CHAPTER 4: COMMON PHYSICAL CONCERNS

Those who support and care for persons with intellectual disability can get clear signals from findings of research with Special Olympic athletes.

1. Arrange routine vision and hearing examinations, particularly for age-related deterioration. Adults with Down syndrome are particularly likely to have vision and hearing problems. Those over the age of thirty are at increased risk for early development of cataracts, refractive errors such as near- and far-sightedness, and degeneration of the cornea.
2. Encourage healthy dietary habits and promote or provide regular daily dental hygiene. Schedule routine dental appointments for cleaning, examinations, and maintenance of oral health. Individuals with intellectual disability are much more likely than individuals without disability to report that they have not had their teeth cleaned by a dental hygienist within five years, or that they have never had their teeth cleaned by a dental hygienist.
3. Promote or provide proper foot care, ensuring that cleanliness is maintained, nails are correctly cut, and clean socks and properly fitting shoes are worn. It’s been said that to determine how well a person with disability or dependency needs is being cared for, check the condition of his or her teeth and toenails. Although this form of assessment is far too simplistic, it does provide a telling measure.
4. Provide well-balanced meals and regular weight-bearing exercise such as walking to promote overall health and bone maintenance. Individuals with Down syndrome as well as underweight or small-boned individuals are more at risk of bone loss and osteoporosis. Also at risk are individuals who experience delayed puberty or early menopause, which can be part of some conditions linked with intellectual disability.

People with intellectual disability have the right to be as healthy as anyone else. They also have the right to the same health care access and treatment as others within the general population. Examples of legislation that protects the equality rights of all persons with disability are section 15 of the 1982 Canadian Charter of Rights and Freedoms, the 1990 Americans with Disabilities Act, and Britain’s 1995 Disability Discrimination Act. In addition, the 2006 United Nations Convention on the Rights of Persons with Disabilities is a declaration of commitment to equality rights that has now been ratified by 143 countries.

1. Prepare or promote the preparation of well-balanced meals that include adequate sources of fibre such as fruits, vegetables, and whole grain breads.
2. Encourage adequate fluid intake. Eight glasses of water or other fluids each day can be considered adequate, unless an individual has fluid intake restrictions or other requirements. Caffeine-containing drinks have a dehydrating effect and milk or dairy-based drinks may be constipating for some people.
3. Promote or provide regular daily exercise. For individuals in wheelchairs, occasional side-to-side movement, if possible, or exercise while seated in the chair may be helpful. A physiotherapist may be able to recommend exercises and activities.
4. Encourage supported individuals to move their bowels when they feel the urge.

Medical assistance should be sought

1. if constipation is experienced for the first time or there has been a change in bowel routine
2. if constipation does not respond to natural remedies such as increased dietary fibre or fluid intake, or to replacing sedentary activity with regular exercise such as walking or swimming
3. if blood is evident in stool or during bowel movements, or rectally at any other time
4. if unplanned weight loss occurs
5. if pain occurs with bowel movements, or abdominal pain or cramps occur
6. if nausea or vomiting occur
7. if constipation lasts for more than two weeks.

1. Be conscious of situations and conditions that are likely to trigger seizures for supported individuals. Avoid or reduce exposure to triggers whenever possible.
2. Provide appropriate assistance to the individual if a seizure does occur.
3. After a seizure, record the conditions under which the seizure occurred, along with a description of the seizure activity. Describe how long the seizure lasted and emergency measures if needed. Describe any events that accompanied the seizure, such as loss of bladder control or injury. Describe the nature of the recovery after the seizure.

The foundation to providing appropriate support is respect for the right of individuals with intellectual disability to make informed choices and decisions about their own lives. Informed choices and decisions mean that people make their decisions based on a full and adequate understanding of all available options and their possible consequences. For supported persons with intellectual disability, it also means that they are able to discuss choices with people who are important to the decision and who genuinely have the best interests of the supported person in mind. When more severe disability exists, others must make decisions based on how they understand the supported person’s wishes and values, still in the genuine best interests of that person.

Men and women with intellectual disability often lack the skill and opportunities to independently practice healthy living. Support providers and health care professionals are important to maintaining and improving health of people with intellectual disability through healthy living practices. This means that it is important for support providers and health care professionals to locate or develop best practice health promotion programs and then apply those programs. This gives persons with intellectual disability the same opportunities to live healthy lives as other citizens.