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Scenario: Anxiety and health assessments

This video was developed with and acted by, people with an intellectual disability. It represents the results from the IDS-TILDA study.
In this video, we will be showing you a short scenario which demonstrates how fear and anxiety can impact on a health assessment. The young woman attending the doctor is anxious. She has abdominal pain, and talks to her friends in the waiting room. How are you Rita? I’m not feeling very well. Are you not? I have a pain in my tummy. Pain in your tummy? Yeah. I hate going to the doctor. Why? I get scared. Yeah, you get scared. Sure, everybody, sure, we all like the doctor. We all like the doctor, because the doctor is very nice. I can’t understand what she’s saying. It’s the same as you’re talking to me. It’s not like talking to my friends.
It is much harder to talk to the doctor. As you can see, she is expressing her anxiety, as her friends attempt to comfort her. However the anxiety appears to heighten as her turn comes.
Next, please!
How are you today, Rita? OK. Do you get tired a lot? Yeah. I’ll change your tablets.
OK. I’m going to listen to your heart, Rita. OK.
That’s good, Rita. Despite the doctor appearing to be friendly and nice, the person does not voice their need. Is there anything else that I can help you with? No. No?
I give this book to you, Healthy Eating. Thank you. Bye, Rita. Bye.
Supporting the person with drawings or diagrams as a routine, encouraging them to point out the area of complaint, and providing opportunity rather than assuming would have helped the person express and explain.
Ah, so how did you get on with your stomach? I’m too scared to ask her. Ah, she gave you the book. She gave me this book to read, but I can’t read. You can’t read.
Hmm. Designing services with reasonable adjustment to meet the health needs of people with an intellectual disability, and promoting education for health care professionals, will contribute to advancing equality in service provision. Communication is the key towards making reasonable adjustment. It is the person with intellectual disability who requires the support. It is therefore the health care professional’s responsibility to make those adjustments, and promote good communication. This is not simple, and will not always succeed. However, it is our duty of care to engage and try. Next week, we will be giving you practical tips to improve your communication with people with intellectual disability in health assessment.

This video was developed with and acted by people with an intellectual disability. It represents the results from the IDS-TILDA study, which told us that almost 20% of older adults with an intellectual disability had difficulty with communication. This figure increased with the severity of the level of intellectual disability.

What is of concern is that one in every three adults said they had difficulty in making themselves understood when speaking with health care professionals.

The scenario portrayed in the video reflects these results. The person going to the doctor is anxious, and subsequently does not voice her real concerns despite the doctor being pleasant.

As you will see in the next article, communication is one of the many barriers that create health disparity. Greater emphasis on communication to ensure success for the person with intellectual disabilities is needed. This will be the focus of Week 2 of this course.

Health disparities, as you have learned, do exist, and if the person cannot express their needs, health conditions can be overlooked.

Recognising that people with an intellectual disability do have communication challenges, initiating tools to support communication, will contribute to overcoming the challenges.

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Improving Health Assessments for People with an Intellectual Disability

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