Suchergebnisse

Background  While disparities in the health status for persons ageing with intellectual and developmental disabilities have been well documented, interventions that address individual risks in physical, emotional, social and environmental health among this population are lacking. This pilot study evaluated the feasibility of two inhome interventions designed to reduce health risks and improve health outcomes among persons ageing with intellectual and developmental disabilities.Method  Interventions and assessment tools were developed. Adults with intellectual and developmental disabilities, aged 32 and over (n = 201) living in non‐institutional settings were recruited and assigned to either an advance practice nurse (APN) intervention of inhome multidimensional assessment, targeted recommendations and follow‐up visits (n = 101) or an inhome health risk appraisal (HRA) with printed feedback only (n = 100).Results  The development and pilot testing of the interventions, assessment tools and methods demonstrated feasibility in the population from mild to moderate intellectual and developmental disabilities. In addition, high levels of health risks were identified (mean = 5.0; range 0–16) in the sample suggesting the need for effective interventions. Both pilot groups showed significant reduction in health risks between baseline and follow‐up. Further rigorous randomized field trials are required to test the effectiveness of each intervention.Conclusions  Community‐based preventive interventions are feasible for randomized trials in this population.

Background  Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community‐based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot study that explored the feasibility of using an in‐home preventive model based on a comprehensive geriatric assessment with persons ageing with an intellectual and developmental disability.Method  The APN intervention was fully provided to a sub‐sample (n = 70) of 201 participants with an intellectual and developmental disability enrolled in a programme called 'Stay Well and Healthy!' The APN intervention included an initial home visit for a comprehensive geriatric assessment with follow‐up home visits to review health status and assess adherence with recommendations and provide education and support to promote health and prevent functional decline.Results  Advanced practice nurses identified a number of active health‐related problems for persons ageing with an intellectual and developmental disability (mean 5.2; range 1–14) that had potential effects on function and survival. The majority of recommendations (mean 14.4; range 6–35) were for clinical preventive services (42.2%) and self‐care for health‐related issues (36.8%).Conclusions  This study showed that there were problems consistent with persons ageing with an intellectual and developmental disability and older adults without disability. The in‐home preventive APN intervention to promote healthy ageing and reduce health disparities in this population is feasible, needed, and warrants further study.