Search results for ‘Subject term:"learning disabilities"’ Sort:
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Inclusion and healthcare choices: the experiences of adults with learning disabilities
- Authors:
- FERGUSON Morag, JARRETT Dominic, TERRAS Melody
- Journal article citation:
- British Journal of Learning Disabilities, 39(1), March 2011, pp.73-83.
- Publisher:
- Wiley
Those with learning disabilities have fewer decision-making opportunities than the general population. This study investigated the decision-making experiences of two groups of individuals with a learning disability. Group 1 included irregular attenders who had opted out of healthcare appointments for avoidable reasons, and group 2 included regular attenders who had attended all appointments or not attended for unavoidable reasons. Interviews were carried out with 4 people with learning disabilities and/or their 13 primary carers. In addition to these interviews, physiotherapy staff participated in a focus group. Those with learning disabilities described experiences of and opportunities for making everyday decisions but mostly identified others as being responsible for making their health care choices. Overall, the paper concluded that a greater understanding of the health care expectations and experiences of individuals with learning disabilities, and those that support them, is required to enable people with learning disabilities as participants in their own health care decision-making processes.
Lucy's treatment
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2011
- Place of publication:
- London
This film is a drama set in an accident and emergency department. Lucy is a woman with Down’s syndrome who is resisting treatment for a dog bite. She is with her mother when the nurse comes to assess her. The nurse does not communicate well with Lucy. She is doing a pressurised job, but this cannot excuse her behaviour towards Lucy. The nurse also makes a common mistake of believing she can’t provide treatment which goes against her patient’s wishes. It is Lucy’s mother who explains that where a person lacks capacity to make a decision about treatment, the decision must be made in the person’s best interests. Lucy is given a tetanus injection using a limited amount of restraint. NB This film is no longer available to view.
Roger's assessment
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2011
- Place of publication:
- London
Actors have been used in this film. Roger is a man with learning disabilities living in a supported living service. An assessment of his mental capacity to make different financial decisions is being undertaken by Tracey, a social worker. Tracey decided to do the assessment after concerns were raised that staff working with Roger were crossing the line between supporting him to make financial decisions and making some financial decisions for him. The assessment covers different types of financial decisions including day-to-day expenditure and paying household bills. This film has now been revised and is available under the new title: 'Mental Capacity Act: making decisions about money.'
Allocating homes for people with intellectual disability: needs, mix and choice
- Author:
- WIESEL Ilan
- Journal article citation:
- Social Policy and Administration, 45(3), June 2011, pp.280-298.
- Publisher:
- Wiley
Noting that in social housing, allocation of vacant placements is controlled by policies and guidelines with which decision-makers are required to comply, this article aims to examine the tensions between considerations of needs, mix and choice in allocations policy. It is based on information from a research project about housing choice when allocating housing for people with intellectual disability in the state of Victoria, Australia. The project included semi structured interviews with over 50 people involved in policy formulation, decisions concerning housing allocations, providing housing and support, and advocacy for people with intellectual disability. The article draws on analysis of, and examples from, the interviews to discuss elements in the allocation process, focusing on tensions between needs and choice, between needs and mix, and between choice and mix. The author suggests that recognising the interrelationships between needs, mix and choice is a possible way forward in developing a new understanding of what these concepts mean in the context of allocation policies, to guide future reforms in the social housing sector.
The first critical steps through the criminal justice system for persons with intellectual disabilities
- Authors:
- MERCIER Céline, CROCKER Anne G.
- Journal article citation:
- British Journal of Learning Disabilities, 39(2), June 2011, pp.130-138.
- Publisher:
- Wiley
This paper discusses the initial steps of the judicial process for persons with intellectual disabilities who are suspected of a minor offense in the context of the Canadian criminal justice system (CJS). During this stage, plaintiffs, police officers, and crown attorneys make a series of decisions that will have a significant impact on the course of the judicial process. The main objective of this study was to document the criteria that influence dispositions by police officers and crown attorneys about persons with intellectual disabilities in the CJS. A secondary objective was to report suggested improvements to better support them throughout the judicial process. Fourteen semi-structured interviews were conducted with key informants from the CJS and from service and community organisations. The informants identified a series of implicit criteria that influence the decisions made and dispositions taken in the case of a suspected offence. Suggestions for improvement include early screening for intellectual disability, educating police officers and crown attorneys about intellectual disabilities, a preference for the use of summons to appear over other types of procedures, and drafting memorandums of understanding between various organisations and police services regarding persons with intellectual disabilities. The findings emphasise the need for more effective screening and diversion procedures for persons with intellectual disabilities within the CJS.
‘It's only right that we get involved’: service-user perspectives on involvement in learning disability services
- Authors:
- HOOLE Lucy, MORGAN Sally
- Journal article citation:
- British Journal of Learning Disabilities, 39(1), March 2011, pp.5-10.
- Publisher:
- Wiley
Promotion of service-user and carer involvement is part of the mainstream policy agenda in health and social care. Much effort has been invested into involving people with learning disabilities in decisions regarding aspects of their lives through advocacy projects and the utilisation of person-centred planning approaches. However, people with learning disabilities continue to be a group of people who are the `most excluded, least independent and most likely to lack control in everyday life'. This article describes a focus group that was conducted to explore the lived experiences of people with learning disabilities as users of services. Thematic analysis revealed three key themes: feelings of unfairness and inequality; experiences of inclusion and power; and future visions. Implications for practice are discussed. Overall, the focus group participants sought greater equality in the decision-making process that affected their everyday lives, breaking down the barriers to meaningful involvement in service development.
The history of self-advocacy in Wales
- Authors:
- BOXALL Yvon, KUROWSKI Katrina
- Journal article citation:
- Llais, 100, Autumn 2011, pp.30-33.
- Publisher:
- Learning Disability Wales
People with learning disabilities often have little chance to express their basic rights. Self-advocacy has made people more aware of equality and the right to community life. Since the early days of the All Wales Strategy (AWS), most self-advocacy was being developed through day services, and was supported by day service staff. Self-advocacy groups focused on people speaking up for themselves to make choices or decisions. This article charts the development of self-advocacy since the launch of the AWS. It describes recent developments such as Individual Planning which was used as to promote the idea that people need to be at the centre of any decisions that affect their lives and lifestyle, and Participation which was also used as a building block in the early days. The article then discusses the development of People First in Wales and how it has contributed to ‘choice and control’, ‘community’ and ‘change’.
Involve Me
- Author:
- -
- Journal article citation:
- Viewpoint, 124, September 2011, pp.20-21.
- Publisher:
- Mencap/Gateway
Involve Me is a 3-year project on increasing the involvement of people with profound and multiple learning disabilities (PMLD) in decision-making, through supporting people to make personal decisions and influencing decision-makers. It looked at decision-making at 4 levels: personal decisions in everyday life, decisions about the immediate environment (such as in a group home), community decisions and national decisions. The findings of the Mencap and British Institute of Learning Disabilities project have been used to produce recommendations and resources for those involved with services for people with PMLD, including a practical guide to involving people with PMLD. This article describes the project and its key activities (including sharing stories, creative communication, multimedia advocacy and peer advocacy) and key messages. It includes a brief case study.
Evaluation of a structured assessment framework to enable adherence to the requirements of Mental Capacity Act 2005
- Authors:
- RAMASUBRAMANIAN Lakshmiprabha, RANASINGHE Newton, ELLISON Joseph
- Journal article citation:
- British Journal of Learning Disabilities, 39(4), December 2011, pp.314-320.
- Publisher:
- Wiley
The Mental Capacity Act 2005 for England and Wales provides a statutory framework to empower and protect vulnerable people who are not able to make their own decisions. It outlines who can make decisions, in what situations, and how they should go about this. This paper presents findings from an audit which examined the quality, thoroughness and completeness of making decisions for people with learning disabilities who lacked capacity in making specific decisions for themselves. A checklist, or structure assessment framework, was created and tested on 20 patients in a specialist inpatient unit. Prior to the introduction of the checklist there were low levels of recording, with little regard to capacity. All areas showed significant improvement following the introduction of the structure assessment framework. The audit showed that the use of the checklist enabled a structured discussion to take place regarding the decision-making process and ensured complete documentation. The checklist enabled full adherence to the Mental Capacity Act and established better standards of practice.
Can clinicians and carers make valid decisions about others' decision-making capacities unless tests of decision-making competence and capacity include emotionality and neurodiversity?
- Authors:
- MACKENZIE Robin, WATTS John
- Journal article citation:
- Tizard Learning Disability Review, 16(3), 2011, pp.43-51.
- Publisher:
- Emerald
This paper offers academic criticism and explanation for the lack of knowledge of many of those involved in capacity assessments, especially non-professionals such as carers of the learning disabled. It suggests that current guidance for capacity assessments do not take into account issues of emotionality. The Mental Capacity Act 2005 Code of Practice suggests that healthcare professionals and carers may undertake assessments of decision-making capacity, yet the guidance it provides for their doing so overlooks salient issues. Many of those involved in the daily lives of those, who may lack decision-making capacity such as the learning disabled, demented, mentally ill and neurodiverse, must decide whether to respect their decisions as competent, or to disregard the decisions on the grounds of incompetence and to act in the person's best interests. Many will lack training in their clinical and legal responsibilities and liabilities. It is therefore vital that they are protected by an increased knowledge of mental capacity legislation and practice.