CPAT Health-Self Promotion Approach

Health empowerment is a social process of recognizing, promoting, and enhancing the client’s patient’s’ abilities to meet their own needs, solve their own problems, and mobilize necessary resources to take control of their own lives. In other words, patient empowerment is a process of helping people to assert control over factors that affect their health. Increasing empowerment enhances their potential for their participation, in concert along with their clinicians to, in the prevention and treatment of diseases that are dependent on a change in personal behavior. It is a critical aspect of the continuum of care and the goal to achieve a higher state of wellness that begins in the clinical setting, followed by transition to the community, and ultimately to the person’s lifestyle. Knowledge is power, therefore communication and education is the central key factor in the process of self-health management and empowerment. Empowerment requires an individual to take care of one’s self and be well-informed to make choices about care from the among the all available options identified in concert with the healthcare team. To successfully empower adults with intellectual disability, providers must work with them to develop an interdisciplinary comprehensive plan and then work collaboratively towards a seamless transition.

The information collected from the patient should include walking/mobility assessment, motor control/strength evaluation, physical characteristics (BMI, Waist-Hip-Circumference, body fat%, vision, etc.), biomarker and blood assessment, psychological screening (depression, anxiety, etc.), intellectual assessment, and quality of life. Each assessment should be validated survey/assessment tool and follow the standards procedure for each respectable assessment tool. If certain elements are not collected, the recommendations and sections should be adjusted to represent the data collected.

Physical Activity Recommendations

Adults with intellectual disability are more likely to have both chronic health conditions and susceptibility to episodic illnesses. They are more likely to experience conditions such as fractures, skin conditions, respiratory disorders, intestinal obstruction, pneumonia, and trauma and they s are significantly more likely to be at abnormal body weight, which leads to a high risk of cardiac disease, high blood pressure, high cholesterol, diabetes.

Physical activity can be used to help these individuals prevent the onset of this conditions/diseases. The physical activity recommended should take into consideration their strength and mobility. Since many individuals with disabilities/CP have limitations in strength and mobility, the recommended physical activity treatments should work around these limitations. It is also important for the patient preference on activities, in addition to the resources and accessibility to the patient as well. 

Diet Recommendations

An unhealthy diet can lead to obesity and other adverse health conditions. The research literature demonstrates a significant portion of community-dwelling adults with intellectual disability have “nutritionally poor” diets that are inadequate in some essential nutrients, not drawn from recommended food groups (e.g. fruits, vegetables, and dairy), and are excessive in other foods (e.g. fats, sweets, and junk food).

Recommendations should consider changes to patient’s diet in regards to sugar and refined foods intake, cholesterol, eating more healthy fats, eliminate trans-fat, and water consumption. A reminder that these are recommendations and you should work with your patient to find foods and areas to maintain or improve a healthy diet.

Self-Care Recommendations

Assessment of health behaviors should be a standard part of practice across the continuum of care. Assessments can inform the care team about the client’s strengths and need for client- and family-centered intervention. Health assessment should include a holistic approach that promotes self-empowerment by educating the adult with intellectual disability about his or her illness and treatment options.

Evaluation and treatment should emphasize the importance of adult’s active participation in history, guided health review, and development of a health action plan. These can include, but not limited to sleeping habits, maintenance of hygiene, being safe during activities (using a seatbelt for driving, wearing a helmet for bicycle riding, following clinician recommendations, etc.), and the annual checkup visits with clinicians.

Risky Behavior Recommendations

Risk behaviors are actions that can potentially threaten your health or the health of others. The Center for Disease Control and Prevention (CDC), has listed 6 risk behaviors that account for most of the deaths and disabilities among young people:

1. Tobacco Use
2. Alcohol and other drug use
3. Unhealthy dietary behaviors
4. Inadequate physical activity
5. Sexual behaviors that can result in STD’s, pregnancy’s, and HIV infections
6. Behaviors that contribute to unintentional injuries and violence 

The recommendations should be geared to limiting these activities as much as possible. The goals should be focused on what the patient wants to achieve.

Quality of Life Recommendations

Maintaining a high-quality social health is very important. Social health is getting along with others, family, friends, supervisors, colleagues, and other community members.  Maintaining healthy relationships and caring for your social health involves:

1. Seeking and lending support when needed
2. Communicating clearly and listening to others
3. Showing respect and care for yourself and others

Recommendations should pertain to good sleeping habits, trying mindfulness meditation, and resources to try and participate in group/community settings and events. The participants goals should be considered when writing recommendations. 

Psychological Screening Test Results

Adults with intellectual disability are also more likely to have a mental health condition compared to persons in the general population. Studies have found that 40% of people with intellectual disability had a diagnosable mental illness or psychiatric condition, including psychosis, and anxiety, affective, obsessive compulsive and personality disorders, alcohol and substance abuse, or attention deficit hyperactivity.

In older adulthood, mental illness prevalence rates can reach 70% when dementia is included. Because of the high rates of mental illness, adults with intellectual disability are also more likely to be on psychiatric medications such as antidepressants, antipsychotics, and antiepileptic medications.

For the psychological assessment, tests and surveys administered should be validated and follow the standardized procedure. These screening tools should not be used as diagnostic and therefore should be cautioned when interpretation and creating recommendations. If there are any abnormal results, then a specialist should be involved.

It is also recommended that the recommendations should be centered around a patient’s goals. Similarly, cognitive assessment tool should be validated and follow the standardized procedure and caution should be used when interpretations and creating recommendations, as multiple factors can influence cognitive function, such as sleep, mood/depression, and diet. The recommendations should pertain to the patient’s goals.