Note: This article was adapted from a section in the Direct Support Professional Training Student Guide.

Health Needs

Over the course of our lives, we might face health problems. Individuals with developmental disabilities also face health problems. One of the responsibilities of a helper (a family member or a professional support person) is supporting individuals to be as healthy as possible. This includes:

• Knowing about a person’s health and healthcare needs
• Responding to changes in a person’s health
• Supporting healthy habits
• Supporting preventive health care
• Supporting individuals when they get sick
• Supporting individuals with their medications

In this article, we discuss how to monitor an individual’s health and respond to changes. There are four steps:

1. Get to know an individual’s normal health and health history
2. Talk with the individual often about their health
3. Look for changes in the individual’s health
4. Take the right action when the individual’s health changes

All four of these steps are very important. First, you have to know about someone’s health to know when it changes. Second, you should always try to talk with the person you support about how they are feeling. Third, you may need to watch for non-verbal signs or use your senses, to tell you if there is a change in the person’s health. Finally, when there is a change in a person’s health, you have to know what to do about it.

Step 1: Get to know an individual’s normal health and health history

By spending time with the individual you will get to know what is normal for them. You also need to know an individual’s health history. This will help you notice a change in their health. The person you support probably has a file which includes information on their health history. You may also want to talk to:

• People who know and care about the individual (helpers and friends).
• People who know about the individual’s health (doctors, nurses, helpers, regional center service coordinator).

If a person you support does not have a Health Profile, you should help develop one. This helps you know the person’s health, but it also ensures that everyone on their support team is on the same page.

Step 2: Talk with the individual often about their health

Communication includes asking questions and listening to the individual and others on the support team. It starts with asking every day, “How are you feeling?”

If the person you support tells you they are not feeling good, you should ask follow-up questions. Follow-up questions give you information to decide how to respond to the change in health. For example, if an individual tells you their stomach hurts, you might ask, “When did it start hurting?” or “Can you show me where it hurts?”

Step 3: Look for changes in the individual’s health

A person cannot always tell you if something has changed. You need to use your senses to notice any non-verbal signs of changes in the person’s health.

When looking for signs and symptoms of illness, you should watch for changes in:

• Daily routines
• Behavior
• Ways of communicating
• Appearance
• General manner or mood
• Physical health

To gather information that will help you learn about someone’s health and changes in it, you need to use all of your senses: sight, hearing, touch, and smell. For example:

• You might see tears, redness or swelling of the skin, or cloudy urine.
• You may hear labored or noisy breathing, crying, moaning, coughing, or screaming.
• You may feel hot, moist, or cold skin.
• You may smell an unusual or unpleasant odor coming from the individual’s mouth, body, or body fluids.

If you notice a change in the person’s health, ask the person about it. If the individual is unable to tell you, you must observe and listen. For example, the individual you support might be holding their stomach and crying. This behavior may mean something is wrong.

The individuals you support rely on you to identify changes that may be the signs and symptoms of an illness or injury and to make sure they receive the health supports they need to stay healthy.

Step 3: Take the right action when an individual’s health changes

If you see a change in the person you support that you think is a sign or symptom of illness, decide quickly what to do. You can:

1. Call 911
2. Make an urgent call to the doctor
3. Give routine treatment at home

Below we explain when you should choose each option.

Call 911 for a medical emergency that requires immediate medical attention. For example:

• Bleeding that won’t stop
• Unconsciousness
• Lack of pulse
• Trouble breathing
• Chest pain or pressure
• Broken bones
• Choking
• Injuries to the head, neck, or back
• Shock
• A seizure lasting five minutes or more
• Electrical shock
• Drowning or near drowning
• Severe burns (burns that cover more than one part of the body or on head, neck, hands, feet, or genitals)

If you think you need to call 911, do it! Don’t call someone to ask if you should. If you have any question in your mind, make the call. Quickly recognizing signs and symptoms that require emergency medical treatment can be the difference between life and death.

If you think an individual has been poisoned, first call the Poison Control Center at 1-800-222-1222 to get advice, and then call 911.

Make an urgent call to the doctor: Call the doctor for a serious sign or symptom that requires an urgent report to the individual’s doctor. For example:

• Fast changes in the way they act
• Sleeping most of the day
• Holding their stomach
• Showing pain or discomfort
• Not being able to hold their bladder or bowels
• Fever of 101 degrees or higher
• Rash lasting several days or getting worse
• Increase in seizure activity
• Sore throat/difficulty swallowing
• Not being able to walk/limping

Always report these changes to the doctor as soon as possible. When in doubt, call the doctor.

• When you call the doctor, tell them about:
• The symptoms the individual reported to you
• The signs you have seen
• The signs others have seen
• When the change first began or was noticed
• Any recent history of similar signs or symptoms
• Current medications
• Known allergies

Give routine treatment at home: You can treat an individual at home if the person’s health can be treated with simple First Aid or if the doctor writes an order that allows you to give treatment at home. For example, a helper may provide minor First Aid at home for a small scratch on the finger. Some symptoms reported by the individual, such as a headache or swelling of the ankles, may be treated at home if there are written doctor’s orders that specify what to do.

Remember, it is important to be familiar with the individual, their health history, the person’s medications, and any written doctors’ orders before giving routine treatment.

Reference:

Direct Support Professional Training (Section 8), Student Resource Guide (Year One). California Department of Education and the Regional Occupational Centers and Programs in partnership with Department of Developmental Services. Updated January 2004.