Health needs

Cooper(3l) reviews the effects of age on the physical health of people with mental retardation, and stresses the existence of significant health needs among this population.

The needs of older people with mental retardation arise not only from the normal ageing process but also from the specific social, health, and mental health needs of this population, including dementia. As with many ageing people, declining mobility and energy levels may deter someone from consulting their doctor. The problems of access to health care for people with mental retardation is further complicated by their failure, and the failure of their carers, to recognize the signs and symptoms of illness. Carers may not recognize that changes in behaviour are due to physical or mental illness, instead attributing changes to the mental retardation itself. It is important to determine the aetiology of any mental retardation, even late in life, because of the possible health implications.

Late diagnosis of serious illness affects prognosis, and there is concern within the hospice movement that people with mental retardation are being referred for palliative care, their malignancy having been diagnosed too late for any other medical intervention. Because the law on consent to treatment is poorly understood within generic health services, people with mental retardation may not be offered standard medical care. (32)

People with mild mental retardation living at home without a caring relative also need effective monitoring. A recent American study, (33> comparing the health status of elderly people with mental retardation living at home and in community residential facilities, showed that those living at home had difficulty accessing health care.

Because of the high prevalence of epilepsy among people with mental retardation, the management of epilepsy is particularly relevant, and requires regular review of seizures, medication, and side-effects throughout life.

There is an increased risk for a number of medical conditions in people who have Down syndrome,(34) including sensory impairments, thyroid disease, leukaemia, and atlantoaxial instability. The later sequelae of congenital heart disease include pulmonary hypertension and congestive heart failure.

Signs of poor physical care among elderly people with mental retardation (e.g. blepharitis, pressure sores, or tooth decay) may indicate a deterioration in their functioning, but may also indicate that carers are not coping, and this emphasizes the necessity to ensure access to primary care. Many health issues, such as visual and hearing impairment, can be easily and quickly corrected, leading to significant health gain. Overall, uptake of services by elderly people with mental retardation is poor. (31)

People with mental retardation need to have access to regular health screening.(35) In later life, women at risk of osteoporosis should be offered hormone replacement therapy. Pictorial health education materials are available to help health-care professionals provide information about illness, medical procedures, and treatment to people with limited verbal communication.*3.6)

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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