Patients with Intellectual or Developmental Disabilities (IDDs) have unique needs. It is important Nurses know how to properly provide care, and make health care more accessible for this population.
An IDD, includes many severe, chronic conditions that are due to mental and/or physical impairments. It usually lasts throughout a person’s lifetime. People who have IDDs have problems with major life activities such as:
- Language
- Mobility
- Learning
- Self-help
- Independent living
According to the Association of American Medical Colleges (AAMC), IDDs encompass hundreds of diagnoses — autism, cerebral palsy, and Down syndrome among them — that affect about 6.5 million people in the United States.
Research suggests that the attitudes of healthcare professionals are among the biggest barriers to people with IDDs receiving equitable access to services.
Nurses must provide care that enables people with complex care needs and difficulty with cognitive functioning to live fully with as much physical, emotional, social, and spiritual well-being as possible.
The “fundamental principle that underlies all Nursing practice is respect for the inherent dignity, worth, unique attributes, and human rights of all individuals” (ANA, 2015, p. 1).
Here are some helpful guidelines for treating patients with mental and/or physical disabilities.
- Speak directly with the patient, not to any companion that the patient may have.
“Don’t make the mistake of thinking they don’t contribute to their care, because they are your most valuable source of information,” Priya Chandan, MD, MPH, PhD, an Assistant Professor of Neurosurgery at University of Louisville School of Medicine said.
- Avoid making assumptions about what assistance the patient needs. Offer assistance, wait for offer to be accepted and wait for instructions.
- Talk to persons with disabilities in the same way and with a normal tone of voice (not shouting) as you would talk to anyone else.
- Ask how you can help them and respect their answers.
- Use “people-first language”: refer to “a person with a disability” rather than “the disabled person” or “the disabled”.
- When communicating with a person with a disability, it is important to take steps to ensure that effective communication strategies are used. This includes sitting or standing at eye level with the patient and making appropriate eye contact.
- Presume that patients with disabilities are competent to handle their own medical care. If patients do not have anyone to assist them, do not ask them whether they brought an aide or a companion.
- Be patient because it may take the person extra time to communicate. Do not speak for the person or complete the person’s sentences.
- Allow time for history taking and thorough exam.
- Don’t be afraid to ask the patient questions if you are unsure.
- Keep in mind that the personal space of a person with a disability includes the person’s wheelchair, scooter, crutches, walker, cane, or other mobility aid.
- Do not push or move a person’s wheelchair or grab a person’s arm to provide assistance without asking first.
- If the person uses a communication device, such as a manual or electronic communication board, ask the person the best way to use it.
- Do not pretend to understand if you do not. Tell the person you do not understand what he or she has said and ask the person to repeat the message, spell it, tell it in a different way, or write it down. Use hand gestures and notes.
- Repeat what you understand and note the person’s reactions, which can indicate if you have understood correctly.
- Develop a specific communication strategy that is consistent with the person’s abilities: nod of the head or blink to indicate agreement or disagreement with what you have asked or said.
It’s important to understand that a person with disabilities often has the same wants, needs, dreams, and desires as anyone else, so treat them as such.