Promoting good health in adults with Down syndrome What do the updated Primary Care of Adults with Intellectual and Developmental Disabilities Guidelines & Tools say? Dr. William Sullivan, family physician Surrey Place Centre & St Michael’s Hospital Family Health Team University of Toronto
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Promoting good health in
adults with Down syndrome
What do the updated Primary Care of Adults with Intellectual and
Developmental Disabilities Guidelines & Tools say?
Dr. William Sullivan, family physician
Surrey Place Centre & St Michael’s Hospital Family Health Team
University of Toronto
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
Canadian Family Physician 2011 May;57(5): 541-550
Available online:
http://www.surreyplace.on.ca/Primary-Care
update April 2018
Primary Care of Adults with IDD:Tools
Available online:
http://www.surreyplace.on.ca/Primary-Care
update April 2018...
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s new?
Approaches to care
General health
-pain and distress
-polypharmacy and long-term use of medications
-life transitions
Physical health
-revision or expansion of many guidelines
-women’s gynecological and reproductive health
-sleep disorders
Mental health and behaviour
-psychosocial context; HELP framework
-behaviours that challenge (communicate)
-elaboration on mental health interventions (holistic)
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for all adults
with IDD?
• Health care as partnership (individuals;
caregivers; family physician; inter-professional
team)
• communication
• shared decision making
Primary Care of Adults with DD: Tools
Today’s visit
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for all adults
with IDD?
• Supported decision making (strengths and
challenges)
• Life transitions (to adulthood; aging; end of
life)
• Assessment/reassessment of cognitive and
adaptive functioning in adulthood
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for all adults
with IDD?
• Periodic comprehensive health assessment
• Health action plan
Primary Care of Adults with DD: Tools
Preventive care checklists
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for all adults
with IDD?
• Physical activity and optimal diet
• Oral hygiene and health
• Immunization (increased risks of infection and
severity of illness)
• Sleep
• Review of medications (polypharmacy; drug-
drug interactions)
• Cancer screening
• Importance of adaptations for individual needs
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for all adults
with IDD?
• comprehensive and systematic assessment of
behaviours that challenge (HELP)
• review of psychotropic medications
• behaviour crisis plan
• addictions
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
Good health and wellness are possible with
appropriate preventive care and planning!
Primary Care of Adults with DD: Tools
Health Watch Table
for adults with Down syndrome
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
• Vision
• Hearing
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
Cardiovascular disease
• cardiac defects, e.g., AVSD; tetralogy of Fallot
• pulmonary hypertension/vascular disease
• importance of early detection for surgical
correction and management
• signs can be missed
• physical activity levels?
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
Neuromuscular and skeletal disorders
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
Endocrine disorders
• autoimmune thyroid disease
• celiac disease
Primary Care of Adults with IDD:
Canadian Consensus Guidelines
April 2018 update: what’s important for adults
with Down syndrome?
Dementia
Thank you!
Questions?
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