Abuse (Physical or Sexual)

Both men and women with Down syndrome are at higher risk for physical and sexual abuse than their non-disabled peers. Nurses working with this population should be well-versed in the warning signs of abuse, and should act immediately when abuse is suspected. Teaching and counseling, tailored to the individual’s cognitive level, can be highly effective in averting abuse.

Obstructive sleep apnea is seen in one out of every two adults with Down syndrome. It is not always associated with obesity in this population, and may be related to low tone in the airways and structural abnormalities. It’s important for nurses to report any symptoms of sleep apnea, including:

• snoring and periods of apnea during sleep
• unusual sleeping positions
• daytime sleepiness
• irritability, depression or paranoia
• significant behavioral changes
  

In some cases, surgery is indicated to avoid hypoxia and cor pulmonale. Other adults may benefit from supplemental oxygen under pressure, such as bi-pap or CPAP. Nurses working with these individuals can play a key role in promoting and reinforcing correct and regular use of these devices

In general, solid tumors are less common in people with Down syndrome. However, men with Down syndrome are at a higher risk for testicular cancer. If possible, they should be taught to perform regular testicular self-examination and report abnormal results to the health care provider. Annual testicular examinations by the health care provider are also important. Nurses can encourage self-exams by setting up a visual reminder system, ensuring that the client knows the correct procedure, and following up on a regular basis.

Gingivitis, periodontal disease, orthodontic problems, and bruxism (tooth grinding) are more common in individuals with Down syndrome than the general population, and often cause tooth loss. However, dental caries are less common. Nurses can play an important role by identifying and reporting early signs of periodontal disease, and encouraging good dental hygiene and regular check-ups. Because many adults with Down syndrome have motor impairments that can interfere with good oral hygiene, it’s important to check periodically to see that the client is using proper techniques for brushing and flossing.