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Neuro Rehab 1 > Adults with Intellectual & Developmental Disabilities > Flashcards

Adults with Intellectual & Developmental Disabilities Flashcards

1
Q

why are people w IDD living longer (3)

A
  1. improved medical care
  2. US public policy: education, setting of care/de-institutionalization
  3. advocacy: self & family/friends
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2
Q

what is the significance of how people w IDD age

A

premature aging
- accelerated problems at a higher rate (ie issues w vision, osteoporosis)

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3
Q

what is the significance of people w IDD experiencing health and healthcare disparities

A

leads to poor health outcomes

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4
Q

what are 5 systems that have health issues in IDD

A
  1. MSK
  2. metabolic
  3. cardiovascular & pulm
  4. GI and GU
  5. sensory (vision, hearing)
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5
Q

what are 5 health issues experienced in IDD

A
  1. obesity
  2. dental disease
  3. falls
  4. mental illness
  5. fatigue, poor sleep
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6
Q

what are 4 various MSK conditions that can develop over time in IDD

A
  1. hip dislocation
  2. patella alta
  3. spondylolysis
  4. cervical spine stenosis
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7
Q

what should be considered as contributing to MSK conditions that develop over time in IDD

A

impact of chronic abnormal joint biomechanics

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8
Q

what are 3 common MSK/ortho health issues in IDD

A

pain
dec bone mineral density
osteoporosis (inc vs gen pop)

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9
Q

what is the significance of MSK pain in IDD

A

often underreported/unrecognized
- IDD difficulty interpreting and communicating the pain
- dec access to providers who would recognize

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10
Q

what is a challenge with MSK health issues in IDD

A

proper screening/dx and treatment
- difficulty to get access
- difficult to lie still to be scanned

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11
Q

what screens for MSK/ortho health issues like osteoporosis in IDD

A

dual emission XR absoptiometry scan

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12
Q

what are 4 metabolic health issues in IDD

A
  1. metabolic syndrome - early onset
  2. DM
  3. coronary artery dz
  4. hypercholesteremia
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13
Q

what is the significance of metabolic health issues in IDD

A

can lead to death

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14
Q

what is the incidence of obesity in IDD

A

inc rates
- esp if + down syndrome, women + IDD

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15
Q

etiology of obesity in IDD

A

multifactorial:
- modifiable risk factors
- non modifiable (ie meds, mobility limitations)
- reliance on caregivers to move

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16
Q

what is the significance of obesity in IDD (2)

A

impacts development of metabolic syndrome

neg social stigma

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17
Q

what type of intervention is needed for obesity in IDD

A

multifactorial to treat multifactorial etiology

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18
Q

what are 3 cardiopulm health issues in IDD

A
  1. cardiovascular dz
  2. COPD
  3. other lung conditions (pneumonia & influenza)
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19
Q

what is the significance of cardiopulm health issues in IDD

A

significantly higher death rates compared to gen pop

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20
Q

what impacts the death rate d/t COPD or other lung conditions in IDD

A

33% in severe ID
50% in IDD institutions

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21
Q

what are 3 GI/GU health issues in IDD

A
  1. new or pre-existing incontinence (urinary, bowel, or both)
  2. inc mortality rate d/t bowel obstruction, perforated ulcers
  3. no regular cancer screening for colon, breast, prostate
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22
Q

what is the major issue with GI/GU health issues in IDD

A

undiagnosed, therefore untreated

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23
Q

what are 3 factors that impact GI/GU health issues in IDD

A

communication
cognition
interpretation of nociception

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24
Q

what sensory health issues are very prevalent in IDD (2 and related)

A

vision impairments more common vs gen pop
eye dz

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25
Q

what is the most common cause of vision impairments in IDD

A

uncorrected refractive errors (ie astigmatism, myopia, hyperopia)

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26
Q

what 2 vision impairments are there a high occurrence of in IDD

A

nystagmus
strabismus

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27
Q

what 3 eye diseases are common in IDD

A

cataracts
conjunctivitis
inflammatory conditions

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28
Q

what is the incidence of hearing issues in IDD

A

30% fail when screened

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29
Q

what organization provides most data to give insight into health issues in IDD

A

special olympics healthy athletes

30
Q

what are 6 oral health issues in IDD

A
  1. OA of TMJ
  2. xerostomia (dry mouth)
  3. dental caries
  4. periodontal dz
  5. impaired chewing - esp w tooth loss
  6. tooth loss
31
Q

what is the significance of dental caries in IDD

A

often underdiagnosed, or untreated or treated by extraction instead of fillings/root canals

32
Q

what is the incidence of tooth loss in IDD

A

> 65yo w IDD, more likely to have lost all natural teeth vs gen pop

33
Q

what is the significance of dental disease in IDD

A

directly impacts individuals overall systemic health and communication, taste, smell, smile, facial expressions

34
Q

what is the incidence of falls and the significance

A

higher rate vs gen pop
higher rate of falls at younger age

significance: 2x inc risk of injury vs gen pop

35
Q

what mental health issues are common in IDD

A

anxiety and depression
- and many others

36
Q

what is the challenges (2) with mental health issues in iDD

A
  1. lack of provider confidence in dx
  2. dec provider knowledge of presentation of mental illness in IDD
37
Q

when is it important to consider mental health issue influences in our practice of treating someone w IDD

A

if seeing changes in behavior we don’t understand
- screen mental health

38
Q

what are 2 impacts of chronic fatigue in IDD

A
  1. affects level of exertion
  2. diminished ms mass and force production associated w chronic condition
39
Q

what is a possible cause of chronic fatigue in IDD

A

developmental issues growing up that were exacerbated leading to chronic fatuge

40
Q

what are 2 impacts of poor sleep in IDD

A

pain
gastroesophageal refulx

41
Q

life expectancy in IDD and what is suspected reasoning

A

20yrs less than gen pop
- in US avg 75-80yr -> 55-60 in this pop

d/t chronic issues, access to healthcare

42
Q

describe the utilization of healthcare services in IDD

A

individuals w IDD don’t receive health services that diverse range of health conditions require

43
Q

what are 3 barriers to health care services in IDD

A
  1. nature of health care system
  2. common characteristics among individuals w ID/IDD
  3. characteristics and skills of providers
44
Q

what are 5 barriers d/t the nature of the health care system and IDD

A
  1. inadequate medical insurance coverage
  2. lack of accessible treatment facilities
  3. poor coordination w/i healthcare system and b/w providers
  4. poor continuity of care for individuals w IDD - rarely see same provider
  5. poor coverage for and limitations in use of speciality services
45
Q

what is often a healthcare provider when people w IDD become adults

A

hard fro pts to transition from pedi to adult providers since there are less adult providers

46
Q

describe the specifics that lead to poor coverage and limitations in specialty services for IDD (2)

A
  1. inadequate # of specialized providers (ie derm, gastroentero, immunol)
  2. insufficient reimbursement and inapprop limitations by payers for certain services
47
Q

how is there a lack of accessibility to treatment in IDD

A

physical lack of accessibility to facility
- lack of transportation

also lack of providers willing to work w this pop

48
Q

what are 5 ways that the characteristics of persons w IDD are barriers to health care

A
  1. limited communication skills -> impedes clinician-pt interactions
  2. physical and behavioral impairments
  3. difficulty adhering to treatment regimens
  4. reliance on caregivers to seek care in system w high caregiver turnover
  5. inadequate family resources
49
Q

what are 3 provider characteristics that are barriers to healthcare to IDD

A
  1. lack of primary care provider training
  2. poor documentation of services
  3. provider attitudes
50
Q

how is there a lack of primary care provider training in healthcare of IDD (2)

A
  1. in interacting w individuals w IDD
  2. management of common problems in individuals w IDD
51
Q

how is there poor documentation of healthcare services provided to IDD

A

lack of medical records that accurately document case hx

52
Q

what negative provider attitudes are present w regard to IDD (4)

A
  1. persistent lack of knowledge
  2. disbelief in pts w IDD will benefit from treatment
  3. doubt pts w IDD willing to take care of selves
  4. more difficult to work w and less compliant
53
Q

what are 4 major roles of PTs in treating IDD

A
  1. design & implement safe exercise exercise programs
  2. adapt equipment & positioning
  3. identify community resources
  4. expand service delivery
54
Q

what are 3 goals of PT exercise programs in IDD

A

fitness
vitality
pain management

55
Q

what are 4 targets of PT exercise programs in IDD

A

wt management
bone health
strength/ms mass
cardiovascular fitness

56
Q

who should PT consult w when prescribing adaptive equipment for IDD (2)

A

community organizations
PCPs

57
Q

what are 2 goals of adaptive equipment and positioning in IDD

A
  1. support full participation
  2. enhance comfort for sleeping in home
58
Q

what community resources should PT seek out in advocating for IDD (3)

A
  1. community gyms w trainers/equipment accessible
  2. consultation w vocational/employer services
  3. advocate for accessible rec and outdoor opportunities
59
Q

what are 4 roles of PT in service delivery to IDD

A
  1. facilitate transition of pedi to adult service provision
  2. training in working w people w IDD
  3. collaborate w other providers
  4. access to care
60
Q

what other providers should PT collaborate w in service delivery to IDD (3)

A

pedi
adult
neuro

61
Q

what are 5 attributes PT should consider when thinking ab IDD access to care

A

attitudes at clinic
funding
physical accessibility
transportation
community programming

62
Q

what are 5 screening fields of FUNfitness for IDD

A

flexibility
strength
balance
aerobic
education

63
Q

what is the average age of pts w IDD screened in FUNfitness

A

22.6yo

64
Q

what is the greatest need of people w IDD screened by FUNfitness

A

education

65
Q

what do coaches of FUNfitness for IDD need

A

guidance ab fitness

66
Q

what has FUNfitness found ab incidence of health issues in screening IDD

A

almost all athletes have a limitation in an area of screening
- 70% have limitations in 3+ areas of 5

67
Q

Healthy Athletes found that 50% of those screened w IDD found limitations in what 3 fields across all ages

A

flexibility
strength
balance

68
Q

what are 4 things which success as an adult w IDD is linked to

A
  1. excellent med care
  2. participation in regular fitness activities
  3. support systems
  4. “accept me for who i am” attitude
69
Q

what are 3 ways PT should address mental health in IDD

A
  1. screen for mental health conditions
  2. use relaxation techniques
  3. refer for CBT
70
Q

what are 5 modes of communication in IDD

A

verbal
ASL
written
assistive tech
via healthcare proxy

71
Q

what are 4 strategies to utilize when communicating w someone w IDD

A
  1. speak at slightly slower pace
  2. be redundant but not repetitive
  3. allow extra time for pt response
  4. confirm comprehension - teachback method
72
Q

what are 3 ways to modify PT treatments for IDD

A
  1. employ communication strategies
  2. consider likely presence of co-morbidities and multisystem involvement
  3. break down task into few easy steps

Neuro Rehab 1 (27 decks)

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