General Hospital Care for People with Learning Disabilities is a comprehensive resource for those health professionals in a general hospital setting who may come into contact with people with learning disabilities. The book explores the nature of learning disabilities and highlights specific healthcare needs. It takes the reader through all the key factors in the healthcare process, through pre-admission assessment, care planning, intervention and treatment, and liaison and discharge planning, while highlighting key healthcare needs at each stage. The Department of Health, the National Health Service Executive and Mencap have all reported that people with learning disabilities have increased health needs comparedto the general population, yet these needs are often poorly met and people experience difficulties in accessing appropriate services. This is a timely and accessible resource for healthcare professionals in need of a general introduction to caring for people with a learning disability. Relevant to the care of both children and adults with a learning disability Use of case studies to illustrate examples of situations explored in the main text Focuses on key areas of communication, understanding behavior and the often difficult area of consent
Preface vii Acknowledgements ix 1 Understanding Learning Disability 1 Introduction 1 Definitions and causes of a learning disability 2 How to establish if your patient has a learning disability 9 Perceptions and attitudes towards people with a learning disability 10 Health needs of people with a learning disability 15 Family/carer's needs 30 Introduction to person-centred approaches 32 Conclusion 35 References 38 2 The Process of Health Care 40 Introduction 40 The patient journey 41 Pre-admission 53 Care planning and developing care pathways 68 Intervention and treatment 71 Liaison and discharge planning 78 Conclusion 80 References 83 3 Communication 85 Introduction 85 What is communication? 86 Models of communication - verbal and non-verbal 90 Developing relationships with people with a learning disability 93 Communicating with people with a learning disability 98 Tools to aid communication 109 Helping people with learning disabilities to make choices 118 Communicating with family and carers 123 Conclusion 124 References 125 Introduction 127 What do we mean when we say a person displays challenging behaviour? 128 What could different behaviours mean? 130 How hospital admission can affect individual behaviour and ways of overcoming this 135 How to respond to behaviour in health care situations 137 The use of behavioural indicators in the assessment of pain 152 Risk assessment 159 Conclusion 160 References 165 5 Consent 167 Introduction 167 What do we mean by consent? 167 Ethical decision making 169 The law on consent and capacity to consent (in England and Wales) 172 Defining capacity 177 Obtaining consent 181 Advocacy and empowerment 188 Planning for future care 189 Emergency situations 190 What to do when consent is refused 190 Record keeping 193 Conclusion 194 References 197 6 Ethical and Political Aspects of Care 198 Introduction 198 Health care ethics and professional accountability 198 Safeguarding children and vulnerable adults 208 Cost 213 Values and beliefs 214 Political issues affecting service provision in both learning disability and secondary care services 217 Interdisciplinary approaches and partnership working 224 Where do we go from here? 230 Conclusion 232 References 237 Useful Websites and Contacts 239 Index 246
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