Evidence and Practice

Clinical

Forensic risk assessment in people with learning disabilities: principles and process

Why you should read this article: • To refresh your knowledge of the principles of forensic risk assessment • To recognise the benefits of, and the different evidence-based approaches to, forensic risk assessment • To increase your understanding of risk formulation and the development of a tailored risk management plan While forensic healthcare is a highly specialised area of clinical practice, many learning disability nurses will, over the course of their careers, be required to provide care to people who have had contact with the criminal justice system. Robust risk assessment and risk management systems are central to ensuring the well-being and safety of people with learning disabilities who have forensic needs. Although the core assessment skills required to undertake forensic risk assessments are embedded in nurses’ skill set, learning disability nurses need to develop their knowledge and understanding of how to apply these skills in forensic practice. This article explores the principles of forensic risk assessments and the elements of the forensic risk assessment process as a foundation to risk formulation. The author uses a fictitious case study to illustrate forensic risk assessment, risk formulation and the development of a tailored risk management plan.

Promoting oral health for people with learning disabilities

Why you should read this article: • To refresh your knowledge of risk factors for suboptimal oral health in people with learning disabilities • To recognise the importance of education and training for healthcare professionals and carers to support oral health for people with learning disabilities • To read about interventions that can be used to support access to dental care for people with learning disabilities People with learning disabilities have poorer oral health compared with the general population. Risk factors for suboptimal oral health in this group include diet, reliance on others for oral care and barriers to accessing dental care. This article discusses these risk factors and considers the importance of education and training for carers and healthcare professionals, including dentists and dental students, to enhance oral health in people with learning disabilities. The author uses a fictional case study to illustrate some of the challenges experienced by people with learning disabilities in accessing oral care and how the use of interventions such as desensitisation programmes, as well as reasonable adjustments, can help address these challenges.

How to support adherence to medicines among people with learning disabilities

Why you should read this article: • To recognise the importance of education, reasonable adjustments and medication reviews in supporting optimal medicines adherence in people with learning disabilities • To enhance your awareness of factors that contribute to suboptimal medicines adherence in people with learning disabilities • To acknowledge the importance of involving family or carers in supporting medicines adherence Rationale and key points People with learning disabilities often have long-term conditions that require the regular use of medicines. Medicines adherence can be particularly challenging in this population and support with taking medicines is often not provided in a way that meets people’s needs. Suboptimal medicines adherence can negatively affect the health outcomes of people with learning disabilities, which are already poorer than those of the general population. • Achieving optimal medicines adherence among people with learning disabilities requires a multi-component strategy that includes education, reasonable adjustments and medication reviews. • Factors that cause and/or contribute to suboptimal medicines adherence among people with learning disabilities include burdensome medicine regimens, medicines prescribed in unsuitable forms, overmedication and overprescribing, lack of medication reviews, lack of reasonable adjustments, suboptimal communication from healthcare professionals and suboptimal care coordination. • Family and carers are often those who administer medicines, so it is crucial to involve, educate and support them about the person’s medicine regimen so that they can help ensure the medicines are taken as prescribed. Reflective activity ‘ How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting a person with a learning disability to take their medicines as prescribed. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take to support a person with a learning disability to take their medicines as prescribed.

Supporting people with learning disabilities and a fear of needles to receive the COVID-19 vaccine

Supporting people with learning disabilities and needle phobia to be vaccinated

How a desensitisation programme was used to prepare people for the COVID-19 vaccination

How to support the accurate diagnosis of constipation in people with learning disabilities

How to diagnose constipation in people with learning disabilities

Diagnosis can be complicated by behaviours of concern in this patient group

Exploring the experiences of fathers who have a child with a learning disability

Exploring the experiences of fathers who have a child with a learning disability

A literature review showed the need for tailored services or interventions to support fathers

CPD articles

Obesity and nutrition: supporting positive dietary behaviour change in people with...

Why you should read this article: • To enhance your knowledge of the causes of, and risk factors for, obesity in people with learning disabilities • To acknowledge the importance of nutrition as a key controllable factor in preventing long-term conditions • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Obesity is a major global concern and is more common among people with learning disabilities than in the general population. If unmanaged, obesity can lead or contribute to various long-term health conditions, such as type 2 diabetes, cardiovascular disease and cancer. People with learning disabilities often rely on support staff, families and carers to meet their individual nutritional needs, but care teams and families may lack adequate knowledge of public health recommendations about healthy diet and optimal nutrition. More needs to be done to enhance the diet, and subsequently improve the health outcomes, of people with learning disabilities. This article provides an overview of obesity in people with learning disabilities, including contributing factors, associated health conditions and nutritional considerations. It also details recommendations for nurses to promote a healthy diet and support positive dietary behaviour change in this population.

Rare epilepsy syndromes: understanding treatment goals and management challenges

Rare epilepsy syndromes: understanding treatment goals and management challenges

How nurses can provide adequate care and support to service users, family members and carers

Supporting people with learning disabilities to attend general practice appointments

Supporting people with learning disabilities to attend GP appointments

Learning disability nurses' role in supporting people with learning disabilities in primary care

Responding to distressed behaviour at the intersection of learning disability and neurodivergence

Distressed behaviour at the intersection of learning disability and neurodivergence

The need to reframe behaviours that challenge as expressions of distress or unmet needs

Conducting mental health assessments of people with learning disabilities

Conducting mental health assessments of people with learning disabilities

Advice on overcoming communication issues and cognitive impairments to conduct an effective assessment

Ensuring effective communication when undertaking a systematic health assessment

Ensuring good communication when undertaking a health assessment

How a systematic assessment works in practice and skills nurses use to engage service users

Practice question

Photographs of quilt squares brought together in the form of a mosaic or eQuilt: arts and crafts activities can stimulate discussion on mental health and well-being

Learning disabilities: can arts and crafts help mental health?

Arts and crafts activities can stimulate discussion on mental health and well-being

Illustration of therapeutic untruths shows two seated people talking, the woman has her arm on the man's shoulder and a voice bubble has a tick in it, but her thought bubble has a cross in it

Are therapeutic untruths acceptable when talking to a person with a learning disability?

While no one wants to tell direct lies, therapeutic untruths can be beneficial

Photo shows nurse talking through a health action plan with a woman with learning disabilities and a family member: health promotion can be used collaboratively by nurses and people with learning disabilities to empower and reduce health inequalities

What is health promotion and how can it be used with people with learning disabilities?

Tailoring health education to specific needs can empower people and reduce inequalities

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