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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
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)
Review of compliance: Tees, Esk and Wear Valleys NHS Foundation Trust: Durham Rd
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2011
- Pagination:
- 14p.
- Place of publication:
- London
Durham Road, part of Tees, Esk and Wear Valley NHS Foundation Trust, was inspected as part of a targeted inspection programme in hospitals that care for people with learning disabilities. Durham Road provides a respite service for patients with learning disabilities and a service for the assessment and treatment adults with learning disabilities. The inspection was to assess how well they experience effective, safe and appropriate care treatment and support that meets their needs and protects their rights; and whether they are protected from abuse. Durham Road was found to meet all the essential standards of quality and safety reviewed.
Working together: easy steps to improve how people with a learning disability are supported when in hospital: guidance for hospitals, families and paid support staff
- Authors:
- HARKNESS Jenny, et al
- Publisher:
- Home Farm Trust
- Publication year:
- 2006
- Pagination:
- 33p.
- Place of publication:
- Bristol
This guidance has been produced by a working group of family carers, hospital staff, learning disability nurses and paid support staff, facilitated by HFT. Its aim is to help ensure that people with learning disabilities get the right kind of support and effective treatment during their stay in hospital. Four sections explain what family carer, paid support staff and hospital staff should be doing before admission, at admission, during admission, and at the end of a hospital stay to achieve the best outcomes for people with learning disabilities. The guide stresses the importance of working together. Appendices include a checklist for an admission meeting, The Traffic Light Hospital Assessment and The Risk, Dependency and Support Assessment.
Bron's legacy - a lesson that must not be ignored
- Authors:
- FLYNN Margaret, et al
- Journal article citation:
- Llais, 77, Summer 2005, pp.3-7.
- Publisher:
- Learning Disability Wales
This article describes Cartrefi Cymru's experience of supporting a tenant with a learning disability in secondary care. It presents a diary of events towards the end of the clients life, and raises concerns about practice at the interface of health and social care in Wales.
Managing the needs of people who have a learning disability
- Author:
- BRITTLE Richard
- Journal article citation:
- Nursing Times, 9.03.04, 2004, pp.28-29.
- Publisher:
- Nursing Times
A recent report from the National Patient Safety Agency has highlighted the risks facing people with a learning disability when they enter hospital. Recent policies and current patterns of care will see increasing numbers of people with a learning disability accessing generic health services, including hospitals. Nurses may need to develop suitable approaches to deal with the demand. This article offers some practical considerations.
A five decade retrospective review of admission trends in a NHS intellectual disability hospital
- Authors:
- WONG Yim Lun, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 9(3), 2015, pp.108-115.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine the trend of admissions and inpatient characteristics in a NHS intellectual disability hospital from 1975 to 2013, in particular looking at the effect following the Winterbourne View scandal. Design/methodology/approach: A retrospective review of all admissions over a three-year period (January 2011-January 2013) was completed. This information was compared with admissions to the same hospital in three-year period over the last four decades (1975-1977, 1985-1987, 1995-1997, and 2003-2006). Number of admissions, gender, age, source of admission, length of stay, reasons for admission, type of admission, and diagnosis of psychiatric illnesses were included. Findings: There were 87 admissions (including 29 from out of area) in the study period of 2011-2013. The number of admissions had varied over the years but male admissions were consistently higher than female. A majority of people stayed over six months. For the first time in five decades, there were more formal inpatients than informal ones. The diagnosis of Autism Spectrum Disorder (ASD) and of Attention Deficit Hyperactivity Disorder had increased. Originality/value: This study has examined admission trends over five decades. It has highlighted that the Mental Health Act legislation is being used more frequently and that co-morbid mental disorders, such as ASD are commonly associated with those admitted to hospital. A well planned-out community health care system, as well as adequate social provision are keys to maintain people with intellectual disability in the community. Furthermore, a better understanding of the symptomology of challenging behaviours, and appropriate use of mental health legislation are crucial in providing a high-quality service that has clear treatment goals and values. Some of these issues have contributed to the failure of the recent initiative to reduce the size of the inpatient intellectual disability following Winterbourne View scandal. (Publisher abstract)
A preliminary report on the closure of the Challinor centre
- Authors:
- YOUNG Louise, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 25(2), June 2000, pp.119-126.
- Publisher:
- Taylor and Francis
Reports on preliminary data for 32 individuals with intellectual disability who were relocated from a large state institution in Australia to small community-based group homes. These results suggest the relocation has enabled a more active and normalised lifestyle. However, community-based services may need to incorporate more effective active treatment programmes if adaptive behaviour gains are to occur.
Working with clients with learning disabilities and multiple physical handicaps: a comparison between hospital and community based therapists
- Authors:
- PIMENTEL Susan, RYAN Susan
- Journal article citation:
- British Journal of Occupational Therapy, 59(7), July 1996, pp.313-318.
- Publisher:
- Sage
This comparative study looks at hospital and community based occupational therapists who work with clients with learning disabilities and multiple physical handicaps. The factors examined were the time spent by occupational therapists with this group, the interventions used, and the learning support needed for the therapists. Information was gathered from questionnaires and semistructured interviews. Results showed a distinct difference between the two groups of occupational therapists, with remedial activities being the focus in the hospital setting and functional activities in the community. Most of the respondents felt that they had not had either sufficient education at college or sufficient support when they started their service. A change in role from therapist to consultant was found in those working in the community and this group also placed more emphasis on keeping up to date with developments in this specialist field.
Protocol for investment in health gain: mental handicap (learning disabilities)
- Author:
- GREAT BRITAIN. Welsh Office. NHS Directorate. Welsh Health Planning Forum
- Publisher:
- Great Britain. Welsh Office. NHS Directorate. Welsh Health Planning Forum
- Publication year:
- 1992
- Pagination:
- 71p.,bibliog.
- Place of publication:
- Cardiff
This document highlights the areas offering opportunities for the improvement in healthcare to people with learning difficulties in Wales as there is increasing emphasise on care in the community.