Primary Care of Adults with Mental Retardation.

Title

Primary Care of Adults with Mental Retardation.

Creator

Tyler Jr Carl V; Bourguet Claire

Publisher

Journal of Family Practice

Date

1997
1997-05

Description

BACKGROUND. There is a national trend to deinstitutionalize mentally retarded adults, placing them in community residential settings. As a result, community-based primary care physicians will assume responsibility for their medical care. Primary care physicians may have uncertainties regarding the medical care of this population. The purpose of this case series is to describe the medical care of a group of adults with mental retardation during their first year of community residence following deinstitutlonalization, and to provide practical advice to family physicians who care for these adults. METHODS. Medical diagnoses and medications at the time of deinstitutionalization of a series of 21 adults were abstracted from institutional records and transfer forms. Follow-up data were obtained from office medical records. RESULTS. In the first year following deinstitutionalization, each patient averaged 6.6 office visits to a family physician. Newly identified major health impairments were: chronic persistent hepatitis due to hepatitis B, acid peptic disease, gastroesophageal reflux disease, dysphagia, primary degenerative dementia, absence seizures, bronchiectasis, and idiopathic iridocyclitis. Significant changes in pharmacotherapy included consolidation of multidrug anticonvulsant regimens and discontinuance of psychotropics and laxatives. Health maintenance practices included hepatitis B immunizations, cholesterol determinations, smoking cessation counseling, and calcium supplementation. CONCLUSIONS. Newly deinstitutionalized patients require careful diagnostic and therapeutic reassessment. Family physicians assuming their care need to look for conditions common in this population, including dysphagia, seizure disorders, chronic hepatitis B, and sensory impairments. Previously neglected health maintenance practices need to be instituted. Pharmacotherapies, particularly anticonvulsants, psychotropics, and laxatives, may be amenable to dosage reduction or discontinuance. [ABSTRACT FROM AUTHOR]

Subject

COMMUNITY health services; PRIMARY care; PHYSICIAN-patient relations; DEINSTITUTIONALIZATION; MENTAL disabilities; MENTAL disability care facilities – Patients

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

487–494

Issue

5

Volume

44

Citation

Tyler Jr Carl V; Bourguet Claire, “Primary Care of Adults with Mental Retardation.,” NEOMED Bibliography Database, accessed February 25, 2021, https://neomed.omeka.net/items/show/5781.

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