Case studies that may come in useful for Student nurses.

Health study cases for LD week.

Sorry this is an old report but I hope this report will come in useful, mainly for those who haven't seen it before. Updated 13.2.2013

Study case 1. Mr Jones is eighteen years old.

He was send to a mental impairment service from the Children team nine months prior to his eighteenth birthday.

At the time he was living in a supported flat with 24 hour 1 to 1 support from a private run domiciliary care service, where he had resided for about one year.

He was diagnosed Autism and depression, for which he was prescribed medication by the children's psychiatrist.

At the time he was told that he had severely behaviour problems, he had attacked staff several times a week.

This caused a high level of staff sickness to injury or stress.

He has had threaded members of the public.

He often went out to meet young women, which he had relationships with.
He was well known to the police service, which had been called out many times because of his violence behaviour towards staff.

He was in court many times for assault and threatening behaviour and been detained in young offenders institution twice.

Shortly after his referral, he was again detained in a prison which was 150 miles away from the service.

The mental impairment service attended two reviews at the prison and travelled to see him during his period of detention.

The remain prior to his eighteenth birthday was to gather information and liaise with children's' services.

It was clear that due to his level of learning disability he was not coping well in prison.

The service advised him that psychiatric assessment was done during his time of detention, with a view to finding him a hospital near his home area, and planned for a local psychiatrist to travel to the prison and carry out the assessment.

However, before he could be moved, his time of detention ended and he was released back to his old address.

He was placed on a higher level of 24 hour care with two or three staff at all times.

He has been detained on a low secure unit many times in order to treat episode of psychosis.

A few months later, the housing and support provider felt after many attacks, they couldn't give support any longer to Mr Jones due to his behaviour.

He was evicted from the property. An emergency referral was then made to an alternative care provider which was based about 60 miles away from his home.

He was moved to another supported flat with 24 hour support from two staff.

A mouth of residing in this placement he again turned up in court following previous assaults and was remanded in prison. At this point he turned eighteen.
He was officially moved to the mental impairment service on the day of his 18th birthday.

Shortly after this, a move to this a move to a low private secure therapeutic facility was planned under section 37 of Mental Health Act. The unit is 156 miles away from Mr Jones’s home.

People with LD and Mental Health problems can be misunderstood but it doesn't that everything is down to LD and Mental Health.

Some people may be unaware of what they could be saying or and doing.
There are all different kinds’ behaviour problems.

For example; I understand that crime can be a serious thing, I feel for people when they lose the people they love.

No one is saying that people with LD should be treated any different because of their LD but there needs to be awareness of balance if it comes to a case of a person with LD who hasn't been aware of what they may have done until they have told in a prison but at the same time we must understand the feeling of the victims loved ones.

The person with LD may be very angry with themselves to a point they could take they own life because they wouldn't be able to stand a life time in prison.

I am not saying all people with LD don't know what they are doing but for the ones don't wouldn't do such crimes if it hadn't of been for their problems.

Some causes could be done to LD, Mental problems or and the side effects of most medications. Health staffs need to look into these things so these people don't put themselves through these things.

Case 2 com pair Mr Jones’s case with mine as a child.

How do you think my life would have ended up now if I was still on those dangerous tablets? Do you think I would have ended up like Mr Jones or not?

Possible side effects from medications.

 Heavy medication can be dangerous for children. A lot of heavy medications can cause behaviour problems. The Medications, disabilities and health problems don't excuse behaviour problems but they don't hell them. On the other hand. Some behaviour problems cause crime but others don't, this can vary from person to person.

Some people find it hard to pay attention in the daytime and sleep at night. Medication can make some people over tried to a point where some people don't sleep at all and others sleep too long. Some people can be very sleepy and dreamy yet they can't sleep even if they get the chance to. This is hyperactively.

Some people start to get better when they come off medications but other get worse.

Some people can get moody or and have tempers for no reason through medication. This can be common in children as well as teenagers and adults.

Some people can get angrily if they can't manage to achieve the skills they want to achieve.

For eg; tying shoe laces.

Most people feel alone thinking everyone is cleverer better than them.

Some people feel useless. The worlds seemed too big for them

with some medication some people are unaware of the world around them.

My questions are to you, there's no right or wrong answers, and I am just interested what you think.

Please send me an email on sarajgorman@gmail.com.

Back in roughly the late 60s to early 70s doctors put babies on Phenobarbital (phenobarbitone) for Epilepsy. Most babies were taking 3 to 500mgs one tablet three times a day, that’s how dangerous the medication was for a child or any human being any age.
 The purpose of Phenobarbitone tablets were to help the soldiers sleep in the 1st or and 2nd world war.
If you would like to research it on the Internet, Health staff and Health students.

If you research this please send an email me to let me know what you have found out. sarajgorman@gmail.com

Mr Smith's case.

Case three. Mr Smith is twenty - six years old West Indian man with mild LD and psychotic disorder for which he receives prescribed medication.
He has a long history of petty offences for which he has been arrested and in court many times.
These include burglary, theft and minor drug offences.

He had spent five years on offender register due to previous sex offenders against a girl under age sixteen.

Mr Smith resides in the area he has moved to different rented places over the years.
He often fails to keep appointments and very guarded about his whereabouts, making it hard to engage effectively with him.

He finds it hard to help himself and many of his placements have failed. His currently saying with family and is soon to be evicted.

It is known that Mr Smith does not adhere voluntary to his medication regime.

Mr Smith is very hard to house due to his history of unstable tenancies, and his offending behaviour.

He had just been arrested for burglary and his court case has been put on hold for two mouths.
There has been an on-going issue with the police as he and his family feel that his LD is not taken into account by police or professions with the criminal justice system.

He has taken custody many times with no request for an appropriate adult, or any support from health or social services.

Why do you think Mr Smith committed the crimes he had done?

Do you think by the sounds of cases he meant to commit these crimes or not?

Make notes on the balance of the feelings of the victims and Mr Smith’s feelings in case of if he didn't know what he was doing. How do you think he felt when he became aware?

In the case that he may have meant to commit these crimes what do you think should happen to him because of his LD?

What should to happen to him if he didn't know what he was doing?

What do you think caused it he didn't mean to do? LD, Mental Health problems or even the medication he's taking.
What should to happen to him if he didn't know what he was doing?

What do you think caused it he didn't mean to do? LD, Mental Health problems or even the medication he's taking.


Do you think he may be misunderstood? Without excuses there may be all kinds of possibilities but we need to understand the feelings of the victims, families, lovers and friends.

Health students and Health staff, if you want to answer these questions, you may be able to research Mr Smith's LD on the internet. Please email if you want if you answer to try to answer these questions.

People with learning disabilities and Health problems have to cope with Stress too, which makes people more ill through worry.


Stress is one of the worse killers today, there seems to be a lot of stress today for everyone over one thing or another.

Many people turn to things bad for their health due to stress for example; smoking. It can be hard for a lot of people to accept things that they don't want to live with as it is. Bad news is bad enough as it is without it been confusing and stressful.

If we lose something or someone in our live we don't want to lose. Whether like it or not it happens. It's bad enough for people without LD but the stress can make people with LD more ill. Another example is relationship break ups, family break ups and etc.

I am not saying that people without disabilities don't suffer their problems but people with disabilities have our own stresses without anything on our minds, that's own learning disabilities and Health problems things on our minds on top of the problems all people have, can make life even harder to cope with.

We don't expect any magic wands but we need more understanding and support to cope with our lives. Thank you.

Sexual Health.
Back in 1991, my favourite singer Freddie Mercury from Queen died of a Sexual disease called Aids.

I know he didn't have learning disabilities but there's still isn't enough awareness about Sexual diseases in people with learning disabilities.

I am sure Freddie would have liked people with LD and Health problems to get a lot of support for our Sexual Health as much as people without.

Whether we have LD or not we all have feelings.

Freddie was just as ill as people with LD would be.

There again what people need to understand due to our life Health problems. Other illnesses everyone can have, people with LD can be twice as ill as people without LD. It could make us die quicker because of our LD and the Health problems we may have already.
There needs to be more education on Sexual health that's accessible in schools and colleges.

It can be hard enough teaching young people as it is why education on health is important but people with learning disabilities are slower learners so many of us may need more support to learn.

For example; some people may not understand why we are advised to use condoms and may even have problems putting them on, mainly if we have problems with our hands. In my case with problems griping, without been personal I am lucky that I have had partners who knew how to put them on.

There still needs to be more education on choices, pregnancy, conception, support and etc.

In March 2009, Jade Goody died of cervical cancer; this is just an example of many young people who have died of cancer.

I want to raise awareness of cervical cancer.

We all know its right to have Smears to get ourselves checked out.

Many women could be scared of having Swears if they have suffered rape and Sexual abuse at any time during our lives. This can have the same big effects on our lives as much females without LD.

May be counselling should be advised to females if they fear swears due to the bad experiences we may have had. Most of us may feel as if we can't go through smears so there needs be support for us to cope with our fears.

Information should be accessible for all females’ not just females with learning disabilities mainly when we have been through rape and Sexual abuse at any time during our lives, this can put a big effect on any female's life, body and mind. We understand males have suffered sexual abuse and rape as well, which we must raise awareness of these kind of things for males with and without LD.

There's still not enough awareness of people with learning disabilities who have cancer.

I had cancer of the throat at the age of 23, even though I was very lucky it didn't spread to any other part of my body but even though the treatment knocked me about I was lucky to get better. Here's a person LD who didn't better from cancer but could if Health staff looked after better. I don't think they looked after her at all.

Mencap wrote the Death Indifference report back in 2007. Someone with LD died of Cancer because she found it hard to communicate with the doctors and nurses in the hospital, she found hard to responded to the treatment so the hospital reported. 

Emm