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Couvrette R, Milot É, Fortin G. Factors Influencing Palliative and End-of-Life Care for Adults with Intellectual Disabilities: A Scoping Review of Health and Care Workers' Experiences. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2024:1-19. [PMID: 38704821 DOI: 10.1080/15524256.2024.2346113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
In developed countries, there has been an increase in the longevity of adults with intellectual disabilities. In the later stages of their lives, people with intellectual disability have specific needs in terms of palliative and end-of-life care that need to be better understood in order to offer appropriate care. This scoping review aimed to identify the main factors influencing the provision of palliative and end-of-life care from the perspective of health and care workers involved with adults with an intellectual disability at the end of life. Seven databases were systematically searched for relevant articles published between 2002 and 2022. NVivo qualitative research analysis software was used to conduct a thematic analysis of the 50 included studies. Three main factors were identified: the location of care and death, the involvement of the person with intellectual disability, and collaborative practices.
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Affiliation(s)
- Romane Couvrette
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Canada
- Centre for Research and Expertise in Social Gerontology (CREGES), Montréal, Canada
| | - É Milot
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Canada
- Centre for Research and Expertise in Social Gerontology (CREGES), Montréal, Canada
| | - G Fortin
- School of Social Work and Criminology, Université Laval, Québec City, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec, Université Laval, Québec, Canada
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Ashok N, Hughes D, Yardley S. Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography. Palliat Med 2023; 37:1047-1062. [PMID: 37294100 PMCID: PMC10503257 DOI: 10.1177/02692163231175928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with diagnoses of intellectual disability or serious mental illness have higher mortality rates due to physical comorbidities; better understanding is needed to guide best practice in provision of palliative care for these populations. AIMS To identify multivoiced perspectives, drawn from lived experience of: what works, and what does not, in palliative care for people with intellectual disability or serious mental illness; challenges in, and opportunities to improve, palliative care. DESIGN A systematically constructed qualitative meta-ethnography. Protocol published (PROSPERO: CRD42021236616). DATA SOURCES MEDLINE, PsychINFO, CINAHL PLUS and Embase used without date limitations. Papers published in English, containing qualitative data on palliative care provision for people with a diagnosis of intellectual disability or serious mental illness were included. Global five-point strength score applied for relevance/quality appraisal. RESULTS Familiarity (of location, people and/or things) is important for good palliative care. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common. Adapting training for palliative care staff to address concerns and beliefs about mental illness is one of the methods that helps avoid diagnostic overshadowing. Proactive identification of service arrangements to meet needs of persons with personality, psychotic, delusional and bipolar affective disorders will help optimise care. CONCLUSIONS Evidence, including the voices of people with intellectual disability or serious mental illness is urgently needed to guide efforts to improve their access to and experience of palliative care. More evidence is especially needed to understand, develop and implement best practice for people with psychosis, bipolar affective disorder, mania and personality disorder.
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Affiliation(s)
| | | | - Sarah Yardley
- University College London, London, UK
- Central & North West London NHS Foundation Trust, London, UK
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Foo B, Wiese M, Curryer B, Stancliffe RJ, Wilson NJ, Clayton JM. Specialist palliative care staff's varying experiences of talking with people with intellectual disability about their dying and death: A thematic analysis of in-depth interviews. Palliat Med 2021; 35:738-749. [PMID: 33730929 DOI: 10.1177/0269216321998207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The cognitive and communication challenges experienced by people with intellectual disability present difficulties for health professionals, particularly in the face of illness and dying. AIM To explore the experiences of specialist palliative care staff in talking with people with intellectual disability about their dying and death, and factors that influence these conversations. DESIGN An inductive thematic analysis was conducted on data from a larger qualitative semi-structured interview study. SETTING/PARTICIPANTS Twenty palliative care staff from health services across Australia were interviewed. Participants were employed in multidisciplinary specialist palliative care teams and had provided palliative care to dying persons with intellectual disability. RESULTS Specialist palliative care staff did not consistently talk with people with intellectual disability about their dying and death. Conversations were influenced by (a) the perceived capacity of the person with intellectual disability, (b) experience and expertise of palliative care staff, (c) the relationship between palliative care staff and dying person and (d) values of palliative care staff and other caregivers (namely family members and paid carers). CONCLUSIONS Specialist palliative care staff experience difficulties in talking with people with intellectual disability about their dying. Development of communication guidelines, resources and training for palliative care teams are urgently required to improve palliative care for this patient group. A more comprehensive research agenda on the needs of people with intellectual disability and their caregivers in palliative care is needed, with a particular focus on strategies to effectively communicate about dying and death.
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Affiliation(s)
- Baby Foo
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Michele Wiese
- School of Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Bernadette Curryer
- Centre for Disability Research and Policy, The University of Sydney, Sydney, NSW, Australia
| | - Roger J Stancliffe
- Centre for Disability Research and Policy, The University of Sydney, Sydney, NSW, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury, NSW, Australia
| | - Josephine M Clayton
- Centre for Learning & Research in Palliative Care, HammondCare, Greenwich Hospital, Sydney, Australia; Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
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Scholz B, Goncharov L, Emmerich N, Lu VN, Chapman M, Clark SJ, Wilson T, Slade D, Mitchell I. Clinicians' accounts of communication with patients in end-of-life care contexts: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:1913-1921. [PMID: 32650998 DOI: 10.1016/j.pec.2020.06.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/02/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Communication between patients and end-of-life care providers requires sensitivity given the context and complexity involved. This systematic review uses a narrative approach to synthesise clinicians' understandings of communication in end-of-life care. METHODS A systematic, narrative synthesis approach was adopted given the heterogeneity across the 83 included studies. The review was registered prospectively on PROSPERO (ID: CRD42019125155). Medline was searched for all articles catalogued with the MeSH terms "palliative care," "terminal care" or "end-of-life care," and "communication". Articles were assessed for quality using a modified JQI-QARI tool. RESULTS The findings highlight the centrality and complexity of communication in end-of-life care. The challenges identified by clinicians in relation to such communication include the development of skills necessary, complexity of interpersonal interactions, and ways in which organisational factors impact upon communication. Clinicians are also aware of the need to develop strategies for interdisciplinary teams to improve communication. CONCLUSION Training needs for effective communication in end-of-life contexts are not currently being met. PRACTICE IMPLICATIONS Clinicians need more training to address the lack of skills to overcome interactional difficulties. Attention is also needed to address issues in the organisational contexts in which such communication occurs.
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Affiliation(s)
- Brett Scholz
- Medical School, The Australian National University, Canberra, Australia.
| | - Liza Goncharov
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Nathan Emmerich
- Medical School, The Australian National University, Canberra, Australia
| | - Vinh N Lu
- College of Business and Economics, The Australian National University, Canberra, Australia
| | - Michael Chapman
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
| | - Shannon J Clark
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Tracey Wilson
- Medical Intensive Care Unit, University of Maryland, Baltimore, USA
| | - Diana Slade
- School of Literature, Languages and Linguistics, The Australian National University, Canberra, Australia
| | - Imogen Mitchell
- Medical School, The Australian National University, Canberra, Australia; Canberra Health Service, ACT Health, Canberra, Australia
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Adam E, Sleeman KE, Brearley S, Hunt K, Tuffrey-Wijne I. The palliative care needs of adults with intellectual disabilities and their access to palliative care services: A systematic review. Palliat Med 2020; 34:1006-1018. [PMID: 32552409 PMCID: PMC7596767 DOI: 10.1177/0269216320932774] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is evidence that people with intellectual disabilities experience healthcare inequalities, including access to specialist palliative care, but to date, there has not been a systematic review of empirical evidence. AIM To identify the palliative care needs of adults with intellectual disabilities and the barriers and facilitators they face in accessing palliative care. DESIGN Systematic review using a narrative synthesis approach (International prospective register of systematic reviews (PROSPERO) registration number: CRD42019138974). DATA SOURCES Five databases were searched in June 2019 (MEDLINE, Embase, PsycINFO, the Cochrane library and CINAHL) along with hand searches and a search of the grey literature. All study designs were included. RESULTS A total of 52 studies were identified, all of which were conducted in high-income countries, the majority in the United Kingdom (n = 28). From a total of 2970 participants across all studies, only 1% were people with intellectual disabilities and 1.3% were family members; the majority (97%) were health/social care professionals. Identified needs included physical needs, psychosocial and spiritual needs, and information and communication needs. Barriers and facilitators were associated with education (e.g. staff knowledge, training and experience), communication (e.g. staff skill in assessing and addressing needs of people with communication difficulties), collaboration (e.g. importance of sustained multidisciplinary approach) and health and social care delivery (e.g. staffing levels, funding and management support). CONCLUSION This review highlights the specific problems in providing equitable palliative care for adults with intellectual disabilities, but there is a lack of research into strategies to improve practice. This should be prioritised using methods that include people with intellectual disabilities and families.
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Affiliation(s)
- Emily Adam
- Cicely Saunders Institute of Palliative Care and Rehabilitation, King's College London, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care and Rehabilitation, King's College London, London, UK
| | - Sarah Brearley
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Irene Tuffrey-Wijne
- Faculty of Health, Social Care & Education, Kingston University and St George's, University of London, London, UK
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McKibben L, Brazil K, Hudson P, McLaughlin D. Informational needs of family caregivers of people with intellectual disability who require palliative care: a two-phase integrative review of the literature. Int J Palliat Nurs 2019; 25:4-18. [PMID: 30676158 DOI: 10.12968/ijpn.2019.25.1.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND: People with intellectual disabilities are living longer, with increasingly complex needs and their family caregivers may have a broad scope of unmet needs. AIMS: To identify the most common needs of family caregivers, to identify gaps in the literature, and distinguish the information needs of family caregivers of people with intellectual disabilities who require palliative care. METHODS: This two phase literature review used five electronic databases (CINAHL, PsycINFO, Medline, Cochrane and Pubmed). Phase 1 involved a review of systematic reviews of the needs of family caregivers across healthcare settings. Phase 2 explored the commonly reported information needs from phase 1, in relation to family caregivers of people with intellectual disability who require palliative care. There was no research explicit to the information needs of these family caregivers. FINDINGS: This review reveals potential information needs which may exist, guided by the palliative caregiving literature; alluding to information needs surrounding the disease, finances, and psychological or practical support. CONCLUSION: It is surmised that a greater scope of informational need exists for this population and further research is pertinent for international healthcare settings.
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Affiliation(s)
- Laurie McKibben
- PhD graduate, School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Kevin Brazil
- Professor, School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Peter Hudson
- Professor, Centre for Palliative Care, Centre for Palliative Care, St Vincent's Hospital and The University of Melbourne, Fitzroy, Victoria, Australia
| | - Dorry McLaughlin
- Lecturer, School of Nursing and Midwifery, Queen's University Belfast, UK
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Tuffrey-Wijne I, Davidson J. Excellence in palliative and end-of-life care provision for people with intellectual disability. Int J Palliat Nurs 2018; 24:598-610. [PMID: 30571253 DOI: 10.12968/ijpn.2018.24.12.598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND: People with an intellectual disability experience significant inequalities in end-of-life and palliative care provision. AIMS: To identify the key characteristics of practice initiatives and case reports that have won a UK award for the outstanding provision of end-of-life care for people with ID (2008-2018). METHODS: Thematic content analysis of the written nominations for award winners and those highly commended (n=25). FINDINGS: Four themes were identified: (1) Good practice was dependent on 'champions' with drive, enthusiasm and determination, supported by committed organisations and managers. (2) Collaboration was essential, including collaboration with families. (3) Care was highly individualised, putting the person's story at the centre. (4) There was a focus on staff training and use of specifically designed or adapted tools. CONCLUSION: The good practice examples are encouraging. Focus is now needed on ensuring that good practice is sustained, replicated and embedded within policies and organisational cultures. Currently, it remains over-dependent on committed individuals within organisations.
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Wark S, Hussain R, Müller A, Ryan P, Parmenter T. Challenges in providing end‐of‐life care for people with intellectual disability: Health services access. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:1151-1159. [DOI: 10.1111/jar.12408] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Stuart Wark
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Rafat Hussain
- ANU Medical School & Research School of Population HealthAustralian National University Canberra ACT Australia
| | - Arne Müller
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Peta Ryan
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Trevor Parmenter
- Centre for Disability StudiesSydney Medical SchoolUniversity of Sydney Sydney NSW Australia
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McLaughlin D, Barr O, McIlfatrick S, McConkey R. Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study. Palliat Med 2014; 28:1213-21. [PMID: 25239129 DOI: 10.1177/0269216314550373] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed. AIM This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services. DESIGN A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice. SETTING/PARTICIPANTS Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom. RESULTS In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice. CONCLUSION Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.
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Affiliation(s)
- Dorry McLaughlin
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Owen Barr
- Institute of Nursing and Health Research, School of Nursing, University of Ulster, Newtownabbey, UK
| | - Sonja McIlfatrick
- Institute of Nursing and Health Research, School of Nursing, University of Ulster, Newtownabbey, UK All Ireland Institute of Hospice and Palliative Care, Dublin, Ireland
| | - Roy McConkey
- Institute of Nursing and Health Research, School of Nursing, University of Ulster, Newtownabbey, UK
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Dunkley S, Sales R. The challenges of providing palliative care for people with intellectual disabilities: a literature review. Int J Palliat Nurs 2014; 20:279-84. [DOI: 10.12968/ijpn.2014.20.6.279] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Susie Dunkley
- Hospice Community Nurse Specialist, St Peter's Hospice, Charlton Road, Bristol, BS10 6NL, UK
| | - Rachel Sales
- Senior Lecturer, Department of Nursing and Midwifery, University of the West of England, Bristol, UK
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McLaughlin D, Barr O, McIlfatrick S, McConkey R. Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities. BMJ Support Palliat Care 2014; 5:531-7. [DOI: 10.1136/bmjspcare-2013-000615] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/19/2014] [Indexed: 11/03/2022]
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Bowers B, Webber R, Bigby C. Health issues of older people with intellectual disability in group homes †. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2014; 39:261-269. [PMID: 25750581 PMCID: PMC4348046 DOI: 10.3109/13668250.2014.936083] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND This paper explores how group home staff in Victoria, Australia, responded to residents with an intellectual disability (ID) as they developed age-related health conditions. METHOD The analysis was based on a longitudinal study that followed 17 ageing group home residents over a 3-year period. Eighty-three interviews were conducted with 30 group home staff in 17 group homes. Dimensional analysis, a variant of grounded theory, guided data collection and analysis. RESULTS Findings revealed that the organisations all had systems in place to address health issues. However, the results also suggest an inability of staff to differentiate between significant health conditions and normal age-related changes, thus contributing to delays in care for serious medical conditions. CONCLUSIONS Lack of knowledge about normal ageing and an absence of organisational policies influence timeliness of diagnosis and treatment for people with ID. Group home staff could be more effective advocates for older residents, leading to improvements in health outcomes, if they had basic knowledge about normal ageing and symptoms of common age-related illnesses and if group home agencies provided clearer guidance to their staff. The study has implications for staff education and organisational policy development for group homes.
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Affiliation(s)
- Barbara Bowers
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin USA
| | - Ruth Webber
- Faculty of Education and Arts, Australian Catholic University, Melbourne, Australia
| | - Christine Bigby
- Department of Social Work and Social Policy, La Trobe University, Melbourne, Australia
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Friedman SL, Helm DT, Woodman AC. Unique and universal barriers: hospice care for aging adults with intellectual disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:509-532. [PMID: 23167489 DOI: 10.1352/1944-7558-117.6.509] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
As life expectancy of people with intellectual disability (ID) has increased, there has been a concurrent increase in age-related illnesses and conditions similar to that of the general population. These circumstances result in people with ID dying from typical life-ending conditions, and thus, they require similar end-of-life services such as palliative and hospice care. Although there are notable barriers to hospice for all, people with ID face additional challenges in accessing the benefits of these services. This article presents a review of the literature on these issues, underscoring the multiple challenges and the importance of a more collaborative approach between hospice and palliative care workers with people with ID, their families, and other important stakeholders.
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Kirkendall AM, Waldrop D, Moone RP. Caring for people with intellectual disabilities and life-limiting illness: merging person-centered planning and patient-centered, family-focused care. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2012; 8:135-150. [PMID: 22680049 DOI: 10.1080/15524256.2012.685440] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The number of older people with intellectual disabilities (IDs) is increasing in parallel to the lengthening life expectancy of the overall population. Little is known about the needs of older people with IDs who are at life's end. Service providers who offer direct care to people with IDs have begun to develop partnerships with hospice and palliative care specialists to provide focused care that is more specialized for their clients or residents who are approaching the end of life. However, community-based programs utilize different philosophies of care that focus on the daily management of people with IDs compared to programs that focus on care at the end of life. Merging these two approaches to care in community-based residences or community-based programs for people with IDs brings challenges for both types of programs. This article compares person-centered planning and patient-focused, family-centered care and proposes means for merging the two seemingly disparate approaches to care.
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Affiliation(s)
- Abbie M Kirkendall
- School of Social Work, Greenspun College of Urban Affairs, University of Nevada Las Vegas, Las Vegas, Nevada 89154-5032, USA.
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Clute MA. Bereavement interventions for adults with intellectual disabilities: what works? OMEGA-JOURNAL OF DEATH AND DYING 2010; 61:163-77. [PMID: 20712142 DOI: 10.2190/om.61.2.e] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Examination of the theory base for bereavement and loss is currently just beginning for adults with intellectual disabilities (ID). Yet, as life spans increase for individuals with ID, these adults experience more and more loss and bereavement events. Practitioners, especially grief counselors, are finding it increasingly critical for them to understand best practice principles for working with bereaved adults with ID in their daily work. Practitioners also are asked to guide families and care providers regarding grief and death education. This article provides counselors and other professionals with a review of existing bereavement intervention research for adults with ID. Practice recommendations are made on three levels: informal support; formal intervention; and community education.
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Affiliation(s)
- Mary Ann Clute
- Eastern Washington University, School of Social Work, Cheney 99004, USA.
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16
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Affiliation(s)
- Hannah Crawford
- Tees, Esk & Wear Valleys NHS Foundation Trust, Normanby, Middlesbrough, United Kingdom
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Cartlidge D, Read S. Exploring the needs of hospice staff supporting people with an intellectual disability: a UK perspective. Int J Palliat Nurs 2010; 16:93-8. [DOI: 10.12968/ijpn.2010.16.2.46755] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Sue Read
- School of Nursing and Midwifery, Keele University, Clinical Education Centre, University Hospital of North Staffordshire, NHS Trust, City General Hospital, Newcastle Road, Staffordshire, United Kingdom
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Li S, Ng J. End-of-life care: nurses' experiences in caring for dying patients with profound learning disabilities--a descriptive case study. Palliat Med 2008; 22:949-55. [PMID: 18799514 DOI: 10.1177/0269216308096905] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study identifies areas of expertise and deficits in the specific knowledge and practical skills of nurses in the care of dying patients with profound learning disabilities in one NHS Primary Care Trust in the UK. In response to these findings, we have developed a simple observational checklist applicable to profound learning disability nursing to identify disease-related personality and physiological changes. The method consists of a descriptive case study of five nurses qualified in learning disabilities nursing, using semi-structured interviews. The disease trajectory was used as a framework of reference to guide the data analysis. Themes showed were 'certainty of knowing' about disease-related changes in patients' habits and behaviour and 'uncertainty and ambiguity' in the patho-physiology of advanced diseases and disease progression. This study interprets a lack of patho-physiological knowledge in both malignant and non-malignant diseases leading to delayed diagnosis and timely intervention. Timeliness of observation and intervention are emphasised.
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Affiliation(s)
- S Li
- Department of Mental Health and Learning Disabilities, Faculty of Health and Social Care Sciences, Faculty of Health and Social Care Sciences, Kingston University, Surrey, UK.
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Tuffrey‐Wijne I, Curfs L, Hollins S. Access to palliative care services by people with learning disabilities: is there equity? ACTA ACUST UNITED AC 2008. [DOI: 10.1108/17530180200800017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tuffrey-Wijne I, Whelton R, Curfs L, Hollins S. Palliative care provision for people with intellectual disabilities: a questionnaire survey of specialist palliative care professionals. Palliat Med 2008; 22:281-90. [PMID: 18477723 DOI: 10.1177/0269216308088686] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is a growing interest in the palliative care needs of people with intellectual disabilities (ID). There are indications that palliative care staff face particular problems providing care to this group, but empirical data about the extent of the problem are lacking. This study aims to gain insight into the current use of palliative care services by people with ID in London, to identify the prevalence and severity of problems faced by palliative care professionals and to identify strategies that will facilitate an improvement in access and delivery of palliative care services to people with ID. A postal questionnaire was developed for this study and returned by 543 professionals working in 53 specialist palliative care services in London (57% response rate). Sixty-seven percent of respondents had supported a patient with ID at some point in their palliative care career. Problems arising from the patient's difficulty in understanding the illness and treatment were reported as the most pertinent. Other prevalent problems included difficulty around communication, assessment and patient fear. Respondents emphasised the need for collaboration with carers and other services. Link worker schemes, training and access to background information were seen as most helpful. The authors conclude that palliative care services appear to be under-used by people with ID. There is a distinct set of problems related to the provision of palliative care for people with ID. Palliative care services should assess the nature and level of their service provision for people with ID. Future research should include epidemiological studies to assess need and include people with ID as informants to evaluate the effectiveness of palliative care provision.
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Affiliation(s)
- I Tuffrey-Wijne
- Division of Mental Health, St George's, University of London, Cranmer Terrace, London, UK.
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Tuffrey-Wijne I, McEnhill L. Communication difficulties and intellectual disability in end-of-life care. Int J Palliat Nurs 2008; 14:189-94. [DOI: 10.12968/ijpn.2008.14.4.29133] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Linda McEnhill
- National Network for the Palliative Care of People with Learning Disabilities, Cambridge, UK
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