Epilepsy and Learning Disability Relationship

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Introduction

Epilepsy refers to a chronic illness that affects children and adults alike. Symptoms of the illness include periodic seizures, which come in the form of convulsion (Durand et al., 2014). The convulsion is attributed to anomalous electrical activity in the brain that interferes with its functioning. No known medication can effectively reverse the condition. A study by Hansen, Zelano, Åsberg, and Kumlien (2017) reveals that people with epilepsy stand high chances of dying relative to the normal population. The major causes of fatality for these patients include “disorders of the circulatory system and neoplasms” (Hansen et al., 2017, p. 1).

To clear the debate about the link between learning disability and epilepsy, a study conducted at St George’s, University of London, by Epilepsy Research UK (2016) revealed that individuals with learning disabilities had a higher probability of developing epilepsy among other conditions such as diabetes. However, research by Durand et al. (2014) indicates that not all people with epilepsy have a learning disability. This finding complicates the relationship between the two conditions. This paper explores epilepsy and learning disability to uncover the relationship between the two chronic conditions. To achieve the stated goal, the paper explores the factors that healthcare providers consider when making decisions to diagnose a person with epilepsy for the learning disability. Additionally, the paper explores the interventions available for patients with epilepsy who are also diagnosed with a learning disability.

Considerations for its Inclusion in Health and Social Care Services

The nature of symptoms is one of the factors that nurses consider when making decisions to diagnose persons with epilepsy for a learning disability. Symptoms of both conditions are similar, with the only difference being their magnitude (Barkley, 2014). However, people with epilepsy are distinguishable from those who have a learning disability. According to Durand et al. (2014), the seizures for patients with epilepsy may be recurrent, the apprehension may go on for a longer period, and that the seizures may be too complex to put into a typical convulsion class.

To detect epilepsy from people with a learning disability, learning disability nurses inspect the mentioned signs. If the seizures for the affected victims of epilepsy are infrequent and/or last for shorter periods, the patient is examined for other symptoms of learning disability. If the other symptoms are positive, the patient is diagnosed with a learning disability. Some of the symptoms, which need to be examined, include the loss of memory, poor social skills, and emotional disorders. However, according to Berney and Deb (2012), it is crucial to point out that identifying epilepsy in people with a learning disability is not easy since such individuals demonstrate recurring behaviours that may be mistaken for epilepsy. This situation calls for the involvement of learning disability nurses whose task involves enhancing the health, comfort, and autonomy of patients with any form of learning disability.

The Health Promotion Role of the Learning Disability Nurse Supporting the Victims

One of the roles that the learning nurses perform is to assess the patient at different stages of treatment to determine the type of care they deserve. For example, a study by Mafuba and Gates (2015) reveals how “people with learning disabilities have reduced access to screening and health promotion services” (p. 2). Hence, the learning disability nurse will be tasked with ensuring that these services are available to the patients. People with epilepsy and a learning disability do not only exhibit the signs of epilepsy but also show intellectual difficulties, which manifest in the form of speech, hearing, and vision problems (Gaddes, 2013). These indicators do not affect all the patients equally. They are unique to different patients. Therefore, the nurse must examine each patient before availing any kind of treatment. The treatment availed to each must be designed in a way that it satisfies the observed medical needs.

Mafuba and Gates’ (2015) research reveals how learning disability nurses assume a facilitatory role in their field. For example, the nurses help to learn disability patients to access health services, owing to the reported difficulties that this category of patients experience when it comes to getting timely medical attention (Mafuba & Gates, 2015). This goal is achieved by administering the right behavioural therapies to patients with a learning disability to promote self-care (Durand et al., 2014). In most cases, nurses identify patients with similar needs and divide them into clusters for group therapy. Other roles include assisting patients with personal hygiene and/or performing their day-to-day activities.

Barriers to Inclusion and the Health Promotion

One of the challenges facing the learning disability nurses in their attempt to facilitate inclusion and health promotion concerning patients with a learning disability is short staffing. Sprinks’ (2014) study substantiates this claim. According to the author, chief medical experts in the UK have raised alarm concerning the diminishing number of learning disability nurses. The concern is founded on the recent drop in the number of certified learning disability nurses by more than 700 (Sprinks, 2014). This observation notwithstanding, the number of patients with a learning disability continues to grow, leading to a low nurse-patient ratio (Mendes, 2013). The low number of learning disability nurses contributes to work overloads, which lower their ability to facilitate the process of inclusion and health promotion for patients with a learning disability. Research by Mendes (2013) indicates that the health outcome of patients largely depends on the productivity of healthcare providers. In this regard, the reduced productivity of the nurses because of work overloads may negatively affect the health outcome of the patients with a learning disability. Other than staff shortage, the lack of adequate knowledge by learning disability nurses is a great barrier to the provision of healthcare services not only to patients with epilepsy but also to those who have a learning disability. Gaddes (2013) observes that most learning disability nurses have inadequate knowledge about the learning disability and epilepsy. Based on the above view, it can be concluded that patients with a learning disability do not receive the right care from nurses.

Facilitation Role of the Learning Disability Nurse

One of the major roles that nurses play to facilitate health inclusion and health promotion for people with epilepsy who also suffer from a learning disability revolves around the identification of such individuals. Nurses are responsible for providing care to patients. Therefore, they are in close contact with them (patients) (Baker, Baker, & Jacoby, 2013). The close contact with the patients facilitates the detection of the illnesses affecting the patients. Given that patients with epilepsy exhibit similar symptoms as those evident in persons suffering from learning disability, nurses play a central role in differentiating individuals who have epilepsy and learning disability from those suffering from both illnesses. Once nurses identify the symptoms of learning disability in a patient with epilepsy, they refer them to the relevant caregivers for treatment. Therefore, nurses play a central role in identifying patients with epilepsy who require interventions related to a learning disability. Without nurses, people with epilepsy and a learning disability may go undetected, hence complicating the process of treating them.

The other role that nurses play in the process of facilitating inclusion and health promotion for people with epilepsy who also suffer from a learning disability involves providing them with specialised care when needed. When providing such care, the nurse is obliged to follow the best practices to ensure that the interventions offered result in the least reaction on a patient (Cortese et al., 2015). Additionally, the learning disability nurses have to innovatively empower the patients to engage in the decision-making process for their health (Mendes, 2013). In addition to providing specialised care on demand, learning disability nurses also work closely with primary and secondary healthcare providers to promote patients’ health.

Lastly, learning disability nurses play a significant role in mediating patients and their physicians. Nurses are responsible for administering the usual care and some forms of treatments, which include behavioural therapies. This plan empowers patients to embrace self-care to minimise instances of inpatient care and to reduce emergency cases. The intermediary role of learning disability nurses is becoming increasingly important, as the concepts of Continuum of Care and Accountable Care Organisations emerge. The mentioned concepts require healthcare providers to establish long-term relationships with patients to boost health.

One of the policies for learning disability nurses to act on in detecting and promoting health for people with epilepsy and a learning disability is the Beneficence Medical Ethical provision. The stated provision requires nurses to act in the best interest of the patient to ensure that their health is maximised (Fosi, Lax‐Pericall, Scott, Neville, & Aylett, 2013). In this regard, nurses who provide care for people with epilepsy must act with due diligence to detect any sign of learning disability while availing the right treatment to the patient. A nurse who negligently fails to use his or her skills to detect a learning disability in people with epilepsy may be held accountable for a patient’s deteriorated health. Therefore, nurses must utilise their skills to detect the signs of a learning disability in people with epilepsy.

However, although the principle of beneficence empowers learning disability nurses to do everything to detect and avail the necessary treatment to patients with epilepsy who also have a learning disability, the autonomy provision limits such power. The mentioned principle requires healthcare providers to consult patients before administering any type of treatment. If the patient is of unsound mind, the learning disability nurse may stick to the provisions of the Mental Capacity Act, which was established to take care of patients who may be incapable of making valid decisions on their own. Otherwise, patients should be allowed to participate in their treatment by making decisions regarding the kind of services to be administered to them based on their cultural and religious convictions (Cortese et al., 2015). Without such a requirement, healthcare providers would administer treatments that would violate patients’ will.

Conclusion

Epilepsy refers to a chronic illness that manifests in the form of periodic seizures. The illness is attributed to a brain disorder. Patients with the illness are at a high risk of contracting learning disability. The relationship between the two diseases is important since the symptoms of the two illnesses are very similar. This paper has explored the relationship and the role of learning disability nurses in providing the necessary care to the affected patients. The paper has established that learning disability nurses play a pivotal role in detecting people with epilepsy and a learning disability, including organising for their treatment.

References

Baker, G. A., Baker, G. A., & Jacoby, A. (2013). Quality of life in epilepsy: Beyond seizure counts in assessment and treatment. London, England: Psychology Press.

Barkley, R. (2014). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York, NY: Guilford Publications.

Berney, T., & Deb, S. (2012). Oxford textbook of epilepsy and epileptic seizures. Oxford, UK: Oxford University Press.

Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W.,… Zuddas, A. (2015). Cognitive training for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomised controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 164-174.

Durand, M. A., Gates, B., Parkes, G., Zia, A., Friedli, K., Barton, G.,… Wellsted, D. (2014). Wordless intervention for epilepsy in learning disabilities (WIELD): Study protocol for a randomised controlled feasibility trial. Trials, 15(1), 455-456.

Epilepsy Research UK. (2016). People with learning disabilities ‘more likely to develop epilepsy. Web.

Fosi, T., Lax‐Pericall, M. T., Scott, R. C., Neville, B. G., & Aylett, S. E. (2013). Methylphenidate treatment of attention deficit hyperactivity disorder in young people with learning disability and difficult‐to‐treat epilepsy: Evidence of clinical benefit. Epilepsia, 54(12), 2071-2081.

Gaddes, W. H. (2013). Learning disabilities and brain function: A neuropsychological approach. Berlin, Germany: Springer Science & Business Media.

Hansen, J., Zelano, J., Åsberg, S., & Kumlien, E. (2017). Cause of death in patients with poststroke epilepsy: Results from a nationwide cohort study. PLoS ONE, 12(4), 1-11.

Mafuba, K., & Gates, B. (2015). An investigation into the public health roles of community learning disability nurses. British Journal of Learning Disabilities, 43(1), 1-7.

Sprinks, J. (2014). Shortfall in learning disability nurse numbers sparks fears for the future. London, England: RCN Publishing.

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