learning disability awareness training. aims of session: what is a learning disability barriers to...
TRANSCRIPT
Learning Disability Awareness Training
Aims of session:
• What is a Learning Disability
• Barriers to health care for people with learning disabilities
• Reports
• Reasonable adjustments
• Case studies
• Evaluation
What is a learning disability
Learning DisabilityCognitive impairment, which reduces the abilityto understand new or complex information
A reduced ability to cope independently.
The limitation can show in many different ways; spoken, written, coordination, attention and self control.
Which started before adulthood, with a lasting effect on development.
What is NOT a learning disability
• Difficulty reading, writing and numeracy
• Emotional difficulties which disrupt schooling, influencing achievement
• Attention deficit hyperactivity disorder
• Asperger’s syndrome and some individuals with autism
Barriers to health care
COMMUNICATION:
• Abbreviations/jargon• Difficulties with reading and writing• Information not accessible• None or limited verbal communication• Different methods of communicating
Barriers to health care
PHYSICAL:
• Examinations• Equipment• Reliance on additional support from carers• Transport/parking• Cognitive ability• Sensory impairments
Barriers to health care
Emotional:
• Alien world! unfamiliar• Don’t understand what is happening• Difficulty with waiting for long periods of time• Difficulties with being around lots of people• Difficulties with noise• Frightened of procedures • Bad past experiences
Barriers to healthcare
Challenging behaviour:
• New situations can cause distress and stress• May be a way to communicate pain• May be a pleasure• May be a way to gain control by attracting your attention• This can challenge the health and safety of self and
others
MARTIN
“Martin was often smiling – he loved to go out, liked the movement of the coach and listening to the music. When he was young, he liked being in our car as well. He loved getting behind the wheel and turning it around”
“Martin will always be the light of my life. He had a quirky sense of humour and oodles of charm”.
REPORTS
These problems have been highlighted in a number of reports such as:
• Treat me right (Mencap 2004)
• Death by Indifference (Mencap 2007)
.
REPORTS
The government responded in a number of ways such as:
• Health care for All (2008)
This produced 10 important recommendations which
concern the ‘reasonable adjustments’ that are needed to
make healthcare services accessible for people with
learning disabilities as they are to other people.
Reasonable Adjustments
• Hospitals have a clear ‘duty of equality’. This does not mean treating everybody the same but rather that hospitals must make ‘reasonable adjustments’ to meet the needs of people with a learning disability (Working Together 2006).
• Core standards for Better Health should be amended to reflect the requirement to make ‘ reasonable adjustments’ to services to ensure they are accessible to people with learning disabilities (Healthcare for All, 2008).
• You must make reasonable adjustments to ensure that each person has the same opportunity for health, whether they have a learning disability or not (Disability Discrimination Act 2005)
Group Work
Split into two groups you will be provided with a description of a patient accessing your work setting.
You will write down what “reasonable adjustments” you as staff supporting this patient could put in place.
Group Work
GROUP 1• No verbal communication
• Wheel chair bound
• Has a moulded wheelchair therefore has a specialist sling
• Lives in residential home staff shortage they are unable to support
• The person is slapping themselves on their head
GROUP 2• Has limited verbal
communication
• Gets up from sitting or lying frequently to pace around
• Has severe epilepsy
• Is sensitive to loud noises
• Has an elderly mother supporting him who has back problems
Reasonable Adjustments
• Arrange pre-admission visits.
• Allow extra time or staff to support (use the risk dependency and support assessment).
• Consider appointments or surgery times.
• Appropriate equipment to hand (and know how to use it).
• Communicate in a way that the patient and carers can understand, are there accessible communication aids to be more effective.
Reasonable Adjustments
• Explain what is happening as a matter of routine.
• Link with local community learning disability team (CLDT) for advise, and support
• Always consider pain control
• Involve parents carers in handover to ensure they are aware fully what is happening or to explain support needs to ward staff
Reasonable Adjustments
• Encourage the family/paid carer to take regular breaks; provide use of staff kitchen.
• Identify if the family would like to stay over; can this be accommodated on your ward.
• Ask if there is a Hospital Traffic Light Assessment if so read it. (see next slide)
• Take all necessary steps needed to support the person to make decisions. Providing information in a format that they will understand (MCA).
Risk Dependency and support assessment tool
Work with those who know the patient best to fill out the Risk, Dependency andSupport Assessment so you can identify and agree what additional support may berequired, and who is best to provide it.
Carry out further hospital risk assessments on any areas of likely risk identified in theRisk, Dependency and Support Assessment.
The senior member of hospital staff with responsibility for patients with a learningdisability should be informed of the admission and the outcome of the Risk,Dependency and Support Assessment in order to authorise and secureappropriate funding.
Paid support staff, with the help of families, are usually the best people to provide andadditional support required during a hospital stay. The individual is used to them andthey are familiar with the support the individual needs. Ensure all staff concernedunderstand this and accept their presence.
Hospital Traffic Light Assessment
• A tool to assist you support people with LD.
• Red Section – must know information.
• Amber – how to support me.
• Green – my likes and dislikes.
• 3 pages of very important information to help you to help others.
CASE EXAMPLE
Without TLA• Nurse administering tablets to
patient in medicine pot • Patient spitting them out• Nurse tries several times and
at different times• Patient continues to spit them
out• Nurse documents “patient
refused medication”• Patient begins to have
seizures due to no medication!
With TLA Nurse READS TLA Nurse administers medication
on a spoon one tablet at a time Nurse offers a drink from
patients specialist cup and straw
Patient takes all medication well
Patient experiences no seizures!
GROUP WORK
• You are now aware of the TLA
• You have had examples of reasonable adjustments
• You are aware of the RDAT
Group Work
Split into two groups you will be provided with a description of a patient accessing your work setting.
You will write down what “reasonable adjustments” you as staff supporting this patient could put in place.
Group Work
GROUP 1• No verbal communication
• Wheel chair bound
• Has a moulded wheelchair therefore has a specialist sling
• Lives in residential home staff shortage they are unable to support
• The person is slapping themselves on their head
GROUP 2• Has limited verbal
communication
• Gets up from sitting or lying frequently to pace around
• Has severe epilepsy
• Is sensitive to loud noises
• Has an elderly mother supporting him who has back problems
Contact Details
Learning Disability Liaison Team
Nottingham University Hospital
0115 924 9924 Ext. 62562