Adults with intellectual disability: how to detect signs of illness

From the website of NSW Council for Intellectual Disability:

Life_stages.jpgHealth_problems.jpgAdults – signs of illness

Key facts

People with intellectual disability can have the same health problems as anyone else.  They often have more health problems.  Many people with intellectual disability find it hard to explain their symptoms.

It is really important to have regular health checks and watch out for signs of health problems.

Common signs that a person is unwell

If a person finds it hard to say they are feeling sick, you need to watch out for signs that may point to a health problem.  For example, the person:

  • seems sad
  • is reluctant to do normal things
  • doesn’t want to eat
  • has challenging behaviour
  • looks tired and has no energy
  • has unexplained bleeding, eg from the anus or vagina.

Some of the signs seem obvious when you read them.  But, when carers are busy or stressed, it can be easy to miss that a person might be sick.

Watch out for common health problems

  • Hearing problems – Does he seem to ignore you?  Does he want the TV very loud?
  • Vision problems – Does she seem hesitant on stairs?  Does she have trouble finding things that are nearby?
  • Tooth or gum disease – Is he holding his jaw, or refusing food?  Do his gums bleed when his teeth are being cleaned?  Does he have bad breath? Does he brush his teeth at least daily?
  • Gastric problems – Is she choking or coughing during meals?  Is she vomiting?  Does she seem in pain after eating?
  • Swallowing problems – Does he take a long time to eat or does food fall out of his mouth?  Does he cough or choke when eating or drinking?
  • Poor nutrition – Does she lack energy?  Is she underweight or overweight?  Is she developing pressure areas?
  • Bowel problems – Does he seem to have pain in the abdomen, or when opening his bowels?  Chest infections – Watch very carefully for this if the person is immobile.  Can you hear a rattle or wheezing sound in his chest when he breathes?  Is he breathing fast?  Does he have a cough or a temperature?  Does his skin have a bluish tinge especially around the mouth and finger tips?
  •  Muscle and joint problems – Is she holding a part of her body, or having trouble moving?  If she is immobile, look for any redness or swelling and if there is any discomfort when you move her.
  • Arthritis – Does he have trouble using small items, e.g. a knife and fork?  Does he seem uncomfortable when moving around?  Does he have swollen joints?
  • Diabetes – Excessive thirst, frequent urination and frequent infections may point to diabetes.  Being overweight and not having enough exercise increase the risk of diabetes.  Is there a family history of diabetes?
  • Skin disease – Is there a skin rash?  Is she scratching or picking at her skin? Is the skin dry and scaly?
  • Epilepsy – Does he seem to be in a daydream?  Does he have seizures or muscle spasms?  Has he forgotten something he would normally remember?  Does he have unexplained periods of drowsiness?
  • Mental illness – Does he not want to do normal things?  Does he seem depressed or anxious?  Is he hurting himself or other people?  Is his behaviour different to normal?
  • Grief – Is she tearful?  Is she having trouble concentrating?
  • Dementia – Is he becoming forgetful?  Does he seem lost in familiar places?  Is he losing everyday skills?
  • Reactions to medication – Has her behaviour changed?  Has she got a rash, swelling, vomiting or diarrhoea?  Is she falling over of very sleepy?
  • Sleep apnoea – Does he snore?  Is he restless at night? Does he seem tired when he wakes in the morning?  Does he seem drowsy in the daytime?  Does he have trouble concentrating or seem irritable?

If a person with intellectual disability is showing these sorts of symptoms, it is important to get the doctor to check if there is a medical problem that can be treated.

Organise regular health checks

No matter how alert you are to signs that a person is unwell, there might be health problems that you and the doctor are not aware of.  You can ask the GP to do an annual Medicare health check and get a dental check every six months.

You might be interested in these fact sheets

Annual health assessments
Adults – what kinds of health services are there?
Causes of intellectual disability and health care
Dental care
Mental health

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