In 2007 the Royal Mencap Society ( Mencap ) published its Death by Indifference article. This study highlighted their belief that people with larning disablements receive worse health care than people without larning disablements ( LD ) . They proceed to foreground six instances of alleged favoritism of people with LD that lead to the deceases of these people. Mencap believe that these deceases could hold been prevented. This essay identifies three debatable scenarios that can happen for people with larning disablements in an acute infirmary scene. Further, this essay will discourse how these three scenarios can be prevented or minimised and will supply mentions to high spot and support this. In its decision, this essay will see the points raised to summarize its findings.
The first issue for treatment is the deficiency of consciousness of the wellness demands of a patient with LD ‘s. This essay highlights this scenario, as a deficiency of apprehension of that individual ‘s attention and status could take to the patient ‘s attention being compromised and later endanger the patient ‘s life. Glasby A.M ( 2002:1392 ) remarks that preparation and support enables healthcare staff to develop their accomplishments and assurance, enabling them to work efficaciously with people with LD. This suggests that their apprehension of the patients LD can cut down the hazards posed by their medical status. The National Patient Safety Agency ( NPSA ) , claim that unwellness is frequently misdiagnosed or undiagnosed because many agues care staff have minimum or no cognition of the health care needs of the LD patient. NPSA ( 2004 cited by Kent A 2008 ) . This consciousness can assist put in the right degrees of attention and can cut down staff perchance overrating and presuming the patient ‘s ability to grok and join forces in an ague attention puting. The hazard of which can ensue in decease to the patient with LD ‘s. Melville et Al ( 2005 cited by Gibson T 2006:595 ) found that following a short preparation programme, 81.4 % of pattern nurses taking portion felt more enabled to run into the demands of people with LD ‘s and 66.6 % claimed that they had altered their pattern and apprehension as a consequence of the cognition they had gained.
Leading on from this, the 2nd scenario this essay will foreground is that of communicating. This topic was chosen because hapless communicating can lose critical information which could take to holds or misdiagnosis of a patient ‘s intervention. One of the points raised in the Mencap 2007 study is that the Doctor did non pass on efficaciously with the parents due to the patient being unable to pass on. Mencap believe this was one of the conducive factors towards the patient ‘s decease. Weaver D ( 2010: 60 ) suggests barriers to communicating are physical and psychological. The patient ‘s disablement could impact their address which is a physical barrier or that psychologically they could be introvert ensuing in passively accepting the sentiments of others. These barriers would propose that ideally a health care worker in an acute environment should recognize the communicating issue and be able to pass on efficaciously with the patient and those closest to them. It could be argued that healthcare staff could be incognizant of the actions and marks displayed by LD ‘s, these indicants could be due to straiten or non being able to convey their feelings of hurting. Mencap 2007 province that patients with a LD may happen it hard to pass on their symptoms and to appreciate the information they are being told. Subsequently it could be suggested that hapless communicating, can take to many jobs therefore possible holds or misdiagnosis. An illustration could be a patient accepting intervention non to the full cognizant of what is go oning to them or the deductions, non being able to convey hurting or their likes and disfavors. Suggested stairss to understate communicating jobs would be to discourse with household members, friends, GP or carers on the best method of communicating, examples being images, objects or mark linguistic communication, discuss who should be involved. Mencap ( 2004:26 ) remark that it is non ever easy to place people with larning disablements and simple step such as placing on the patients wellness records that they have LD can raise consciousness of that patient ‘s specific wants and demands. Patience and simple linguistic communication should be utilised to explicate relevant information.
A 3rd scenario that may be encountered when supplying attention for people with LD ‘s is the patient ‘s capacity to understand consent and later to supply that consent to intervention. Keenan P, McIntosh P ( 2000 cited by Read S 2005:15 ) , indicate that many people with LD ‘s are inactive receivers of their attention, this suggests that due to their deficiency of ability to do determinations in an ague puting their passiveness could take to their demands being overshadowed. This essay highlights this because if a misinterpretation takes topographic point sing consent from a patient or a patient passively agrees, so intervention and the patient can be affected, this can ensue in the decease of that patient. In the Mencap 2007 study, there was a hold in intervention because the physicians claimed the patient would non co-operate and therefore could non accept to it. This suggests a misinterpretation of the patients consent and can misidentify it for refusal. An illustration being a patient drawing out a nog provender because they are dying or in hurting. This does non automatically intend they are non accepting to intervention and that they would prefer to go through off. It can merely intend that they do non understand the effects of accepting or non accepting to intervention. Many professionals do non cognize or understand the jurisprudence environing the capacity and consent to intervention by a patient with LD ‘s, Mencap ( 2007 ) . The jurisprudence in Scotland assumes that a patient has the ability to supply consent, unless it can be proven that they are incapable, Scots Government ( 2008:4 ) . This suggests that if a patient has LD ‘s it does non intend that they are unable to do determinations themselves. It can besides be argued that because that patient may move foolishly it does non intend that their capacity is non at that place. General guidelines of this act should be that the patient benefits from a determination and be the least restrictive, the wants of the patient should be taken into history and treatment with relevant people like household, carer, named individual or defender. The Act protects people who may non hold the capacity to do determinations, significantly though it is besides at that place to back up and advance their engagement in determination devising and to guarantee their liberty and safety.
Therefore in decision the punishments of non being able to place the wellness demands and efficaciously find consent to intervention with a patient with larning disablements in an ague scene are high and perchance lethal. The author witnessed this when a patient with LD ‘s was brought into their ward and during their appraisal it was highlighted to the author by the staff nurse, that people with a LD are more likely to hold dysphagia, which is a get downing trouble. Harmonizing to Tingle J ( 2004:438 ) this can take to a respiratory piece of land infections, a chief cause of early decease for people with LD. This was a good illustration of a staff nurse cognizing the wellness issues environing a patient with a LD. Powrie E ( 2003 cited by Gibson T 2006:594 ) high spots that 70 % of practise nurses surveyed were diffident if the wellness demands of people with a LD were being met. This would propose that preparation and support aid understand larning disablements better therefore assisting to forestall decease. This should advance that maintaining of good instruction and preparation in maintaining accomplishment degrees up to day of the month. There are many mechanisms in topographic point to assist healthcare workers pass on and increase their consciousness in non lone legal policy but to besides increase their consciousness of LD ‘s. Good support systems and preparation can promote good communicating accomplishments, and besides assist staff understand the importance of listening to the patient, their households and carers. Healthcare workers have a responsibility of attention toward their patients in non merely being an advocator in their optimal wellness but to guarantee that they have entree and apprehension to the attention that they are entitled excessively. The Nursing and Midwifery Council ( NMC ) province that people should be involved in their attention that nurses have a responsibility to safeguard the patient with larning disablements, NMC ( 2007 ) .