Predictors of access to healthcare professionals for people with intellectual disability in Ireland (original) (raw)
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There is an urgent imperative to improve the healthcare provided to people with intellectual and associated developmental disabilities. People with intellectual disability have unique and significant health vulnerabilities throughout their lives. There are specialized services supporting them through childhood, but when they reach adulthood the current expectation is that their health needs can be met by mainstream health services. This paper argues the case for a network of services with specialist expertise and experience in working with people with disabilities collaborating with and complementing existing specialist and mainstream health services.
Specialist health services for people with intellectual disability in Scotland
Journal of Intellectual Disability Research, 2002
provided by each locality in Scotland. Only three services (%) have completed the process of resettlement. There was a wide-ranging variability in the number of beds/day places and professionals employed per population per trust. Conclusions There is widespread diversity in the service provision between different parts of Scotland. Geographical distances and responsibilities for service provision to remote and rural communities did not appear to account for these differences.
Changes in the Provision of Day Services in Ireland to Adult Persons With Intellectual Disability
Journal of Policy and Practice in Intellectual Disabilities, 2018
Internationally, changes are advocated in the support available to persons with intellectual disability. Socially inclusive personalized arrangements are intended to replace congregated and segregated day services. The study examines the changes in the provision of day services within Ireland over a 5-year period when new policies were being promoted but at time of economic stringencies. Secondary analysis was carried out on data extracted from the National Intellectual Disability Database on all persons aged 18 years and above in 2009 and 2014 who received day services, which were grouped into four main types: care centers, sheltered workshops, employment schemes, and vocational training. Participants in each type of service were profiled by age, level of disability, and living arrangements. Variations in the provision of these services across nine regions were also examined. In 2009, 59% of persons attended care centers, but the proportion had increased in 2014 to 69%. There were reductions in the numbers attending sheltered workshops (down from 23 to 16%) and those receiving employment supports (down from 13 to 11%). By 2014, variations in the numbers attending care centers were evident across the country. The increase in care provision does not accord with national or international policies. Rather, it may reflect ineffective policy implementation strategies and financial cutbacks which services experienced during this period. This study illustrates the value of a national dataset for monitoring policy implementation.
Frontline care in Irish intellectual disability services
Journal of Intellectual Disabilities, 2008
The ongoing development of generic intellectual disability services in Ireland, driven by a policy of inclusion and normalization, has posed significant challenges to the interdisciplinary team, with the creation of new frontline carer roles not linked to any particular profession. It is within this context that attention has been focused on the appropriateness of nursing to frontline caring in intellectual disability service provision. The separation of caring and nursing posts that is now evident within many residential services suggests that decisions have already been made regarding the appropriateness of nursing within particular settings. These decisions have, however, been made in the absence of any real attempt to delineate the contribution of nursing to frontline caring in Ireland. This study is the first of its type in Ireland and seeks to set out the unique interventional contribution of nursing and non-nurse caring within frontline intellectual disability services.
Journal of Applied Research in Intellectual Disabilities, 2000
The use of primary care services by three matched groups of people with intellectual disabilities was compared over a period of one year. Differences in the patterns of provision were detected between hospital intellectual disability specialists and general practitioners. The degree of behavioural disturbance and disability of the subjects were found to be the most important predictors of primary care contact.
In tandem with a growing population, Ireland is further witness to a change in the demography of persons with intellectual disability. The Annual Report of The National Intellectual Disability Database highlights in particular that people with intellectual disability are surviving into old age and that they are requiring services appropriate to their age group (Kelly et al., 2008). The trend for institutional care has been outmoded (Sheerin and McConkey, 2008; McConkey et al., 2005) with more persons with an intellectual disability living in the community. In 2008 a total of 26, 023 people were registered on the National Intellectual Disability Database (Kelly et al., 2008). From this database it is evident that there were more males (56.6%) than females (43.4%), with the highest proportion of both males and females diagnosed as having a moderate level of intellectual disability. Of these individuals, 25,433 were in receipt of services, 16,708 (64.2%) were living at home with family/carer and only 8290 (31.9%) were living in full time residential services. These residential services mainly included community group homes and residential centres while 950 individuals (3.7%) lived independently or semi independently (Kelly et al., 2008). This move to the community is based on the principle of normalisation (Wolfensberger 1972) who later reconceptualised normalisation and proposing to replace the term with 'social role valorisation' reflecting his concern that certain groups in society such as persons with intellectual disability were perceived as having devalued social roles (Wolfensberger 1983). He argued that devalued groups tend to be cast into negative roles and called for a move away from segregation, special treatment and institutionalisation. Social role valorisation embodies the ideal that persons with an intellectual disability should be integrated into society, and offered the opportunity to access generic services which serve the general public. In tandem with the increased life expectancy and prevalence of persons living in the community it follows that all healthcare workers of the future will be required at some level to engage and support persons with an intellectual disability and their family/carer(s).
An audit of the Irish National Intellectual Disability Database
2010
With improved healthcare, people with intellectual disabilities (ID) are living longer (World Health Organization, 2000), and are requiring a range of services (Kelly, Kelly, & Craig, 2009). In addition, as countries plan community based support services to people with ID and their families, the costs of these services are rising (Organisation for Economic Cooperation and Development, 2006). Many countries are developing services with an emphasis on service user involvement in the planning and evaluation processes of service delivery (e.g. Department of Health & Children, 2001). In addition to service planning, service-based and national datasets and databases are regularly used for research purposes (e.g. the US National Epidemiological Catchment Area Database, Judd & Akiskal, 2003; the Paediatric Intensive Care Audit Network, McKinney et al., 2005). Accurate data, therefore, need to be available to both research teams and governmental agencies to best understand the needs of the target population and to provide and plan person-centered specialist support services (National Disability Authority, 2007). The need to measure and maintain the quality of these data has been highlighted (German et al., 2001).
Primary care for persons with intellectual disabilities: issues for practice
2011
In tandem with a growing population, Ireland is further witness to a change in the demography of persons with intellectual disability. The Annual Report of The National Intellectual Disability Database highlights in particular that people with intellectual disability are surviving into old age and that they are requiring services appropriate to their age group (Kelly et al., 2008). The trend for institutional care has been outmoded (Sheerin and McConkey, 2008; McConkey et al., 2005) with more persons with an intellectual disability living in the community. In 2008 a total of 26, 023 people were registered on the National Intellectual Disability Database (Kelly et al., 2008). From this database it is evident that there were more males (56.6%) than females (43.4%), with the highest proportion of both males and females diagnosed as having a moderate level of intellectual disability. Of these individuals, 25,433 were in receipt of services, 16,708 (64.2%) were living at home with family/carer and only 8290 (31.9%) were living in full time residential services. These residential services mainly included community group homes and residential centres while 950 individuals (3.7%) lived independently or semi independently (Kelly et al., 2008). This move to the community is based on the principle of normalisation (Wolfensberger 1972) who later reconceptualised normalisation and proposing to replace the term with 'social role valorisation' reflecting his concern that certain groups in society such as persons with intellectual disability were perceived as having devalued social roles (Wolfensberger 1983). He argued that devalued groups tend to be cast into negative roles and called for a move away from segregation, special treatment and institutionalisation. Social role valorisation embodies the ideal that persons with an intellectual disability should be integrated into society, and offered the opportunity to access generic services which serve the general public. In tandem with the increased life expectancy and prevalence of persons living in the community it follows that all healthcare workers of the future will be required at some level to engage and support persons with an intellectual disability and their family/carer(s).
British Journal of Learning Disabilities, 2013
• This article synthesises current literature regarding ageing and service provision for people with an intellectual disability. • People with intellectual disability are living longer. • Services need to respond to the needs of older people with intellectual disability. Summary People with an intellectual disability are living longer, and the numbers continue to rise. Ireland has and is seeing a dramatic change in the age profile of clients and the support services they require. While Ireland had specifically trained nurses in intellectual disability, they predominately work in residential settings. This can be seen as been at odds with the philosophy of supporting people with intellectual disability live at home with their family and the primary care system. As the ageing population is rising, intellectual disability services need to proactively develop and respond to this changing age profile by reviewing and adjusting the way in which they deliver services, not only in terms of how services develop and respond to a changing age profile but also in terms of collaborative working across all health services.