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Caring for People with Developmental Disabilities

Monday July 16, 2001
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Developmental disability (DD): what does this term imply to the average nurse? Confusion, fear, dread? Many nurses do not have a clear idea of what DD is, nor how to care for people with developmental disabilities.
When caring for people with DD, nurses face several challenges. For instance, they may have preconceived ideas or anxieties related to past professional or personal experiences. Or, nurses may feel intimidated by people whose appearance or behavior is unfamiliar. Nurses may also lack the clinical knowledge or experience needed to care for people with DD.
As with all patients, how a nurse reacts will affect the person with DD both physically and emotionally. The person with DD may be fearful that he or she will be hurt, frustrated or saddened that he or she is being ignored, or that he or she generates fear in others. People with DD may also actually receive inadequate or inappropriate care because their needs are not understood.
Remember, people with DD are people first, not their diagnosis. Nurses must be aware that they may have preconceived ideas that will affect the care they give. By recognizing and identifying these ideas, the nurse can move toward more enlightened care.
Communication is essential. The nurse needs to develop a therapeutic relationship with both the person with DD and family members or caregivers. Because an individual uses a wheelchair for mobility or communicates in nonverbal ways does not mean that he or she can not participate in the plan of care. Do not assume a physical impairment indicates a mental impairment as well. On the other hand, be aware that many people with mental retardation are able to make decisions regarding their own care.
When providing direct care, be sure to inform your patient of what you are going to do before you proceed. Talk with the person even though he or she may not be verbal enough to respond. If the individual is mentally retarded use simple sentences when speaking. Make instructions clear and concise.
When an individual is accompanied by a family member or other caregiver, include them when planning care. These caregivers often have assisted an individual for a long time. They are aware of the person's needs and have advanced skill levels to meet these needs. They are a wonderful resource for the nurse.
Lastly, nurses need to act as liaisons between the patient and other members of the healthcare team. Make sure that all members of the team are aware of the patient's needs and how best to meet those needs. It will also lessen the patient's and their caregivers' fears and frustrations.
Common diagnoses that are considered developmental disabilities are cerebral palsy and mental retardation. Many people with a DD do not experience lowered intellectual functioning. However, people with mental retardation do account for a large percentage of those who are developmentally disabled.
Nurses who care for people with DD can experience a richly rewarding practice. According to the mission statement of the Developmental Disabilities Nurses Association, "As nurses in the specialized field of Developmental Disabilities, our mission is to continually develop our expertise in order to assure the highest quality of life to the people we serve throughout their life span."