Administration of emergency antiepileptics in staffed care homes for people with intellectual disabilities in High Wycombe: survey of staff training status
| Pages | 41-46 |
| DOI | https://doi.org/10.1108/20441281211198853 |
| Published date | 13 January 2012 |
| Date | 13 January 2012 |
| Author | Sharada Deepak,Elizabeth Obe,Rajnish Attavar |
| Subject Matter | Education,Health & social care |
Administration of emergency antiepileptics
in staffed care homes for people with
intellectual disabilities in High Wycombe:
survey of staff training status
Sharada Deepak, Elizabeth Obe and Rajnish Attavar
Abstract
Purpose – The purpose of this paper is to ascertain the training status of staff in care homes for people
with intellectual disabilities managed by the non-health sector in High Wycombe, with regard to
administering emergency antiepileptic medication and to identify training needs.
Design/methodology/approach – Management of seizures in people with intellectual disabilities and
epilepsy comes with its challenges. Although there are clear guidelines for the same, implementing
them in the community,especially in the non-health sector setting, raises the issue of training staff in the
administration of emergency antiepileptic medication. A survey was undertaken in response to the
varying staff training needs. A short semi-structured questionnaire was designedand administered over
the telephone to the managers of these care homes.
Findings – Less than half of the care homes had staff trained to administer emergency antiepileptic
medication. The commonest reason cited was their policy of admitting only patients with well controlled
seizures. This paper identified the need for staff training and raising awareness amongst relevant
healthcare professionals.
Practical implications – The survey highlights the practical difficulties arising in the implementation of
national and trust level healthcare policies in the community.
Originality/value – This paper is of value to clinicians working with people with intellectual disabilities
and epilepsy, GPs, and staff and management in the care homes in the health and non-health sectors.
Itraises questionsaround delineation of responsibility and communication between various professionals
in various levels of care involved in managing people with intellectual disabilities and epilepsyto ensure
provision of safe and effective care for this population.
Keywords Epilepsy, Intellectual disabilities, Learning disabilities,Buccal Midazolam, Training,
Rectal Diazepam, Surveys, Intellectual disabilities
Paper type Research paper
Introduction
Epilepsy and intellectual disabilities commonly co-exist. Epilepsy affects 14-24 per cent of
people with an intellectual disability (Rutter et al., 1976). The frequency of life-time history of
epilepsy ranges from 7 to 15 per cent of people with mild to moderate intellectual disability,
45-67 per cent of people with severe intellectual disability and 50-82 per cent of people with
profound intellectual disability (Goulden et al., 1991).
There are particular challenges in providing information and support for this group as there
may be occasions where people with intellectual disabilities and epilepsy cannot make their
own decisions due to a lack of mental capacity.There is no evidence to suggest that different
antiepileptic drugs should be used for those with intellectual disabilities than for those
without intellectual disabilities. However, there is a higher mortality risk for people with
epilepsy and intellectual disabilities (NICE 2004).
DOI 10.1108/20441281211198853 VOL. 6 NO. 1 2012, pp. 41-46, QEmerald Group Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTALHEALTH AND INTELLECTUAL DISABILITIES
j
PAGE 41
Sharada Deepak is a
Specialty Registrar Year 4,
CAMHS, Berkshire
Healthcare Foundation
Trust, Reading, UK.
Elizabeth Obe is a
Consultant Psychiatrist,
Psychiatry of Learning
Disabilities, High
Wycombe, UK and is also
based at Oxfordshire
Learning Disabilities Trust,
Oxford, UK. Rajnish Attavar
is a Consultant Psychiatrist,
Psychiatry of Learning
Disabilities, Aylesbury, UK
and is also based at
Oxfordshire Learning
Disabilities Trust,
Oxford, UK.
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