I recently read on social media ‘Don’t complain about getting old – it’s a privilege denied to many’. This is an interesting statement when the position of people with learning disabilities is considered because even though overall the life expectancy of the group of people to whom this label is applied is increasing, it is still significantly less than the wider population. Indeed it has been reported that the life expectancy at birth for people with learning disabilities is 19.7 years less than for their non-disabled peers (Glover et al, 2017). Nonetheless, the same study also indicates that many of these premature deaths are avoidable and amenable to good quality healthcare (Glover et al, 2017) suggesting that with appropriate and timely healthcare interventions this gap in life expectancy could be reduced.
Some might feel that simply extending life expectancy could mean that older people with learning disabilities would (as with the wider population) experience the complex health problems and frailty that are often associated with getting older. However, at present, we know that people with learning disabilities often experience age related health problems at an earlier age – for example people with Down Syndrome are at increased risk of early onset dementia and levels of frailty in people with learning disabilities in their 50s can be comparable to those of people aged 75+ in the wider population. Such complex health problems can have a significant impact on individual quality of life not least because these health changes can lead to increased support needs and this, in turn, can lead to a change in living arrangements.
So what can the learning disability nurse do to promote the right to health and healthy ageing for people with learning disabilities? A key role is in promoting health across the lifespan – if healthy eating, exercise and appropriate weight management are present during early and mid-adulthood then the risk of some of the age related health problems (such as diabetes and cardio-vascular problems) may be reduced.
Monitoring health on a regular basis so that any changes in what is normal for an individual can be recognised at an early stage, the appropriate assessments undertaken and (where necessary) interventions commenced at an early stage is also important. Promoting access to annual health checks for people with learning disabilities and ensuring that an action plan is both developed and implemented is an important element of this.
Older people with learning disabilities may experience the double jeopardy of discrimination both on the basis of disability and on the basis of age. Nurses are well positioned to identify and challenge any such discrimination. Working with individuals and their support networks, learning disability nurses can do much to promote the right of older people with learning disabilities to preventative and responsive healthcare.
Ruth Northway, Professor of Learning Disability Nursing
Glover, G., Williams, R., Heslop, P., Oyinlola, J., Grey, J. (2017) Mortality in people with intellectual disabilities in England, Journal of Intellectual Disability Research, 61 (1) 62 - 74
If you are interested in a career in learning disability nursing then places are available at USW for a September 2018 start. NHS Bursary available.