scholarly journals The impact of transforming care on the care and safety of patients with intellectual disabilities and forensic needs

2017 ◽  
Vol 41 (4) ◽  
pp. 205-208 ◽  
Author(s):  
John L. Taylor ◽  
Iain McKinnon ◽  
Ian Thorpe ◽  
Bruce T. Gillmer
Keyword(s):  
Intellectual Disabilities ◽  
Target Population ◽  
Community Services ◽  
Challenging Behaviour ◽  
National Plan ◽  
Policy And Practice ◽  
Distinct Subgroup ◽  
Hospital Beds ◽  
People With Intellectual Disabilities ◽  
The Impact

SummaryNHS England recently published a national plan to develop community services for people with intellectual disabilities and autism who display challenging behaviour by using resources from the closure of a large number of hospital beds. An ambitious timescale has been set to implement this plan. The bed closure programme is moving ahead rapidly, but there has been little progress in developing community services to support it. This paper discusses the impact of the gap between policy and practice on the care and safety of patients with intellectual disabilities and forensic needs who form a distinct subgroup of the target population and are being disproportionately affected by this government policy.

scholarly journals Delivering the Transforming Care programme: a case of smoke and mirrors?

2019 ◽  
Vol 43 (5) ◽  
pp. 201-203 ◽  
Author(s):  
John L. Taylor
Keyword(s):  
At Risk ◽  
Intellectual Disabilities ◽  
Community Services ◽  
National Plan ◽  
Care Programme ◽  
Number Of Patients ◽  
Hospital Beds ◽  
People With Intellectual Disabilities ◽  
Independent Sector

SummaryThe Transforming Care national plan for England to develop community services and close hospital beds for people with intellectual disabilities and/or autism was published in October 2015 and is due to finish in March 2019. In this editorial the key plan objectives are evaluated, with particular reference to people with intellectual disabilities and/or autism who offend or are at risk of offending. The conclusion is that, to date, the plan has failed to meet its targets to reduce the number of in-patients with intellectual disabilities and/or autism and to invest in community services, and the number of patients in independent sector beds is increasing.

Challenging Behaviour in People with Intellectual Disabilities: The Assessment and Intervention Team

2016 ◽  
Vol 33 (S1) ◽  
pp. S475-S475
Author(s):  
K. Courtenay ◽  
S. Jaydeokar
Keyword(s):  
Intellectual Disabilities ◽  
Developmental Disorders ◽  
Models Of Care ◽  
Community Services ◽  
Challenging Behaviour ◽  
Community Based ◽  
People With Intellectual Disabilities ◽  
Competing Interest ◽  
Intervention Team ◽  
Age Range

ObjectivesPeople with intellectual disabilities (ID) present with behaviours that challenge community services. Community models of care as alternatives to hospital care exist but are often vary in their function. Certain strategies have been developed to manage challenging behaviour in people with ID. Data from a three-year period on a community-based service for people with ID and challenging behaviour that uses an objective, multi-disciplinary approach is presented.MethodsA case note survey of adults with ID under the care of the Assessment and Intervention Team (AIT), a challenging behaviour service in the London Borough of Haringey.ResultsOver the three-year period, 65 adults were managed by AIT. Forty-four were male and 21 were female. The age range was 21–64 years of age. The level of ID was mild ID 61%, moderate 39%. Diagnoses included psychotic disorder (25%); mood disorder (20%); developmental disorder (40%); dementia (10%); challenging behaviour (45%). Six people (11%) were admitted to hospital during their time with AIT. The length of care under AIT ranged from four to fourteen months.ConclusionsAIT managed effectively people with ID living in the community who presented with complex problems putting their placement at risk. The rate of hospital admission was reduced in this period compared with the previous three years. The length of stay in in-patient services was reduced. The most common reasons for the behaviours included mental illness and ‘challenging behaviour’. People with developmental disorders were a large proportion. Community alternatives are effective with positive benefits to the person.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Sexual Health in Spanish People with Intellectual Disability: the Impact of the Lockdown due to COVID-19

2021 ◽  
Author(s):  
M. Dolores Gil-Llario ◽  
Irene Díaz-Rodríguez ◽  
Vicente Morell-Mengual ◽  
Beatriz Gil-Juliá ◽  
Rafael Ballester-Arnal
Keyword(s):  
Sexual Abuse ◽  
Sexual Behavior ◽  
Sexual Health ◽  
Intellectual Disabilities ◽  
Sexual Activity ◽  
Policy Implications ◽  
The People ◽  
People With Intellectual Disabilities ◽  
Technological Improvements ◽  
The Impact

Abstract Introduction The lockdown due to COVID-19 affected the sexual health of the people with intellectual disabilities by differentially modifying the frequency and characteristics of people’s sexual activity depending on whether or not they lived with a partner during this period. The aim of this study was to analyze the extent to which the sexual behavior of people with intellectual disabilities (with and without a partner) was affected during the lockdown. Methods The sample consisted of 73 people with intellectual disabilities between 21 and 63 years old (M = 39.63; SD = 10.11). The variables analyzed were the physical, social, and technological environment during the lockdown, sexual appetite, sexual behavior, online sexual activity, and sexual abuse. The data were collected between the months of May and June of 2020. Results The lockdown increased the sexual appetite of a third of the sample (38%), especially the youngest participants. Sexual activity focused on autoeroticism and online behavior, particularly sending nude images of oneself (88%) and viewing pornography (83.6%). Rates of sexual abuse during this period were relatively high (6.8%). Conclusions The sexual activity of people with ID was important during the lockdown, and they had to adapt to the circumstances of isolation in a similar way to the general population. Technological improvements in terms of devices and connection quality at home allowed their sexual behavior to be reoriented, opening the door to new risks for the sexual health of people with ID. Policy Implications Cybersex and the increase in sexual abuse due to confinement are aspects that should be included in programs to improve the sexual health of this group.

A systematic review of adverse childhood experiences (ACEs) with people with intellectual disabilities: an unsafe gap in the literature

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chloe Crompton ◽  
Bethany Duncan ◽  
Graham Simpson-Adkins
Keyword(s):  
Systematic Review ◽  
Intellectual Disabilities ◽  
Adverse Childhood Experiences ◽  
World Health ◽  
Inclusion Criteria ◽  
Childhood Experiences ◽  
Content Type ◽  
Adverse Childhood ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose This paper aims to systematically review the available evidence that explores adverse childhood experiences (ACEs) in people with intellectual disabilities (PwID). It is important to systematically review this literature as, to date, there is little known about the number of studies in this area, despite the World Health Organization declaring ACE prevention and support as a global public health priority. Design/methodology/approach Published studies were identified from electronic database searches. Key journals and reference lists were also hand searched. Findings Two studies met the inclusion criteria and the prevalence and frequency of ACEs experienced by participants of these studies analysed. Overall, due to the small number of studies meeting the inclusion criteria, it is difficult to establish any meaningful conclusions. Originality/value This appears to be the first systematic review to try and identify a research base looking at the prevalence of ACEs within a PwID population. Findings suggest that this is a highly neglected area of research, and the authors hope to have identified that further evidence is required to draw clearer conclusions about the impact of ACEs on PwID.

Commentary on “A family’s battle to understand ‘challenging behaviour’”

2017 ◽  
Vol 22 (2) ◽  
pp. 105-108
Author(s):  
Joann Kiernan
Keyword(s):  
Intellectual Disabilities ◽  
Design Methodology ◽  
Local Communities ◽  
Challenging Behaviour ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Individuals With Intellectual Disabilities

Purpose The purpose of this paper is to provide a commentary on issues raised in the paper “A family’s battle to understand ‘challenging behaviour’”. Design/methodology/approach Drawing on literature associated with issues identified in the paper this commentary will reflect on the evidence associated with providing specialist support to people with intellectual disabilities and challenging behaviour. Findings Families, individuals and services are unable to access timely and appropriate specialist support for individuals with intellectual disabilities and challenging behaviour. As individuals go on to develop behaviours associated with a lack of intervention their levels of vulnerability increase due to their exclusion from services and their local communities. Originality/value The commentary provides a discussion on the issues faced by individuals and their families in relation to intellectual disabilities and challenging behaviour.

Huronia's Double Bind: How Institutionalisation Bears Out on the Body

Somatechnics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 92-111
Author(s):  
Jen Rinaldi ◽  
Kate Rossiter
Keyword(s):  
Intellectual Disabilities ◽  
Lived Experiences ◽  
Institutional Care ◽  
The Body ◽  
Interview Data ◽  
Double Bind ◽  
Total Institution ◽  
People With Intellectual Disabilities ◽  
Gendered Bodies ◽  
The Impact

Frequently missing from histories of forced institutionalisation are close readings of the enduring impact on survivors' corporeality. In this article the authors analyse interview data featuring people who survived the Huronia Regional Centre: a total institution designed to warehouse people with intellectual disabilities that operated in Canada from 1876 to 2009. These interviews reveal the impact of institutional technologies on the bodies of the institutionalised, and how institutional survivors resisted those technologies. Institutional rituals meant to organise and cleanse residents, resulted in the reification of institutional subjects as inescapably contaminated. Drawing from Mary Douglas's theory of dirt and Julia Kristeva's interpretation of dirt as abjection, the authors engage with interview data on daily institutional care routines, particularly dressing, eating, showering, and the administration of medication, to show how these rituals produced for the institutionalised subject meanings around gender and disability as markers of defilement. The authors argue that the kinds of deeply oppressive and often violent rituals central to lived experiences of institutionalisation are grounded in the assumption that disabled gendered bodies are already-abject, hence the institutional demand for the institutionalised to be brought under control.

scholarly journals Trainer and support staff’s experiences of engaging with the Who’s Challenging Who? challenging behaviour training course

2019 ◽  
Vol 24 (3) ◽  
pp. 367-380 ◽  
Author(s):  
Samantha Flynn ◽  
Richard P Hastings ◽  
David Gillespie ◽  
Rachel McNamara ◽  
Elizabeth Randell
Keyword(s):  
Intellectual Disabilities ◽  
Thematic Analysis ◽  
Perspective Taking ◽  
Current Practice ◽  
Support Staff ◽  
Challenging Behaviour ◽  
Structured Interviews ◽  
Training Course ◽  
People With Intellectual Disabilities

Background: The Who’s Challenging Who? (WCW) training is coproduced and delivered by people with intellectual disabilities (IDs), and it aims to improve staff empathy for people with challenging behaviour (CB). This study qualitatively describes trainees’ and trainers’ experiences of the WCW. Methods: Semi-structured interviews were undertaken with managers ( n = 7), support staff ( n = 6) and the WCW trainers ( n = 4; three had IDs). Interviews were transcribed verbatim and analysed using thematic analysis. Results: Two cross-cutting themes were drawn from the data: (1) valued roles of the trainers, whereby trainers and trainees benefited from the training being coproduced and delivered by people with IDs, and (2) beyond the training, within which trainees reported that they were engaging in increased reflection about their past and current practice. Conclusions: Being trained by people with IDs and CB appears to be a useful method, which can lead to perspective taking and reflection about supporting people with IDs and CB.

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