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Abuse, neglect, and exploitation: considerations in aging with lifelong disabilities
- Authors:
- ANSELLO Edward F., O'NEILL Peggy
- Journal article citation:
- Journal of Elder Abuse and Neglect, 22(1-2), January 2010, pp.105-130.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews existing data primarily from North America, but including Australia and Ireland, for factors known to contribute to the victimisation of older adults with lifelong learning disabilities. Many “are relatively high functioning, engaged and happy members of their communities”, but some, are or have been abused, neglected or subject to exploitation, and the prevalence of such maltreatment is discussed. Existing data is also scanned for the treatments currently in practice and the authors suggest initiatives to build further on continued community living, by improving upon preventive practices and identification techniques. The authors discuss why there greater risk of abuse for those with lifelong disabilities and why these are underreported. Consequences of maltreatment are listed, followed by the issues and needs of family carers, such as the lack of long-term planning until crisis point. The authors suggest recommendations for practice, such as adapting mental health interventions, and implications for public policies on prevention and identification.
Stay well and healthy!: pilot study findings from an inhome preventive healthcare programme for persons ageing with intellectual and/or developmental disabilities
- Authors:
- ARONOW Harriet Udin, HAHN Joan Earle
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(2), June 2005, pp.163-173.
- Publisher:
- Wiley
This pilot study evaluated the feasibility of two in-home interventions designed to reduce health risks and improve health outcomes among persons ageing with intellectual and developmental disabilities. Two hundred and one adults with intellectual and developmental disabilities, aged 32 and over living in non-institutional settings were recruited and assigned to either an advance practice nurse (APN) intervention of in-home multidimensional assessment, targeted recommendations and follow-up visits (n = 101) or an inhome health risk appraisal (HRA) with printed feedback only (n = 100). The development and pilot testing of the interventions, assessment tools and methods demonstrated feasibility in the population from mild to moderate intellectual and developmental disabilities. In addition, high levels of health risks were identified in the sample suggesting the need for effective interventions. Both pilot groups showed significant reduction in health risks between baseline and follow-up. Further rigorous randomized field trials are required to test the effectiveness of each intervention. The authors conclude that community-based preventive interventions are feasible for randomized trials in this population.
A pilot of a gerontological advanced practice nurse preventive intervention
- Authors:
- HAHN Joan Earle, ARONOW Harriet Udin
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 18(2), June 2005, pp.131-142.
- Publisher:
- Wiley
Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community-based health care systems. This American study presents a description of an advanced practice nurse (APN) intervention used in a pilot study that explored the feasibility of using an in-home preventive model based on a comprehensive geriatric assessment with persons ageing with an intellectual and developmental disability. The APN intervention was fully provided to a sub-sample (n = 70) of 201 participants with an intellectual and developmental disability enrolled in a programme called 'Stay Well and Healthy!' The APN intervention included an initial home visit for a comprehensive geriatric assessment with follow-up home visits to review health status and assess adherence with recommendations and provide education and support to promote health and prevent functional decline. Advanced practice nurses identified a number of active health-related problems for persons ageing with an intellectual and developmental disability that had potential effects on function and survival. The majority of recommendations were for clinical preventive services and self-care for health-related issues. This study showed that there were problems consistent with persons ageing with an intellectual and developmental disability and older adults without disability. The in-home preventive APN intervention to promote healthy ageing and reduce health disparities in this population is feasible, needed, and warrants further study.