Vulnerable Population and Self Awareness

Vulnerable Population and Self-Awareness Paper 3about developmental syndromes and practitioner discomfort or lack of understanding in workingwith persons with ID" (Minnes, p. 255). This shows how patients with these types of conditionscan become vulnerable in acquiring health care. Away from the larger institutions, facilities,physicians may not be as knowledgeable or use to caring for these patients. This, along with alack of communication and possible behaviors can be barriers in them receiving adequate healthcare.In my work, I find nurses and care providers, are reporting information to the physicians,primary care and specialty, regarding the everyday needs as well as recent illnesses. I believe thisis because some of them are not able to speak for themselves. Even if some patients canverbalize what is happening, I see physicians, especially the specialists, turning to the nursingstaff for information instead of asking the patient directly.Some patients with Down Syndrome have been described as passive, wanting to pleaseothers, loving and non-confrontational. I have seen this as well as them being very trusting andcaring. They are very "child-like" concerning care: very trusting. I have assisted physicians indoing physical exams, including annual pelvic exams, on patients with Down Syndrome. Theycan be very compliant.When an invasive procedure or exam is done, they tend to respond as children do:panicked, upset, crying, and acting out. "Several parents wondered whether the level of functioning of their child influenced the quality of the relationships with practitioners. In onecase, we were told that a daughter's 'hysterical' first reaction to a Pap smear test meant that shewas never tested again" (Minnes, p. 254). Having seen firsthand these reactions, I can see howthis could occur, especially in the community or home settings. This is another way thispopulation can be vulnerable in receiving adequate health care. Just because a population is

Vulnerable Population and Self-Awareness Paper 4resistive to routine medical or health related procedures does not mean they should be excludedfrom routine screenings. Where I work, we use sedation as needed to help the patient relax for the exam. We also try to book together exams to decrease the anxiety as well. Desensitizingactivities can be utilized. "Presently, however, there is no research to suggest that preventativehealth practices that are recommended for the general population, throughout the life-span,should be withheld from people with intellectual disabilities" (Evenhuis, p. 181).I spent five years doing home health nursing in the state of Georgia. One of our patientswas a young woman who lived with her elderly father. She had Down Syndrome. I discoveredthat the majority of nurses did not want to go and do the teaching or interact with her or her father. Once it was learned that I had experience with the developmentally disabled, I wasassigned as her primary nurse. I soon learned that the father could be "overbearing" wanting tobe involved in every way with the weekly visits. I took my time and spoke with him as well aswith her, developed a rapport and soon learned his "overbearing" was his way of advocating for his daughter and seeing that