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Fat Chance? Opportunities to change for people with learning disabilities. Daniel Marsden – Community Learning Disability Nurse. Evidence Base. Gaps in the evidence / research Not a homogeneous group Obesity Medway - 36% BMI 25> (Young, 1996)

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fat chance opportunities to change for people with learning disabilities

Fat Chance?Opportunities to change for people with learning disabilities.

Daniel Marsden – Community Learning Disability Nurse

Daniel Marsden - Community Learning Disability Nurse

evidence base
Evidence Base
  • Gaps in the evidence / research
  • Not a homogeneous group
  • Obesity
    • Medway - 36% BMI 25> (Young, 1996)
    • 64% adults and 26% 10-19year olds (Marshall et al, 2003)
    • 26% Overweight 35% BMI 30> (Martin, 2005)
  • Hypertension
    • 32% of those aged 40-49 years old (Marshall et al, 2003)
  • Coronary Heart Disease
    • Second most common cause of death (14-20%, Hollins et al, 1998)

Daniel Marsden - Community Learning Disability Nurse

possible causes
Possible Causes

Likely to

Interact

Non- specific

Syndrome

specific

Predisposing factors

Daniel Marsden - Community Learning Disability Nurse

suggested causes
Non-specific

Many non- specific to people with learning disabilities

The impact of these may be greater if dependent on others

Syndromes

Prader Willi

Down’s

Bardet Bidel

Carpenter

Cohen

Borjeson Forssman Lehmann

(Jeffreys, 2000)

Suggested Causes

Daniel Marsden - Community Learning Disability Nurse

predisposing factors jeffreys 2000 p 32
Medication

mental health problems

limited access to exercise

lack of knowledge

boredom

communication difficulties

provision of poor diet by services

low self-esteem

Hypothyroidism

sedentary lifestyle

inappropriate use of food as reward

lack of literacy skills

lack of power and control over life

low income

attitudes of carers/ staff

Predisposing Factors(Jeffreys, 2000, p.32)

Daniel Marsden - Community Learning Disability Nurse

personal view
Personal View
  • Low exposure to health promotion messages
  • Motivation
  • Support available
  • Place of residence
    • Prasher & Roy (2000) found weight higher in people living family homes and lowest in those living in institutions.
  • Unclear policy guidance and service priorities
    • social care settings may not view health improvement as their business.

Daniel Marsden - Community Learning Disability Nurse

activity levels
Activity Levels

Messent et al (1998) compared fitness levels with general population:

  • The men were 24-28% less active
  • The women were 42% less active
  • 93% did <1hour moderate exercise/ week

Daniel Marsden - Community Learning Disability Nurse

new opportunities
New Opportunities

Valuing People (dh 2001)

  • Health Facilitators
    • Strategically developing links between LD and other health services
  • Annual health checks
    • Platform for health promotion advice

Daniel Marsden - Community Learning Disability Nurse

bridging role
LD social care issues

Access

Staffing/support

Transport

Individual problems

Public Health Agenda

Partnerships statutory and private industry

Leadership within statutory services

Partnership between health social care and industry

Bridging Role

Daniel Marsden - Community Learning Disability Nurse

interventions
Interventions
  • Health education
    • 1-1 work – weight management
    • Organised groups, peer education, videos, games.
  • Skills teaching
    • meal planning
  • Include and engage
    • Professionals
    • Peers
    • Private industry

Daniel Marsden - Community Learning Disability Nurse

strategic opportunities
Strategic Opportunities
  • Social Care Staff = Public Health Staff.
  • Evaluation and sharing results/ resources.
  • Creating leadership

Daniel Marsden - Community Learning Disability Nurse

questions
Questions
  • How can public health professionals engage individuals in healthy lifestyles?
  • How do public health professionals support services to provide healthy options?
  • Should health services provide more support to people with learning disabilities?

Daniel Marsden - Community Learning Disability Nurse

references and thanks
References and thanks

Thanks to Greatfield Lodge Staff and Users, Alison Williamson – Teeside University and all at Janet Cobb’s Primary Care Network

Hollins, S., Attard, M.T., von Fraunhofer, N. and Sedgwick, P. (1998) Mortality in people with learning disabilities: risks, causes and death certification findings in London. Developmental Medicine & Child Nuerology, 40, 50-56.

Illingworth, K., Moore, K.A. and McGillivray, J. (2003) The development of athe nutrition and activity knowledge scale for use with people with an intellectual disability. Journal of Applied Research in Intellectual Disabilities, 16, 159-166.

Jeffereys, K. (2000) Managing and treating obesity in people with learning disabilities. Learning Disability Practice, 2, 4, 30-34.

MarshallD., McConkey, R. and Moore, G. (2003) Obesity in people with intellectual disabilities: the impact of nurse-led health screenings and health promotion activities. Journal of Advanced Nursing, 41, 2, 147-153.

Messent, P. et al (1998) Physical activity, exercise and health of adults with mild and moderate learning disability. British Journal of Learning Disabilities, 26, 1, 17-22.

Prasher, V. and Roy, A. (2000) Physical Health in The L.D. Book on www.ldbook.co.uk

Daniel Marsden - Community Learning Disability Nurse