Clinical assessment for people with developmental disability who are ageing

People with developmental disability experience similar age-related physical and mental changes as the general population, although they can occur at a younger age. These changes often compound existing chronic illness and impairments.

Comprehensive clinical assessment of people with developmental disability who are ageing requires a systematic approach, including regular review by their general practitioner (GP) and annual health assessments. For advice on comprehensive health assessment tools that are specific to people with developmental disability, see Comprehensive health assessments.

When conducting health assessments for people with developmental disability who are ageing, GPs need to consider:

• common health problems in people with developmental disability who are ageing
• the presence or risk of frailty
• medication reviews to reduce polypharmacy and risk of adverse effects (eg cognitive effects, hypotension and falls); drug doses may need to be reduced
• preventive health needs
• changes in mood or behaviour, including sleep—changing social and living circumstances with age (eg retirement, change of accommodation, bereavement) can significantly affect mood and mental health
• adaptive functioning—to inform support needs including personal care, domestic tasks, using transport, work skills, communication and socialisation
• indications of functional decline (assessment will be most informative if compared to a baseline functional assessment)
• changing support needs—may include equipment or increased level of staff or carer supports; see also Social and functional support for people with developmental disability who are ageing
• needs of family carers—they will also be ageing, and may have chronic health conditions and diminishing capacity to provide care; current and future guardianship should be discussed with the family (see also Consent, capacity and decision making for people with developmental disability)
• advance care directives and planning for end-of-life care with the person, their family or carers.

It may take time or several consultations to piece together an accurate picture of the person’s health status. With the person’s consent, information should be obtained from several sources, including family, friends and support workers. If the person does not already have a personal health record (eg My Health Record), encourage them (or their support people) to start one. For advice on taking a medical history for a person with developmental disability, and obtaining information from other sources, see here.