How can GPs assist people with intellectual disability during COVID? By Dr Aline Smith

21 April 2020

Dr Aline Smith is a Aline is a GP working in the CESPHN region who is experienced in helping people with a variety of mental health problems and holds a Masters degree in Mental Health from the NSW Institute of Psychiatry. She is also committed to providing medical care to people with a broad range of physical and mental disabilities. 

Below is Dr Smith's advice sheet on how to best care for people with intellectual disability at this time:

Having to self-isolate or having to curb their usual social activities plus the need to adopt physical and social distancing can be a challenging concept and practice for this group of people.

They require a lot of support from their carers, family and support workers to assist in demonstrating and explaining this situation to them.

This is the time for GPs to provide guidance as well as some proactive care to this group of vulnerable patients.

GPs need to: 

  1. Continue to provide the medical care to these patients and support to their families, carers or support workers
  2. Explain how care is to be delivered to them as you transition to telehealth /telephone consultations
  3. That these telehealth consultations will be bulkbilled Medicare items allowed during the COVID pandemic
  4. Discuss when face to face consultations will be necessary and how they can access this if required
  5. Discuss whether you will continue to provide home visitation services to the patient or if this will be withdrawn to be replaced by telehealth services only
  6. Discuss options of provision of face to face care in an emergency should it be required
  7. Update the care plan of the patient with:
    Medications
    Allergies
    Medical history (past and current)
    Specialists or other health professionals
    Management

And provide a copy for the patient/family/Carer or support worker

  1. Immunize patients esp influenza and pneumonia vaccination
  2. Upload shared health summary to My Health Record
  3. Provide information about COVID resources

Attached is an example of a home visit policy for our practice for our disabled and elderly patients developed during the preparation stage of the pandemic.

In summary, the care for people with disabilities can be effectively managed if good communication and clear guidelines are in place for support staff and families/carers to know how to access their GP for medical care. There is a lot a GP can do for these patients apart from being vigilant about testing for COVID i.e. to prevent patients from getting ill by providing immunisation, education and advice, optimising treatments and continue to provide management of the patients’ chronic disease during a pandemic. Let’s all continue to provide much needed medical service to this group of vulnerable patients in our community.

Dr Smith's The Village Medical Practice Home and Group home visit policy is below:

Only existing patients NO NEW HOME VISIT PATIENTS

This policy is to prevent where possible the spread of Covid 19 to vulnerable home visit patients, providers of care, patients in our waiting room and doctors 

  1. TVMP will continue to support our Home Visit and Group Home patients
  1. The last routine face to face home visit will be for the administration of the flu vaccination
  1. All consultations during the pandemic will be conducted on the phone only:-
    Phone consultations may or may not attract a private fee * (mostly will be bulkbilled)
    Face to face consultations can only be conducted by doctor’s advice to patient
    In particular: Phone consultations should be booked for fever, runny nose, flu like symptoms** first
  1. Doctors in consultation with the patient/house manager/team leader/carer may continue to have the usual regular contact either as telephone consults or home visits

** any patient presenting at the surgery with cough, fever , runny nose or flu like symptoms , OR accompanied  by a carer with these symptoms will not be admitted to the practice but will wait outside until screened by telephone by a doctor. And may be asked to be examined in their car.

Non-Urgent after-hours care (weekdays/public holidays 6.00 pm -6.00 am, weekends sat 12.00 noon to 6.00 am Monday) can be accessed 8724630 

TVMP: The Village Medical Practice 130 Smith Street Summer Hill NSW 2130