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Learning disability and dementia: dispelling myths and developing
services
Dr Karen Watchman Alzheimer Scotland Centre for Policy and Practice
Programme
• Dementia in people with a learning disability – true or false
• What is different about dementia in people with a learning disability?
• Implications for service development and delivery
Down’s syndrome/dementia
True or False?
Karen Watchman
Risk factor
Risk in people with Down’s syndrome:
• 1in 50 aged 30 – 39
• 1 in 10 aged 40 – 49
• 1 in 3 aged 50 – 59
• More than half of those who live to 60 or over
Risk in people with other types of LD:
• 1 in 10 aged 50 – 65
• 1 in 7 aged 65 – 75
• 1 in 4 aged 75 – 85
• Nearly three-quarters of those aged 85 or over
Haveman, M.J. et al. (2009) Dementia in Older adults with intellectual disabilities, IASSIDD
Changes
• Loss of daily living skills
• Difficulty with kerbs
• General inactivity
• Loss of sociability
• Increased irritability
• Loss of hobbies previously enjoyed
Diagnosis
• Diagnosis difficult
• Typical tests not suitable
• Some assessment tools
• Baseline assessment
• Diagnosis often not shared – consistent with dementia strategy?
Misdiagnosis
• Physical
• Undiagnosed pain
• Emotional or grief
• Social
• Effects of medication
What is different about What is the same for dementia in people with a everybody? learning disability
• Age • Diagnosis • Capacity • Progression • Ability to plan ahead • Financial situation • Life history • Social circumstances • Available services • Progression • Communication • Family situation • Where people live
• Need for support • Need for information • Stigma • Intervention • Medication • Keep active • Terminal condition • Pain detection • Discrimination • Cognitive changes • Need to plan ahead • Need for support and
information • Impact
Models of care – service development
• Ageing in place
• In place progression
• Referral out
• Where do people live and die?
• Lessons learned from dementia specific accommodation (here and Canada/USA)
Karen Watchman
Lessons learnt– service development • Training • Environmental adaptations • Impact on others • Role of architectural and design
team • Transition • Role specification (re-learning
required) • Impact on staff • Involve families • Importance of life story work • Complexities of residents at
different stages of dementia • Accuracy of diagnosis? • Need for pro-active planning for
ageing population with a learning disability
Karen Watchman
