Caring for the Physical and Mental Health of People with Learning Disabilities

Citation

Butcher, H. (2013), "Caring for the Physical and Mental Health of People with Learning Disabilities", Tizard Learning Disability Review, Vol. 18 No. 3, pp. 151-153. https://doi.org/10.1108/TLDR-03-2013-0024

Caring for the Physical and Mental Health of People with Learning Disabilities is a practical guide for paid and family carers that could be used as handy reference for specific health issues or guidance for health action planning. The book covers both proactive and reactive healthcare, for example, by covering both identification of swallowing problems and ways of managing them. It tells readers what to look out for in an individual for signs of common health problems, provides overviews of health issues more common in people with specific conditions and gives good dietary and weight loss guidance. Readers are given tips on health related problems, such as collecting urine samples.

One chapter lists important health screening programmes and another describes health checks, including a reproduction of the “Cardiff Health Check”. Readers can turn to chapters that are relevant to the people they care for, including well‐written guides to sleep problems, epilepsy, Down syndrome and autism. The appendix contains a very useful guide to genetic causes of learning disability. The thorough glossary of medical terms will be helpful for carers navigating their way through healthcare services and communicating with health professionals.

The chapter on mental health is very informative about the most prevalent conditions, giving an insight into possible causes and common features of various mental illnesses. The authors state that depression is fairly straightforward to treat, however, this may not be the case for many people with learning disabilities; the challenges for people with learning disabilities engaging in and benefitting from talking therapies are not discussed here. Pointers are given about supporting people with anxiety problems, although some readers might want to learn more about day‐to‐day ways of reducing anxiety, to enable them to proactively support a person's mental health needs. The authors provide a clear table of medications, their uses and possible side effects, although do not comment on over‐medication of people with learning disabilities.

A separate chapter addresses psychiatric care, including the professionals who can have a role in supporting someone with mental illness and the last resort option of admission into hospital. Hospital assessment orders (Section 2) and hospital treatment orders (Section 3) of the Mental Health Act 1983 are explained, as well as the procedures when a person with learning disabilities is involved in a crime.

A clear explanation of the Mental Capacity Act 2005 is given in the chapter on the law – setting out the issues of capacity and consent and clarifying common mistakes relating to these. Capacity and consent for children is also discussed. A frequent challenge for carers and health facilitators is health services’ adherence to the Equality Act 2010, enabling people with learning disabilities to access healthcare and have their needs accommodated. Although the Equality Act is not covered, the authors have included a helpful table of “How to overcome barriers to obtaining health care” at the end of Chapter 1 (that readers could miss if they were to skip this “About this book” introduction). Useful tips include arranging preparatory visits to health settings and ensuring the GP mentions the person's learning disability and additional needs in referral letters.

The style of the book is straightforward and most of the language used is accessible for average readers who aren’t used to academic or medical text, although some sections may feel lengthy for those who have limited time to find information. Where medical terminology is used, the common term is given too. In places the book refers to people with learning disabilities in terms that may sound depersonalised to carers, perhaps due to the medical rather than social approach of the book.

The book has a few long passages of information not directly related to healthcare, to the expense of topics not included in the book. The introduction to learning disabilities examines IQ testing and level of learning disability, rather than a general background and context of healthcare; beginning by categorising people and what they can or cannot do is unhelpful for readers considering healthcare needs on an individual basis throughout the rest of the book. The chapter on autism describes characteristics of autism that are described in many other resources, whereas more discussion of how common features impact on an individual's health would have been beneficial to readers. The section on nutrition includes more detail than is needed for carers to offer people with learning disabilities a healthy diet. Information on dental healthcare, hearing, vision and the often overlooked issue of sexual health could have been covered too for a more comprehensive guide. Guidance and signposting for health education was perhaps outside the scope of this book; the useful websites listed in the references do include some easy read health information.

In light of the reports Health Inequalities and People with Learning Disabilities in the UK (Emerson and Baines, IHaL, 2010), Death by Indifference (Mencap, 2007) and Six Lives (Health Ombudsman, 2009), more guidance is needed for paid and family carers and other health facilitators to effectively monitor individuals’ health and advocate for their health needs. This book provides a good overview and is a reference to use as a starting point in doing this, but may need to be supplemented with additional resources to ensure nothing is missed when supporting physical and mental healthcare of someone with learning disabilities.