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

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
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
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
References
1. Prater (2006) Am Fam Physician 73(12):2175

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.