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1 – 9 of 9Anna M. Palucka, Miti Modi and Yona Lunsky
The purpose of this paper is to study the profiles of adults with autism spectrum disorder (ASD) requiring an inpatient psychiatric admission.
Abstract
Purpose
The purpose of this paper is to study the profiles of adults with autism spectrum disorder (ASD) requiring an inpatient psychiatric admission.
Design/methodology/approach
This paper examines profiles of 27 inpatients with intellectual disability (ID) and ASD who were admitted to a specialized inpatient unit in two time periods (January 2005 to June 2009 and July 2009 to December 2013) to explore changes over time in patient profiles.
Findings
Findings suggest that individuals who were admitted more recently between July 2009 and December 2013, were younger and more likely to come from other ethnic backgrounds than those admitted between January 2005 and June 2009. There was a trend for recent admissions to come from family homes, have moderate to profound ID and have longer hospital stay.
Originality/value
This is the first study to compare profiles of adults with ASD receiving inpatient services over time. The value of the study lies in illustrating that the needs of this growing patient group are changing which has implications for the treatment provision including specialized inpatient treatment.
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Yona Lunsky, Ami Tint, Jonathan A. Weiss, Anna Palucka and Elspeth Bradley
Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their…
Abstract
Purpose
Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their families and health care providers to improve ED care, it is important to understand these encounters in greater detail. The purpose of this paper is to provide a descriptive summary of the ED experiences of adolescents and adults with ASD, from the perspective of their families.
Design/methodology/approach
A subset of data from a larger prospective cohort study was used. Specifically, 46 parents of adolescents and adults with ASD provided details concerning 49 ED visits over a 12-month period.
Findings
Results suggest a range of presentations requiring ED use, and also diverse profiles of those with ASD who visited the ED, in terms of age, gender, and ASD severity. While overall degree of satisfaction with care received in the ED was high, parents provided recommendations to improve the ED experiences for their family members with ASD.
Originality/value
This is the first study to provide detailed accounts of ED visits from the perspective of parents of adolescents and adults with ASD. Families play an important role in the lives of individuals with ASD across the lifespan and it is important to include their perspective to improve hospital-based care for those with ASD.
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Amanda Sawyer, Johanna Lake and Yona Lunsky
The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple medications, with psychotropic medications being the most commonly…
Abstract
Purpose
The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple medications, with psychotropic medications being the most commonly prescribed. Direct care staff play an important role in psychotropic medication administration and monitoring, yet little is known about their knowledge and comfort with medication. The paper aims to discuss this issue.
Design/methodology/approach
A 15-item survey, focusing on self-reported knowledge and comfort with psychotropic medication, was completed by 152 direct care staff employed at three agencies providing residential services for individuals with ID across Ontario.
Findings
In total, 62 per cent of staff respondents reported that psychotropic medications were among the top medications regularly taken by the individuals they support, with behaviour listed as the most commonly reported reason for taking this medication. The majority of staff reported monitoring medication, however, the frequency of monitoring varied considerably. Generally, staff reported feeling comfortable and knowledgeable about medication use, but, most reported a desire for additional medication training.
Originality/value
This is the first Canadian study to examine staff knowledge and comfort regarding medication use, and the first study to assess PRN (“as needed”) as well as regularly administered medications.
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Olivia Mendoza, Anupam Thakur, Ullanda Niel, Kendra Thomson, Yona Lunsky and Nicole Bobbette
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental…
Abstract
Purpose
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care.
Design/methodology/approach
In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations.
Findings
Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care.
Originality/value
This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.
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Brianne Redquest and Yona Lunsky
There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes…
Abstract
Purpose
There has been an increase in research exploring the area of intellectual and developmental disabilities (IDD) and diabetes. Despite being described as instrumental to diabetes care for people with IDD, the role and experiences of family carers, such as parents and siblings, are often neglected in this research. However, it is clear that family carers do not feel that they have sufficient knowledge about diabetes. The purpose of this commentary is to extend the content from “Diabetes and people with learning disabilities: Issues for policy, practice, and education (Maine et al., 2020)” and discuss how family carers can feel better supported when caring for someone with IDD and diabetes.
Design/methodology/approach
This commentary discusses specific efforts such as STOP diabetes, DESMOND-ID and OK-diabetes for people with IDD including family carers. Encouragement is given for health care providers to recommend such programmes to people with IDD and their family carers. It is also suggested that health care providers involve family carers in diabetes care planning and implementation for people with IDD.
Findings
It is hoped that if changes are made to current diabetes practices and more research with family carers is conducted, diabetes prevention and management for people with IDD will be more successful and family carers can feel more confident in providing support to their loved ones.
Originality/value
Research exploring the role of family carers in diabetes care for people with IDD and diabetes is very limited. This commentary makes recommendations to help family carers feel better supported in their role. It also provides areas for future research.
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This is a case study of a Canadian man with a learning disability who visited emergency departments more than 50 times in a 10‐year period, in times of stress. During these visits…
Abstract
This is a case study of a Canadian man with a learning disability who visited emergency departments more than 50 times in a 10‐year period, in times of stress. During these visits he gave false reports of his current symptoms and psychiatric history, sometimes gaining hospital admission. The case illustrates how such behaviour can develop over time, and how a general health services model (rather than a specialised learning disability service) can fail to meet the needs of independent clients with learning disabilities. It offers some suggestions for how better to meet the needs of such clients in the future.
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Anna M. Palucka, Poonam Raina, Shi‐Kai Liu and Yona Lunsky
Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those…
Abstract
Purpose
Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those individuals are served in that system. It is, therefore, important to understand the profile of those admitted to non‐forensic specialized units for individuals with ID and mental health issues. This paper aims to address this issue.
Design/methodology/approach
Demographic, clinical and criminal profiles of individuals discharged over nine years from a specialized dual diagnosis program were reviewed to delineate clinical subgroups.
Findings
A total of 20 out of 84 total discharges were identified as having past or current criminal justice system involvement. The most common offence was assault and 60 per cent of these individuals had admissions longer than one year. Subgroups by psychiatric diagnosis differed in their age, legal status, offence history, and length of hospital stay, as well as in therapeutic interventions and discharge process.
Research limitations/implications
The results suggest that inpatients with ID and criminal justice system involvement present with unique treatment, support and risk management needs based on psychiatric diagnosis. The number of individuals in clinical subgroups was low, thus further research is needed to determine if the observed patterns hold true in bigger samples.
Originality/value
The study delineates the complexity and heterogeneity of treatment and supports needs of individuals with intellectual disabilities and offending behaviour.
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Elspeth Bradley, Yona Lunsky, Anna Palucka and Soula Homitidis
The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM…
Abstract
Purpose
The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.
Design/methodology/approach
Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.
Findings
The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.
Originality/value
The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.
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