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An exploration of the experiences of declining mobility in older adults with Intellectual Disabilities.

An exploration of the experiences of declining mobility in older adults with Intellectual Disabilities.

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An essay for the 2012 Undergraduate Awards Competition by Shelagh Meskell. Originally submitted for Nursing Intellectual Disabilities , with lecturer Eileen Carey in the category of Nursing & Midwifery
An essay for the 2012 Undergraduate Awards Competition by Shelagh Meskell. Originally submitted for Nursing Intellectual Disabilities , with lecturer Eileen Carey in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Aug 30, 2012
Copyright:Attribution Non-commercial

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10/27/2013

 
i
Table of Contents
i-ii
Abstract
iii-iv
An exploration of the experiences of declining mobility in older adults with IntellectualDisabilities1.0 Introduction
1-2
2.0 Literature Review
2.1 Mobility status of older individuals with Intellectual Disabilities 32.2 Risk of falls in the older person with Intellectual Disabilities 3-42.3 Physical and biological predictors of declining mobility 4-72.3.1 Low bone mineral density and bone conditions 5-62.3.2 Vitamin D deficiency and mobility 6-72.3.3 Epilepsy, anti-epileptic medication and their effects on mobility 72.4 The psychological impact on mobility in the older adult with ID 8-92.4.1 Fear of falling 8-92.4.2 Dementia and mobility 92.4.3 Depression and mobility 92.5 Assessing the mobility of the older person with Intellectual Disabilities 10-132.5.1 Global assessment
 – 
Activities of daily living 10-112.5.2 Mobility assessments 122.5.3 Gait and falls assessment 12-132.5.4 Assessment of psychological impairment 132.6 Opportunities and Interventions 13-162.6.1 Physical interventions 14-152.6.2 Environmental interventions 16
3.0 Conclusion 17-18References v-xi
 
ii
Appendices
 
xv-xxiii
 Appendix 1: Profile of the population registered on the NIDD in 2010 xvAppendix 2: Proportion of individuals with different degrees of Intellectual Disabilities byage group: 1974-2010 xviAppendix 3: Age-specific prevalence rates of health conditions in older people with ID inIreland xviiAppendix 4: The Modified Rivermead Mobility Index xviiiAppendix 5: The Participation and Limitation Survey xix-xxAppendix 6: Performance-Oriented Mobility Assessment xxi-xxiiAppendix 7: Overall difficulty
in ADL’s and IADL’s
xxiii
 
iii
Abstract
In Ireland today, records demonstrate that people with Intellectual Disabilities are livinglonger (NIDD 2011). This increase in life expectancy though positive, is also accompaniedby associated physical and psychological changes which affect the health and social status of this group of people as they
grow older
. The most common physical changes affecting thisgroup of people include: an increase in the prevalence of cardiovascular and respiratoryillnesses, auditory and visual differences, and changes to bone health, affecting mobility.Indeed falls are identified as the most common cause of morbidity and mortality in olderpeople and can result in negative effects for the individual as well as putting pressure oncarers, the health system and the government (HSE 2008). Psychologically, fear of falling,dementia and depression can impact on the mobility of the older person. Specifically,declining mobility is classed as being one of the four main changes as experienced by theolder people with Intellectual Disabilities (Gates 2007). This review firstly explores thecurrent literature on the mobility status of older people with Intellectual Disabilities.Secondly, the multi-faceted physical and biological, psychological and social nature of predictors which affect mobilisation and ambulation are discussed. Thirdly, the importance of mobility assessment in the context of the older person with an Intellectual Disability ishighlighted. Finally, opportunities for supporting the older people with IntellectualDisabilities who are experiencing declining mobility are debated. These opportunities presentthemselves as preventative measures and interventions. Preventative measures such asincreased Vitamin D intake and the promotion of screening, and interventions such asphysical adaptations and aids focused on promoting independence are also debated. Throughthe review of the literature it becomes apparent that further research which explores the livedexperiences of individuals with Intellectual Disabilities who are currently experiencingdeclining mobility would be a great addition to the evidence available.

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