It is with enormous pride that we offer this new and exciting book - Learning Disability Nursing at a Glance; one that is in a series of popular nursing texts. The aim of this book is to provide learning disability nursing students with user-friendly, contemporary information in relation to some of the key clinical practice issues that they may encounter when working with people with learning disabilities. At the outset we need to make clear our use of terminology in this text. Generally speaking within the UK, the term 'learning disability is used to describe people with significant developmental delay that results in arrested or incomplete achievement of the 'normal' milestones of human development. The term 'learning disabilities' is also used elsewhere throughout the world, but it holds different meanings in many other countries; paradoxically so too in the UK. It is this difference in meaning that causes confusion to, what we hope, will be an international audience of readers. Elsewhere in the world alternative terms to 'learning disability are used, such as 'mental retardation', and 'mental handicap, but these terms are felt to portray negative imagery concerning people with learning disabilities. There are more positive international terms in use, such as 'intellectual disability' and 'developmental disability' but we have decided to adopt the consistent use of a term which we believe seems most appropriate to this text, and for the readership, as well as those who this book is principally about, and that is 'learning disability. Therefore, throughout the remainder of this book we will only use the term learning disability, save where certain Acts and, or, other technical works require other terminology for accuracy.
The text has been edited using expert contributions from learning disability academic staff as well as clinicians. While there are currently a number of texts available that describe nursing practice from an adult perspective, there are few that deal with practice specifically related to people with learning disabilities. And indeed fewer still that address the needs of people with learning disabilities across the life spectrum, from children through to adolescents and on to adults and older people. Also, many of the current texts related to people with learning disabilities that are available tend to deal with the subject of learning disabilities, rather than learning disability nursing, this book does both. Uniquely, the book is aimed at health and social care students, as well as registered nurses, but will be of use to a wide range of other students from a wide variety of vocational, academic and professional backgrounds, and other fields of nursing. Principally the book is intended to provide nursing students with material that is accessible, up to date, and readily available. The text addresses the principles underpinning contemporary learning disability nursing practice that students are likely to encounter, and these are discussed in the context of maintaining health and wellbeing. And in order to reflect the contemporary field of learning disability nursing practice, the text embraces both primary and secondary care perspectives. Learning disability nurses can now be found working and supporting people in diverse care contexts, such as community learning disability teams, treatment and assessment services, outreach services, residential settings, day care and respite services, health facilitation and hospital liaison roles, mental health and, or, challenging behaviour services, special schools and specialist services for people who can be located on the spectrum of autistic conditions. Additionally, they can be found working for many different agencies and organisations, such as health, social care, education and the independent sector (this comprises the private, voluntary and not-for-profit organisations), and also alongside numerous other professional disciplines that include clinical psychologists, social workers, occupational therapists, speech and language therapists, and consultant psychiatrists in learning disabilities as well as a range of professionals within mainstream health, social services and education. Given this complexity, there is need for a text that holds an overarching aim of helping learning disability nursing students understand fundamental aspects of their practice, in order to provide safe, effective and compassionate care to people with learning disabilities in a variety of situations. From an academic perspective, there is often a lot of support available to learning disability nursing students for their academic assessment and progression. However, when in practice, learning disability nursing students may find themselves being supervised from a distance and, as such, this proposed text could accompany them in a variety of settings to assist their integration of theory and practice. This text is based upon the principles of care; a foundation text to encourage the learning disability nursing student to grow and develop.
The book has been designed to be used as a quick reference guide in either practice settings, educational establishments or at home and has been written in easy-to-understand language, drawing heavily on diagrams and pictures to support visual learners. Therefore it is not intended that you read this book from cover to cover in one sitting, rather - as its name implies - the text should be seen as an 'at a glance' guide or manual.
The book is divided into 12 parts, each containing a variable number of chapters that relate to the theme of that part. The parts of the book include: an introduction to learning disability nursing, an exploration of learning disability, childhood development, adolescence, adults with a learning disability, people with a learning disability and additional mental health needs, vulnerable adults with a learning disability, biophysical aspects of learning disability nursing, older people with a learning disability, medication, the learning disability nurse and issues of inclusion.
We hope that Learning Disability Nursing At A Glance will come to be seen as a highly regarded textbook, not only in the field of learning disabilities but also more widely, and that it will be used widely by the many professionals and students from a wide range of different professional and academic backgrounds. We believe that the excellent end product that you have before you is due, in no small part, to the excellent contributions that have been made by our many friends and colleagues across the UK and Southern Ireland, and we offer our thanks for contributing to this book. We hope that you find the book helpful and that through using it, in some small way, it assists you in supporting people with learning disabilities enjoy good health and wellbeing in their lives. Bob Gates, Debra Fearns, Jo Welch

Contributors viii

Preface xi

How to use your revision guide xiii

About the companion website xvii

Part 1 Introduction to learning disability nursing 1

1 What is learning disability nursing? 2

2 Nursing and midwifery standards 4

3 The six Cs 6

4 The student nurse perspective 7

Part 2 Exploration of learning disability 9

5 What is a learning disability? 10

6 Causes of learning disability 12

7 Chromosomal disorders 14

8 Genetic disorders 16

9 Other causes of learning disability 18

Part 3 Childhood development 21

10 Screening and genetics 22

11 Developmental milestones 24

12 Common childhood diseases 26

13 Developing communication 28

14 Learning through play 30

15 Education 32

16 Screening for autistic spectrum conditions 34

17 Safeguarding children 36

Part 4 Adolescence 39

18 Puberty 40

19 Bullying 42

20 Child and adolescent mental health services 44

21 Transitions 46

Part 5 Adults with a learning disability 49

22 Working with adults with learning disability 50

23 Communicating with people with learning disability 52

24 Sensory impairment 54

25 Living with Autistic Spectrum Conditions 56

26 Epilepsy in adults with learning disability 58

27 Management of epilepsy 60

Part 6 People with a learning disability and additional mental health needs 63

28 Managing challenging behaviour 64

29 Mental health issues 66

30 Personality disorder 68

31 Offenders with a learning disability 70

Part 7 Vulnerable adults with a learning disability 73

32 Mental Capacity Act 74

33 Human rights 76

34 Equality Act 2010 78

35 Mental Health Act 80

36 Ethics, rights and responsibilities 82

Part 8 Biophysical aspects of learning disability nursing 85

37 Biophysical aspects of learning disabilities 86

38 Common health issues 88

39 The Health Action Plan 90

40 Pain assessment and recognition 92

41 Palliative and end-of-life care 94

42 Dementia in people with Down's syndrome 96

43 Sexual health issues 98

44 Postural care 100

Part 9 Older people with a learning disability 103

45 Older people with a learning disability 104

46 Dementia care 106

47 The Mental State Examination 108

Part 10 Medication 111

48 Antidepressant and antipsychotic drugs 112

49 Antiepileptic drugs 114

50 Nurse prescribing 116

51 Drug calculations 118

Part 11 The learning disability nurse 121

52 The community learning disability nurse 122

53 Healthcare facilitators 124

54 The health liaison nurse 126

55 The assessment and treatment learning disability nurse 128

56 The prison nurse 130

Part 12 Inclusion 133

57 Person centred planning 134

58 Employment 136

59 Housing and leisure 138

60 Ethnic minorities and learning disability 140

61 Parents with a learning disability 142

62 Family perspectives 144

63 A service user's perspective 146

64 Advocacy 148

65 Health passports 150

66 Hate crime 151

67 Sex and individuals with a learning disability 152

68 Spirituality 154

69 The twenty-first century: Networking for success 155

Further reading and resources 157

Index 161

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