/10.1108/jidob-08-2017-0017.
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Purpose The purpose of this paper is to elucidate how care professionals/providers construe, understand and make sense of the characteristics that are important when providing care to adults with intellectual disability and autism spectrum disorder, based on their experiences of working within their roles within a residential care setting. Design/methodology/approach Care professionals and providers working at a community autism and intellectual disability service were interviewed to ascertain their experiences of working with this client group. The research design adopted a qualitative methodology using repertory grids. Findings Ten members of staff who agreed to participate formed the study’s sample. This consisted of team leaders, support workers, one member of the executive management team and one clinical member of staff. Ten themes were identified for working effectively with people with autism and intellectual disabilities. These were: making autism-specific adaptations, approachable, reflective/self-aware, strong understanding of their residents/empathetic, benevolent, empowering, follows plans consistently, confident in ability to support residents with autism, resilient, respectful. Practical implications The paper discusses each of these ten themes above and how employers can aid in selecting individuals who may be more suited to working with this patient group. Originality/value A literature search demonstrated a lack of empirical research, especially qualitative research, on this topic.
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Merrick, Joav, Isack Kandel, and Mohammed Morad. "Health Needs of Adults with Intellectual Disability Relevant for the Family Physician." Scientific World JOURNAL 3 (2003): 937–45. http://dx.doi.org/10.1100/tsw.2003.91.
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People with developmental disability, mental retardation, or intellectual disability are living longer and becoming prone to age-related health problems and diseases of old age much like the general population. This worldwide trend is also seen in Israel, where today 39.8% of persons with intellectual disability in residential care are 40 years old and above. There is a need for service and staff providers to receive training; a need for more research and better service for this aging population. This review presents health concerns for older persons with different levels of intellectual disability, health concerns in persons with Down syndrome, and persons with epileptic seizures and cerebral palsy in relation to general practice and family medicine. The review is concluded with recommendations on health and aging in adults with intellectual disabilities and the call for formalized training in the topic for specialists in family medicine.
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Thayer, Nick, Simon White, Jasmeen Islam, Wesley Jones, Stephanie Kenzie, and Rajni Kullu. "Reducing risks associated with medicines and lifestyle in a residential care population with intellectual disabilities: evaluation of a pharmacy review initiative in England." BMJ Open 11, no. 8 (August 2021): e046630. http://dx.doi.org/10.1136/bmjopen-2020-046630.
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ObjectivesA collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmacist reviews for care home residents with intellectual disabilities (IDs). This study aimed to characterise the medicines and lifestyle risk outcomes of the service and determine how these align with national priority issues in ID.DesignDescriptive statistical analysis of routinely collected service delivery data.SettingResidential care homes in the Wirral, England for people with ID.Participants160 residents.InterventionsPharmacist review of residents’ medicines and lifestyle risk factors between November 2019 and May 2020.Primary and secondary outcome measuresNumbers of medicines prescribed, the nature of pharmacists’ interventions/recommendations and general practitioner (GP)/psychiatrist acceptance.ResultsThe 160 residents were prescribed 1207 medicines, 74% were prescribed ≥5 medicines and 507 interventions/recommendations were made, averaging 3.3 per resident. The highest proportion (30.4%) were lifestyle risk related, while changing and stopping medicines accounted for 17.9% and 12.8%, respectively. Of the recommendations discussed with GPs/psychiatrists, 86% were accepted. Medicines with anticholinergic properties were prescribed for 115 (72%) residents, of whom 43 (37%) had a high anticholinergic burden score. Pharmacists recommended anticholinergic discontinuation or dose reduction for 28 (24%) residents. The pharmacists made interventions/recommendations about constipation management for 10% of residents and about respiratory medicines for 17 (81%) of the 21 residents with respiratory diagnoses.ConclusionsThe findings indicate considerable polypharmacy among the residents and a high level of pharmacists’ interventions/recommendations about medicines and lifestyle risk, most of which were accepted by GPs/psychiatrists. This included anticholinergic burden reduction and improving respiratory disease and constipation management, which are national priority issues. Wider adoption of collaborative pharmacist review models could have similar benefits for residential populations with ID and potentially reduce pressure on other health services.
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Moro, Marta, Chiara Salvato, Gianni Terrazzani, Donatella Serraglia, Cristina Saramin, Pietro Giusti, and Alessandro Chinellato. "Costi e bisogni sanitari degli anziani non autosufficienti presso le strutture residenziali: strategie e interventi per una popolazione che invecchia." Farmeconomia. Health economics and therapeutic pathways 6, no. 2 (June 15, 2005): 135–40. http://dx.doi.org/10.7175/fe.v6i2.828.
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CONTEXT: The number of elderly is constantly increasing in the western world and many of this people spend the last years of their life in a nursing home with physical and/or mental disabilities. OBJECTIVE: To estimate the Health Service resource and direct costs for Community Residential Care (CRC) disabled elderly people. METHODS: A retrospective observational study was conducted between January 2002 and December 2002 among all CRC (23 CRC and 1665 disabled residential elderly population REP) of the Local Health Authority n° 9 of Treviso. For each CRC data regarding patients, hospitalisation, clinical analysis, general practitioner and hospital medical doctor assistance, drug utilisation were collected and analysed. RESULTS: Males were 27% and female 73% with an average age 78 and 86 years old respectively. Frequency of hospitalisation, clinical analysis and drug utilisation vary widely between the CRC and an inverse correlation is observed between cost of hospitalisation and drug plus clinical analysis. The first causes of hospitalisation are pneumonia 7.2% and cardiovascular disease 4.9% both considered preventable cause of hospitalisation. Regarding the drug consumption analysis enalapril, furosemide, omeprazole are the most used molecules with a consumption of 308, 185, 166 DDD/1000 REP/die; systemic antibiotics are the more expensive drugs with a cost of 0.3 euro/REP/die. Unexpected laxatives consumption is lower than data from literature with a 17% of the total REP exposed. Finally average annually cost for a REP in CRC is 16,445 euros and beside the direct sponsor of local health authority to the CRC hospitalisations cost are the most important (899 euros) while drugs, medical assistance and sanitary material cost are similar with an annual cost of 530 euros, 492 euros, 450 euros respectively. Hypnotic and anxiolytic consumption appear to be correct with literature data with about 30% population exposed. CONCLUSION: Females are disabled about 10 years after males, many hospitalisation could be avoided with correct sanitary programs and finally and inverse correlation of drug consumption and hospitalisation is observed.
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Dhandapani, Asha, Sathyan Soundararajan, and Claire Jones. "Audit on use of PRN (pro re nata) psychotropic medication for behavioural disturbance in individuals with intellectual disability in the community." BJPsych Open 7, S1 (June 2021): S75—S76. http://dx.doi.org/10.1192/bjo.2021.240.
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AimsPsychotropic medication is commonly used in people with Intellectual disabilities (ID). This may be attributed in part to an increased prevalence of mental illness in this population and the presence of challenging behaviour which has been shown to increase rates of prescribing. Whilst there are a number of studies looking at regularly prescribed medication there are few studies on “as and when” required (PRN) medication.Psychotropic medication continues to be used to manage behavioural disturbances in people with ID. Where there is no clear cut psychiatric illness, the role of psychotropic medication is an adjunct to a comprehensive multimodal treatment plan.The aim is to find out if prn psychotropic medication for behavioural disturbance is being used appropriately and safely in these individuals.MethodFiles and PRN protocols of individuals known to be using prn psychotropic medications for the management of acute episodes of agitation and behavioural problems and supported by professional staff teams was studied.We collected the data by contacting the residential homes, carers, Collecting details from case notes, from the Staff nurse who made the protocol for their patientsA questionnaire based on the standards mentioned above was developed and files and prn protocols were marked against these standards.ResultThe standards from the medical file were 100 % achieved. Thus indicating the importance of the psychotropic prn medication and documentation of the same.However, the protocol that needs to be with the patient/carers had some lacuna/deficits. Overall only in 53% of the case, standards were achieved. This needs to be highlighted to the team.The Audit gave an insight into what needs to be improved.THE FOLLOWING AREAS NEEDED IMPROVEMENT 1.There should be a prn protocol/ similar instruction to the staff about the use of prn medication(written by appropriately trained professional)2.Prn protocol should be accessible to direct care staff3.There should be a description of when to use the prn medication4.There should be a description of what non-pharmacological de-escalation methods ought to be tried before using prn/ is there a detailed behaviour support plan available5.Protocol should describe what the medication is expected to do6.Protocol should describe the minimum time between doses if the first dose has not worked7.Protocol should state the maximum dose in 24 hour period8.Use of prn should be recordedConclusionI hope this audit will help in improving the patient care with the right psychotropic prn medication, with correct doses and further details as mentioned in the standards of the protocol.We also hope to ensure that in our area, prn psychotropic medication used for agitation and behavioural disturbance is used safely, appropriately and consistently by staff teams. This would be in accordance with the guidelines.
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Udovenko, Iuliia, Tetiana Melnychuk, and Julia Gorbaniuk. "Mentoring as an individual form of preparing orphans for independent living in Ukraine." Current Problems of Psychiatry 21, no. 3 (September 1, 2020): 167–73. http://dx.doi.org/10.2478/cpp-2020-0016.
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Abstract Objective: The purpose of the study is to analyze and define the content, specifics, and procedures of social and psychological work with citizens who have expressed a desire to become mentors for orphans. Introduction: In Ukraine, there are more than 750 foundations of institutional care and upbringing of children, in which approximately 106,000 children live. Only 8% among them have the status of orphans and children deprived of parental care; the other 92% have parents, but due to some difficult life circumstances of parents or presence of special needs or disability in children, they cannot live or be brought up in the family. It means that 92% of children without the status of orphans or children deprived of parental care cannot be adopted or placed for living and upbringing to other forms of family placement (guardianship/care, foster family, family-type orphanage). Along with this, out of 8% of orphan children and children deprived of parental care, there are no opportunities to be accommodated in any family forms of upbringing the following children: teenagers and youngsters, brothers and sisters from families with many children, and children with disabilities. In such children, close emotional relationships with meaningful, constant adults, which is a vital necessity for their psycho-emotional development and well-being, have been lost or were not formed at all. Accordingly, the introduction of mentoring for orphans and children deprived of parental care who live in relevant institutions is motivated by the necessity to satisfy the need of every child in emotional support, assistance and protection by a significant, authoritative person, and friend. Methods: The study uses an experience which was gained during the realization of the project as the author-developer of the methodology of socio-psychological work with citizens and children concerning preparations for mentoring and training for both coordinators and mentors of the Mentoring Program in cooperation with specialists of the “One Hope” non-governmental organization; in the role of educator for the preparation of coordinators for the Mentoring Program implementation, as well as in the role of expert during the implementation of Mentoring Program by the community organization “One Hope” during the 2009-2016 period [1]. Also, authors participated in developing of the mentors preparing program over orphans and children deprived of parental care in order to receive approval at the state level. Results: Mentoring for orphans and children deprived of parental care residing in institutions has been implemented in Ukraine since 2009 by the “One Hope” (“Odna Nadia”) public organization in cooperation with the Kyiv City Children’s Service and the Kyiv City Center of Social Services for Families, Children and Young People. The project “One Hope” was launched in the city of Kyiv and the Kyiv region during 2009-2016. Since 2016, mentoring as an individual form of support and assistance for a child living in a residential institution has been introduced in Ukraine at the state level. Conclusions: If an orphan child or a child deprived of parental care is unable to live and being brought up in a family, then the mentor’s role in the life of this child is of paramount importance. This is due to the fact that such a form of individual support through mentoring will facilitate the preparation of every orphan child for independent living in the future.
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Lewis, Anna, Simon Cassidy, Sidra Aslam, Vanessa Wood, Chris Arnold, Jacqueline Batchelor, Brian Apter, et al. "DECP Annual CPD Conference Individual Presentations and ReviewsEP role in raising literacy attainments in Medway’s schoolsExploring resilience in studentsExploring looked after children’s experiences of child and adolescent mental health services. Listening to looked after children: Best practice provision in mental health provisionDeveloping emotional resilience in ‘challenge averse’Risk and resilience factors in Europe: Siestas, girlfriends and families Dr Chris ArnoldFrom powerless to powerfulFoucauldian Iterative learning conversationsWhat does Dyslexia do for teachersA psychosocial study exploring the school experiences of adolescents who have self-harmedWhy well-being?Are synthetic phonics programmes and the phonics screen major causes of dyslexia?Life at a Residential Special School: Children’s views and perspectivesNurturing Me: An approach to gain the child’s perspective on well-beingThe role of the educational psychologist in further educationThe assessment of phonological awareness using PhAB2: Special studiesSupporting children affected by the imprisonment of a family member: An overview of Birmingham’s innovative champion modelWell-being in the Scottish context – how Edinburgh EPS ‘Gets it Right’Pastoral Adolescent Mental Health Strategy (PAMHS) for secondary schools – introduction to a practical psychological toolHidden victims of the justice and education systems: Giving children of prisoners a voiceThe well-being of children starting to learn to play musical instrumentsTanzanian teachers’ constructions and perceptions of ‘inclusive’ education for girls and girls with disabilities and the potential for improving well-beingThe Homunculi Approach: A how-to guide for those working on the autistic spectrum or with mental health difficultiesSchool-based applications of mindfulnessThe ‘Emotional-Warmth’ dimension of professional child-care: Empowering the carers of young people who have been rejected, neglected and abusedUsing the Holistic Politico-Psychological (HPP) model of mental health as a framework for the psychological formulation of mental distressEmotional Literacy Support Assistants (ELSAs) – developments and reflectionsOut of School: Exploring children’s experiences and adult understandings of extended non-attendance." DECP Debate 1, no. 155 (June 2015): 8–26. http://dx.doi.org/10.53841/bpsdeb.2015.1.155.8.
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Ahlström, Gerd, Eva Flygare Wallén, Magnus Tideman, and Marianne Holmgren. "Ageing people with intellectual disabilities and the association between frailty factors and social care: A Swedish national register study." Journal of Intellectual Disabilities, November 2, 2021, 174462952110371. http://dx.doi.org/10.1177/17446295211037170.
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The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65–79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing.
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Farkas, Marianne, and Steve Coe. "From Residential Care to Supportive Housing for People With Psychiatric Disabilities: Past, Present, and Future." Frontiers in Psychiatry 10 (November 22, 2019). http://dx.doi.org/10.3389/fpsyt.2019.00862.
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Banks, Faye, Amy Fielden, David O'Sullivan, and Barry Ingham. "The informal culture of a direct care staff team supporting people with intellectual disabilities who present with behaviours that challenge." Tizard Learning Disability Review ahead-of-print, ahead-of-print (August 25, 2021). http://dx.doi.org/10.1108/tldr-01-2021-0001.
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Purpose Research into culture within intellectual disability services, has predominantly focussed on small group homes in Australia. The current investigation aimed to explore the transferability of the dimensions of culture identified in the literature, to a residential Intellectual Disability service in the UK. The purpose of this study was to better understand the impact of informal culture upon the behaviour of direct care staff, particularly around managing behaviour that challenges. Design/methodology/approach Semi-structured interviews were conducted with direct care staff. Interview transcripts were analysed thematically using template analysis. Findings Themes regarding leadership, perceptions of managers, team functioning, and relationships between direct care staff and service users, were identified, corroborating the existing literature. Additional themes relating to being aware of the risks posed by service users, and the emotional impact of behaviour that challenges, also emerged. Originality/value To the best of the authors’ knowledge, this is the first qualitative study to explore informal culture within a community residential Intellectual Disability service in the UK.
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Green, Rachael, Penelope Fay Mitchell, Kira Lee, Ella Svensson, Jia-Wern Toh, Carolyn Barentsen, Michala Copeland, J. Richard Newton, Kari Christine Hawke, and Lisa Brophy. "Key features of an innovative sub-acute residential service for young people experiencing mental ill health." BMC Psychiatry 19, no. 1 (October 23, 2019). http://dx.doi.org/10.1186/s12888-019-2303-4.
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Abstract Background Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia. Methods This paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015–17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims. Results Consistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the ‘door is always open.’ High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards. Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice. Conclusions The Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.
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"11.H. Workshop: Epidemiology of diseases and health inequalities in people with and without intellectual disabilities." European Journal of Public Health 31, Supplement_3 (October 1, 2021). http://dx.doi.org/10.1093/eurpub/ckab164.831.
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Abstract All people have a right to equal healthcare without discrimination on the basis of disabilities. In practice, however, health inequalities still remain. Ideally we would define future public health having sufficient attention to minority groups and their specific needs. One of these groups is people with intellectual disabilities (ID), defined by severe limitations in adaptive and functional behaviour. As a result of these limitations, people with ID suffer from worse health, higher hospitalisation rates and higher premature mortality compared to people without ID. In reducing these health inequalities acquiring accurate information on disease epidemiology in people with ID compared to those without ID is crucial. However, this crucial information is still lacking. This workshop will dive into disease epidemiology in people with ID by highlighting different aspects of health and the difficulties that arise when researching people with ID. First, It has been proven difficult to identify ID in existing data sources. ID-diagnoses in medical records are not too reliable, physicians do not always recognise IDs, or people are embarrassed of their ID-diagnosis. By gaining information on received services or supports specifically for people with ID a more complete representation of the ID-population is gained. Second, prevalence rates on chronic diseases in people with ID are often inconsistent across the literature, probably due to different age and sex patterns of chronic diseases and chronic comorbidities compared to people without ID, but these patterns are often not taken into account. By reporting on chronic disease prevalence and comorbidity patterns in people with versus without ID, a novel insight is gained in comparative epidemiology of chronic diseases of people with and without ID. Third, although it is known that people with mild ID suffer more mental health disorders dan people with no ID, exact prevalence rates and data on the care provided to these people in mental health services is missing. A retrospect database study performed in Dutch mental health care gives insight in this knowledge gap, not only for those people whom are recorded with their mild ID in these mental health services, but also for those people who were not recorded as such. Fourth, the current pandemic of a novel infectious disease stresses the strong need for accurate knowledge of disease epidemiology, particularly concerning high-risk groups such as people with ID. A large-scale registration of COVID-19 in people with ID living in residential settings was developed in the Netherlands, to provide necessary insight in the medical impact of COVID-19 among people with ID and inform policy makers and care providers on specific risks and consequences of COVID-19 in the ID population as compared with the general population. Key messages Insight in disease epidemiology and disease care in people with intellectual disabilities compared to people without intellectual disabilities is crucial in reducing health inequalities. Although it is difficult to identify all people with intellectual disabilities in data sources, using multiple methods and data sources results in a more complete overview of this group of people.
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Kumawat, Mr Vikas, and Mrs Lolita lal lal. "ASSESS THE KNOWLEDGE OF FIRST DEGREE RELATIVES REGARDING HOME CARE OF PSYCHIATRIC PATIENTS." IDC International Journal 8, no. 1 (January 5, 2021). http://dx.doi.org/10.47211/idcij.2021.v08i01.006.
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ABSTRACT This study was conducted to “Assess the knowledge of first degree relatives regarding home care of psychiatric patients in Gwalior Mansik Arogyashala. This topic focuses primarily the adaptation of the research method for the study. Research methodology gives a bird’s eye view of the entire process of tackling a research problem in a scientific and systematic way. Family members play a major role in providing care giving assistance to elderly persons and their families this include both the provision of direct and indirect care. Mental illness is an age old problem of mankind. It is documented in all cultures around the world in the oldest literature. Till recently, the actual cause of mental illness was not known and there were few effective treatment methods. Mental patients were often a source of disturbance to others. Mental health, rather than just those suffering from a mental illness, should be a problem for all of us. Care of a psychiatric patient based on non-residential psychiatric services in mental asylum that provide rehabilitation or care for people affected by a mental illness or psychiatric disabilities. Key Words: Mental illness, effective treatment, design, and sample, home care, psychiatric.