ELPIDA Course - English

The World Health Organisation (WHO) have adopted the International Classification of Functioning, Disability and Health (ICF 2001), a comprehensive review of health status seen from a biological, personal and social perspective (8).

The tendency for people with ID is that they are at risk of being diagnosed late in their disease trajectory, due to lack of screening or ‘diagnostic overshadowing’. Health problems that may have been present since childhood are likely to remain undetected, thereby increasing the chances of impaired learning, communication and personal development (9). There are examples of older adults with ID, using the same medication they started with when they were children or youth. Since the body change when we age, the conversion of the drug in the internal organs becomes slower and the risk of overdose and poisoning is greater.

Diagnosis that overshadows/dominates other signs of health problems are:

• Behaviour or challenging behaviour are interpreted as mental illness and not as their way of expressing physical discomfort.
• Medication for mental disorders can camouflage bodily ailments.
• Dementia makes it difficult to discover other disease signs.
• Communication problems.
• Indifference/discrimination: Negative attitudes among health professionals, lack of experience and cooperation.
• Service providers/family members who lack sufficient competence to detect signals on illness.
• Lack of organised screening surveys.
• Waiting too long to consult a doctor.

Regular health checks for people with ID have a major effect and reveal undiagnosed conditions, ranging from severe disorders like cancer, heart disease and dementia, to conditions such as hearing impairment and vision. 

The proportion of undetected hearing and visual impairment is especially large, even among people with mild and moderate ID. Reversible changes in hearing function are often neglected by staff members/family who are in direct contact with the person. For many, but certainly not for all, removal of earwax is a solution to the problem. 

Regular health control is a health preventive measure: symptoms and findings treated before they cause health damage and loss of function. It provides a better health follow-up of each person, and an opportunity to capture signs of functional disorder or illnesses as early as possible during the process.

Preventive health care is important and can save the individual from unnecessary suffering and society from unnecessary expenses. A thorough first-time survey will provide a good basis for registering changes and initiating treatment measures. A first-time functional check should start when people are in their mid/end of 30’s and followed up regularly so that an individual profile is developed.  

Health assessment measures for people with ID are mainly based on reports from staff or family members. However, you will also find health assessment measures that are user-led and encourages self-reporting.

Some videos that shows adults with ID accessing important health checks are:

Health Check Resources for Adults with Learning Disability (20): 

A guide to your LD health check - for adults with learning disabilities (21):