Online Program

Health status and health utilization of adults with intellectual disability utilizing community residential services

Sunday, November 3, 2013

Erika Shulkusky, BS, KenCrest Healthcare services, KenCrest Services, Plymouth Meeting, PA
Kathleen Fisher, PhD, CRNP, College of Nursing & Health Professions, Drexel University, Philadelphia, PA
Thomas Hardie, EdD, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
Margaret O'Neil, PT, PhD, MPH, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, College of Nursing and Health Professions, Philadelphia, PA
Michel Miller, PhD, Department of Special Education, Drexel University, Philadelphia
Paulina Sockolow, DrPH, MS, MBA, College of Nursing and Health Professions, Drexel University, Philadelphia, PA
Carolee Polek, PhD, College of Health Sciences, University of Delaware, Newark, DE
Background: Adults with intellectual and developmental disabilities (I/DD) have poorer health, reduced life expectancies and barriers to health promotion programs and medical care compared to adults without disabilities. This study's purpose was to conduct a needs assessment to determine health status and utilization of health services in adults with I/DD living in community residential facilities. Methods: Systematic chart reviews were conducted for 40 adults with I/DD living in community residential facilities. Data extracted from the charts included: problem lists with ICD-9 codes, medication lists, health encounter lists for an 18 month interval, health status data (heights, weights, BMIs, blood pressure) and laboratory results. Descriptive data analyses were generated to determine health status and to identify need for health promotion programs. Results: Mean age was 49.5 years; (52%) are males. Primary diagnosis for residents was mental retardation (50% mild, 33% moderate, 15% severe, 3% profound). A majority of participants (85%) had mental health disorders including: bipolar disorder (38%) and depression (32%). On average, residents used 2.6 psychotropic medications and 5.75 additional medications for other conditions (e.g. thyroid, seizure disorders, hyperlipidemia). BMI indicated healthy weight in 13% of participants, overweight (28%), obesity (59%) and morbid obesity (23%). Health encounter data suggest that over 18 months, the participants had an average of 39 visits across multiple services (e.g. psychiatry, dental, podiatry). Conclusions: Participants in this study had poor health status and high health utilization. Targeted interventions and health promotion programs focused on healthy weight and increased activity are warranted to improve health outcomes.

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related nursing

Learning Objectives:
List differences in health status including unhealthy weight by level of disability, gender and living arrangement for persons with an intellectual/developmental disability. Identify targeted interventions for weight management in this vulnerable population that are consumer driven. Identify health care utilization among adults with intellectual disability who are receiving community residential services.

Keyword(s): Disability Studies, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the director of healthcare services at KenCrest Services, a faith-based organization that provides services for over 4,000 individuals and families with an intellectual and developmental disability (I/DD). I have worked for persons with I/DD and KenCrest services for 25 years. My current role requires supervision of nurses and administrative staff, development of health care policies, procedures and protocols to ensure the best quality of health care for individuals supported by KenCrest Services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.