Learning Disabilities in Nursing - Article Example

Definition of the term "learning disabilities" and the prevalence of the condition Learning disabilities can be assessed in three realms and these include: intellectual ability, legislative and social competence. When analysing learning disabilities through the intellectual ability lens, one is required to understand what the term intelligence actually is. Because the latter term may require an in depth analysis, for purposes of this paper, the most important thing to know is that intelligence can be assessed through standardised tests that have been created for this reason. In these tests, individuals are required to answer certain questions and their scores are then compared to other members of the population in the form of percentiles and deviations. In fact, this is where the name Intelligence Quotient emanates. Persons with low IQ are perceived as those with learning disabilities. (Gates & Loannides, 2005) In the legislative realm, learning disabilities have been the subject of reform from as far back as the early twentieth century. In the year 1913 learning disability legislations reflected major perceptions of it being part of mental illness and it was perceived as a condition in which one had either arrested or incomplete mental development. However, in the year 1959, another piece of legislation injected a new definition into it as they brought put new terms such as abnormality, severe sub normality and psychotic disorder. These definitions brought about greater integration of persons with learning disabilities. However, in the year 1989, an even more integrative definition was introduced. Here, severe mental impairment may be defined as a state of incomplete mental development that impeded social functioning while mental impairment was defined as a state of incomplete development of the mind and also includes the impairment of social functioning and intelligence thus leading to irresponsible conduct or extremely aggressive behaviour. In the social competence realm, a person with learning disability is one who has an inability to adopt to meet demands of society. In this regard, one must be unable to adhere to social rules or adjust his or her behaviour to existing situations and also be able to live independently. (Gates & Loannides, 2005) Generally speaking however, learning disabilities are defined differently in the UK as compared to other areas of the world. In the UK the term refers to an individual who lacks the ability to learn new skills or process complex information and also to one who manifests an inability to live independently. Usually, the condition starts prior to their adulthood. In Scotland however, learning disabilities refer to persons with lifelong conditions that began prior to adulthood and those ones that impede one's ability to comprehend information, cope on their own or learn new skills. In terms of prevalence of the condition, it has been shown that the rate has been relatively constant over the past few decades. In other words, there are about three in every one thousand people within the United Kingdom who may regarded as possessing severe learning disorders. This corresponds to about two hundred and thirty thousand people with the disease. Additionally, it has also been shown that there are roughly five hundred and eighty thousand persons with mild learning disabilities. In Scotland, it has been found that there are approximately one hundred and twenty thousand people ho fall within this category. Causes and manifestations of learning disabilities and the health problems that may be involved It is essential to identify the causes and manifestations of learning disabilities owing to the fact that it prepares parents to take care of their child without self blame. Additionally, a knowledge of the causes assists in the process of understanding certain manifestations. Also, it goes a long way on being able to ameliorate these effects and understanding the level of risk presented to other members of one's family. (Gates & Loannides, 2005) Studies have shown that learning disabilities may be caused by either environmental factors or genetic factors. Environmental factors refer to those external features that may lead to the condition. Genetic factors generally refer to those traits that are transferred from a parent to their offspring. Genetic causes of learning disabilities may be further divided into chromosomal causes and genetic causes. Genetic causes refer to those condition caused by an abnormality in one's DNA structure. It may either be autosomal dominant or autosomal recessive. The former cases are represented by Phenlyketonuria and Hyler Syndrome while the latter cases are characterised by Hurler Syndrome. Chromosomal causes may either be automosomal or sex related. In autosomal chromosome malfunctions, individuals may have Down Syndrome or Cri du Chat. In the former case, such individuals normally suffer from failure of the chromosome twenty one to disjoin. In this regard, individuals usually possess small ears, eye defects and severe intellectual ability. Its occurrence is approximately one in sic hundred and fifty. Cri du cat on the other hand is more rare than Downs Syndrome owing to the fact that only one in thirty seven thousand births may possess this condition. Usually, the learning disability for this condition is classified as being moderately severe. Chromosomal malfunctions may also occur in the form of sex related abnormalities. One example is the Kleinfelter Syndrome. In this regard, such individuals suffer from the failure of their XY chromosome to disjoin during cell division. Consequently, they have an extra X chromosome. This condition is limited to males and such person usually posses moderate learning disability or in other are cases profound learning disability also, the latter case has a prevalence rate of about one in very five hundred individuals. The other example is the Turner Syndrome which is limited to females. Here, a person looses one of their sex chromosomes and this may lead to a learning disability. (Gates & Loannides, 2005) Environmental factors may occur prior to conception when an individual engages in substance abuse, eats unfavourable diets and is faced with certain medical conditions. In the pre natal stages, learning disabilities may be caused by x-rays, syphilis, bacterial or viral infections and anoxia. At birth, learning disabilities may be caused by forceps deliveries or premature births. In post natal stages, it may be due to poor nutrition, infections, trauma, social deprivations and certain toxic agents. It can therefore be asserted that most of these environmental factors are in fact preventable. Mothers who take the time to go through these step- by-step procedures are assured of success in this regard. Changing social attitudes towards people with learning disabilities and how these may relate to the provision of health and social care both past and present Societal attitudes have undergone numerous changes over the past decades. This is largely seen by the fact that there have been gradual progressions towards inclusion of such persons within society. During the eighteenth and nineteenth century, people with learning disabilities were perceived as useless members of society. This was largely because of the industrial revolution that treated people based on their ability to contribute to the economy of the country. Since these people could make minimal contributions, then their worth was considered quite minimal. (Gates & Wilson, 2005) As time progressed, persons with learning disabilities were treated as a threat to society. This is because it was assumed that they could not engage in leisure activities responsibly. Consequently, most of them ended up being irresponsible or engaging in vices such as prostitution. This misconception led to the alienation of persons with learning disabilities. By placing them in institutions, it was assumed that society would be freed from the latter mentioned social evils. Additionally, when these persons were placed in those institutions, it was assumed that they were beyond reform and that their situation could not improve with any kind of care availed to them. With time, mental institutions began soliciting some interest from other members of society. This was because, it was discovered that provision of care could enhance their quality of life. Also, it was found that persons with learning disabilities could be freed from the condition after some time. Because of these issues, these institutions began conducting tests to prove whether one's abilities were adequate enough to restore them back to society. However, the tests were rather crude with patients being asked to differentiate between such things such as flies and butterflies. By the mid twentieth century, more interest was generated in terms of care for people with learning disabilities. At that time, the concept of normalisation was introduced. This is defined as '[utilisation] of means which are as culturally normative as possible in order to establish and/or maintain personal behaviours and characteristics which are as culturally normative as possible.' (Gates & Wilson, 2005) Due to the latter term, many people with learning disabilities were released from separated institutions in order to pursue an active life in society. During the nineteen eighties, normalisation was implemented more aggressively with greater emphasis on the support, creation and defence of their respective social roles. Additionally, there were five key areas that were emphasised in this regard and they include; choice - where person with learning disabilities were given the ability to decide who they wanted to live with or where they wanted to work. On top of this, the element of community presence was important in enriching their lives. The other element was competence in which a person with learning disabilities was granted greater independence. Respect and community participation were also other elements that were promoted in this process. (Gates & Wilson, 2005) During the nineteen nineties, the government introduced legislations that would promote less dependence on long term care and enhance the tendency to live within people's respective homes. It can therefore be said that attitudes of society have taken a shift towards greater inclusion of persons with learning disabilities into society. Parents and inter agency collaboration have made these processes more effective. Society has learnt that learning disabilities do not signify the end of the road for persons affected by them. In fact, with the right kind of self management approach, persons with learning disabilities can live successfully. This can be made possible by establishing strategies and skills that could lead to attainment of this matter. In other words, through the establishment of effective ways to accommodate a person with a learning disability, it can be possible to facilitate their learning process and assist them in the process of self fulfilment. (Gates & Wilson, 2005) Importance for healthcare practitioners to work in partnership with people with learning disabilities using advanced communication skills and understanding issues of consent It has been asserted that the key thing behind coping with disabilities is changing patience especially as nursing practitioners. Most of these health practitioners have to realize that the key thing is teaching the latter groups self confidence rather than merely gaining skills. As a nurse dealing with learning disability cases, it would be instrumental for one to identify the need to be resourceful. Additionally, there are certain circumstances in which these individuals may be going through certain challenges that may threaten their perception of the world. A nurse, it imperative for one to understand that all these patients are looking for is assistance, care and the right skills required to go about handling some of these issues. As a learning disability nurse, one ought to be prepared to work with a wide variety of persons with learning disabilities. This is usually because there may be certain individuals who may require support only in a crisis, on the other hand, others may require support at all times or on a regular basis. Here, there will be a need to collaborate with family members and careers in order to offer a comprehensive package for the person with learning disabilities. (Gates & Atherton, 2004) It should be noted that a good learning disabilities nurse must posses certain skills in order to succeed in life. The first one amongst these is the issue of good communication skills. Because there are so many parties around the child with learning disabilities, then the learning disabilities nurse must be able to interact and listen properly to these groups so as to ensure that the best healthcare is dispensed. On top of the latter, there is also a need for a nurse to be highly assertive. This is because the role will entail changing and challenging societal attitudes. This means that a nurse needs to protect the interests of the learning disability child i.e. he/ she needs to ensure that people are not discriminating against that child and that they are in fact supporting him or her. In close relation o this feature is the fact that nurses must have an ability to think quickly on their feet. Additionally, they need to be in a position where most of their solutions are in line with some of these assertions. It should also be noted that heath care practitioners need to exercise a lot of patience with this group. This is because progress may be painstakingly slow. For example, one may find that there are certain circumstances in which a learning disabilities child may take so long to learn how to make their own cup of tea. By the time they accomplish such a feat, then a learning disability nurse will have put in a lot of effort. (Gates & Atherton, 2004) Development of strategies to compensate for the skills that may be lacking within an individual's life can be a particular important way to deal with this matter head on. On top of the latter, it would be important for persons working with learning disability issues to look for self advocacy skills that would assist in this process of self actualization. Reflective summary Through this experience, I have learnt that being a learning disability nurse is all about possessing good people skills. In other words, there is a need for a paradigm shift. Unlike the emergency accident sections of nursing, one ought to be prepared for slow processes. Besides this, the line of work usually causes one to interact with others from various sectors of health care and the community. This field of nursing requires one to be able to incorporate physical, social and psychological skills because one must place healthcare in a broader context. Additionally, I have also learnt that understanding the causes and manifestations of learning disabilities can lead to better provision of health care for those people who are living with a person with such a condition. Besides that, understanding learning disabilities can go a long way in enacting preventive measures that could lead to prevalence of the condition. All in all, it can be said that being a learning disability nurse entails extra skills that may not be prevalent among other nursing fields. This is because there are numerous stakeholders involved and also because due assistance will be required. If all these issues are handled in a responsible manner, then this can go a long way in making the quality of life for an individual with a learning disability more worthwhile. References Gates, B. & Loannides, S. (2005): The nature of learning disability and its causes; NHS WIS, Vol. 1, retrieved from http://www.nhshealthquality.org/nhsqis/files/GIRT_Unit%201.pdf accessed on 15th Jan 2009 Gates, B. & Atherton, H. (2004): Working with people with learning disabilities; NHS, QIS, V1.0, retrieved from http://www.nhshealthquality.org/nhsqis/files/GIRT_Unit%204.pdf accessed on 15th Jan 2009 Gates, B. & Wilson, A. (2005): The importance of inclusion and healthcare for people with learning disabilities; NHS, QIS, V1.0, retrieved from http://www.nhshealthquality.org/nhsqis/files/GIRT_Unit%203.pdf accessed on 15th Jan 2009 Read More