Health Needs and Challenges that Older People with Intellectual Disabilities in Australia and the UK - Research Paper Example

Evidence Based Practice Introduction Disability is a common phenomenon in the human experience with an estimated 20% of the human population (approximately 4 million people), suffering from some form of incapacitation. The number of disabled people in different parts of the world increases each year due to a subsequence amplification in the number of the aged population. According to the Australian Institute of Health and Welfare (1997) an estimated 400,000 people in Australia (2% of the total population), suffer from some form of intellectual disability. Cooper et al (2004, p. 414) argues that an estimated 2% of the populace in UK suffer from intellectual disabilities Nevertheless, from 1960-95 the numbers of people suffering from intellectual disabilities in this regions increased by a worrying 53%. It is noteworthy that the health and medical requirements of people with intellectual disabilities are quite different from those of people without intellectual disabilities. Historically, people with intellectual disabilities, particularly the aged, have been denied their rights and marginalized especially in accessing health care. In spite of the milestones attained by advocates of the rights of people with intellectual disabilities, the majority of the affected population, particularly the aged, is still confronted with many rights restrictions. This paper will describe in detail the health needs and challenges that older people with intellectual disabilities in Australia and the UK are confronted with. Older people with intellectual disabilities require access to proper health care, treatment, medication and rehabilitation in order to deal effectively with the difficulties they face as a consequence of their age and intellectual incapacitation. The human rights of their needs in health as well as the efforts by Australian and UK governments to address the health needs and challenges of aged people with intellectual disabilities will also be analyzed. This paper will also examine the attitudes in Australia towards people with intellectual disabilities. At the end of the paper a summative conclusion will be drafted followed by the list of references cited in the paper. Search terms The key terms and concepts identified included intellectual disability, disability, rights of health needs human rights for intellectual disability, intellectual disabilities, and learning disabilities. Database selection The database selection was searched in Ebcohost and ProQuest catalogs and databases, as well as the databases that are freely available in the internet. General search I started the search with general search items, as I refined it to concepts that are more specific. I started the search with a general search so that I could be able to identify the relevant information that are available on my research topic. The general search also helped in identifying better concepts that could help in my research. The general search also helped me know whether I needed to expand or narrow on my topic. Advanced search The advanced search option in the Ebcohost library helped in carrying out sophisticated search for the research topic. The advanced search also helped in the search because it provided the title of the articles, the subject, the author names, as well as the publication title. Boolean operators The advanced search mode was critical in using Boolean operators like “or” “and” “not.” The Boolean operator “or” helped in identifying articles that had either of the search concept “intellectual disability.” The Boolean operator “and” helped in identifying both search concepts in the article. In this case, I used the Boolean “and” because I wanted to connect the search terms “intellectual disability” and “human rights.” Challenges of Aged Populations with Intellectual Disabilities For a very long time in the history of human existence, people with intellectual disabilities have been the victims of extreme human rights restrictions (Griffiths et al 2003, p. 25). It is probably for this reason that, in different parts of the world social policy is currently formulated in a manner to enhance the recognition, assimilation and inclusion of people with disabilities into the societal mainstream. According to Nirje (1985, p. 67) this is aimed at ensuring that people with disabilities are “able and allowed to be themselves among others”. There are many challenges, which confront aged people with intellectual disabilities and hinder them from accessing health care and medical services. Firstly, Doody et al (2012, p. 275) posit that most of the aged populations living in the UK and Australia who suffer from intellectual disabilities depend heavily on others to give them the support they require to lead healthy and quality lives. This has a propensity to unintentionally exclude the affected populations from active involvement in community-based activities and services. A second challenge that aged individuals with intellectual disabilities commonly encounter in Australia and the UK is that their inappropriate or intrusive mannerisms (owing to their intellectual disabilities) prevent them from gaining admission or access to community-based activities and services (Bland et al. 2003, p. 325). In comparison to the mainstream population, it is very difficult for aged populations with intellectual disabilities to access social or medical care services. Dowse (2009, p. 576) argues that this is mostly because aged people with such incapacitations are perceived as being unable to coexist with current categories of clients. Additionally, while some services may not be formulated to offer full term admittance, the location of community services that do so may be inaccessible to the aged, who also suffer from intellectual disabilities. Dowse (2009, p. 576) posits that another common challenge is financial constraints; more often than not the affected populations lack the monetary resources required to access services such as health and medical care. It is noteworthy that the resources needed in order to respond to the health and medical requirements of aged populations with intellectual disabilities are often time very diverse and complicated. Even in cases where money is not a problem for the affected population, Dowse (2009, p. 576) purports that there is often a lack of trained medical personnel required to serve the aged and intellectually disabled populations in Australia and UK. Regional and administrative duties may also impede the aged populations with intellectual disabilities from accessing the health care that they require (Dowse 2009, p. 576). Health Needs of Aged People with intellectual Disabilities The health needs and requirements of aging populations suffering from intellectual disabilities are quite different from those of aging populations who do not suffer from intellectual capabilities. Patja (2000, p. 591) posits that in spite of the fact that the life expectancy of aged people with disabilities in the UK has increased in the last couple of years, in comparison to the mainstream population this category of individuals still experiences extreme health inequalities. While in the nation of Australia the mortality ratio for persons with extreme intellectual disabilities is 8.4 in Australia it is 4.9 (Cooper et al 2004, p. 414). The factors that cause the inequalities in health experienced by the aged populations in UK and Australia range from psychological, biological, developmental and social. The effects of intellectual disabilities increase with age; as a result, the health needs and requirement for support is very high in people who are aged and suffering from intellectual disabilities. The aged people with intellectual disabilities in Australia and the UK are confronted with a myriad of medical conditions and health needs. According to Janicki et al (1985, p. 291) claim that it is important to identify the commencement of the aging process. In addition to an individual’s chronological age there are three main factors which are indicative of old age. These are: •Firstly, the aged population is characterized by an increased rate of physical frailty and reduced physical reserves which are a consequence of their old age, rather than any disease or trauma. •Secondly, Janicki et al (1985, p. 291) argues that aged populations also experience a diminishing of their functional skills, for instance the maintenance of personal hygiene, individual care and other important activities in their day to day life. •In the event that the aged persons do not suffer from severe intellectual disabilities, they seek to perceive their old age and desire to engage in age appropriate roles and responsibilities in their communities. Holland (2000, p. 30) purports that the main health and societal requirements of aged populations with intellectual disabilities may be summarized into three main ways. Firstly, it is very important for social care workers to acknowledge the different transformations that occur in the life of a human individual as they age. The society should be responsive to the contexts, which characterize old life and establish services and programs through which the needs of the aged populations with intellectual disabilities in Australia and UK may be addressed effectively. Secondly, Holland (2000, p. 30) points put that there be enough health care practitioners and professional who possess adequate knowledge regarding age related health issues as well as the accurate detection, treatment, management and rehabilitation of the aged people with intellectual disabilities. The most important medical services include general practice support, special care in elderly disabilities and services and mainstream health services to respond to issues such as auditory and visual impairments (Holland, 2000, p. 30). Thirdly, it is necessary that health, social and career care providers dealing with the aged populations with intellectual disabilities in Australia and UK be sensitive to the aged populations need for emotional support. This is especially so for aged persons with disabilities who experience transformations in their family contexts due to occurrences such as bereavement (Holland, 2000, p. 30). According to Cooper et al (2004, p. 414) the different health needs by the aged population suffering from intellectual disabilities is often time a consequence of the broad spectrum of illness that people in this category are faced with. Such illnesses include dental diseases, epilepsy, nutritional problems, epilepsy, sensory impairments, gastro-esophageal reflux disorder, dysphasia, nutritional problems and accidents (Cooper et al, 2004, p. 414). Additionally, the aged people with early onsets of disabilities commonly suffer from the condition of Down syndrome. The aged people with Down syndrome condition are highly predisposed to congenital heart disease, hearing and visionary problems, musculoskeletal problems and hypothyroidism. Doody et al (2012, p. 275) agree that aged people in Australia and UK, as in many other regions of the world, suffer from an assortment of intellectual disabilities. Those already affected by Down syndrome also report very high rates of dementia, particularly Alzheimer dementia. Additionally, Holland (2000, p. 28) argues that aged people with intellectual disabilities in Australia and the UK are commonly diagnosed with mental disorders and psychiatric issues. Cooper & Bailey (2001, p. 46) purport that medical experts find it very difficult to notice and diagnose mental problems in aged people with intellectual disabilities since most of the affected population suffers from language impairments which make it difficult to attain important information. Human Rights of Needs in Health Griffiths et al (2003, p. 26) claims that by making use of the term “rights” the implication is that the heath needs of the aged population with intellectual disabilities are an entitlement that the affected population should enjoy as a consequence of their being human. According to the Human Rights adopted by the United Nations, there are several rights, liberties and freedoms that every human being- irrespective of their conduct, state and social status- are entitled to. These include the right to food, housing, security, health, access to information and knowledge, freedom of association and expression. As indicated by Gosse et al (2002) the rights that are stipulated in law are inalienable and aged people with intellectual disabilities should not be restricted from accessing and enjoying them. Ozdowski (2013) posits that in spite of the need for the formulation of alternative human rights policies to accompany discrimination laws being urgent, the aged people suffering from intellectual disabilities in Australia rarely utilize the anti-discrimination laws that have been formulated by the Australian government for their benefit. Stratford (1991, p. 11) asserts that “each and every human life is equally sacred; each one of us is of infinite worth. To regard the life of a human with a mental or physical handicap as being less valuable than the life of a normal human being is to violate this fundamental notion of equality”. According to Griffiths et al (2003, p. 25) there are many challenges that people with intellectual disabilities are confronted with. Historically, the rights to marry, learn, work, procreate and even received necessary health care has been overly restricted for people with intellectual disabilities. Stratford (1991, p. 4) further argues that in spite of the rights for aged and intellectually disabled populations being outlined clearly in the Declaration of Human Rights for Disabled Persons, the aged and intellectually disabled populations are frequently exposed to the contravention, denial and restriction of their rights. Stratford (1991) claims that there are five main areas in which the human rights of the aged and intellectually disabled people are contravened; these include: •Access to necessary health care, education, physical therapy, training and rehabilitation aimed at enabling the aged attain their full potential for purposes of living a quality life (Ashman et al, 1995, p. 107). • Being protected from different types of abuse and exploitation due to their old age and intellectual incapacitation. • The opportunity to live with their families and loved ones, or in other contexts, which they choose for themselves. • Access to qualified caretakers. • Opportunity to engage in productive work for purposes of acquiring financial stability and a quality standard of life. Response of Australian and UK Government to Health Needs Hatzidimitriadou & Milne (2005, p. 341) assert that “Despite the acknowledged increase in the number of older people with intellectual disabilities (ID) in the UK, the age-related health and social care needs of this population have yet to be fully understood and addressed”. Dowse (2009, p. 581) purports that in the year 2001 a white paper in the UK elaborated the policy by the government of UK regarding intellectual disability. In this white paper commonly referred to as Valuing People: A New Strategy for Learning Disability for the 21st Century the need for social inclusion and the formulation of person centered interventions for intellectually disabled persons is encouraged (Dowse, 2009, p. 581). According to Harris (1997), it is very important for the governments in Australia and UK to engage in strategic planning and policymaking aimed at ensuring that the different health needs of the aged people with intellectual disabilities are sufficiently met. Buys & Rushworth (1997, p. 29) reveals than increased numbers of reports and special case analysis in the nation of Australia reveal that the existent Australian service models and demarcations between the different social and health programs in the region are unsupportive of the needs of aged people with intellectual disabilities. According to Buys & Rushworth (1997, p. 29) the aging and disability service institute in Australia is perceived as offering services to two different groups; this is due to the lack of linkage between services offered to aged populations and that offered to disabled populations. Lennox and Kerr (1997, p. 365) argue that this often time denies aged people with intellectual disabilities the services they require because the disability service providers consider them “old” and therefore unsuitable for the program; the aged care services, on the other hand, perceive the as relatively “young” and therefore unsuitable (Wen,1997). Nevertheless, Cooper et al (2004, p. 415) assert that the Australian and UK governments have been very dedicated in ensuring that they eliminate the inequalities in health and medical care access between the aged populations with intellectual disabilities and the mainstream population. This has mostly been achieved through the formulation, endorsement and implementation of laws that prohibit any form of discrimination against the aged populations with intellectual disabilities. Such laws include the Human Rights Act of 1998, Australian Disability Discrimination Act of 1992 and the UK Disability Discrimination Act of 1998 (Cooper et al, 2004, p. 415). These legislations are aimed at ensuring that the community services, programs and activities adjust and modify their policies and strategies in order to accommodate the needs of aged populations who are intellectually disabled in both Australia and the UK. Dowse (2009, p. 576) claims purports that in spite of the fact that although legislatures such as the UK Mental Capacity Act of 2005 and the guardian laws in Australia are aimed at ensuring that people with intellectual disabilities are protected and their welfare enhanced, these frameworks also possess the propensity to restrict the participation of aged and intellectually disabled persons in the public arena. Additionally, Wen (1997) purports that recent developments in the nations of Australia and UK also impact upon the manner in which the needs and interests of aged people with intellectually disabilities may be addressed. This is mostly due to transformations in the construction of the needs of people categorized as “dependent” or “at risk”. Attitudes towards People with Intellectual Disabilities: An Australia Perspective In order to attain the social transformation that is necessary for the promotion of social inclusion and integration of the aged people with intellectual disabilities in Australia and the UK, it is important to investigate and understand the perceptions, attitudes and mindsets that govern the general population in these regions regarding the aged with intellectual disabilities. In order to determine the attitudes of people in Australia towards the population with intellectual disabilities Yazbeck et al (2004, p.97) carried out an investigative study involving the general population in Australia, particularly students and experts in disability services. This investigative study was carried out by use of three validated questionnaires and a self reported measure of “social desirability” by the selected research sample. The findings from this research revealed that in contrast to members of the general population, both the experts in disability services and students involved in the investigative study harbored positive attitudes towards people with intellectual disabilities. The levels of positive attitudes were higher in responds that were younger, with higher educational achievements and those with previous contact with people with intellectual disabilities (Yazbeck et al, 2004, p. 97). In spite of the different attitudes that the general population have towards people with intellectually disabilities, particularly the aged, Dowse (2009, p. 582) purports that in the contemporary day there are many social transformations at the international level which necessitate the formulation and regulations of opportunities for people with intellectual disabilities. Additionally, Wen (1997) purports that a majority of the individuals in mainstream populations in both the UK and Australia are presently aware of the political actions and self advocacy by people with intellectual disability who wish to enjoy equal rights with the mainstream populations, especially in regard to health and medical care. Antonak & Livneh (2000, p. 223) the investigative studies examining the attitude of people to individuals with intellectual disabilities requires the utilization of techniques and equipment that are accurate reliable and multi-facetted. It is only through the utilization of such techniques that conclusive information may be acquired regarding the connection between such attitudes and the acceptance and integration of aged individuals with intellectual disabilities into mainstream society (Antonak & Livneh 2000, p. 223). Personal Opinion of Health Rights of Aged Populations with Intellectual Disabilities My personal opinion regarding the health rights of aged people with intellectual disabilities is that they should be empowered. As indicated by Dowse (2009, p. 577) the phenomenon of empowerment requires that the individuals who consume the services and programs created for aged and intellectually disabled individuals be allowed the opportunity to exercise their rights in the involvement in health care. Wen (1997) asserts that although there are many aged persons who suffer from severe intellectual disabilities and require the assistance of caretakers and guardians to make important decisions, there are many aged persons who are not yet incapacitated by their intellectual disabilities. It should not be taken for granted that all aged persons in the UK and Australia suffer from extreme intellectual incapacitation. By empowering the aged people with intellectual disabilities, these populations would not only have increased control over their lives, they would also be more responsible (Dowse 2009, p. 577). As indicated by Molony (1993 p. 170) I agree that there are three main factors that should be considered by programs and agencies aimed at delivering services to the aged population with intellectual disabilities in Australia and the UK. Firstly, such services must consider the reduced functional capacities and increased levels of frailty by the target population (Molony 1003, p. 170). Secondly, the decrease in the development and preservation of abilities and skills by the aged population who are also intellectually incapacitated must be acknowledged. Finally, as indicated by Janicki et al (1985), there is need for such services to be appropriate to the specific age and health requirements of the population being served. Conclusion With special inclination towards health care services, this paper has discussed in detail the human rights of the aged people with intellectual disabilities in Australia and the UK. In spite of the different attitudes that the general population have towards people with intellectually disabilities, particularly the aged, in the contemporary day there are many social transformations at the international level, which necessitate the formulation, and regulations of opportunities for people with intellectual disabilities. Additionally, a majority of the individuals in mainstream populations in both the UK and Australia are presently aware of the political actions and self-advocacy by people with intellectual disability who wish to enjoy equal rights with the mainstream populations, especially concerning health and medical care. From the analysis and discussions made it this paper it is undisputable that there is an urgent need for health and social services to formulate collaborative strategies that will be effective in ensuring that the transforming needs and requirements of aged people with intellectual disabilities are met. Primary and specialist professionals in the medical profession should be encouraged by governmental policies to take their duties of maintaining the physical and intellectual health of the aged populations with intellectual disabilities serious. This implies early detection, treatment, management and rehabilitation of aged populations with intellectual disabilities. Bibliography 3R project: System Wide Human Rights Survey, Welland, ON: Community Living Welland Pelham And the Role of the Nurse in Ireland,” Journal of Intellectual Disabilities, 164: 275-286 Antonak, R & Livneh, H, 2000, “Measurement of Attitudes towards Persons with Disabilities,” Ashman, A F, Suttie, J N & Bramley, J 1995, “Employment, Retirement and Elderly Persons Australian Institute of Health and Welfare 1997. Available Online: Bland, R, Hutchinson, N & Oakes, P 2003, “Double Jeopardy? 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