CASE SCENARIO

My patient, W.B., is a 43-year-old man with an intellectual disability who has lived with his mother his entire life. He communicates with augmentative and alternative communication. He presents to my office with his brother, who recently took over providing support after their mother passed away. W.B.’s brother lives out of state and is unable to care for W.B. full time; he requests assistance in determining the best options for further care for W.B. How can I support W.B.’s transition into long-term care, and what is the family physician’s role in this transition?

COMMENTARY

When caring for a person with intellectual and developmental disabilities, clinicians should provide patients with options for community living, services, and supports, allowing them the opportunity to make their will and preferences known.¹ With any major life change, a person centered–planning meeting should be held in which the aspirations, goals, and preferences of the person with a disability are explored with their circle of support. A circle of support includes the people who are significant and valuable to the person with a disability (eg, family, friends, clergy, professionals, experts). Such meetings are typically facilitated by an experienced professional. With the help of the person’s circle of support, the results of the meeting can then be translated into a plan for services and supports to implement the plan as closely as possible to the person’s wishes.