Also - safeguarding “mate crime” - Landman 2014

Research :

Marsh and McMeel (2023) state that,

 Leading causes of premature death among people with learning disabilities are respiratory disease, cardiovascular disease and gastrointestinal disorders including constipation . In the final report of the Confidential Inquiry into Premature Deaths of People with Learning Disabilities (CIPOLD), noted that the people they had studied had a range of treatable conditions at the time of their death, of which the most commonly reported was constipation (37% of the sample).

Marsh, L. and McMeel, A. (2023) ‘How to support the accurate diagnosis of constipation in people with learning disabilities’, Learning Disability Practice, 27(4). Available at: https://doi.org/10.7748/ldp.2023.e2231.

Recommendations:

Education on Diet i.e, a higher fibre diet, explained in a way Peter would understand.

Education on his medication: Peter states that he does not know what they are for - education on his medication for himself in a manner that Peter would understand

Education on the screenings that he's eligible for - i.e, the screenings explained to Peter in a way he would understand

Medication referral - look at his medication.

Blood tests

Observations during the health screening

Salt referral

Onward counseling and carers' input due to the ongoing financial abuse going on

This study concluded that despite GP’s knowing about STOMP and its mission, it was noted that specialist LD teams should be in charge of determining whether or not a medication is benefiting the individual. It also noted that STOMP training should be delivered to front-line LD nursing teams as they are the ones who are most directly involved in the care and management of the medications of people with learning disabilities and they will recognise the adverse effects of medication changes or alterations better than a doctor who has only met the individual once before.

The Care Act 2014 mandates that local authorities must investigate suspected financial abuse.

Health improvement scotland

Right decision service

Kings College London (2021) Learning from Lives and Deaths People with a Learning Disability and Autistic People (LeDeR), www.kcl.ac.uk. Available at: https://www.kcl.ac.uk/research/leder.

White, A; Sheehan, R; Ding, J; Roberts et al examined the 2021 LeDeR and found Dysphasia to be the 5th most common long term heath condition for people who passed away in 2021 at 23%.

Intervention works....

2018 - 16% of LD deaths attributed to aspirational pneumonia.

Improvement of Dysphasia management group formed during LD week 2019.

2021 - number of deaths dropped to 3.1% of all respiratory deaths.

What we will do for Peter...

Address nutritional intake, what does he like to eat? Are there things that he likes that are more malable? Does he need more help at home around food? Can he get a POC? More befriender hours?

Produce easy read docs for him. Perhaps make him a menu, meal plan? Social story?

Refer for blood work? Check levels - iron, calcium etc. Medication review?

Refer to SaLT - swallow assessment? Video fluoroscopy of swallow?

People with Learning Disability experience poorer health than non disabled peers.

Only 15% of people undergo screening, we know from research that over 60 yr+ general public are affected by triple A.

AAA - Is a bulge or swelling of the Aorta, often asymptomatic and more common in men over 65, critical if it ruptures.

Nursing role: easy to read pamphlets, immediate referral to cardology for abdominal ultrasound.