Death and Grief as Experienced by Adults with Developmental Disabilities: Initial Explorations

2005 ◽  
Vol 50 (3) ◽  
pp. 181-196 ◽  
Author(s):  
John H. Hoover ◽  
Marc A. Markell ◽  
Paulette Wagner
Keyword(s):  
Primary Care ◽  
Developmental Disabilities ◽  
Staff Training ◽  
Cognitive Disabilities ◽  
Death And Dying ◽  
Primary Care Providers ◽  
Behavioral Changes ◽  
Residential Facilities ◽  
Care Providers ◽  
Wake Patterns

The experiences of persons with developmental disabilities (DD) in two northern-tier states were studied on an exploratory basis. Overall, the analysis reveals that caregivers in residential facilities believed that persons with DD (primarily global cognitive disabilities) benefit from the same grief processing rituals as other individuals. Some conflicting attitudes were revealed, however. Specifically, many respondents expressed a sense that caregivers (or family members) “know best” when individuals with disabilities prove “ready” to experience the activities and ritual surrounding loved ones' deaths. In addition, many respondents argued that clients with cognitive disabilities ought to be educated ahead of time as to what happens during the death and dying process. Primary care providers reported very few overt behavioral changes, though four clients in 10 were observed to cry more frequently (for more than 1 month) and about one-fifth reportedly experienced changes in sleep/wake patterns. Initial evidence emerged that staff training patterns varied by facility, not with years of service.

Use of Transition Resources by Primary Care Providers for Youth With Intellectual and Developmental Disabilities

2018 ◽  
Vol 56 (1) ◽  
pp. 56-68
Author(s):  
Paul B. Dressler ◽  
Teresa K. Nguyen ◽  
Eric J. Moody ◽  
Sandra L. Friedman ◽  
Laura Pickler
Keyword(s):  
Primary Care ◽  
Developmental Disabilities ◽  
Transition Planning ◽  
Primary Care Providers ◽  
Intellectual And Developmental Disabilities ◽  
Care Providers ◽  
Improvement Project ◽  
Successful Transition ◽  
Transition Clinic ◽  
Systemic Barriers

Abstract Youth with intellectual and developmental disabilities (IDD) often experience difficulties with successful transition from pediatric to adult healthcare. A consultative Transition Clinic for youth with IDD was piloted as a quality improvement project, and assessed the engagement of primary care providers (PCPs) for transition planning after patients were seen in clinic. Although many PCPs found the clinic and resources useful, individual and systemic barriers often prohibited them from participating in transition planning for this patient population. These findings highlight systemic barriers that need to be addressed to ensure successful transition, as well as the need for a specialized Transition Clinic with involvement of specialists with expertise in IDD, such as Developmental-Behavioral Pediatrics, to assist throughout transition process.

scholarly journals Implementing a Clinically Based Fall Prevention Program

2017 ◽  
Vol 14 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Judy A. Stevens ◽  
Matthew Lee Smith ◽  
Erin M. Parker ◽  
Luohua Jiang ◽  
Frank D. Floyd
Keyword(s):  
Primary Care ◽  
Staff Training ◽  
Fall Prevention ◽  
Fall Risk ◽  
New York State ◽  
Primary Care Providers ◽  
York State Department ◽  
Care Providers ◽  
Risk Screening ◽  
Fall Risk Screening

Introduction. Among people aged 65 and older, falls are the leading cause of both fatal and nonfatal injuries. The burden of falls is expected to increase as the US population ages. The Centers for Disease Control and Prevention (CDC) developed the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative to help primary care providers incorporate fall risk screening, assessment of patients’ modifiable risk factors, and implementation of evidence-based treatment strategies. Methods. In 2010, CDC funded the New York State Department of Health to implement STEADI in primary care sites in selected communities. The Medical Director of United Health Services championed integrating fall prevention into clinical practice and oversaw staff training. Components of STEADI were integrated into the health system’s electronic health record (EHR), and fall risk screening questions were added to the nursing staff’s patient intake forms. Results. In the first 12 months, 14 practices saw 10 702 patients aged 65 and older. Of these, 8457 patients (79.0%) were screened for fall risk and 1534 (18.1%) screened positive. About 52% of positive patients completed the Timed Up and Go gait and balance assessment. Screening declined to 49% in the second 12 months, with 21% of the patients screening positive. Conclusions. Fall prevention can be successfully integrated into primary care when it is supported by a clinical champion, coupled with timely staff training/retraining, incorporated into the EHR, and adapted to fit into the practice workflow.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

The Bridge Program: A Model for Delivering Mental Health Services to Asian Americans through Primary Care

2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Asian Americans ◽  
Mental Health Professionals ◽  
Primary Care Providers ◽  
Care Providers ◽  
Bridge Program ◽  
Community Awareness

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.

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