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Health Care for Adults with Developmental DelayAka: Mental Retardation in Adults and their Medical Care

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  1. Comorbid Conditions: Physical
    1. Poor dental hygiene (recommend regular dental care)
    2. Skin Breakdown
      1. Observe perineum and decubitus areas
    3. Sleep Apnea
    4. Methicillin-resistant Staphylococcus aureus
      1. Associated with PEG or tracheotomy sites
    5. Aspiration
      1. Consider checking pulse oximetry with feedings
      2. Consider speech pathology evaluation
    6. Gastroesophageal Reflux disease
    7. Constipation and Fecal Impaction
      1. Maintain bowel regimen to prevent Constipation
    8. Pelvic Pain in women
      1. Control Dysmenorrhea (signalled by behavior change)
      2. Consider STD or pregnancy
    9. Seizures
      1. Differentiate from extrapyramidal drug effects
    10. Neuromuscular Scoliosis, Contractures, Spasticity
      1. Consult with orthopedics and physical therapy
    11. Osteoporosis
  2. Comorbid Conditions: Behavioral
    1. General
      1. May be due to stress, pain, anger, fear...
      2. Carefully evaluate for cause
      3. Benzodiazepines may exacerbate in 10% of cases
    2. Sexually offending behavior
    3. Self-injury (e.g. head-banging)
    4. Aggressive behavior
    5. Insomnia or other sleep problems
    6. Hyperactivity
    7. Repetitive behaviors
  3. General Measures to Assist Appointment
    1. Person well known to patient should accompany them
    2. Brief social visits can desensitize patient to office
    3. Talk the patient through examination
    4. Engage the patient in decision making
    5. Consider Ativan 2 mg taken 2 hours before appointment
  4. References
    1. Prater (2006) Am Fam Physician 73(12):2175

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