Over the last 30 years there has been a considerable increase in the life expectancy of people with learning disabilities. This has resulted in changing patterns of morbidity and mortality and an increasing recognition of the health needs of people with learning disabilities. Major strides forward have been made in the reduction of preventable illnesses among the general population. However, among people with learning disabilities such illnesses have received only limited health promotion attention until recently. In the last decade major gaps have been identified in the ability of current primary health services to respond to the needs of people with learning disabilities. The need to respond effectively to this situation has been identified as a priority by the current United Kingdom Government. Following an overview of the literature in relation to the changing health profile of people with learning disabilities and the need for health screening, consideration is given to some of the key difficulties which may be encountered when attempting to utilize current primary health services. The analysis of data derived from the health screening of 373 people with learning disabilities by a community nursing service in Down and Lisburn Health and Social Services Trust reveals the need for further action in relation to cardiovascular status, sensory deficits, mobility and aspects of sexual health.

Health screening for people with learning disabilities by a community learning disability nursing service in Northern Ireland.

The widespread nursing interpretation of clinical supervision following the accepted definitions of Butterworth and Faugier, elides refinement of boundaries between personal and professional development and growth. In so doing, nursing interpretation confuses the differences between two similar processes and ultimately distorts the purpose of clinical supervision. In nursing supervision, the patient can become lost, thus perpetuating the avoidance of anxiety in intimate therapeutic work, originally described by Menzies in 1959. While a tension naturally exists between the two processes, this paper demonstrates the utter importance of working within the tension of boundaries that define the triadic situation of supervisor, supervisee and patient. When supervision is accepted as personal development, the triadic situation may deteriorate into a dyadic one between supervisor and supervisee only, significantly altering the relationship to the point where the supervisee becomes a patient. Parallel process, ordinarily reflecting the therapeutic nurse-patient relationship in the supervisory one, may then become merely a process running parallel to the supervisee, while utilizing the patient as a source of material for personal growth. This paper demonstrates through Faugier's casework material the necessity of defining boundaries and the difficulties associated in maintaining them, rather than prosaically declaring that 'supervision is not therapy'.

How not to do clinical supervision in nursing

Health screening and follow-up was provided for 35 adults with learning disabilities who live in the community, using the OK Health Check as a screening tool. This paper reports how community nurses for people with learning disabilities can help overcome barriers faced by people with learning disabilities in accessing primary and generic health services. The ability of a community nurse to achieve effective health outcomes for people with learning disabilities in partnership with other professionals is also demonstrated.

Community Nurse Learning Disabilities: A Case Study of the Use of an Evidence-Based Screening Tool to Identify and Meet the Health Needs of People with Learning Disabilities

People with intellectual disabilities are among the most socially excluded and vulnerable groups in Ireland today. They are at increased risk of early death and they receive poorer health care than the general population. The World Health Organization has pointed out that inequalities in service provision to this group extend to the delivery of palliative care. The population of people with intellectual disabilities is an ageing one, and its changing demographics challenge services that were originally developed for children and young adults and that focused on enabling their clients to lead full and productive lives. Conditions such as cancer, cardiovascular and respiratory disease are now leading causes of death, and this has important implications for service planning. Although the population is relatively small, its needs demand high priorities in the healthcare services. This is because many people with intellectual disabilities need support throughout their lives and have longer and more int...

Palliative care for disadvantaged groups: people with intellectual disabilities

• The aim of this study was to evaluate a specialist nursing service programme for people with an intellectual disability residing in the community. It is important to correct the imbalance in the literature that has neglected the voices of the clients themselves or denied expression by their proxies.



• The aim of the study was to gain a better understanding of matters of importance for clients and their families and to involve them in the evaluation of a service that directly affects their care.



• Only three clients were able to participate; however, 17 parents (next of kin) agreed to be interviewed.



• In-depth interviews were audio-taped, transcribed and analysed relating to the questions asked and were checked against the domains of the nursing practice in the disability area: continuity of care, advanced nursing practice, education and credentialling, personal and professional attributes, primary health care, and normalization.



• The findings confirm the high regard in which the programme is held. Service evaluation is crucial in providing evidence for programme funders. The favourable outcome of this evaluation meant that the programme gained funding for another few years.

Evaluating a community nursing service: listening to the voices of clients with an intellectual disability and/or their proxies

Research confirms that the needs of people with learning disabilities are often missed out of health promotion. This paper reports the results of health screening clinics run for people with learning disabilities.

Specialist services for people with learning disabilities.

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Specialist services for people with learning disabilities.