Showing papers by "Tamar Heller published in 2010"

Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies

Abstract: The authors examined the health-related literature on aging and intellectual disabilities (ID) published since 1999, with specific focus on examining findings on age-associated health risk factors, such as cardiovascular, gastrointestinal, and musculoskeletal system health issues, and age-related oral health. They also examined studies of lifestyle health risks, primarily the contributions to overweight or obesity. Although the review revealed varying differences in the prevalence of health risk factors, significant evidence is emerging that cardiovascular disease is as prevalent among people with ID and is as common a cause of death as in the general population. However, the review showed that the variations in prevalence were culturally dependent. Digestive system problems were evident with high occurrence rates of helicobacter pylori, gastroesophageal reflux disease, and constipation. The review revealed a growing body of work on health risk factors, such as overweight and obesity, which are often linked to the onset of a variety of diseases and impairing conditions. Healthier lifestyles, better nutrition and more exercise, and greater surveillance of health risks were seen as ways to improve the health status of aging adults with ID.

Siblings of Adults With Developmental Disabilities: Psychosocial Outcomes, Relationships, and Future Planning

Abstract: As siblings play an increasing role in the lives of people with intellectual and developmental disabilities as a result of the longer lifespan of this population and the aging of their parents, more investigative work in this area is warranted. To lay a foundation for this, the authors reviewed the English-language literature on siblings of adults with intellectual and developmental disabilities, focusing on three main questions: (1) what are the psychosocial outcomes of having a sibling with an intellectual and developmental disabilities on the sibling without a disability?; (2) what factors relate to the nature of the sibling relationship?; and (3) what factors relate to future planning, including expected and future relationships when parents can no longer provide care? This literature review looked at published work for the period 1970–2008 on adult siblings over 21 years of age that addressed relationships, psychosocial outcomes, and/or involvement in future planning. Twenty-three relevant studies were identified. Overall, these studies present a mixed, but generally positive picture of the psychosocial outcomes of having a sibling with a disability. They also indicate that siblings tend to have long-lasting close relationships with their siblings with a disability and anticipate taking on greater supportive roles as both grow older.

Work stress and depression among direct support professionals: the role of work support and locus of control

Abstract: Background Although work stress can impede the capacity of direct support professionals and contribute to mental health challenges, external (i.e. work social support) and internal resources (i.e. an internal locus of control) have been shown to help DSPs cope more actively. We examined how work stress was associated with depression, with a particular focus on the role of resources. Method Direct support professionals (n = 323) who serve adults with intellectual and developmental disabilities from five community-based organisations completed a cross-sectional, self-administered survey which measured work stress, work support, locus of control, and depression. Results Multiple regression analyses demonstrated that work stress was positively associated with depression, while resources were negatively associated with depression. In particular, work support moderated the effects of client disability stress, supervisory support lessened the effects of role conflict, and locus of control moderated the effects of workload. Conclusions Such findings suggest the importance of external and internal resources for staff mental health. This research underscores the need for strong work social support systems and interventions to help staff manage work stressors.

Health Matters: The Exercise and Nutrition Health Education Curriculum for People with Developmental Disabilities

Abstract: This comprehensive curriculum provides the tools to set up and work through an exercise and nutrition education program for adults with intellectual and developmental disabilities.This innovative curriculum is an interactive program specifically designed for people with intellectual and developmental disabilities (ID/DD). The schedule is flexible, consisting of 1-hour sessions (consider running 3 sessions each week) that encourage participants to understand their attitudes toward health, food and exercise; to gain skills and knowledge about healthy eating and exercising; to identify food and exercise preferences; to participate in food preparation and exercise activities; and to locate places in their community where they can exercise regularly.Strategies that are woven throughout this curriculum include making choices, self-determination, self-efficacy, self-advocacy, and rights and responsibility, along with problem-solving techniques and conflict resolution. Direct staff or health professionals can easily adapt the curriculum to meet the unique needs and capacities of individuals with ID/DD and their agencies, and there are specific guidelines for adapting the entire curriculum for use with people with more severe disabilities. The curriculum includes all necessary handouts, worksheets, and instructions for the program instructor in either the book or on the accompanying CD.

Evaluation of community-based health promotion programs for special olympics athletes

Abstract: Health screenings conducted during Special Olympics competitions and games have consistently shown that a significant number of athletes with intellectual disabilities (IDs) were overweight or obese, and surveys have indicated that athletes need more fitness training than they receive from their sport practices. In 2002, Special Olympics initiated five community-based health promotion pilot projects for athletes. The projects lasted multiple weeks across the U.S. and were aimed at improving physical fitness and lifestyle behaviors. This study reports on an evaluation of the program and on predictors of program success. The subjects included 56 athletes with ID who participated in these five programs. Data were drawn from interviews with the participants and 54 coaches, residential staff, and parents at baseline and after program completion, along with data from five program directors after program completion. Qualitative and quantitative findings were presented for the following areas: psychosocial and physical health status, physical and nutrition cognitions and supports, and health behaviors among the athletes; program satisfaction among coaches and athletes; and process and structural variables associated with implementation of the programs. Positive psychosocial and health benefits included improved perceived health, reduced body weight, increased fiber intake, improved self-confidence, more positive attitudes toward exercise, and decreased barriers to exercising. Several themes emerged related to implementing health promotion programs, such as obtaining “buy-in” from athletes, coaches, family members, and carers to ensure ongoing support; implementing structured recruitment strategies; formalizing existing relationships; and identifying and incorporating time, money, and transportation constraints and assessment protocols into the program design. Results support the need to broaden health promotion programs to more community-based settings.

Health Matters for People with Developmental Disabilities: Creating a Sustainable Health Promotion Program

Abstract: Adults with developmental disabilities are at significant risk for health problems. Effective health promotion can improve outcomes and that's why adult day and residential agencies, schools, and other organizations need this invaluable program development guide. An urgent call to action and a start to finish framework for health promotion, this book shows administrators and service providers how to increase supports for health education, exercise and nutrition by implementing their own successful program. With practical guidance on every stage of program development, readers will discover how to effectively communicate the key points of a health promotion program; win the support of senior management and direct support staff; manage practical aspects like budgeting, gathering resources, and recruiting staff; use Universal Design to develop a program that welcomes people with intellectual, developmental, and physical disabilities; motivate program participants with creative activities and strategies; ensure lasting improvements in health behaviors; and evaluate the program's outcomes and identify areas for improvement. To help them implement their own health promotion program, readers will get practical planning tools, including a ""getting started"" checklist, a sample Program Timeline and budget, lists of Internet and community resources, and assessment tools for determining their participants' needs, their current resources, and the success of their program. The ideal complement to the proven Health Matters (ISBN 978-155766-999-5) health education curriculum, this highly accessible program development guide will help service providers ensure better health and better lives for adults with a wide range of disabilities.

Health trends from an international sample of older adults with intellectual and developmental disabilities

Abstract: Background: The aim of this study was to compare the health status data of 4449 adults with intellectual disabilities (ID) aged 40 years and older, from three international sites and identify cross-cultural trends in the prevalence of ageassociated organ system morbidities. Study group: Data from samples of older adults with ID in Taiwan, Israel and New York State, United States, collected in three previous studies, were combined for analysis using multivariate logistic regression analyses. Methods: All data were collected using the Rochester Health Status Survey (RHSS), a survey instrument designed to collect data on demographics, morbidity, and health services usage of adults with ID through chart-review by a medical professional. Results: Irrespective of site, the likelihood of the presence of auditory problems, gastrointestinal, cardiovascular, infectious disease, eye, musculoskeletal, and respiratory conditions in people with ID increased with age and the likelihood of the presence of dermatological, endocrine, and psychiatric conditions did not increase with age. Conclusions: Prevalence of organ system diseases with increasing age in people with ID seems to be similar to expected patterns in reference population data for people without ID. The data suggest that it could be useful to increase vigilance, preventive measures, and appropriate screenings for people with ID, similar to efforts that have been incorporated in general practice guidelines. Such efforts may be useful in the delay of onset and/or reduction of the prevalence of some morbidities and secondary disability-related conditions in people with ID. Further studies are needed in these areas.