This essay is going to discuss communication, training, education, and consent and identify problems, which can occur when providing care for people with learning disabilities in NHS acute hospital settings and discuss how these can be used to prevent or minimised death.
In today society, there are 1.5 million individuals with a learning disability. Learning disabilities is caused by the way the brain develops. There are many different types of learning disabilities for instance, Attention Deficit Hyperactive Disorder (ADHD), Autism, Down's syndrome and Cerebral Palsy. A learning disability is permanent and usually has a considerable impact on people's lifes. Learning disabilities can affect people in many different ways, such as difficulty in written or oral communication, and difficulty in learning and developing social skills (Mencap, 2008:1-4).
Within NHS, hospital's providing care to individuals with a learning disability can pose a challenge. This can affect the delivery of care and the care individuals are entitled to. Many pitfalls medical professionals face when providing care and treatment to patients who have a learning disability can vary. Multidisciplinary teams have a duty of care to ensure no harm comes upon those they treat. Lack of communication throughout care services can become a risk to patient care. Cardy (2005:14) commented, "Communication is often poor, especially in relation to health, disease, treatment and death". Most individuals with learning disabilities have problems communicating and quite often, patients rely on people who know them best to express their concerns. The use of communication in prevention of death promotes a safeguard. Ideally, professionals should work as a team to ensure this is enforced and improve the delivery of care to their patient. Involving family, carers and advocates can establish a way which the needs of the patient is put forward without delay heightening the requirement of communicating with people who know the patient best. Communication is essential in relation to diagnosis and the assessment process. Physical pain and emotional distress is something that can be apparent when an individual is not well. However, individuals with learning disabilities display this type of behaviour and they may not necessarily be in any pain (Turner, 2009: 274-275). Individuals who are close to the patient detect when a change has developed and know when something is wrong. This expresses the need for communication, especially if patients cannot express themselves. Multidisciplinary teams listening and taking into account what family's, carer and advocates have to say it can enable early detection of problems can limit the time, diagnosis and treatment plan, which can effectively promote care and minimising medical conditions getting worse which can prevent death occurring.
Breakdown of communication caused by ignorance can lead to many discrepancies with in a healthcare environment, health needs not visible or identifiable to health services can escort to neglect, which can lead to death. However, being able to communicate effectively with individuals, who may have different communication requirements, being aware of the right way to communicate enables affective delivery of care and minimise potential risk. When communicating healthcare professionals must have good knowledge and sufficient education and training when dealing with people with learning disabilities. The need for more training can help reduce the risk of death within learning disabilities. Brittle (2009:1) states, "The DH is commissioning a public health observatory to provide data on learning disability. This body will also be charged with ensuring medical students and NHS professionals receive training on learning disabilities, equalities and human rights". Having sufficient training can minimise and prevent death as your aware of the needs of the patient and what challenges they come across as an individual's (Jackson and Read, 2008:1-10).
Lack of awareness can also pose a high risk to patients receiving care and many people working in hospitals may not have a clear understanding of learning disabilities especially if they are not specialised. Without training patients with learning disabilities deems a low priority as they have very little understanding about this area of care. Hitchen, (2008:1) comments "Medical schools and nursing schools have a responsibility to train and expose student to people with learning disabilities at an earlier stage. That is what changes people's values and opinions and that has a bearing on how they deal with people in the future". Medical professionals who are aware of the criteria of needs for the patient can establish ways, which is suitable for the patient making them, feel comfortable. Clinical health setting is target-driven and individual's with exceptional requirements, needs care delivery at their going rate, within their time. This is how the health service lets society down when learning disabilities is the focus (Hitchen, 2008:1).
Lack of awareness of health needs of people with learning disabilities owing to limited training and education is a risk in itself. People with learning disabilities need time to adjust in hospitals settings and while the importance of having understanding of how individuals need to be treated, this can help in gaining consent from patient to promote their care and prevent and minimise ill health and even death.
Consent for care or treatment is very important throughout nursing intervention. It is essential that patients give consent before any care and treatment takes place. When dealing with patients who have a learning disability issues can arise, for instance, treating individuals who have communication restrictions and have a low ability to understand. Technical medical terminology maybe too much for the patient to take in and they may not understand what is required of them and what medical professionals require to do. It may be a case of translating terms used into simpler language so the patient is able to understand and give consent. Otherwise, it may get dismissed and assumed the individual does not have the capacity to consent to treatment, therefore putting them at risk (Brooker and Waugh, 2007: 157-160). The Nursing and Midwifery Code of Conduct (NMC) (NMC, 2008:1) provides that nurses "Must be aware of the legislation regarding mental capacity ensuring that people who lack capacity remain at the centre of decision making and are fully safeguarded". Clinicians often find it hard to know how to handle consent. Some professionals assume that individuals do not have the power to give consent. Professionals should always assume that the person has capacity, even when the person has learning disabilities. Individuals should not judge a patient's ability to give consent by their condition or behaviour. This can become very worrying situation as patients needing medical treatment need medicines and they need to be monitored and treated efficiently otherwise it can lead to further deterioration of health and even death.
Caring for people with learning disabilities within the healthcare profession is an important aspect of the health service. Understanding the care that is required is vitally important in maintaining the integrity of individual's. Communication is a key aspect when dealing with someone with a disability and medical professionals must ensure that they can understand the patient's needs, this assists in preventing unnecessary deaths from occurring. Educating and training individuals is required to have the necessary skills to understand the needs of people with a learning disability, without training individuals will not understand the speciality of care required for a patient with different needs.
People living with learning disabilities have the right to be treated in the same way as other people, no matter how severe their disability. There are ways of having effective communication to enable medical professionals to carry out their role at a high standard. Many people with learning disabilities do not have an adequate level of support in their lives, which highlights the importance of being able to treat them with the respect and dignity they are entitled to and help provide a professional and effective service to that individual while in a healthcare environment.
- Brittle, R (2009) 'We Must not Lose Specialist Skills in Learning Disabilities', Nursing Times, February [Online] Available at: http://www.nursingtimes.net/nursing-practice-clinical-research/we-must-not-lose-specialist-skills-in-learning-disabilities/1992641.article [Accessed: 03 May 2010].
- Cardy, P (2005) 'Learning Disability and Palliative Care' International Journal of Palliative Nursing, 11 (1), pp.14.
- Hitchen, L (2008) 'Is Learning Disability Nursing Undervalued?', Nursing Times, April [Online] Available at: http://www.nursingtimes.net/whats-new-in-nursing/is-learning-disability-nursing-undervalued/1219852.article [Accessed: 03 May 2010].
- Jackson, S, Read, J. (2008) 'Providing Appropriate Healthcare to People with Learning Disabilities' British Journal of Nursing (Learning Disabilities Supplement), 17 (4), pp. 1-10.
- Mencap (2008) Making Rights A Reality. Available at: http://www.mencap.org.uk/document.asp?id=2371 [Accessed 02 May 2010].
- Mencap (2009) An Introduction to the Mental Capacity Act 2005. Available at: http://www.mencap.org.uk/document.asp?id=12726&audGroup=&subjectLevel2=&subjectId=6&sorter=1&origin=subjectId&pageType=&pageno=&searchPhrase [Accessed 02 May 2010].
- Nursing and Midwifery Council (2008) Consent . Available at: http://www.nmc-uk.org/aArticle.aspx?ArticleID=4004 [Accessed 02 May 2010].
- Ogston-Tuck, S. (2007) 'Legal Issues that Impact on Nursing Practice', in Brooker, W, Waugh, C. (ed.) Foundations of Nursing Practice Fundamentals of Holistic Care, Kennedy Boulevard, Philadelphia. pp. 157-160.
- Turner, N (2009) 'Treat Me Right! A revolutionary Approach to Learning Disabilities' British Journal of Healthcare Assistants, 3 (8), pp. 408-410.
- Turner, N (2009) 'Treat Me Right! Better Care Through Communication' British Journal of Cardiac Nursing, 4 (6), pp.1-2