A CASE STUDY

The Individual Accessing Health And Social Care

The Individual Accessing Health and Social Care

Introduction

This is a case study of 35 years-old man with moderate learning disability? who has been admitted to hospital complaining of urinary tract infection. Mr X is obviously anxious and confused. He is finding difficult to orientate himself to his new environment which is increasing his anxiety. This case study is based on research into urinary tract infection management for people with learning disabilities. The evidence base consists predominantly of behavioural techniques for children and multidisciplinary programmes for non-learning disabled adults (Howells? 2004? 449-453). Due to the limited number of studies on the management of urinary tract infection for people with a learning disability? this paper presents a summary of the literature that is currently available.

The Case

Mr. X is a 35 year old man with moderate learning disability. He has been admitted to hospital complaining of urinary tract infection. Mr. X is obviously anxious and confused. He is finding difficult to orientate himself to his new environment which is increasing his anxiety. He has limited verbal communication and is unable to read or writhe lives in learning disability home. His parents live far from the house. They usually come to visit him every month. He is also has urinary tract infection and epilepsy. He is currently taking some medication for urinary tract infection and epilepsy twice a week. Mr. X was referred to the clinical psychology service due to persistent physical and psychological problems. At the time of referral he was suffering from urinary tract infection in his 'good'? right leg. As is typical in people experiencing urinary tract infection? he had undergone many investigations including MRI scans? X-rays and physiotherapy assessments. Unfortunately none of them identified a definitive diagnosis to account for his ongoing pain and no pharmacological treatment totally alleviated his discomfort. Mr. X's pain was constant and flare-ups were triggered by exercise? tiredness and anxiety.

1) Factors affecting health choices and health care access

People with learning disabilities have a lower life expectancy than does the general population (Howells? 2004? 449-453). The probability of survival decreases as the severity of learning disabilities increases Eyman et al. 1993 found the poorest outlook in those with severe disabilities who were nonmobile and required to be tube fed. Approximately 50% of this group died within a 5-year follow-up period (Allan? 1999? 32-37). Those with higher functioning have a longer life expectancy. Indeed? those who survive beyond the age of 50 seem to have fewer health problems than younger patients. The death rate for patients with mild to moderate learning disabilities is twice that of the general population? while those with severe and profound disability levels have rates 7 and 31 times the general population? respectively (Dovey? 2000? 553-561).

Forsgren et al. 1996 followed a cohort of learning -disabled patients in a Swedish province over a 7-year period. During this time? 8.% of the 1478 identified patients ...