Learning disabilities Rose Kennedy ST3

Definition of learning disabilities Mental capacity act Tips for consultations Resources to use

Contents

Defined as “significantly reduced ability to understand new and complex information, to learn new skills (impaired intelligence) and with a reduced ability to cope independently (impaired social functioning)”

Greater health needs but poorer access ◦ Associated co-morbidities – epilepsy, mental illness and

behavioural issues

Challenging consultations- often involving carers, MDT members

Learning disabilities

The act assumes mental capacity, and if deemed to lack capacity we act in the best interests of the patient

To have capacity an individual needs to ◦ Understand the information ◦ Retain the information relevant to the decision ◦ Use or weigh the information ◦ Communicate the decision (by any means)

Capacity is time-specific and decision-specific

Mental Capacity Act

Try to build a rapport and keep continuity

Allow time – offer double appointments

Offer first appointment of the day◦ Less busy waiting area, not having to wait a long time – may

become distressed or upset

Annual health check with an individualised “health action plan” (DoH White paper 2001) Health passport

Demonstrate any procedure/examination before doing it

Tips for consultations

Always address the patient first before discussing with the carer/relative◦ Important to use the carer’s knowledge ◦ Check for consent to have the carer present (safeguarding)

Use simple language, without medical or abstract words.

Health related books to inform patients about different situations http://www.booksbeyondwords.co.uk/

Use websites such as http://www.easyhealth.org.uk/ 500 easily accessible health information leaflets

Tips continued

Easyhealth example: Abortion

GMC – Communication jargon buster tool

Challenging consultation Important to have a plan in your practice Allow time and be patient Use online resources to aid the consultation

Conclusion

GMC Learning disabilities http://www.gmc-uk.org/learningdisabilities/302.aspx

GP online – advance consultations http://www.gponline.com/advanced-consulting-consulting-patients-learning-disabilities/article/1157072

References