LD

Question 1

LD Challenging behaviour (history)

Answer 1

• Clarify HPC (onset, duration, baseline, aggression, response)
• Screen for psych disorders (mood, sleep, appetite, enjoyment, hallucinations, delusional)
• Screen for medical illness (PMHx, medication changes, recent illness)
• Environmental changes (environment, staff, residents, visitors, routine)

Question 2

Dementia in Downs syndrome (history)

Answer 2

• Clarify HPC (onset, duration)
• Explore memory difficulties (short-term, long-term)
• Orientation (day/dates, confused, recognizing people)
• Communication (word-finding, understanding, identify objects)
• Functioning (dressing, washing, toileting, walking, money, shopping, food, transportation)
• PMHx and risk factors (head injury, low mood)
• Other psych disorders (mood, enjoyment, sleep, appetite, abnormal behaviour)
• Risk (wandering, getting lost, fire, flooding, exploitation, abuse, aggression, self-injury).

Question 3

Depression in LD (history)

Answer 3

• Clarify HPC (onset, duration)
• Core features of depression (1-10, tearful, enjoyment)
• Biological symptoms (Energy, sleep, EMW, appetite)
• Other symptoms (concentration, self-worth, guilt, psychotic features)
• Past psych history, PMHx, medications
• Risk

Question 4

Temporal lobe epilepsy (history)

Answer 4

• Clarify HPC (onset, duration)
• Pre-ictal phase (vacant, visual disturbance, unresponsive, involuntary movements)
• Ictal phase (duration, LOC, movements, continence)
• Post-ictal phase (confusion, sleepiness, memory, headache)
• PMHx (medication, conditions, substances, FHx)

Question 5

Pregnancy/parenthood in LD (d/w family)

Answer 5

• Clarify HPC
• Parenting concerns (Baseline functioning, work)
• Explain role of social services (assessment, support, care)
• Sterilization (consent and capacity)
• LD in child (family history, genetic testing, aetiology of LD, antenatal care)

Question 6

Abuse in LD (history)

Answer 6

• Clarify HPC (onset, duration, course)
• Explore social circumstances (family relationships, frequency of visits, bruising etc)
• Psych screen (mood, enjoyment, sleep, appetite, aggression, easily startled, abnormal behaviour)
• Med screen (PMHx, meds, seizures, new Sx)
• Baseline skills (communication, ADLs, other residents)