Compared with the general population, people with learning disabilities have:
• Health inequalities
• Higher levels of health needs
• More health needs that are unrecognised and unaddressed
• More health needs that are sub-optimally managed
• A different pattern of health needs
• Lower life expectancy
• Barriers in accessing and using health services
• Greater disadvantages when services are reactive rather than proactive.
A DIFFERENT PATTERN OF HEALTH NEEDS
• Much more commonly experienced are: risk of choking, epilepsy, gastro-oesophageal reflux disorder, constipation, sensory impairments, osteoporosis, schizophrenia, dementia, bipolar disorder, dysphagia, dental disease, musculoskeletal problems, accidents, falls, and nutritional problems.
• Much less common are: health problems related to smoking, alcohol, and use of illegal drugs.
• Some problem behaviours, e.g. self injury and pica, are fairly specific to learning disabilities and may be associated with specific genetic syndromes.
• The commonest new problems detected at health checks are impacted cerumen, gastro-oesophageal reflux disorder, mental ill-health, obesity, xerosis cutis, visual impairment, constipation, and tinea, but problems are detected across the full range of bodily systems.
REACTIVE RATHER THAN PROACTIVE MODELS OF CARE
Reactive rather than proactive models of care particularly disadvantage persons with learning disabilities.
• They rely on the person (who may have limited speech), or their carer recognising a possible health need, and seeking a GP appointment.
• How long the paid carer has known the person, and how much time they spend with the person, affects their likelihood of recognizing changes indicating possible health needs.
• How well information is shared between support team members/different teams (e.g. day centre staff and paid carers at the persons home) also affects likelihood of recognising possible health needs.
• These factors also influence how well medical advice/treatments are adhered to.
Specifically consider if the person has any of the health needs and disabilities which are commonly experienced by persons with learning disabilities, or any of the health needs included in the QOF, including: