Patients with learning disability in the community

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Abstract
Letters pp 536 Over the past 20 years we have witnessed the closure of large residential hospitals for adults with mental handicap and an exodus from these institutions into community care. This move wasmotivated by a desire to give people with handicaps the opportunity to live as normal a life as possible.1 However, concerns have been expressed by the Department of Health,2 some psychiatrists,3 and patients themselves4 about the change. Adults with learning disability are more prone than the rest of the population to chronic health problems, including epilepsy, dementia, hepatitis, peptic ulcer, dysphagia, and problems relatedto sensory impairment.5 Age related diseases such as stroke, cardiovascular disease, and malignancy will also be of growing concern as life expectancy increases. Many may be surprised to learn that in the Netherlands mental retardation is the greatest single source of …