Individuals with intellectual learning disabilities or developmental disabilities (DD/ID) are people who have a formal diagnosis of mental retardation. According to the American Psychiatric Association [APA], 2000), an individual with an intelligence quotient (IQ) of about 70 or below with some level of impairment in adaptive functioning may be diagnosed with mental retardation, however, the diagnosis must occur before the age of 18. Traditionally, people with DD/ID have had limited control over their environments and limited choices in the services they receive due to institutionalized residential placement.

Intellectual Learning Disability Case study

The context is an initial assessment following referral to the community intellectual learning disability nursing team.

Joseph is a 68-year-old man who is described as having a moderate learning disability. He has brittle asthma and chronic obstructive pulmonary disease (COPD). He lives in supported housing and is assigned six hours per day support. Four years ago, he retired from his job working in a local supermarket. Since then he has become reluctant to go out. He has also been refusing to see his GP or the practice nurse and his support staff are suggesting he needs more care than they can give, saying he should move to a nursing home.

Initial assessment:

• Joseph has lived in supported housing for 17 years.
• He has brittle asthma and COPD.
• Joseph has sores on both his legs that also have an infection.
• He has put on weight, has labored breathing, and also appears to struggle with walking.
• Additionally, he appears withdrawn and angry.
• Joseph self-administers his own asthma medication without supervision.
• Joseph has no contact with any family members.

Priorities identified:

• Physical health assessment
• Manage risks
• Promote person-centered care

Guidance

In reflecting on and deconstructions the decision-making process that may have led to the priorities identified, you may argue that other issues should have been prioritized.  Furthermore, these reflections can form part of your arguments and the development of the critical evaluation of this process.  You can also question, with reference to theory and evidence, why the particular priorities could/should be different, and how and why such priorities might have been decided on.

Illustrative examples (anonymous) can be from your own practice experience as a student nurse.  The work should adhere to usual legal, ethical and professional principles and no person or organisation should be identified.
The assessment of the essay will use level 7 criteria. You must achieve at least 50% to pass this assignment.

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