Subject(s)
Adolescent Behavior , Cerebral Palsy/psychology , Social Behavior , Adolescent , Humans , Social Isolation , SocializationABSTRACT
Structured direct interviews of 43 adults with mental retardation were conducted to evaluate how they express grief and deal with loss. In addition, 100 providers, social workers, and clergy were surveyed to assess their views of how adults with mental retardation cope and respond during a grief situation. Adults with moderate to severe mental retardation display grief responses similar to all adults: a mixture of sadness, anger, anxiety, confusion, and pain. Individuals continue to experience emotional turmoil 1 year beyond the initial death and personal loss. Caregivers and professionals were mixed on how long a grief reaction continues before it can be viewed as dysfunctional. Intense behaviors, such as self-injury, were noted by respondents in 10-15% of grief reactions. Ability to "feel" or display emotional behavior during grief is not contingent only on a conceptual level. Common reactions include a depressive response (crying, fatigue, sleep disruption, loss of appetite) of moderate intensity. Adults with significant mental retardation verbalized an understanding of the irreversibility of death, and their responses reflect personal beliefs as well. An unknown group of these adults may have been exhibiting a depressive disorder.
Subject(s)
Grief , Intellectual Disability/psychology , Adult , Aged , Attitude to Death , Depression/diagnosis , Depression/psychology , Female , Humans , Life Change Events , Male , Middle Aged , Patient Care TeamABSTRACT
Although psychotropic medications are commonly used with older adults who have mental retardation, patterns of medication use for this group are not easily determined. Our objective was to explore relations between prescribed psychoactive treatments and rated behavioral difficulties. Adults with moderate mental retardation living in congregate and group care settings were rated by care providers using a standard behavior rating instrument. Older adults demonstrated a tendency toward higher medication utilization. Results indicated higher drug utilization in the larger setting despite the fact that behavior problems and cognitive level was matched across all settings. Medication utilization appears to be related to multiple factors, not only the behavioral or cognitive characteristics of adults with mental retardation.
Subject(s)
Intellectual Disability/drug therapy , Social Behavior Disorders/drug therapy , Activities of Daily Living/psychology , Adult , Aged , Drug Utilization , Female , Group Homes , Humans , Intellectual Disability/psychology , Iowa , Male , Middle Aged , Social Behavior Disorders/psychologyABSTRACT
There has been little effort directed at training health care professionals in behaviors and attitudes that are effective in communicating with persons with mental retardation. Such training would be beneficial not only to assist those with congenital cognitive deficits but for those with acquired central nervous system conditions as well, for example, dementia. Persons with mental retardation are living in community settings in greater numbers and increasingly participating in vocational, residential, and health care programs. Yet, most health care professionals are not routinely offered an opportunity to gain experience interacting with people who have limited ability to express and understand health care information. An education program was focused on health care professionals' use of basic communication skills when providing health information to an adult who is mentally retarded. A self-study instructional text and a 20-minute companion video provided methods of communicating with a patient with mental retardation in medical and dental care settings. Resident physicians, medical students, nurses, and nursing assistants improved their communication skills, knew more about mental retardation, and were more proactive in health care interviews following training. Health care training needs to incorporate educational opportunities focusing on skills to assist special populations. Brief, structured, and interactive skill training in communication offered early in the health care professional's career has positive benefits for the recipient and the provider.
Subject(s)
Communication , Health Education , Health Personnel/education , Intellectual Disability/psychology , Professional-Patient Relations , Adult , Education, Continuing , Humans , Program Evaluation , United StatesABSTRACT
A preliminary investigation of cognitive decline and depressive symptomatology is presented with older adults who have mental retardation. A series of different assessment instruments are reviewed and tested in a pilot study. A review of dementia and depression with respect to elders with mental retardation is presented to place the study in perspective. Findings reveal decreasing cognitive ability is associated with higher rates of observed depression and reported behavioral problems. Trends suggested those more elderly displayed more depressive behaviors, psychotropic medication was a common treatment, and cognitive decline was associated with lower initial intellectual levels. Dementia and depression is a complicated symptom complex to identify in aging adults with mental retardation.
Subject(s)
Dementia/diagnosis , Depressive Disorder/diagnosis , Down Syndrome/diagnosis , Intellectual Disability/diagnosis , Neuropsychological Tests , Activities of Daily Living , Aged , Dementia/psychology , Depressive Disorder/psychology , Down Syndrome/psychology , Female , Humans , Intellectual Disability/psychology , Intelligence , Male , Middle Aged , Pilot Projects , Psychotropic Drugs/administration & dosage , Social Behavior Disorders/diagnosis , Social EnvironmentABSTRACT
Use of psychotropic medications with elders who are mentally retarded is a very common procedure. However, patterns of medication usage in this group are not easily determined. Objectives were to explore relationships between prescribed psychotropic treatments, the types of reported behavioral difficulties, and the size/type of living settings where these difficulties were exhibited. Subjects were moderately mentally retarded elders who were living in Congregate and Group care settings who were observed and rated by caretakers using a standard behavior rating instrument. Comprehensive medical (drug) and demographic data was obtained on each person. The study revealed that psychotropic use was more frequent in congregate care settings for these older clients. Those more elderly demonstrated a tendency toward higher utilization. Little differences were evident in the general characteristics (sex, IQ, reality orientation) of elders living in the two settings despite differences in drug use rates. Future research needs to focus on differences in behavior problems and setting factors to more fully understand drug utilization rates in elders with mental retardation.