Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 8 of 8
Ethical dilemmas in Community Learning Disabilities Nursing
- Author:
- HOLLOWAY Dave
- Journal article citation:
- Journal of Learning Disabilities, 8(3), September 2004, pp.283-298.
- Publisher:
- Sage
Community learning disability nurses (CLDNs) sometimes face ethical dilemmas arising from choices made by people with learning disabilities. This article reports on the results of a postal questionnaire that asked a sample of CLDNs in England and Wales about support available to them to assist in resolving these dilemmas. They were also asked about their knowledge and use of best interests guidelines. Differences were reported in the availability of support, such as policies and procedures, training, and ethical committees, to help in the areas of relationships and lifestyle, finance, and health care. Additional support was identified by respondents, and the most helpful to CLDNs are characterized by the provision of reflective opportunity and the ability to discuss issues with colleagues and other professionals. This support included talking to colleagues, reflective practice, multidisciplinary working, clinical supervision, access to the evidence base, and training.
Demystifying the process? A multi disciplinary approach to assessing capacity for adults with a learning disability
- Authors:
- SKINNER Rachael, et al
- Journal article citation:
- British Journal of Learning Disabilities, 39(2), June 2011, pp.92-97.
- Publisher:
- Wiley
There appears to be a lack of confidence among professionals in conducting capacity assessments which may lead to reluctance to take responsibility for executing an assessment and forming a judgement. This document explains a 2-phase process developed by a multi-disciplinary group of professionals during a pilot project to assess the capability to consent of adults with a learning disability referred for proposed ophthalmic interventions. The 1st phase in the decision making process is to determine to what extent the person being assessed is able to process and recall information. The 2nd phase involves understanding more detailed information specifically relating to the decision, in this case the procedure or intervention. The use of the process is illustrated via case studies. Over a 2-year period, 17 people who were referred from the eye unit to the capacity team were seen. Of those, 2 progressed to the 2nd phase of the process and 1 demonstrated capacity to make a decision. The process was based on a functional approach, and was used to avoid making decisions based on status approaches. The developed process was fed back to the professionals in the eye unit to enable them to assess capacity in relation to eye surgery, and has also been applied to other situations such as the management of financial affairs and choices about accommodation.
Involving children with learning and communication difficulties: the perspectives of teachers, speech and language therapists and teaching assistants
- Authors:
- FEILER Anthony, WATSON Debby
- Journal article citation:
- British Journal of Learning Disabilities, 39(2), June 2011, pp.113-120.
- Publisher:
- Wiley
Recent policy initiatives in the United Kingdom have highlighted the importance of hearing the child’s voice. Policy has also focused on improving services for children and young people who experience communication difficulties. Professionals who support these children need to work effectively together to enable this to happen. This study examined the perspectives of teachers, speech and language therapists and teaching assistants on involving children with severe learning and communication difficulties in decision-making at school. Semi-structured interviews were conducted at 2 special schools in England with 2 head teachers, 1 deputy head teacher, 3 speech and language therapists, 4 teachers, and 6 teaching assistants. Key findings are discussed, and these are presented under 3 main themes: child-focused issues; professional practice; and variation in perspective according to professional role. Involving children with severe learning and communication difficulties in decision-making was embraced as a key priority by most of the staff who participated. The discussion explores the links between these findings and the research and policy literature and considers the need for professional development opportunities that enhance effective teamwork.
Ethical issues of psychotropic medication for people with intellectual disabilities
- Authors:
- RAGHAVAN Raghu, PATEL Pradip
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(3), September 2010, pp.34-38.
- Publisher:
- Emerald
This paper details the importance of health professionals considering ethical and legal issues surrounding the prescription of psychotropic medications in the UK to people with learning disabilities. Sections entitled ‘decision-making processes’, ‘prescribing psychotropic medication in intellectual disability – clinical concerns’, ‘accessible information’, ‘covert administration’ and ‘good practice in prescribing psychotropic medication’ cover a wide range of ethical, legal, equality and human rights considerations which need taken into account in each individual case. The authors make mention of the English policy guidelines ‘Valuing People’ and ‘Valuing People Now’ (2001 and 2009), the Mental Capacity (England and Wales, 2005) and Adults with Incapacity (Scotland, 2000) Acts and the 2008 General Medical Council guidance on consent. They list nine guidelines for good practice in prescribing psychotropic drugs, including the use of multi-disciplinary, behaviour analysis, diagnosis and discussion of risks and benefits, especially when a patient in unable to understand and give informed consent, involvement of carers, monitoring and measurement of efficacy and side effects, prompt, controlled withdrawal if necessary, use of lowest, optimal doses and avoidance of frequent dose or drug changes and external auditing of clinical practice.
Please don't let it happen on my shift. Supporting staff who are caring for people with learning disabilities who are dying
- Authors:
- BROWN Hilary, BURNS Sophie, FLYNN Margaret
- Journal article citation:
- Tizard Learning Disability Review, 8(2), April 2003, pp.32-41.
- Publisher:
- Emerald
Reports on a qualitative study of services that have cared for a person with learning disabilities during a terminal illness. The project was based on a series of case studies, twenty-one individual case studies were included from twelve different services. Interviews were also carried out with staff, relatives and service users. The research reflects current concern about access to health care as well as the national priority being placed on improvements in cancer services for all patients. The study documents how the service learned of the person's illness, how they mobilised services and made decisions, how effectively agencies worked together and what support staff needed in the person's last months and weeks. It also considers the way staff, as individuals and teams, made sense of their experience and evaluated the input of other professionals. The article looks at two cases in detail to highlight the findings.
Working with women with a learning disability experiencing domestic abuse: how social workers can negotiate competing definitions of risk
- Authors:
- DIXON Jeremy, ROBB Megan
- Journal article citation:
- British Journal of Social Work, 46(3), 2016, pp.773-788.
- Publisher:
- Oxford University Press
Women with a learning disability who experience domestic abuse receive intervention from both social services and the police. Responses from these services have increasingly become focused on notions of risk. This article uses governmentality theory to examine how risk is understood and managed by both services through a focus on policy and practice. The article examines how policy directs social workers to promote positive risk taking whilst assessing and managing risk for those deemed vulnerable or lacking mental capacity to self-protect. It is argued that, whilst social work decision making around risk has primarily been based on the judgement of individual workers, the police have increasingly adopted assessments utilising calculative measures. In addition, the article explores the extent to which these women are treated as autonomous agents responsible for managing their own risk. It is argued that social workers and the police should adopt a common screening process to highlight groups of women who may be at risk of abuse. In addition, social workers should draw on their interpersonal skills to enable women with a learning disability to recognise and make informed choices about abuse. (Publisher abstract)
Capacity to choose and refuse? A case study
- Authors:
- GUTHRIE Susan, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.293-300.
- Publisher:
- Emerald
This case study reflects on the risk assessment, treatment, and care issues for a man in his late thirties with a learning disability, mental illness and a degenerative neurological condition who was under Section by the Mental Health Act. It focuses on the distinctive roles and perspectives of the members of the multidisciplinary team supporting him. The management of risk for this man was particularly complex due to his self-harming and impulsivity. The article focuses on issues around referral to speech and language assessment for dysphagia and management advice. Each specialist clinician (nurse, speech and language therapist, psychiatrist) reflects on their role as a member of a team. The perspective of the man himself is represented, although he was unable to give a consistent descriptive self report. For people with mental illness and intellectual disability the capacity to understand and retain information about their condition may be limited and variable. The authors discuss the multiple ethical issues in attempting to preserve a modified autonomy and in decision making around best interests. They look at the particular challenges encountered when supporting someone with dysphagia if the person is unable to understand and refuses to comply with guidelines outlining restrictions to mealtime choices.
Goal attainment scaling as a method of measuring clinical outcome for children with learning disabilities
- Authors:
- YOUNG Anita, CHESSON Rosemary
- Journal article citation:
- British Journal of Occupational Therapy, 60(3), March 1997, pp.111-114.
- Publisher:
- Sage
Discusses one approach to measuring therapeutic impact - Goal Attainment Scaling (GAS). The authors forward the case for GAS based on their own research regarding occupational therapy with children with learning disabilities. GAS is described and the factors relating to the setting of goals are examined. The main advantages are identified and GAS is seen to have benefits beyond those relating specifically to occupational therapy. The implications for multidisciplinary teamworking are examined and, in particular, it is asserted that co-workers may acquire, through the goal-setting process, realistic expectations of clients. The audit of therapeutic goals is seen to have the potential to inform decision making regarding treatment options. In conclusion, GAS is advocated as a particularly appropriate evaluative tool for the 1990s.