Common Medical Disorders That Affect The IDD Population Developed By: Nicole Thomas, RN,BSN Hill Country IDD Regional Support Team

What is IDD? Developmental disabilities is a severe, chronic disability due to a mental or physical impairment or combination of mental and physical impairments that start before a person is twenty-two years of age, are expected to continue indefinitely, result in substantial function limitations in major life activities, and reflect the person’s need for life long individualized support or assistance.

What is IDD? Examples of developmental disabilities: -Autism -Behavior disorders -Brain disorders -Cerebral palsy -Down syndrome -Fetal alcohol syndrome -Intellectual disability -Spina Bifida

Common disorders among the IDD population Certain disorders are strongly associated with adults with IDD and are more prevalent among this population. The fatal five refers to the top five disorders linked to preventable deaths or health deterioration for individuals with IDD -Bowel Obstruction -GERD -Aspiration -Dehydration -Seizures

Bowel Obstruction Bowel obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine Bowel obstruction is the most common cause of preventable death within the community setting The most important cause of bowel obstruction is the use of multiple prescribed medications with constipating side effects Poor dietary habits low in fiber Lack of hydration Less than adequate active movement or exercise, which is important to the gut

GERD GERD is the backing up of stomach contents, acids, into the esophagus It is undiagnosed until major harm has been done to the bottom of the esophagus Poor dietary habits, immobility , and improper positioning also contribute greatly to the incidence of GERD If untreated it can lead to silent or frank aspiration, life-threatening GI bleeding, and esophageal cancer

Aspiration Aspiration is the most common cause of death in institutional settings, nursing homes, and group settings for the persons with IDD. Aspiration may occur without anyone knowing if the amount of food or liquid is small (Silent Aspiration). The first sign of aspiration may be trouble breathing or signs of pneumonia. Poor body positioning, especially in the individuals who cannot control their own movements or have behavioral issues related to eating can increase the risk of aspiration. Aspiration pneumonia is a common discharge diagnosis following hospitalization.

Dehydration Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated. Individuals who do not swallow well are particularly likely to refuse fluids or indicate fear when they get them, often resulting in dehydration. When fluids are restricted to prevent incontinence resulting in constipation and increased seizure activity as well as drug toxicity.

Seizures A seizure is a sudden surge of electrical activity in the brain. Seizures can occur in a pattern or are more likely to occur in certain situations. Sometimes these connections are just by chance, but other times it’s not. Keeping track of any factors that may precipitate a seizure (seizure triggers) can help you recognize when a seizure may be coming. For example: -specific time of day or night -fever -stress -sleep deprivation -flashing lights -alcohol -menstrual cycle/hormonal changes -low blood sugar -excessive caffeine -medications Seizure deaths can occur from drug toxicity or from controlled seizures Sudden unexplained death in epilepsy occurs on a fairly regular basis.

Resources McGowen, K. G. (2013, July). Health Risk Identification | Health Risk Screening Inc. Retrieved April 28, 2016, from http://hrstonline.com/