Oxford Medical Publications Oxford Handbook of Learning and Intellectual Disability Nursing ii Published and forthcoming Oxford Handbooks in Nursing Oxford Handbook of Midwifery Janet Medforth, Susan Battersby, Maggie Evans, Beverley Marsh, and Angela Walker Oxford Handbook of Mental Health Nursing Edited by Patrick Callaghan and Helen Waldock Oxford Handbook of Children’s and Young People’s Nursing Edited by Edward Alan Glasper, Gillian McEwing, and Jim Richardson Oxford Handbook of Nurse Prescribing Sue Beckwith and Penny Franklin Oxford Handbook of Cancer Nursing Edited by Mike Tadman and Dave Roberts Oxford Handbook of Cardiac Nursing Edited by Kate Johnson and Karen Rawlings- Anderson Oxford Handbook of Primary Care Nursing Edited by Vari Drennan and Claire Goodman Oxford Handbook of Gastrointestinal Nursing Edited by Christine Norton, Julia Williams, Claire Taylor, Annmarie Nunwa, and Kathy Whayman Oxford Handbook of Respiratory Nursing Terry Robinson and Jane Scullion Oxford Handbook of Nursing Older People Beverley Tabernacle, Marie Barnes, and Annette Jinks Oxford Handbook of Clinical Skills in Adult Nursing Jacqueline Randle, Frank Coffey, and Martyn Bradbury Oxford Handbook of Emergency Nursing Edited by Robert Crouch, Alan Charters, Mary Dawood, and Paula Bennett Oxford Handbook of Dental Nursing Kevin Seymour, Dayananda Samarawickrama, Elizabeth Boon and Rebecca Parr Oxford Handbook of Diabetes Nursing Lorraine Avery and Sue Beckwith Oxford Handbook of Musculoskeletal Nursing Edited by Susan Oliver Oxford Handbook of Women’s Health Nursing Sunanda Gupta, Debra Holloway, and Ali Kubba Oxford Handbook of Perioperative Practice Suzanne Hughes and Andy Mardell Oxford Handbook of Critical Care Nursing Sheila Adam and Sue Osborne Oxford Handbook of Neuroscience Nursing Sue Woodward and Cath Waterhouse Oxford Handbook of General and Adult Nursing Ann Close and George Castledine Oxford Handbook of Learning and Intellectual Disability Nursing Second Edition Owen Barr Professor of Nursing and Intellectual Disabilities, Ulster University, Londonderry, UK, Visiting Professor, Faculty of Health Sciences, University of Maribor, Slovenia Bob Gates Professor of Learning Disabilities, University of West London, UK, Emeritus Professor, University of Hertfordshire, UK, Visiting Professor of Learning Disabilities, University of Derby, and Editor in Chief of the British Journal of Learning Disabilities 1 iv 1 Great Clarendon Street, Oxford, OX2 6DP, United Kingdom Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries © Oxford University Press 2019 The moral rights of the authors have been asserted First Edition published in 2009 Second Edition published in 2019 Impression: 1 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this work in any other form and you must impose this same condition on any acquirer Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America British Library Cataloguing in Publication Data Data available Library of Congress Control Number: 2018939874 ISBN 978–0–19–878287–2 Printed and bound in China by C&C Offset Printing Co., Ltd. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-t o- date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-p regnant adult who is not breast- feeding Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work. v Preface It is with considerable pride that the editors OB and BG of this text welcome you to the second edition of the Oxford Handbook of Learning and Intellectual Disability Nursing. This much revised textbook represents the culmination of a 2-y ear project that has sought, as in the previous edition, to involve leading practitioners and academics from the field of learning/i ntellectual disabilities from the UK, as well as the Republic of Ireland and much further beyond, in the production of an authoritative text able to offer essential facts and in- formation on learning/i ntellectual disabilities. The editors set out on this renewed task, knowing that much of the landscape for the practice of learning/ intellectual disability nursing has never been so complex, even more so that the last edition. Nurses for people with learning/i ntellectual disabilities can now be found working and supporting people in a variety of different care contexts such as community learning disability teams, treatment and assessment services, reach-o ut services, residential settings, day-c are services, respite services, health facilitation, mental health and/o r challenging behaviour services, spe- cial schools, and many other specialist services for people who are on the spectrum of autistic disorders. Additionally, they can be found working for many different agencies such as healthcare, social care, education, and the independent sector (this comprises the private, voluntary, and not-f or-p rofit organizations), and also alongside numerous other professional disciplines such as clinical psychologists, social workers, occupational therapists, speech and language therapists, and consultant psychiatrists in intellectual disabilities, as well as a range of professionals within general healthcare, social services, and education. Given this complexity of context and practice, we believe that the Oxford Handbook of Learning and Intellectual Disability Nursing continues to offer students, and newly qualified practitioners alike, up-t o-d ate and concise, practical, applied knowledge, as well as theoretical information, for use in the very many areas where nurses for people with learning/i ntellectual disabilities are located. Notwithstanding that nurses for people with learning/i ntellectual disabilities are the primary audience for this text, we continue to believe, and as evidenced by its use, the wider audience includes a range of other health and/o r social care professionals, who often seek an authoritative text that provides essential facts and information on learning/i ntellectual disability. In keeping with other handbooks in this series, the underlying philosophy of this text is to be both ‘a guide and a friend’, adopting a ‘person- centred’ approach that has incorporated space for the reader to record their own anecdotes, quotations, and notes. Therefore, as with other handbooks, the Oxford Handbook of Learning and Intellectual Disability Nursing’s content is organized, so that there is one topic per left- hand page, with the right- hand pages generally having some blank space for notes and local information, or for diagrams, flowcharts, tables, key point boxes, and other quick-r eference information. The reader will also find a fully updated emergencies section at the back of the book that provides essential information for the manage- ment of, for example, status epilepticus, holding powers under mental health legislation, and dealing with abuse. We believe that unique to this Oxford Handbook is the continuing attention given to differences in legislation and vi vi PREFACE social policy across the jurisdictions of the constituent countries of the UK, as well as the Republic of Ireland. It is important for us to make a brief note on the terminology used in this text. Generally speaking, within the UK, the term ‘learning disability’ is used to describe that group of people who have significant developmental delay resulting in arrested or incomplete achievement of the ‘normal’ milestones of human development. The term learning disability is also used throughout the world, but where it may hold different meanings, paradoxically so too at times in the UK. It is this difference in meaning that might lead to confusion as to what we anticipate will be a continued international readership. Problematic has been determining as to what term we should adopt. Elsewhere in the world, alternative terms to ‘learning disability’ are used such as mental retard- ation and mental handicap, but these terms are felt by many to portray negative imagery concerning people with learning disabilities. Whereas we accept that ‘naming is not a simple act’ (Luckasson, 2003), the increasing internationalization of textbooks has led us to conclude that we needed to adopt a term to re- place learning disability that would enable this book to be seen as relevant to as wide a readership as possible. That term which we believe seems most appro- priate to this text, to the readership, and to those whom this book is principally about and that which seems to have the most universal consensus is that of ‘intellectual disabilities’. Therefore, throughout the remainder of this text, we will not repeat the rather clumsy term used, that of learning/i ntellectual disability, and from hereon, in this book, we will use the term intellectual disability, save where certain Acts and/o r other technical works require its use for accuracy. We have also made a purposeful decision to use the full words of ‘intellectual disabilities’, rather than the abbreviation ‘ID’ in order to highlight, rather than risk minimizing, the importance of intellectual disabilities in the lives of people who live with it. This is also important when considering your role as a nurse for people with intellectual disabilities, and we encourage you to refer to your role as a registered nurse for people with intellectual disabilities (or learning disabilities), rather than an intellectual or learning disability nurse. We feel confident that the Oxford Handbook of Learning and Intellectual Disability Nursing has already become a highly regarded textbook—n ot only in the field of intellectual disabilities, but also more widely, and that it will be used just as widely by the many professionals and students from the range of different professional and academic backgrounds that have an interest in the lives of people with intellectual disabilities. Both editors also strongly believe that the excellent end- product that you have before you is due entirely to the excellent contributions that have been made by our many friends and colleagues from across the UK, the Republic of Ireland, and beyond, and we earnestly thank them for their trust in us by contributing to this textbook. We earnestly hope that all who read this book find it helpful and that its use will assist us all in helping people with intellectual disabilities enjoy health and well- being in their lives. Owen Barr, Derry, Northern Ireland Bob Gates, Taddington, Derbyshire, England January 2018 References Luckasson R (2003). Terminology and power. In: SS Her, LO Gostin, HH Koh, eds. The Human Rights of Persons with Intellectual Disabilities: Different but Equal. Oxford University Press: Oxford; pp. 49–5 8. vii Foreword There have been many developments in learning/i ntellectual disability nursing since I wrote the foreword to the 1st edition of this book in 2009. One such development was the publication of a new nursing strategy entitled ‘Strengthening the Commitment’ (Scottish Government, 2012). That report made a number of recommendations for modernizing the profes- sion and aimed to ensure that nurses with the right skills and knowledge were available to meet the needs of people with learning/intellectual disabilities across their lifespan, in the right place, at the right time. Within that context, it highlighted new and developing roles that nurses for people with learning/intellectual disabilities were adopting, and this is certainly an area that has seen much development. As well as working within specialist learning disability community and residential services, nurses for people with learning/intellectual disabilities are increasingly working in a diverse and growing range of settings that include general hospital services, children’s services, end-o f- life care, schools, and prisons. For those of us that can re- member the Cullen Report (1991), it would seem that the profession is truly demonstrating that its knowledge and skills are ‘facility- independent’. Recent years have also seen increased evidence that the health needs of people with learning/intellectual disabilities are not always appropriately identified and met, and that they experience an increased risk of premature and avoidable death (Heslop et al., 2013). One response to this growing awareness has been a call for all nurses to increase their awareness of the health needs of people with learning/intellectual disabilities and to develop their skills in identifying and meeting such needs. Indeed, at the time of writing this foreword, new standards for pre-r egistration nursing are being developed within the UK and the Republic of Ireland that will ensure a key element is the need for all nurses, at the point of registration, to be able to identify and address the health needs of people with learning/intellectual disabilities. The need for nurses for people with learning/intellectual disabilities, along with nurses from other fields of practice, to have access to key knowledge to enable them to support people with learning disabilities, in whatever setting they may work, is essential—h ence, this new and updated edition of the Oxford Handbook is timely. Whereas there are a number of textbooks avail- able, this new edition continues to adopt its unique approach. As with the 1st edition, it brings together key information in a readily accessible manner, addressing many practice-b ased queries and concerns. It also provides a starting point for further development through recommendations for add- itional reading. In a field of practice that continues to grow, develop, and expand, this book provides an essential point of reference for practitioners that will support them to provide the right care for people with learning/ intellectual disabilities at the right time and in the right place. Ruth Northway Professor of Learning Disability Nursing University of South Wales viii viii FOREWORD References Cullen C (1991). Caring for People Community Care in the Next Decade and Beyond. Department of Health, Mental Handicap Nursing: London. Heslop P, Blair P, Fleming P, Hoghton M, Marriott A, Russ L (2013). Confidential Inquiry into Premature Deaths of People with Learning Disabilities (CIPOLD). Norah Fry Research Centre: Bristol. Scottish Government (2012). Strengthening the Commitment. The Report of the UK Modernising Learning Disabilities Nursing Review. Scottish Government: Edinburgh. ix Dedication In loving memory of Adam Owen Barr