Learning Disability: Barriers to Effective Communication

Learning Disability: Barriers to Effective Communication Communication is the act or process of using words, sounds, or behaviours to express ideas, thoughts feelings, or exchange information (Merriam – Webster, 2014). People with learning disabilities die younger than other people (Heslop et al, 2013). The Independent Inquiry into Access to Healthcare for People with Learning Disabilities (Michael, 2008) followed the Mencap report Death by Indifference (2007). The report concluded that there are inherent risks in the care system that result in high levels of health needs not being met. The inquiry found that people with learning disabilities appear to receive less effective care and that there are many shortcomings in the way treatment is delivered, with avoidable suffering caused by untreated ill health. Effective communication is essential in ensuring high quality health care (Balandin Hemsley, 2008) and is an essential skill for nurses (Nursing Midwifery Council (NMC), 2007). Because communication difficulties are characteristic of people with learning disabilities, the nurse needs strategies that can be used to promote communication and understanding by removing barriers, and developing their skills and knowledge. Why ? Effective communication is a recurring and pervasive theme in government policies, reports and best practice guidelines (Turner, 2014). Good practice guidance on working with parents with a Learning Disability (Department of Health, 2007), the survey of the human rights of adults with learning disabilities, A life like any other? (Joint Committee on Human Rights, 2008) and valuing people now (Department of Health, 2009). In particular, A Life Any Other? highlights the ways in which barriers to communication can all too easily result in the human rights of people with learning disabilities being breached, unmet communication needs can restrict access to public services. For example, research commissioned by Mencap showed that, of 215 GPs interviewed, 75% had received no training to help them treat people with a learning disability (Taylor Nelson Sofres, 2004, cited in Mencap, 2004). Children with LD Regnard et al. (2007) found more than twenty changes in behaviour in children with learning disability when they encountered distress, and it is likely those who have no verbal language are likely to be more receptive to non-verbal communication (Tuffrey –Wijne McEnhill, 2008). It is therefore vitally important for professionals working directly with children to engage with them however possible. Adults with LD Difficulties with communication have been consistently reported as a barrier in supporting adults with learning disabilities at the end of life . HEALTH NEEDS A high People with learning disabilities are likely to need assistance in communication. It has estimated that there are 1.5 million people in the United Kingdom (UK) with learning disabilities and between 50% and 90% suffer from sensory loss (Eric et al, 2012). Most people with learning disabilities have greater health needs than those with no disabilities. They are also likely to die at a younger age (Mencap, 2007). A number of reports in recent years have shown that there are failings in accessing services and in providing appropriate treatment for people with learning disabilities( Equal Treatment: Closing the Gap(2006); Death by Indifference (2007)). A life like no other (2007), a report into services for people with a learning disability in England, found that adults with a learning disability are particularly vulnerable to breaches of their human rights in healthcare services. There is considerable evidence that people with learning disabilities are not receiving the same level of health care as other people. In the UK, there have been many documented examples of secondary health services causing te preventable death of people with learning disabilities, with contributory factors reported to include poor communication, a failure of heath service staff to recognise pain, delays in diagnosis and treatment, a lack of basic care, and the use of Do Not Resuscitate orders (Heslop et al., 2013; Mencap, 2012a). A UK based Confidential Inquiry into premature deaths of people with learning disabilities (Heslop et al., 2013) estimated that 37% of deaths were potentially avoidable. When people with learning disabilities use health services, staff may have difficulty in meeting their needs because they are unable to communicate effectively with them. A number of reports (Department of Health, 2008; Mencap, 2012; Royal College of Nursing, 2010) highlighted the communication complexity between patient and the staff which have resulted in some cases of deaths and poor quality hospital care. HISTORY A report from Mencap (2007), entitles Death by Indifference, highlights the poor treatment received by six people with learning disabilities admitted to acute adult and mental health service. This poor treatment ultimately led to these peoples’ deaths. The report goes as far to say that institutional discrimination exists within the National Health Service (NHS) towards people who have a learning disability with them getting worse health care than non-disables people. One of the major concerns raised by Mencap was the notion of diagnostic overshadowing. This is neglecting to recognise signs and symptoms of ill health assuming them to be characteristic of a person’s learning disability. Death by indifference In 2004, Mencap published Treat me Right, a report which highlighted the inequities of NHS healthcare provision to people with learning disabilities. This also highlighted that that healthcare professional should not depend on carers or family to communicate with service users with learning disabilities and hospitals must perform their legal duty of care. Healthcare providers are accountable to make sure that these service users have their needs met and this include an easy-read information in place. In 2006, the Disability Right Commission further emphasised concerns that people with learning disabilities were not afforded equitable access to healthcare services and treatment and as a consequence suffered more ill health and were more likely to die. In 2007, Mencap published Death by Indifference, a report which told the shocking stories of six people with learning disabilities who suffered potentially avoidable deaths while in various NHS healthcare service by improving communicati on. A subsequent independent inquiry (Micheal, 2008) and port by the Local Government Ombudsmen and Parliamentary and Health Service Ombudsmen (2009) both confirmed that people with learning disabilities were consistently being placed at risk within primary and secondary healthcare services due to lack of and staff –patient communication http://www.ombudsman.org.uk/__data/assets/pdf_file/0013/1408/six-lives-part1-overview.pdf Death by Indifference (Mencap, 2007) attributed the unacceptable standards if care largely to an ignorance or apathy by nurses and other health professionals to understand and listen to their clients with learning disabilities. It is important that the individual is continually consulted about their care regardless of the extent of their learning disability. 74 deaths and counting (2012) The report by Mencap, 2012 relayed details of more potentially avoidable deaths of people with learning disabilities within NHS services. Reasonable adjustments The failure of public services to make reasonable adjustments regarding communication not only makes it extremely difficult for people with learning disabilities to access services, but it may also breach the Equality Act (2010) and Article 8 pf the European Convention on Human Rights (Micheal, 2008, p24). Poor communication with people who have learning disabilities has consequences that range from the relatively insignificant. For example a service user is given coffee when they would prefer tea. NON VERBAL COMMUNICATION Non-verbal communication is as important as verbal in interactions that influence dignity. For example, in a study of older people’s transitions (include older people with learning disabilities) between care service, Ellins et al. (2012) noted the following: ‘one of the most striking findings was that even the smallest gestures by providers to connect with somebody as a human being, such as a smile or a hug could make MAKATON The Makaton language programme is commonly used by people with learning disabilities. Many people with learning disabilities use speech, there are also a range of altranative methods of communication which can be used in conjunction with speech. Sign systems are used widely among people with learning disabilities, either alone or in conjunction with speech. One of the common systems is Makaton(Williams, 2009). However, Hannon (2003) found that no one at the hospital had heard of it. One of the people with a learning disability involved in the study said any of the health care professionals did not understand him. EASY READ Some people can benefit from written information being into an easy-read format. This involves the use of simple sentences and language and the use of photos or pictures to support the meaning of the written words. When producing written information for patients, it may be worth considering accessibility for patients who may be non-verbal or have a learning disability. An easy –to –read, information resource with picture and images and dew words can support people with learning disabilities to have a greater understanding of information and support their decision making. Talking Mats is ‘a visual framework that uses picture symbols to help people with a communication difficulty communicate more effectively’ (Murphy and Cameron 2005, p.3). Using pictures to represent topics and options and a visual scale with people with little or no speech and people who have difficulty in understanding speech can assist them to express their wishes about what will occur in their own life. Service providers, including case managers, can use this tool to help the person with disability consider and discuss a variety of options. The pictures are placed on a mat so that the person with disability can look at the options and choices available and then move them using the visual scale to indicate how they feel about each option. The visual scale might include symbols for liking something, for being unsure and for definitely not liking or wanting something. More complex visual scales can be created, depending on the person’s needs and abilities. Many people with a variety of disabilities use Talking Mats successfully. Nevertheless, there are some people for whom this system is not suitable. Murphy and Cameron (2005) suggested that to use Talking Mats successfully, the person using the mat must be able to recognise picture symbols and must be able to understand at least two keywords at a time. The person must also have a reliable way of confirming his or her views so that the case manager or service provider can be sure that the placement of pictures on the mat does in fact reflect the person’s views PERSON-CENTRED APPROCH Patient- or person- centred approaches to health are increasingly seen as more effi cient as they promote good communication between the clinician and patient but research to support this is lacking (Lewin et al., 2009). The Mental Capacity Act (2005) is based on person- centred principles and gives legal backing to previous guidelines for good practice (Mencap, 2010). It gives responsibility to all healthcare professionals to follow person- centred guidance in addressing issues of choice and consent in healthcare with the learning disabled. The key principles of this include the person being at the centre of any planning and discussion. This does not mean decisions are simply taken in their best interests but ways are sought to actively involve them in decision- making using accessible communication systems when necessary. McCaffery et al. (2010) argues that although there have been major advances in way to increase patient involvement in health decisions, with the benefits of greater involvement and shared decision-making now widely accepted, there has been little attention given to the development of tools and strategies to support participation of adults with lower literacy, who are members of a group with poor health knowledge, limited involvement in health decisions and poor health outcomes. McCaffery et al. (2010) proposed a framework to consider the different stages of shred health decision making and the tasks and skills required to achieve each stage. The 6cs In 2012, the Department of Health carried out a widespread consultation exercise on values for nurses, which were published in ‘Compassion in Practice: Nursing, Midwifery and Care staff: Our Vision and Strategy’. The vision is based around six values: care, compassion, competence, communication, courage and commitment. The vision aims to embed these values (the 6Cs) in all nursing, midwifery and caregiving settings throughout the NHS and social care to improve care for patients. Conclusion In conclusion, the author highlighted the importance and the barriers of communication when working with people with a learning disability, and the some communication methods that a learning disability nurses can use to work effectively with this client group. Good communication is the basis of effective care provision, and the value of developing a relationship and getting to know the individual demonstrates how this enables effective communication to take place. Health care professionals need to develop competencies in identifying individual communication needs, and developing creative ideas for how to overcome these, using a range of tools to aid communication. Person-centred approaches provide a framework to do this on an individual basis, enable and support people to make choices.

Comparison Between Healthy Food and Junk Food Essay

In today’s generation, healthy and unhealthy food plays a big role in youths and adults. Many people don’t really understand the difference between healthy and unhealthy foods, many don’t actually know what the result of eating too many unhealthy foods can do to the body. There are big differences between eating healthy food, unhealthy food and what the result of excessively eating them can do to the body. In the ongoing battle of ‘healthy vs. unhealthy foods’, unhealthy foods have their own advantage. While fast food may appear to be addictive; the ingredients may not be what is causing the addiction, rather, the habitual convenience. In this day in time, America is to lazy to cook raw, nutritious goods at home; society would rather stop by a local fast food restaurant and spend money on junk food that contains poor nutritional value, is high in fat, has preservatives, chemicals, artificial colors and flavors. Unhealthy food can hurt the body in many ways and can create diseases like: obesity, diabetes, and heart disease are major diseases and problems for the body. Sometimes you can counteract them and become healthy again, while others are irreversible and can lead to death. There are products and foods that are meant to be healthy but the producers add chemicals in them to be substitutes for the â€Å"bad stuff. † Some crop foods say that they are â€Å"all natural† when they really contain chemicals that have been added into them from the start of the process. Unlike unhealthy food, healthy food is obviously better for you and your health. people who eat healthy foods tend to have the ability and the energy to do hard work. When someone eats food that is rich in vitamins, proteins, iron and other important nutrients, they will be free from diseases and obesity. For children healthy food is necessary for proper growth and development. Parents can provide a wide variety of fruits, vegetables, whole grains and healthy proteins to make sure that their child get the right nutrients that they need to maintain a balanced diet. Although people believe that they are saving money by getting â€Å"junk food†, they are actually wasting money. In an article written by the New York Times, Is Junk Food Really Cheaper? it states that for â€Å"a typical order for a family of four†¦ costs, at the McDonald’s, about $28. † where as a healthy meal at home costsâ€Å"$14, and feed four or even six people. † Therefore it is actually cheaper to eat a well balanced meal at home, rather than a stop by the local fast food restaurant. Both junk food and Healthy food can be appetizing to your tastebuds but the clear choice to digest into your body is healthy food. Children and adults will benefit plenty by eating the right balanced foods and maintain a healthy living.

Media sends unhealthy signals to young women

Media sends unhealthy signals to young women Every girl has seen a woman in the media stick thin, sun kissed, envy of the way she looks â€Å"perfect†. Women that are put on television, a magazine or advertisements is ultimately fake with Photos, makeup and plastic surgery. This is a dangerous perception of beauty which has resulted in a decline in self-acceptance. Many girls any age struggle with their image believing that they are not thin enough, their hair is not long enough, or even they believe that they are ugly. I believe that the social stereotype of beauty should go back to the ass's.Self-acceptance and self-esteem is one of the biggest issues for young women who believe that they are not beautiful. A high percentage Of girls who do not think they are thin enough go to the extreme of anorexia, bulimia or even diet pills at a young age. A mental condition that they will live with for the rest of their lives, the life expectancy for those with this mental illness is ve ry short because of the lack of nutrients. Women that are models will even reluctantly eat, a model at size 4, is considered fat while the average of America is size 14, in the ass's the average size was 1 1.Many young woman will even change their appearance to â€Å"mold† their self to be perfect. Most popular at the moment is the ideal for long hair so girls will buy hair extensions that could cost up to $300. Some girls will buy colored contacts for the desired blue eyes. Almost every young woman who desperately wants to be perfect will spend hours upon hours on their makeup, sadly I am guilty of this before school I will wake up two and a half hours ahead of time to get ready. Others will get fake nails, fake eyelashes, and self-tanners.A girl could completely change the way that they kook and still not be happy with their appearance. In the ass's skinny was not beautiful, a lot of makeup was not beautiful, but what is beautiful? Confidence? Confidence is something I beli eve that every young woman should have it is a very important thing that helps with growing up in to a woman. Models are a very small majority of America that is mass produced in the media of what young woman believe to be what they should look like. Media had had a very large degrading impact on young woman everywhere.

The Truth Behind Honor By Marguerite De Navarre - 1557 Words

The Truth Behind Honor Honor is a concept that has a great deal to do with entitlement and based on the actions or qualities of a person. There are three main types of honor that society recognizes; family, men, and women and in The Heptameron, Marguerite de Navarre portrays each of the three types of honor throughout her stories. However, there are often a number of complications that follow honor that lie with classified and understandably honorable deeds or traits, and who is it that determines this. Another issue that one may find is that it is also complicated to be able to view one form of honor in the presence of another due to certain views clashing with one another. In addition to this, Marguerite de Navarre’s stories are†¦show more content†¦In the past, it was even more so an issue than it is now, creating little freedom for women. Men held the power in this instance, and believed that they were more worthy of an integral status than women were. In The Hep tameron, Marguerite de Navarre introduces the reader to the Duke of Medici, married to Madame Marguerite who had been too young to consummate the marriage. As a result, he had a great deal of love affairs with the women in town. Eventually this lead to him developing feelings for one of the virtuous women who had been the sister of the man the Duke considered his â€Å"other half†. The Duke then goes on to say â€Å"So be it then! [†¦] Since you are not my friend, I know what I have to do!† (159) Occurring after his friend refused to send word to his sister of the Duke’s request, he responded in the typical manner that he was known for – ruthlessness. At this point, he believed that due to his social standing, it was only right that the sister of the man he had been quite close with were to be his current love affair. His honor lies with the accepting of his offer – without it, he would take her by force. This relates back to manliness and hon or coexisting. Obtaining a women’s virtue is a sign of manliness, no matter the generation, and it is because of this that the Duke believes this virtuous women must sleep with him. If a woman were to refuse, as the sister did in this tale, the man would turn to