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Journal article

The utility of the Montreal Cognitive Assessment as a mental capacity assessment tool for patients with a learning disability

Authors:
EDGE Daniel, et al
Journal article citation:
British Journal of Learning Disabilities, 44(3), 2016, p.240–246.
Publisher:
Wiley-Blackwell

Objective: To determine the psychometric properties of the Montreal Cognitive Assessment (MoCA) in patients with a learning disability and examine it's utility for conducting mental capacity assessment. Method: This study was a cross-sectional, instrument validation study in an inpatient hospital setting, located in the East of England. The sample consisted of two groups: (i) 31 consecutively admitted hospital patients and (ii) 10 multidisciplinary team members who served as a comparison group. The MoCA, a 12-item screen for mild cognitive impairment and the Dysexecutive Questionnaire (DEX), were used in this study. Item analysis was conducted by comparing item endorsement for all participants that had a learning disability utilising Difficulty and Discrimination Indices for each item on the MoCA. The authors examined the internal consistency of a revised scale derived from item analysis and used a one-way ANOVA to determine concurrent validity by comparing scores between two patient subgroups and the comparison group. Results: A 7-item scale, ‘MoCA-LD’ (alpha coefficient = 0.82) emerged from item analysis. A statistically significant negative correlation was observed between MoCA-LD and DEX (Pearson correlation = −0.66, P < 0.01). As expected, participants in the borderline category scored higher on MoCA-LD than those with mild learning disability, as did those with no learning disability (P < 0.001). Conclusion: The MoCA-LD has the potential to be a useful tool for mental capacity assessment in patients with a learning disability. (Edited publisher abstract)

Journal article

A helping hand

Author:
PENFOLD Julie
Journal article citation:
Learning Disability Today, December 2012, pp.12-13.
Publisher:
Pavilion
Place of publication:
Hove

Inequalities in the standard of healthcare for people with learning disabilities (LD) has been an issue in hospitals for some time, but hospitals in West Sussex are addressing this with recent developments. For example, a computer-based tracking system enables patients with LD to receive specialist support based on their care needs – when a person with LD arrives at the hospital, they are immediately flagged on the system to alert a team of specialist nurses. Additionally, a six page ‘passport’ provides essential information about the person with LD, usually completed by the patient’s carer, and advises hospital staff on all matters regarding the persons health.

Journal article

The "forensicisation" of challenging behaviour: the perils of people with learning disabilities and severe challenging behaviours being viewed as "forensic" patients

Authors:
DOUDS Fergus, BANTWAL Ashwin
Journal article citation:
Journal of Learning Disabilities and Offending Behaviour, 2(3), 2011, pp.110-113.
Publisher:
Emerald

Since the closure of long stay learning disability hospitals in 2005, focus in Scotland has shifted on to developing robust community services to cater for the healthcare needs of people with learning disabilities. A small number of individuals with learning disabilities and associated severe challenging behaviours do inappropriately get referred and sometimes admitted to forensic learning disability services. This study investigated this area of clinical practice in the context of referrals to the high secure forensic setting of The State Hospital, Carstairs, Scotland. Five referrals made to the State Hospital's forensic learning disability service between 2005 and 2010 were reviewed. Findings revealed that the identified determinants leading to the making of these referrals were classifiable into psychiatric, environmental and staffing themes. In conclusion, there is a requirement for a specialist in-patient service to meet the needs of this complex group of patients, which demonstrates ‘gaps’ within current services.

Digital Media

Getting better in hospital

Authors:
LEEDS ANIMATION WORKSHOP, (Producer)
Publisher:
Leeds Animation Workshop
Publication year:
2011
Pagination:
(13 mins.), DVD
Place of publication:
Leeds

Six short animated films about people with learning disabilities who need to go into hospital for different reasons. The films feature the following situations: going to A&E with a broken arm; going to the Diabetes clinic; needing an eye operation; being rushed to hospital with chest pains and having treatment for breast cancer. An easy read booklet is included in the pack.

Journal article

Passport to health

Authors:
BLAIR Jim, GLAYSHER Kirsty, COOPER Sue
Journal article citation:
Learning Disability Today, 10(1), January 2010, pp.28-30.
Publisher:
Pavilion
Place of publication:
Hove

To help improve the hospital experience and the standard for care for people with learning disabilities and their families, St Georges Hospital in south west London has been running a new passport scheme. The passport contains important information about the person, such as their health and health difficulties, likes and dislikes, and any medication that they may be on. It is divided into 3 sections: things that must be known; things that are important; and likes and dislikes. The information provides a good overview of the whole individual and not just their ill health, and enables the staff to understand them as people and thus provide better care. Passports have been widely distributed to people with learning disabilities, and are filled out by the person or their supporters before admission. Following the success of the scheme with people with learning disabilities, it has also been rolled out to people with dementia care needs, mental health problems, people who have experienced strokes, and younger people.

Journal article

When one door closes…

Author:
McMILLIAN Ian A.
Journal article citation:
Learning Disability Today, 10(1), January 2010, pp.22-23.
Publisher:
Pavilion
Place of publication:
Hove

The article contains an interview with Shaun Gravestock, a full-time consultant psychiatrist at the newly opened Mental Health and Learning Disabilities at the Bethlem Royal Hospital in Beckenham, Kent. This unit caters specifically for people with learning disabilities who need intensive mental health care. It contains 13 beds, 9 funded by local primary care trusts and 4 available to commissioners around the UK. Gravestock argues that mainstream acute mental health units are not the best places for potentially vulnerable people with learning disabilities, as staff may find it difficult to establish rapport, the atmosphere can be volatile, and staff are under pressure to quickly move patients through the system. The Bethlem unit aims to fill this gap for a specialist service for those with learning disabilities and mental health problems.

Book Full text available online for free

A hospital or a home? Findings from themed visits to NHS and private sector wards for people with learning disabilities

Author:
MENTAL WELFARE COMMISSION FOR SCOTLAND
Publisher:
Mental Welfare Commission for Scotland
Publication year:
2008
Pagination:
16p.
Place of publication:
Edinburgh

The Commission undertook a themed visit to all learning disability in-patient units during the 2007-08 visiting programme. The Commission visited 39 facilities across Scotland from 25 October to 7 November 2007. Prior to the visits, health boards were asked to provide some information about the wards in their areas. Staff were asked a series of questions about the people living in the ward on the day of the visit and about how care and treatment was provided. Commission staff met with individual patients and some relatives and carers. The Commission was particularly interested in seeing how assessment of individual need was taking place and the ways identified needs were being met. Commission staff also looked for evidence within files that would indicate how individual people and carers were being involved in decisions about current and future care. Key recommendations are outlined.

Journal article

The hospital work

Author:
ARCHER Phillip
Journal article citation:
Community Connecting, 1, Summer 2005, p.15.
Publisher:
Community Connecting

Sometimes people with learning difficulties find it very hard if they have to go into hospital when they are unwell. Reports on a book produced by Barnet Hospital, which involved social care services, people with learning difficulties and their families, and aims to help people with learning difficulties to communicate their personal care needs and other information.

Book

Going into hospital

Authors:
HOLLINS Sheila, AVIS Angie, CHEVERTON Samantha
Publishers:
Gaskell, St. George's Hospital Medical School
Publication year:
1998
Pagination:
50p.,illus.,list of orgs.
Place of publication:
London

Part of a series of booklets designed to help people with learning difficulties to understand and cope with major events in their lives. Shows what happens when a person has to go into hospital for an operation. The first part is in pictures and the second contains material to support the pictures for carers and people working with people with learning difficulties, as well as for hospital staff.

Journal article

Residential care debate

Author:
McMILLAN Ian
Journal article citation:
Nursing Times, 14.8.96, 1996, pp.62-63.
Publisher:
Nursing Times

A recently released report commissioned by the Department of Health has confirmed that people with learning disabilities are more likely to thrive in smaller homes in the community than in larger hospitals. The author looks at the reopened debate over the value of village communities.

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