Asking a patient if they're mentally retarded?

[missjustice]

I know nurses have to ask embarrassing or very personal questions sometimes, but is there a polite way of asking a patient if they're mentally retarded?

One of the techs on my floor told me today that as she was about to do an admission interview, the nurse pulled her aside and told her to ask the patient if they had some kind of mental disability, because he had seemed 'slow' while she was talking to him.

The tech said she couldn't think of a nice way to ask so she just asked if he had any learning disabilities as part of the psych section of the interview, but she didn't think he really understood what she was talking about.

How would you approach a topic like this?

[boushie87]

Any intellectual disabilities? Any problems learning or did they think they learned slower or different from other people? Just have to phrase it in a way they may understand. You may need to speak to a relative, a case worker they have if they are DD, etc. to get a true response.

[loriangel14, RN]

You could ask if they have any intellectual disabilities but likely you would have to refer to family for this one. You CANNOT ask someone if they are mentally retarded, that is an offensive term.Usually if they have a true disability they will have family or someone else assisting them.Sometimes you get patients that are just a little odd.

[Bruce_Wayne, ASN, RN]

Your techs do "admission interviews"? I find that weird.

More to your question you can't diagnose somebody with mental retardation so unless you get somebody to say they have MR you can only assess what you can see and document what you see.

The AACAP gives these assessment guidelines.

Patient Interview

♦

Ample time must be allotted for the patient interview, which typically takes longer

than with patients without MR. Sufficient time is needed to put the patient at ease.

♦

The verbal examination should be adapted to the patient's communication skills and

should use clear and concrete language, structure, reassurance, and support. ♦Leading questions and questions requiring yes or no answers should be avoided and the interviewer should ensure that questions are understood.

♦Patients with sensory impairments like blindness or deafness must be approached in a manner that recognizes their needs through the use of appropriate interpreters or communication devices.

♦Mental status may be assessed in the context of conversation, rather than in a formal examination. It is often helpful to start the interview with a discussion of a patient's

strengths and interests, rather than problems, and later focus on the patient's

understanding of disability, limitations, and reasons for the referral.

♦ Nonverbal aspects of the interview include observations of performance on selected

tasks, relatedness, expression of affect, impulse control, attention span, activity level, and the presence of unusual behaviors or seizures.

[erinberrin, CNA]

I know nurses have to ask embarrassing or very personal questions sometimes, but is there a polite way of asking a patient if they're mentally retarded?

One of the techs on my floor told me today that as she was about to do an admission interview, the nurse pulled her aside and told her to ask the patient if they had some kind of mental disability, because he had seemed 'slow' while she was talking to him.

The tech said she couldn't think of a nice way to ask so she just asked if he had any learning disabilities as part of the psych section of the interview, but she didn't think he really understood what she was talking about.

How would you approach a topic like this?

oh god...I would get a phyc nurse.

[heatheryk]

Have you ever been told by a doctor that you have a physical or mental disability?

[Whispera, MSN, RN]

Holy poptarts! I can't imagine an assessment form asking the assessor to indicate if a client is mentally retarded. We assess symptoms. So, you could indicate what you observe rather than the label.

We might know if the person is mentally disabled from history or from his companion. Plus, the word "retarded" has such negative connotations, it's usually avoided in favor of "developmentally disabled." I would feel very rude if I asked the client if he was mentally retarded to his face or if I asked his companion about it in his presence.

Imagine if you were the client and someone asked you that question and you were just having an off day. How would you feel? If a client is mentally disabled and he knew what you were asking he'd probably feel more embarrassed than you would be, if asked the same question. If the client was significantly mentally disabled, he might not even know what you're asking.

I agree with a previous poster in that someone who is mentally disabled would be likely to have someone with him and you can ask that person the questions you need to ask if the client can't answer them.

[caliotter3]

I have an off day every day and my facial expression can be really dead pan, I call it my "duh" look. I saw what someone wrote about me one time and it was not very flattering! I couldn't figure out how they got that impression just from a short conversation. But there are those of us who just plain look dumb, and we get our feelings hurt too! (I had a photo portrait of my daughter with that same "duh" look as a baby. Cute in that circumstance!)

[evolvingrn, BSN, RN]

oh god...I would get a phyc nurse.

Why would you get a psych nurse?

To the original poster Mentally retarded is no longer an acceptable term. I have asked this before and asked if they had any struggles with learning or ever been dx as being developmentally delayed. To which the Patient said "oh yeah, i am developmentally disabled"

[seizetheday]

The term developmental disability isn't synonymous with intellectual disability. While many people with developmental disabilities do have intellectual disabilities some do not. For example someone with cerebral palsy has a developmental disability but isn't necessarily intellectually disabled. Same with high functioning autism - another developmental disability.

I would just ask if the person has any disabilities. The rest of the assessment would be based on observation. If I didn't think the person could understand the questions, I would ask if we could include a family member in the assessment.

[MomRN0913]

I lost my train of thought with the actual question because I saw the tech was doing the admission assessment???

As a nurse you form your plan of care by doing the admission ASSESSMENT, which is a nursing function.

Geez.

I think you find out if the patient is "mentally retarded" by actually doing the nursing assessment.

Anyways, if it is a learning disability, usually when doing the patient teaching form, you can ask the patient if there is any barriers to patient teaching.

[TiffyRN, BSN, PhD]

Have you ever been told by a doctor that you have a physical or mental disability?

Oh, I like this. I've known for several years that using the term "mentally retarded" is not acceptable. But as was pointed out, "developmentally delayed" does not equal the above mentioned now not acceptable term. I know a few former patients that are developmentally delayed that are socially and intellectually average, but they failed to achieve their developmental milestones on schedule.

Interestingly one way we know parents have "issues" around here is if we find out they receive services from an agency called MHMR. That would be "Mental Health Mental Retardation" agency. Hey, I didn't name them!