Care of Adults With Intellectual and Developmental Disabilities: Developmental Disabilities

Approximately 4.8% of individuals in the United States are affected by developmental disabilities (DDs). These individuals have a spectrum of abilities in terms of communication, mobility, and activities of daily living (ADLs). Because there typically is no specific treatment for the underlying disability, the focus of care should be on diagnosing and managing co-occurring medical and mental or behavioral health conditions and improving function and quality of life. Care of patients with DDs is similar to care of patients without DDs, although adjustments may be needed in the physician's interactive approach, engagement of caregivers, and sensitivity to symptoms. Health care can be enhanced by obtaining information about caregivers and guardians, living and work situations, support services received, and functional and instrumental ADL levels. In managing acute conditions, physicians should assess change from baseline and identify and manage maladaptive behaviors that interfere with care. An individualized preventive care plan should be created that may include additional or adapted screening. Needs for consent/medical decision-making support should be identified and addressed, and consent obtained as appropriate. Providing caregiver support and becoming familiar with community resources are other aspects of caring for this population.