A HISTORY LESSON
Written by Sherry Neal, RN-BC, CDDN
The field of Intellectual and Developmental Disabilities (I/DD) has come a long way. Unfortunately, we continue to have persons residing in large institutional settings across the U.S., generally due to funding problems for a person to move into a community or smaller residence. Even though a person may still reside in an institution, the health care services provided are leaps and bounds ahead of what it used to be.
Language for reference to persons with I/DD has also changed. We hear persons referred to less and less as “mentally retarded”. Retarded means less advanced than what is expected at a certain age or a delay in expectations or accomplishments. So while this term describes most of the persons we care for, it is socially offensive and no longer accepted. Persons with I/DD were also called or labeled “idiot”, “imbecile”, “resident”, “moron” and “feeble minded”. Staff working within the field of I/DD would be appalled to hear those labels now. In 2010, then president Barack Obama signed a bill commonly referred to as “Rosa’s Law”. It effectively removed the terminology “mentally retarded” or “mental retardation” from any federal records and replaced those terms with “intellectual disability”.
Metabolic Syndrome is a cluster of disease processes. It consists of Diabetes Mellitus, Hypertension, Obesity, elevated Triglycerides and decreased HDL cholesterol. These diseases may be controlled, but often aren’t, due to either lack of awareness by health care providers, lack of aggressive treatment for persons with IDD, lack of ability to purchase high quality foods and plan nutritious meals or lack of compliance among persons.
It is critical that Metabolic Syndrome be managed and controlled to the best of our ability. Poorly controlled Diabetes Mellitus can cause blindness, kidney disease and failure, poor wound healing and loss of limbs. Hypertension that is not well managed can also cause kidney failure along with other serious and life-threatening conditions like aneurysms, strokes and heart failure. Obesity contributes to heart disease, the development of hypertension and diabetes and social unacceptance. Poor regulation of cholesterol and triglycerides increases stroke and heart attack risk.
“It is critical that Metabolic Syndrome be managed and controlled to the best of our ability.”
Laboratory testing to monitor blood glucose, lipids, kidney function and other key indicators must be performed regularly to allow for early intervention when a problem is first identified. Face-to-face assessments with nurses in the community and the physician or a physician extender must occur regularly to help prevent increased death and other diseases.
Early recognition of Metabolic Syndrome may save lives. All providers of services should remember that although the 2nd generation anti-psychotics are safer than the 1st generation, they are not without their own set of issues. Quite often these medications significantly improve the quality of life for a person with IDD, but the potential side effects must be recognized and managed.