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Heat Related Illness: Symptoms and Prevention
by Jennifer McLaren, MD
People with intellectual and developmental disabilities (IDD) are vulnerable to heat related illnesses, as their bodies may not adjust well to temperature changes. Chronic medical conditions (e.g., cardiac disease, hypertension, obesity, diabetes, kidney and lung disease) that change the body’s normal response to heat are common among individuals with IDD. Medications (psychiatric medications, diuretics, antihistamines, anti-Parkinson’s medications) that affect the body’s ability to control its temperature are also commonly used by patients with IDD. It is important for care providers to help prevent and to recognize heat related illnesses. Symptoms of heat related illness range from mild to life threatening.
| Signs of a severe heat related illness (heat stroke) |
| Symptom |
How symptom may present in someone with IDD |
| High body temperature (103°F or higher) |
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| Headache |
Holding, hitting, or banging their head |
| Increased, strong pulse |
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| Dizziness: unsteady on their feet |
Unsteady on their feet, refusal to get up |
| Confusion |
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| Nausea |
Not wanting to eat |
| Loss of consciousness |
Passing out |
If the individual is experiencing the above symptoms, they may be experiencing a heat stroke, which is a medical emergency. You should immediately:
- Call 911
- Move the person to a cooler place
- Lower their body temperature (with cool cloths or cool bath)
- Do not give the person anything to drink.
Here are some tips to avoid heat related illness:
- Never leave anyone in a vehicle with windows closed on a hot day
- Drink 64 ounces of water a day and potentially more in hot weather (unless on fluid restrictions)
- Avoid the sun between 10:00 am -4:00 pm
- Avoid alcohol and caffeine
- Spend time in cool, shaded open areas outdoors
- Utilize a fan or air conditioning indoors
- Wear light colored, loose fitting clothing
- Eat light meals regularly
- Take cool showers or baths
- Wear hat, sunglasses and sunscreen
For more information regarding heat related illnesses please, refer to https://www.cdc.gov/disasters/extremeheat/index.html
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The Jailer and the Coach
by Melanie Hecker, MPA
Imagine there are two advertisements for Direct Support Professional positions. One posting reads “Looking for full-time Direct Support Professional to be an authority over developmentally disabled clients. Main responsibilities include scolding the clients, controlling them, and keeping them in line”. The other posting reads “Looking for full-time Direct Support Professional to ensure the well-being and happiness of developmentally disabled consumers. Main responsibilities include supporting consumers in their goals and providing assistance with life skills when requested”.
On the surface, these two job descriptions seem completely different. However, these two postings are actually the exact same job viewed through two different lenses: the Jailer Model and the Coach Model.
Traditionally, direct service agencies and providers consider their primary role as one of authority. They seek to focus most of their energy on punishing misbehavior and delivering orders to their consumers. This authority is considered to be absolute: consumers are not allowed to question their providers or make recommendations about their care. Self-advocacy, whether it consists of making suggestions about one’s own care or defending oneself after mistreatment, is considered a form of misbehavior. By extension, everything about service content or delivery is decided by the provider. Consumers are assumed to deserve no say in their care... Continue reading
Full article link: https://centerforstartservices.org/self-advocate-sentinel-jailer-and-coach |
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The Georgetown University Center for Excellence in Developmental Disabilities (GUCEDD) created a video series featuring two people with lived experience of developmental disabilities, Thelma Green and James Beadle. The video series consists of James and Thelma individually sharing their reasons for getting vaccinated and the two of them discussing their journey together. James and Thelma are good friends and James was a very effective influencer to encourage Thelma to receive the COVID-19 vaccine.
Why I Got My COVID-19 Vaccine (After I Really Did Not Want To)
ASL Version: https://vimeo.com/569618837
Spanish Language Version: https://vimeo.com/579908785
Why People with Disabilities Should Get Their COVID-19 Vaccine
ASL Version: https://vimeo.com/569621275
Spanish Language Version: https://vimeo.com/579907573
Getting my COVID-19 Vaccine with Confidence
ASL Version: https://vimeo.com/569626357
Spanish Language Version: https://vimeo.com/579905011
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Did you know the DSM-5 (2013) addresses some cultural concepts related to diagnosis and understanding of psychological distress? In our clinical work, we must be cognizant of cultural differences and how that impacts our conceptualization of a crisis event. In some cultures, some expressions of distress or paranoia that we may interpret as symptoms of a disorder, for example, are considered standard.
The DSM-5 includes a Glossary of Cultural Concepts of Distress with which we should all familiarize ourselves. One such concept commonly known in the Caribbean, Latin American, and Latin Mediterranean cultures is called ataque de nervios, described in the DSM-5 as:
"Commonly reported symptoms include uncontrollable shouting, attacks of crying, trembling, heat in the chest rising into the head, and verbal or physical aggression. Dissociative experiences, seizurelike or fainting episodes, and suicidal gestures are prominent in some attacks but absent in others. A general feature of an ataque de nervios is a sense of being out of control. Ataques de nervios frequently occur as a direct result of a stressful event relating to the family (e.g., death of a close relative, separation or divorce from a spouse, conflict with spouse or children, or witnessing an accident involving a family member). People can experience amnesia for what occurred during the ataque de nervios, but they otherwise return rapidly to their usual level of functioning. Although descriptions of some ataques de nervios most closely fit with the DSM-IV description of panic attacks, the association of most ataques with a precipitating event and the frequent absence of the hallmark symptoms of acute fear or apprehension distinguish them from panic disorder. Ataques range from normal expressions of distress not associated with a mental disorder to symptom presentations associated with anxiety, mood dissociative, or somatoform disorders." (p. 833)
Understanding this concept is critical in working with people and families with these cultural backgrounds and can significantly impact our success in joining with and helping them. We at Center for START Services suggest you take a few minutes and review this table in the DSM-5, which can lead to rich discussion with your teammates and colleagues.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders fifth edition (DSM-5). Washington, DC: American Psychiatric Association.
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Share Good News. We welcome START programs to share their good news - this could be a START team member accomplishment, kudos to an entire START team, an update about a well-received training delivered in your community, or any other news worth celebrating! Your good news updates will be shared as part of future editions of CSS News & Views.
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Upcoming Professional Development
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MHIDD Course for Mobile Crisis Responders
Registration is open for Next Course Beginning on September 7, 2021
This live 6-week online course offers the expert training and support needed to develop expertise in providing effective crisis supports to people with intellectual/developmental disability and mental health needs (MH/IDD). Topics address best practices in crisis assessment, response strategies, and disposition recommendations. Registration fee is $149 per person.
“I appreciated the case study and being able to apply what we learned into our jobs. It was very informative and it already helped me in my job.” - Course Participant
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MHIDD Course for Care Coordinators & Case Managers
Registration is open for Next Course Beginning on October 11, 2021
This live 6-week online course is designed to improve knowledge for care coordinators and case managers to successfully support children and adults with IDD and mental health service needs and their families. Speakers will include family members and people with lived experiences along with experts in the field. Dr. Joan B. Beasley will demonstrate how the information provided can be applied to improve the ability of care coordinators/case managers to identify service and support needs, and monitor outcomes for individuals and their families. Registration fee is $299 per person.
“The format is flawless and helps facilitate a learning experience in a non-traditional way” - Course Participant
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MHIDD Course for Direct Support Professionals
Registration is open for Next Course Beginning on November 2, 2021
This live, 6-session course gives Direct Support Professionals (DSPs) the knowledge, skills, and resources needed to provide individuals with IDD and mental health service needs (IDD-MH) positive, person-centered, strengths and wellness-based supports and services. The course facilitators will demonstrate how the information reviewed during session can be applied in the day-to-day support of people with IDD-MH. Registration fee is $149 per person.
"This course offers the content I need to do my job and the many facets of one’s life we must always consider." - Course Participant
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Other Upcoming Opportunities
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Tuesday August 17th 12:30-2:00 pm eastern
Medication Prescribers' Guide with Lived Experience
Presenters: Andrea Caoili, LCSW, Dr. Jen McLaren, and Melanie Hecker, MPA
Register for this online training & discussion
The Mental Health Summit is Co-sponsored by the AUCD Mental Health Aspects of IDD Special Interest Group (SIG) and features CSS national team members Andrea Caoili, LCSW, Melanie Hecker, MPA, Jennifer McLaren, MD, and Jill Hinton, PhD.
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Have a healthy and happy week,
The Center for START Services
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