Sue Charman from Greenwich community Learning Disability Team has set up a multidisciplinary approach to support clients with a learning disability and ageing/memory issues.
Advances in medical and social care have led to a significant increase in the life expectancy of people with learning disabilities. Dementia generally affects people with learning disabilities in similar ways to people without a learning disability, but there are some important differences. People with a learning disability:
- are at greater risk of developing dementia at a younger age – particularly those with Down’s syndrome: 1 in 3 develop dementia in their 50s
- often show different symptoms in the early stages of dementia
- are less likely to receive a correct or early diagnosis of dementia and may not be able to understand the diagnosis
- may experience a more rapid progression of dementia
- may already be in a supported living environment, where they are given help to allow them to live independently
- may have already learned different ways to communicate (e.g. more non-verbal communication if their disability affects speech)
- will require specific support to understand the changes they are experiencing, and to access appropriate services after diagnosis and as dementia progresses.
A Multi-disciplinary Team was set up in Greenwich to support their Learning Disabled Ageing Population. The team includes members from psychology, psychiatry, speech and language therapy, physiotherapy, nursing and the older people’s service based at Goldie Leigh.
The Ageing Issues team hold two clinics per month; the first is to review 3-4 patients, as a multi-disciplinary team including the patient/family/carer/other representatives. The clinic is also used to review the register to see if there have been any issues that need to be addressed. The second clinic is part of the psychiatry outpatient’s service. Patients that have possible memory issues are discussed as part of the exploratory work prior to diagnosis.
The review of the patients includes a holistic approach to their wellbeing, exploring whether the client has had hearing tests, blood tests and medication reviews as, in the early stages, these can be the reason for decline. An example of this is a 40 year old man with Downs Syndrome was brought to the clinic with a memory and functioning decline, once he was initially reviewed he was supported for a blood test which indicated a hypothyroid issue, which when treated he was able to be discharged from our service.
In the last 2 years end of life care plans have been brought into the clinics which are sensitively discussed with next of kin. When the patient transitions to late stage dementia, the team provide support with forward planning, discussing active resuscitation and hospital treatment in the event of an illness. These plans are reviewed every 6 months as part of the clinic with the multi-disciplinary team. GP’s are invited to attend and if they are unable to an appointment is made to discuss the plans and ensure that the GP’s are in agreement prior to sign off.
Members of this team also support in liaising with the local hospice, and ensure that carers have contact numbers for the professionals for when end of life care is needed. Training is also provided by the team to support carers and other health professionals when required.