Advice and resources : Signs of deteriorating physical health

Overview

People with a learning disability often have poorer health outcomes and shorter life expectancies than the general population.

They are more likely to experience multiple long-term conditions (multimorbidity) and diagnostic overshadowing, where their disability is wrongly identified as the cause of symptoms.

People with a learning disability may not always be able to communicate when they feel unwell, so it's vital to recognise early signs of deterioration.

Early recognition of deterioration can help prevent hospital admissions, reduce harm, and save lives, so it’s important to be alert to changes in their physical health.

Monitoring vital signs

If you are trained and have the right equipment, monitoring and recording any of the following could be a useful indicator of deterioration:

• temperature
• pulse rate
• breathing rate
• blood pressure
• oxygen saturation
• level of consciousness (alert, responsive to voice/pain, unresponsive)

Communicating concerns

Clear communication can save lives. It is particularly helpful if you can use a structured approach to report concerns, such as the SBARD approach (Situation, Background, Assessment, Recommendation).

It is useful to keep a record of all observations so you can use them to explain changes over time.

If you have concerns, don’t delay talking to a healthcare about them.

What is SBARD?

SBARD is a simple and effective communication tool that helps families and carers share concerns about someone’s health clearly and confidently with professionals. It’s especially useful when you think someone with a learning disability may be becoming unwell.

SBARD stands for:

• S – Situation: What is happening right now?
• B – Background: What is the persons usual health or behaviour?
• A – Assessment: What changes have you noticed?
• R – Recommendation: What do you think needs to happen?
• D – Decision: What was agreed or what action was taken?

How to use SBARD as a family member or carer

Here’s an example of how a family member might use SBARD when calling a GP or 111:

• S – Situation: “Hi, I’m calling about my son, James. He seems really unwell today.”
• B – Background: “James has a learning disability and usually he’s very active and chatty. He also has epilepsy and takes regular medication.”
• A – Assessment: “Since yesterday, he’s been very quiet, hasn’t eaten much, and seems confused. He also had a small seizure this morning, which is unusual.”
• R – Recommendation: “I’m worried this might be something serious. I think he needs to be seen by a doctor.”
• D – Decision: This part is when the professional responds and you note down what will happen next.

Tips for families

By staying observant and proactive, family members and carers can play a vital role in preventing serious illness and ensuring people with a learning disability receive the care they need, when they need it.

• Write down the details you need to get across before making a call so you can stay focused.
• Use a health passport or notes to share background information quickly.
• Don’t wait if you notice changes, speak up early.
• Be confident you know the person best.
• Ensure annual health checks available from the GP are completed for individuals aged 14 and over.
• Monitor known health conditions, such as epilepsy, diabetes, or dysphagia.
• Encourage regular dental, vision, and hearing checks.

• Learn more about health checks for people with a learning disability
• Your e-Health Passport