Addressing Health Risks in NDIS Participants
Published: 03 May 2022
Published: 03 May 2022
Australians receiving disability support services have a mortality rate 4.7 times higher than the general population. Many of these deaths are potentially avoidable, yet, alarmingly, the likelihood of dying from a potentially avoidable cause is 3.6 times higher among people living with disability (AIHW 2020).
In 2019, the NDIS Commission facilitated a study investigating the causes of death in people receiving disability supports and services, finding that many people who had died did not receive preventative healthcare measures such as vaccinations, dental check-ups, comprehensive health examinations and referrals to allied health services (NDIS Commission 2019).
Furthermore, some deceased people with identified risk factors such as diabetes, obesity and hypertension had no evidence of referral and follow-up for these conditions (NDIS Commission 2019).
In response to these findings, it was recommended that the NDIS Commission increase providers’ and workers’ awareness and knowledge of how the serious injury and death of people with disability can be prevented (NDIS Commission 2019).
As part of these recommendations, in July 2021, the Australian Commission on Safety and Quality in Health Care and NDIS Commission released a practice alert explaining the importance of undertaking regular comprehensive health assessments for people with disability.
All NDIS participants have the right to be in optimal physical, oral and mental health. It’s therefore the responsibility of providers to monitor participants’ health, safety and wellbeing, help them to maintain their health and assist in accessing healthcare services (ACSQHC & NDIS Commission 2021).
The leading causes of death in people with disability are:
(NDIS Commission 2020)
Those at the highest risk of potentially avoidable death are people with acquired brain injury, vision impairment (as their primary disability) and psychosocial disability (NDIS Commission 2020).
A 2019 study found that the most common underlying cause of death in people with disability (predominantly those with intellectual disability) was respiratory disease, accounting for 19% of cases. Most commonly (in just under half of all cases), this involved aspiration pneumonia (Salomon & Trollor 2019). Other common underlying causes included:
(Salomon & Trollor 2019)
The most common unnatural or external cause of death was accidental choking (Salomon & Trollor 2019).
(ACSQHC & NDIS Commission 2021; Salomon & Trollor 2019)
Factors that may increase the risk of mortality in people with disability include:
(NDIS Commission 2019)
It’s important to have adequate knowledge of the participant’s normal state of health so that any changes or new symptoms can be identified as soon as possible. This will ensure the participant receives appropriate care in a timely manner and may prevent any illnesses from worsening (ACSQHC & NDIS Commission 2021).
Changes that may indicate illness include:
(ACSQHC & NDIS Commission 2021)
It’s important to develop trust with the participant so that they feel comfortable communicating that they are unwell. This also requires understanding the way in which the participant communicates (ACSQHC & NDIS Commission 2021).
Once changes in health have been identified, care should be escalated as soon as possible (ACSQHC & NDIS Commission 2021).
Regular comprehensive health assessments have a variety of benefits for people living with disability, including:
(ACSQHC & NDIS Commission 2021)
A comprehensive health assessment should involve a discussion and review with a general practitioner, where the following is addressed:
(ACSQHC & NDIS Commission 2021)
Based upon this assessment, as well as a physical examination, the GP may recommend preventative care such as regular screening for conditions like cancer (ACSQHC & NDIS Commission 2021).
A healthcare plan comprising any recommendations made by the GP should then be developed in collaboration with the participant and the provider (ACSQHC & NDIS Commission 2021).
Chronic illnesses should be continuously managed in order to prevent the worsening of symptoms. This should include:
(ACSQHC & NDIS Commission 2021; Chang et al. 2017)
NDIS participants should be supported to maintain their health, access healthcare and undertake regular health assessments. This can be achieved through:
(ACSQHC & NDIS Commission 2021)
Question 1 of 4
What is the most common underlying cause of death in people with disability?