Preventing and Managing Secondary Conditions

with Adult Montanans Who have

Intellectual/Developmental Disabilities

 

Health Resource Guide

Updated July 2009


Table of Contents

Introduction

Resources for the Ten Most-Commonly-Reported Secondary Conditions

1.   Communication Difficulties
2.   Physical Fitness and Conditioning Problems
3.   Weight Problems
4.   Low Level of Persistence/Low Tolerance for Frustration Problems
5.   Personal Hygiene Problems
6.   Dental/Oral Hygiene Problems
7.   Vision Problems
8.   Memory Problems
9.   Fatigue
10.  Depression

References


Introduction

In the past several decades, there has been an explosion of interest in health and wellness. Americans, including the more than 30 million adults with disabilities, have access to a great deal of information on caring for their health and achieving well being.

This increased interest also has focused on developing strategies for preventing and managing secondary conditions – health problems that limit the lives of people with disabilities. Information and programs targeting secondary conditions are important parts of the national movement to make all Americans the healthiest they can be. From some perspectives, this focus on health and wellness is the most significant disability development since passage of the Americans with Disabilities Act.

Persons with disabilities are at risk for secondary health conditions such as depression, weight problems and fatigue, that can limit their ability to participate in daily activities. Many secondary conditions can be prevented or effectively managed. Health promotion programs that help people with disabilities prevent or manage secondary conditions may improve their quality of life and may reduce the amount of money they spend on health care such as emergency room or doctor visits.

In 1999 with the assistance of their direct services staff, 749 adults served by the Montana Developmental Disabilities Program completed Life Quality and Health for Adults with Developmental Disabilities Surveys on:

• Types of health care providers (doctors, physical therapists, dentists, etc.) visited in the previous year.

• Health habits (exercise, smoking, tooth brushing, etc.)

• Number of hours that each of 45 secondary conditions caused them to be less happy, independent, skillful, or productive in their activities.

Survey data were used to rank the most commonly-reported and most-limiting secondary conditions. This Resource Guide lists the ten most commonly-reported secondary conditions and provides helpful resources to address each problem.

Return to Table of Contents


#1 Communication Difficulties

Many disabilities affect a person’s ability to hear and understand speech and/or to express thoughts, emotions, needs and wants with intelligible and appropriate speech. Some individuals never develop the ability to speak vocally – they may communicate with sign language or in writing, or rely on others’ ability to interpret the meaning of their gestures, movements, facial expressions, or behavior. Some people use alternative or augmentative communication technology, such as communication boards or devices that display or speak selected text. People with sensory and/or intellectual disabilities may be unable to write, and physical disabilities may make holding a book, turning pages, writing, keyboarding, or signing difficult.

Some individuals with limited speech can reliably communicate a small repertoire of messages using a basic vocabulary. Some individuals have speech that is intelligible only to those who are very familiar with their speech patterns or pronunciation. Other individuals may have lost their ability to communicate due to medical conditions (such as strokes) or medical procedures (such as using a ventilator).

Having limited ability to communicate can be frustrating. The Life Quality and Health for Adults with Developmental Disabilities Survey found that only half (56.2%) of respondents were able to communicate effectively most (90%) of the time.

Communication Resources in Montana

Montana Association for the Deaf (MAD)
Char Harasymczuk, President
914 Wyoming Ave., Billings, MT 59801
406-259-5181

MAD advocates for the social, legal, educational, and economic welfare of deaf Montanans.

Montana Deaf and Hard of Hearing Services (The Deaf Center)
Betty VanTighem, Director
3911 Central Avenue, PO Box 6433, Great Falls, MT 59407
406-771-9194 (TTY)
406-771-9053 (Voice)
406-771-8056 (Fax)
E-mail: MDHHS@mtn-webtech.com

This division of the Montana Association of the Deaf is a nonprofit organization providing an array of services to deaf and hard of hearing Montanans.

Montana IDEA Services for Children and Young Adults with Deaf-Blindness Project
Francisco J. Román, Project Coordinator  froman@mt.gov
Office of Public Instruction
PO Box 202501 Helena, MT 59620-2501
(406) 444-4426 or 888-231-9393  |  Fax: (406) 444-3924 |  TTY:(406) 444-0235

Provides an array of technical assistance and training opportunities for Montana’s individuals with deaf-blindness, their families and service providers.  Services are designed to meet specific individual and unique needs of children and young adults 0-21 who are identified as having deaf-blindness.

Montana Speech-Language and Hearing Association (MSHA)
P.O. Box 215, Miles City, MT 59301
877-747-7734 or 406-234-8727
info@mshaonline.org

MSHA is an organization of certified speech/language pathologists and audiologists with specialized education in serving the needs of individuals with disorders of communication, reasoning, swallowing, or hearing due to medical or developmental conditions. MSHA educates patients and others about these disorders.

MonTECH: Technology-Related Assistance Program for People with Disabilities
The University of Montana Rural Institute, 700 SW Higgins, Suite 250, Missoula, MT 59803
877-243-5511 or 406-243-5751 (Voice)
406-243-4730 (FAX)
tpennell@ruralinstitute.umt.edu 

MonTECH provides free, confidential information about assistive technology devices and services for Montanans of all ages. MonTECH staff cannot diagnose or prescribe assistive devices or services, but their computerized database of manufacturers and service providers has current information (descriptions, prices, contact and location information) on products and services to meet individual needs.

Montana Telecommunications Access Program (MTAP)
Connie Phelps, Director
111 N. Jackson, P.O. Box 4210, Helena, MT 59604
406-444-1486 (V/TTY) or 800-833-8503
cphelps@mt.gov

Dial 711 to use Montana Relay

Great Falls Equipment Distribution
11 38th Street North, Suite #1, Great Falls, MT 59405
406-452-2724 or 877-499-5682 (V/TTY)

MTAP has two services. The Montana Relay Service (866-735-2968) provides telephone access to people whose disabilities make it difficult for them to use a standard phone. Specially trained Communication Assistants (CA’s) are available at all times to relay conversations over a TTY (text telephone) or verbally. There are no restrictions on the number of calls placed or on the length of calls. The Equipment Distribution Program (800-877-2579) provides specialized telecommunications equipment to make using the telephone easier for people who have physical limitations that interfere with hearing, speaking, or holding a telephone. The equipment is loaned for as long as needed at no charge to all qualified Montanans who meet MTAP income eligibility requirements. Qualified Montanans who exceed income guidelines may purchase equipment at reduced prices.

National Communication Resources

National Center on Birth Defects and Developmental Disabilities (NCBDDD)
bddi@cdc.gov

NCBDDD provides information about hearing loss and secondary conditions, conducts surveillance and research activities, and publishes scientific literature.

National Institute on Deafness and Other Communication Disorders

The Institute’s web site is available in Spanish or English and provides information on communication-related health topics, including hearing, ear infection, deafness, voice, speech, and language.

Special Olympics Healthy Hearing
Healthy Athletes Program

Healthy Hearing is a core component of the Special Olympics Healthy Athlete initiative which focuses on improving the health of Special Olympics athletes. Healthy Hearing screens athletes’ hearing; notifies athletes and their coaches if follow-up care is needed; provides corrective (hearing aids) and preventive (custom swim earplugs) services where possible; and studies the prevalence of hearing loss in athletes competing in Special Olympics events.

The University of Arkansas – Rehabilitation Research and Training Center for Persons Who are Deaf or Hard of Hearing
rehabres@cavern.uark.edu

Funded by the National Institute on Disability and Rehabilitation Research, the Center’s research and training enhances the employability of people who are deaf or hard of hearing. Its web site links to sites with information on deafness, employment, post-secondary education, professional and consumer organizations, and rehabilitation.

(Also see resources on vision problems.)

Return to Table of Contents


#2 Physical Fitness and Conditioning Problems

Some people with disabilities are not fit enough to participate in daily activities. An unfit individual may get winded on even short walks, take frequent rest breaks, sweat and be flushed after minimal exertion; or may avoid physical activity entirely. For most unfit individuals, activity level is both the cause and the cure. However, people with cardiac conditions (often associated with Down Syndrome or Williams Syndrome) have low tolerance for exercise, and their exercise programs should be planned with a qualified physician.

On the Life Quality and Health for Adults with Developmental Disabilities Survey, 46.2% of respondents reported they exercise or work hard enough to raise their heart rates only two or fewer days per week, and 51.4% were reported to be very sedentary.

Physical Fitness Resources in Montana

Bitterroot Therapeutic Riding 599 Popham Lane, Corvallis, MT 59828 (406) 961-2999
btr@onewest.net

Butte Special Riders North American Riding  for the Handicapped Association (NARHA) Premier Accredited Center
1179 Beacon Rd Butte, MT 59701 (406) 497-2806
jim.griffin@northwestern.com

Eagle Mount – Billings
2822 3rd Avenue North, Suite 203, Billings, MT 59101
406-245-5422
406-245-5529 fax
lmullowney@eaglemountbillings.org

Eagle Mount – Bozeman (NARHA Premier Accredited Center)
6901 Goldenstein Lane, Bozeman, MT 59715
406-586-1781
eaglemount@eaglemount.org or cchristman@eaglemount.org

Eagle Mount – Great Falls (NARHA Premier Accredited Center)
9 Third Street North, Suite 1, Great Falls, MT 59401
406-454-1449
eaglemount@eaglemount.net

Eagle Mount – Helena
3165 Miranda Drive, Helena, MT 59602
406-227-8689
Vismith4@msn.com

Eagle Mount provides therapeutic recreation opportunities for people of all ages and disabilities in skiing, swimming, horseback riding, ice-skating, fishing, Saturday Nights Out, golf, kayaking, cycling and horticulture.

Montana Cardiovascular Health Program
Lynda Blades, Program Manager
(406) 444-3138
lblades@mt.gov

Ann Bay, Administrative Assistant
(406) 444-5508
abay@mt.gov

Fax #: 406-444-7465

The Centers for Disease Control and Prevention funds this program to conduct statewide activities that promote cardiovascular health and prevent cardiovascular disease and its associated risk factors, such as physical inactivity, obesity, hypertension and high cholesterol.

New Directions Wellness Center
025 Skaggs Building, The University of Montana, Missoula, MT 59812
406-243-4016

New Directions is a fitness and wellness center for people with disabilities. The facility houses an accessible gym, a physical therapist, and the Living Well with a Disability program. Living Well with a Disability is an eight-week workshop designed for adults with physical disabilities. It teaches participants to set and clarify their goals, and to generate, implement and monitor solutions to their problems.

Sheridan Remley, PT, PLLC (Therapeutic Horseback Riding), 1229 Jackson St., Missoula, MT 59802; 406-549-1153  jsheridan@yahoo.com

Shooting Star Ranch Therapeutic Riding Program, 321 Hairpin Lane, Darby, MT 59829, 406-821-4700  diane@nevadajoe.net

Special Olympics of Montana
P.O. Box 3507, Great Falls, MT 59403
1-800-242-6876 or 406-268-6759

Special Olympics is a nonprofit organization that provides year-round, state-wide programs of physical fitness, sports training and athletic competition for children and adults with intellectual and developmental disabilities.

STAR Riding Program, Inc. North American Riding for the Handicapped Association (NARHA) Premier Accredited Center, 2005 Bitterroot Dr, Billings, MT 59105 (406) 245-7227

National Fitness Resources

Breckenridge Outdoor Education Center
P.O. Box 697, Breckenridge, CO 80424
970-453-6422
970-453-4676 fax
boec@boec.org

BOEC is a non-profit organization offering adaptive skiing, snowboarding, wilderness courses, climbing wall instruction, rafting, canoeing, sea kayaking and other experiential education resources. Educational experiences are offered to people with physical, cognitive and sensory disabilities.

Disabled Sports USA
451 Hungerford Drive, Suite 100, Rockville, MD 20850
301-217-0960
301-217-0968 fax
events@dsusa.org

This national non-profit organization offers nationwide sports rehabilitation programs to anyone with a permanent disability. Activities include winter skiing, water sports, summer and winter competitions, fitness and special sports events.

National Center on Physical Activity and Disability (NCPAD)
1640 W. Roosevelt Road, Chicago, IL 60608-6904
800-900-8086

NCPAD is a collaborative effort of the University of Illinois at Chicago, the Rehabilitation Institute of Chicago and the National Center on Accessibility at Indiana University. NCPAD provides resources on fitness, exercise and recreation for people with disabilities.

North American Riding for the Handicapped Association (NARHA)
P.O. Box 33150, Denver, CO 80233
800-369-7433 or 303-452-1212
NARHA@NARHA.org

NARHA promotes the rehabilitation of individuals with physical, emotional and learning disabilities through its worldwide network of member therapeutic horseback riding centers. Montana has several NARHA-accredited facilities.

President’s Council on Physical Fitness and Sports

The President’s Council publishes A Report of the Surgeon General: Physical Activity and Health for Persons with Disabilities.

Wilderness Inquiry
808 14th Ave., Southeast, Minneapolis, MN 55414-1516
612-676-9400 or 800-728-0719 or 612-676-9475 TTY
612-676-9401 fax
info@wildernessinquiry.org

WI offers a variety of experiences designed to make the outdoors accessible to everyone, including persons with disabilities. WI leads canoe, sea kayak, dogsled, raft, horse pack and hiking trips for people with and without disabilities, throughout North American and the world.

Return to Table of Contents


#3 Weight Problems

For all populations in the United States, being overweight is a problem that can limit participation in life activities. Being underweight is also a concern if it reduces muscle strength and function. People with weight problems may be inactive, lack endurance, spend too much or too little time eating, have mobility problems, or be uncomfortable due to ill-fitting clothing.

On the Life Quality and Health for Adults with Developmental Disabilities Survey 39 percent of respondents reported weight problems.

Weight Management Resources in Montana

Montana Dietetic Association

Montana Disability and Health Program: Living Well under the Big Sky (MTDH)
Kathleen Humphries, Nutrition Program Director
The University of Montana Rural Institute, 52 Corbin Hall, Missoula, MT 59812-7056
888-268-2743 or 406-243-4956
khumphries@ruralinstitute.umt.edu | matraci@ruralinstitute.umt.edu

A partnership between the Montana Department of Health and Human Services and The University of Montana Rural Institute, MTDH develops services to prevent secondary conditions and promote the health of Montanans with disabilities. The program has a strong focus on the food and nutrition needs of adults with intellectual and developmental disabilities.

Montana State University Extension Service
MSU Nutrition and Food Office, P.O. Box 173360, Bozeman, MT 59717-3360
406-994-5702

MSU Extension provides research-based knowledge to strengthen the social, economic, and environmental well-being of Montana families, communities, and agricultural businesses. The Nutrition Program and Food and Safety Program help Montanans make informed choices about diet and lifestyles. The Expanded Food and Nutrition Education Program helps low-income families select and prepare nutritious, low-cost foods.

Links to Montana County Extension Offices

National Weight Management Resources

Aim for a Healthy Weight
National Heart, Lung and Blood Institute

This web site offers educational materials for patients and the public, including a Body Mass Index (BMI) calculator, food shopping and preparation tips, dining out ideas, low-calorie menu plans, physical activity ideas, and more.

American Dietetic Association (ADA)

The ADA has advice and information on eating for a healthy weight and can refer visitors to local Registered Dieticians.

American Obesity Association
1250 24th Street, Northwest, Suite 300, Washington, DC 20037
202-776-7711

This leading organization for advocacy and education on obesity has a comprehensive web site with links to “Disability Due to Obesity” (information on Social Security benefits), “Community Action” (community programs and creating a healthy environment), and “Advocacy Updates” (activities and current hot topics.)

Finding a Weight Loss Program that Works for You
International Food Information Council

Co-published by the Partnership for Healthy Weight Management, this free brochure helps in choosing weight loss products and programs. The booklet is downloadable, and includes forms for assessing individual risk factors and weight loss services.

National Institute on Diabetes and Digestive and Kidney Diseases:
Weight Control Information Network

The Network provides current scientific information on obesity, physical activity, weight control, and related nutritional issues to health professionals, people who are overweight or obese, the media, Congress, and the general public. Informational pamphlets are free.

Partnership for Healthy Weight Management

The partnership web site provides Finding a Weight Loss Program that Works for You and another brochure on setting weight loss goals. It also has a BMI chart and materials for use in public information campaigns.

U.S. Department of Agriculture: Food and Nutrition Information Center

This web site has information on weight control and obesity, weight loss programs, practical weight control assistance, and quackery and nutrition misinformation.

U.S. Surgeon General

This is the link to Call for Action to Prevent and Decrease Overweight and Obesity.

Return to Table of Contents


#4 Low Level of Persistence/Low Tolerance for Frustration

Adults with intellectual and developmental disabilities may experience repeated failure in learning new tasks, or may find it difficult to adapt to changes imposed by external sources. When trying to complete tasks and goals, they may consistently give up in frustration after only minimal effort. Individuals may express frustration by withdrawing, or with angry or sad facial expressions, clenched fists or rigid body posture, negative statements about their own abilities, or with verbal outbursts.

The Life Quality and Health for Adults with Developmental Disabilities Survey found that 39 percent of respondents experienced problems with persistence/low tolerance for frustration.

Persistence Resources in Montana

Contact the Quality Improvement Specialist at your regional Developmental Disabilities Program (DDP) office:

Region I DDP
Box 472B – 226 6th St. South
Glasgow, MT 59230
(406) 228-8265
cnwethern@mt.gov

DDP Miles City
P.O. Box 880, 708 Palmer
Miles City, MT 59301
(406) 232-2595
nomartin@mt.gov 

Region II DDP
201 1st St. South, Ste. 3
Great Falls, MT 59405
(406) 454-6085
lhowe@mt.gov  or catmurphy@mt.gov

Region III DDP
2121 Rosebud Dr., Ste. C-1
Billings, MT 59102
(406) 655-7601 or 7602
sgehring@mt.gov  or jarnold@mt.gov  or btrent@mt.gov

Region IV DDP
3075 N. Montana, Rm. 108
Helena, MT 59620
(406) 444-17174
pakindt@mt.gov or dstaley@mt.gov

DDP Bozeman
20 E. Olive, Ste. LL21
Bozeman, MT 59715
(406) 587-6066
brjohnson@mt.gov

DDP Butte
700 Casey, Ste. A
Butte, MT 59701
(406) 782-8728
smatosich@mt.gov

Region V DDP
1610 S. 3rd West, Ste. 202
Missoula, MT 59801
(406) 329-5415
rholmstrom@mt.gov or pmiskuly@mt.gov or psherwood@mt.gov

DDP Kalispell
P.O. Box 2357, 2282 Hwy. 93 South
Kalispell, MT 59903-2357
(406) 751-5930
jallen@mt.gov 

National Persistence Resources

Rehabilitation Research and Training Center on Positive Behavioral Supports

This national research and training develops and disseminates effective, practical, and tested procedures for improving support for individuals with disabilities and problem behavior.

(Also see communication resources and resources listed under depression.)

Return to Table of Contents


#5 Personal Hygiene Problems

A person can improve his or her appearance and hygiene by regularly bathing/showering; shampooing hair; brushing and flossing teeth; using deodorant/antiperspirant; shaving; cleaning and clipping nails, etc. Poor hygiene can affect health, self-esteem, job performance, and social interactions.

The Life Quality and Health for Adults with Developmental Disabilities Survey found that 12.3% of respondents shampooed their hair two or fewer times per week; 19.6% bathed or showered three or fewer times per week; and 87.1% dressed in clean, neat clothing 5-7 days per week.

Personal Hygiene Resources in Montana

Parents, Let’s Unite for Kids (PLUK)
516 North 32nd Street, Billings, MT 59101
406-255-0540 or 800-222-7585

PLUK is a non-profit organization that provides information, support, training, and assistance to Montana parents of children and adults with disabilities and chronic illnesses. The PLUK library and web site are a wealth of information on supporting healthy hygiene behaviors with adults who have intellectual/developmental disabilities, and PLUK has collected best practice resources in education, medicine, law, human services, rehabilitation and technology.

National Personal Hygiene Resources

James Stanfield Company, Inc.
Drawer C9C3, P.O. Box 41058, Santa Barbara, CA 93140
800-421-6534

Offers videotapes on personal hygiene and grooming, including: Hygiene for Males, Hygiene for Females, Grooming for Males, Grooming for Females, and Dress Makes the Man/Woman.

National Christian Resource Center
Bethesda Lutheran Homes and Services, 700 Hoffman Drive, Watertown, WI 53094
800-369-4636, ext. 541

The Center’s Daily Living Skill video series (also available at PLUK, above) includes: Handwashing, Bathing and Showering, Shampooing, Nail Care, Shaving, Bathroom Assistance, Oral Hygiene, Feminine Hygiene, and Personal Appearance Assessment.

Return to Table of Contents


#6 Dental/Oral Problems

People with developmental disabilities are at a greater risk for dental or gum disease. Missing, crooked, malformed, thinly-enameled, or neglected teeth can lead to decay, gum disease, a poor bite, toothache, progressive tooth loss, and malnourishment. Consistent bad breath may indicate tooth decay or infection, and poor dental hygiene may limit a person’s social interactions or eating pleasure.

On the Life Quality and Health for Adults with Developmental Disabilities Survey, 43.9% of respondents reported having their teeth cleaned and 78.9% visited a dentist during the previous year.

Dental/Oral Health Resources in Montana

Caring Program for Children Sponsored and administered by Blue Cross Blue Shield of Montana
800) 447-7828 ext. 3630

Have Healthy Teeth Program
Donna Bainbridge, Program Director
Montana Disability and Health Program, The University of Montana Rural Institute, 52 Corbin Hall, Missoula, MT 59812-7056
406-243-5741 or 406-243-4956
dbridge@ruralinstitute.umt.edu  or matraci@ruralinstitute.umt.edu

Have Healthy Teeth works with members of People First chapters in Helena and Missoula to implement and evaluate low-cost oral health self-management and prevention strategies that establish good oral health behaviors. The program’s key elements are oral hygiene self-management and peer mentoring to assist with compliance. People First Missoula is training peer mentors in Helena who will subsequently train other peer mentors as the program expands to additional Montana People First chapters.

Montana Dental Association (MDA)
800-257-4988
mda@mt.net

MDA has a free lending library for health-related organizations. Several videotapes are available on oral health and disability.

Montana Dental Health Program
Montana Department of Public Health and Human Services, Helena, MT 59620
406-444-0276
cseed@mt.gov

This program promotes dental health educational activities that encourage good dental health practices and help prevent dental cavities, gum disease and oral cancer.

Medicaid Services Bureau (800) 362-8312

Dental Program Manager (406) 444-3182

Montana Children’s Health Insurance Plan (CHIP) (877) 543-7669

CHIP Dental Program Officer (406) 444-7046

Montana Foundation of Dentistry for the Handicapped
PO Box 1154, Helena, MT 59624
406-449-9670 or 888-449-9670
mpetrick@nfdh.org 

A chapter of the National Foundation of Dentistry for the Handicapped, the Montana Foundation has 140 dentists and 57 laboratory volunteers who donate free, comprehensive dental treatment to Montanans with disabilities and elderly Montanans.

Montana Primary Care Association
900 N. Montana Ave., Helena, MT 59601
406-442-2750
mbfrideres@mtpca.org

Montana Community Dental Clinics: Private, non-profit, consumer-directed healthcare corporations that provide quality, cost-effective and comprehensive dental services to medically under-served and uninsured people.

Billings:

Deering Community Health Center
Deering Community Health Center Dental Clinic
123 S. 27th St., Billings, MT59107
406-247-3333
lila@ycchd.org
Hours: 7:00 – 6:00 M-F

Healthcare for the Homeless Volunteer Program (406) 651-6421

Ronald McDonald Care Mobile (406) 238-6008

Bozeman: Gallatin Community Clinic
(406) 585-8701
Hours: 8:00 – 4:30 M -Th

Butte: Community Health Center (with satellites in Sheridan and Dillon)
Community Health Center Dental Clinic
445 Centennial Drive, Butte, MT 59702
406-496-6007
cster@in-tch.com
Hours: 8:00 – 5:00 M,F; 8:00 – 2:00 T; Closed W & Th

Great Falls:

Community Health Care Center, Inc.
Community Health Care Center Dental Clinic
Cascade City-County Health Dept.,
115 4th Ave. South, Great Falls, MT 59405-4597
406-791-9267
loney@co.cascade.mt.us
Hours: 8:00 – 5:00 M – F by appointment

Montana State University College Of Technology
Dental Clinic

(800) 446-2698 or (406) 771-4300
Hours: 8:00 – 1:00 M & T by appointment

Helena Cooperative Health Center, Inc. (with satellite in Lincoln)
Cooperative Health Center Dental Clinic
1930 9th Ave., Ste. 207, Helena, MT 59601
406-457-8928
kwilson@co.lewis-clark.mt.us
Hours: 8:00 – 2:30 M & F Walk-ins; 8:00 – 5:00 T,W,Th

Libby – Lincoln County Community Health Center, Inc.
Lincoln County Community Dental Clinic
711 California Ave., Libby, MT 59923
406-293-3755
maria@lcchc.org
Hours: 9:00 – 5:00 M-F

Livingston Community Health Partners, Inc.
Community Health Partners Dental Practice
126 S. Main St., Livingston, MT 59047
406-222-4777
lfrancis@CHPhealth.org
Hours: 8:00 – 5:00 M,W,F; 11:00 – 7:00 T,Th

Missoula – Partnership Health Center, Inc.
Partnership Health Center Dental Clinic
323 W. Alder, Missoula, MT 59802
406-829-4185
mahne@phc.missoula.mt.us
Hours: 8:00 – 5:00 M; 9:00 – 5:00 T; 8:30 – 4:00 W, Th, F

Montana Migrant Council, Inc. (406) 248-3149

Mobile Dental Clinic – Serving Carbon, Dawson, Treasure, Rosebud, Richland, Bighorn, Yellowstone, Beaverhead, Flathead and Lake Counties (Each site serves 1- 5 counties)

Indian Health Service – Billings Area Office (406) 247-7120
Dental clinics located in Browning, Crow Agency, Lodge Grass, Pryor, Polson, Pablo, St. Ignatius, Harlem, Hays, Poplar, Wolf Point, Lame Deer, and Box Elder.

Urban Indian Clinic (406) 449-5796

Helena Indian Alliance – Leo Pocha Clinic – Serving Great Falls, Butte and Helena
Hours: 8:00 – 4:00 M-F

National Dental/Oral Health Resources

American Dental Association: Tips for People Who Have Special Needs

This web site provides an overview of dental issues of persons with special needs, answers frequently asked questions, and lists additional resources.

Dental Education in Care of People with Disabilities Program
School of Dentistry, The University of Washington
decod@u.washington.edu 

This program trains dentists and dental hygienists to meet the needs of patients with disabilities, and also offers attendant/staff training materials and self-directed study modules.

Dentistry for the Disabled Child and Adult

This site is authored by a dentist who treats patients with disabilities. He lists educational materials and resources, and gives advice on finding a dentist for a person with a disability, on dental hygiene for people with disabilities, and on bruxism (teeth-grinding).

Family Village (dental page)

The Family Village web site integrates online information, resources, and communication opportunities for people with cognitive and other disabilities, for their families, and for disability services and support providers. The dental page links to resources on the dental needs of people with disabilities.

National Oral Health Information Clearinghouse (NOHIC)
1 NOHIC Way, Bethesda, MD 20892-3900
301-402-7364

A service of the National Institute of Dental and Craniofacial Research, NOHIC information specialists provide oral health information for special care patients and professionals, refer requesters to resources, and provide professional and patient education materials (factsheets, brochures, and information packets).

Special Olympics Special Smiles
Shantae Polk, Manager, Healthy Athletes
202-628-3630
spolk@specialolympics.org

Special Smiles is a core component of the Special Olympics Healthy Athletes initiative which focuses on improving the health of Special Olympics athletes. Special Smiles provides access to dental care for athletes and others with intellectual disabilities at Special Olympics games in each state and around the world.

Return to Table of Contents


#7 Vision Problems

Vision problems include near-sightedness, far-sightedness, astigmatism, presbyopia, reduced field of vision, light sensitivity, and blindness. Symptoms of vision problems include squinting at printed matter or holding it at a distance, bumping into or tripping over objects, or closing the eyes for long periods of (non-sleep) time. Incorrect use of prescription glasses or contact lenses may result in vision problems.

Thirty percent of the respondents to the Life Quality and Health for Adults with Developmental Disabilities Survey reported vision problems.

Vision Resources in Montana

International Association of Lions Clubs – Montana Chapters

Sight conservation and work with blind individuals are official activities of Lions Clubs International. Activities include sponsorship of leader dogs and dog training, eyeglass recycling, vision awareness and education activities, eye banks, children’s camps and many other vision-related services.

Montana Affiliate, National Federation of the Blind (NFB)
Dan Burke, 408 Sussex Ave., Missoula, MT 59801
406-546-8546
burkemt@onewest.net

NFB is the nation’s largest and most influential organization of people who are blind. Its purpose is to help people with blindness achieve self-confidence, self-respect and collective self-expression. Resources include a Materials Center of literature and assistive devices, the International Braille and Technology Center, NFB-NEWSLINE (a free talking newspaper service), and Jobline, which offers free national employment listings.

Montana Association for the Blind (MAB)
P.O. Box 465, Helena, MT 59624
406-442-9411

MAB is a non-profit organization which fosters a positive understanding of blindness and promotes the social and economic self-sufficiency of blind and low vision Montanans through quality education, training, and employment services and opportunities. MAB’s quarterly newsletter, The Observer, is available in large print and Braille, on disk or cassette, or via e-mail. Annual membership dues are $5.00.

Montana IDEA Services for Children and Young Adults with Deaf-Blindness Project
Francisco J. Román, Project Coordinator froman@mt.gov
Office of Public Instruction
PO Box 202501
Helena, MT 59620-2501
(406) 444-4426 or 888-231-9393  |  Fax: (406) 444-3924  |  TTY:(406) 444-0235

Provides an array of technical assistance and training opportunities for Montana’s individuals with deaf-blindness, their families and service providers.  Services are designed to meet specific individual and unique needs of children and young adults 0-21 who are identified as having deaf-blindness.

Montana Talking Book Library
1515 East 6th Ave., Helena, MT 59620
406-444-2064

The Talking Book Library advises and assists eligible individuals with disabilities that affect the ability to read print (visual and mobility impairments, cognitive and learning disabilities, etc.). Staff also support other libraries, nursing homes, schools and institutions in providing library services to individuals with disabilities. Inter-library loan services are available between participating libraries. Patrons have access to descriptive videotapes, over 500 locally-produced cassette books, and Braille books.

Montana Vocational Rehabilitation/Blind and Low Vision Services
111 Sanders, P.O. Box 4210, Helena, MT 59604-4210
406-444-2590

Blind and Low Vision Services Program provides a broad range of services through three programs to assist eligible individuals with visual disabilities in finding or maintaining employment and increasing independence. These programs are (1) Vocational Rehabilitation, (2) Visual Medical, and (3) Older Blind. Visual Medical Program services are available to people who need eye treatment to prevent blindness, restore sight, or provide other appropriate eye treatment where loss of vision cannot be prevented or sight restored.

National Vision Resources

Blind, Inc.
100 East 22nd Street, Minneapolis, MN 55404
612-872-0100

Blind, Inc. is a training center that teaches the skills needed by people with blindness to become independent and employable. Classes teach Braille reading, home management, using a white cane, using computer screen reading software, and more.

Opening Eyes – Special Olympics and Lions Clubs International Initiative
David Evangelista, Manager
202-628-3630
devangelista@specialolympics.org

Opening Eyes is a core component of the Special Olympics Healthy Athletes initiative which focuses on improving the health of Special Olympics athletes. Opening Eyes screens athletes’ vision; educates athletes, parents, and coaches about the importance of regular eye care; educates and changes attitudes of eye care professionals about the vision care needs of persons with intellectual disabilities; and increases knowledge of visual and eye health needs of persons with intellectual disabilities through research.

Return to Table of Contents


#8 Memory

People with short-term or long-term memory problems often forget problem-solving strategies and skills necessary for performing tasks. Changes in a person’s ability to remember may be a side effect of medication, or an indication of brain injury, pain, depression, or dementia. Individuals may repeat questions that have been answered, forget information, frequently lose things, or anger more easily than before. Memory aids, prompts or cues may be necessary.

On the Life Quality and Health for Adults with Developmental Disabilities Survey, 29 percent of respondents reported memory problems.

Memory Resources in Montana

Brain Injury Association of Montana (BIAM)
1280 S. 3rd St. West, Ste. 4, Missoula, MT 59801
800-241-6442 or 406-541-6442
biam@biamt.org

This association’s focus is brain injury prevention, research, education, and advocacy. If an individual’s memory problems may be associated with a brain injury, this association has appropriate resources.

Community Bridges
607 S.W. Higgins Avenue, Missoula, MT 59803
406-728-4100, ext. 7525 or 1-800-252-7982

This Community Medical Center program offers comprehensive day treatment and residential services for individuals with traumatic brain injury or other neurological problems caused by motor vehicle accidents and other injuries, aneurysms, anoxia, brain tumors, encephalitis, meningitis, and stroke. Their efforts address memory loss resulting from these events or conditions.

Headway
New Hope Rehabilitation Center, St. Vincent’s Healthcare, Billings, MT 59101
406-238-6440

Headway offers individual treatment programs for adults and adolescents with a wide variety of disabilities related to memory loss.

Montana Orthopedic, Neurologic and Rehabilitative Care: Benefis Healthcare
West Campus, 500 15th Ave. South, Great Falls, MT 59405
406-455-2293

The Center offers occupational therapy, speech/language pathology and several other services to improve an individual’s memory or ability to cope with memory loss. It serves people who have experienced head injury; stroke; loss of abilities to think, reason, and remember; and other disabilities.

The University of Montana – Department of Pharmacy Practice
Skaggs Building 316, Missoula, MT 59812
406- 243-6796

Drug Information Service: 406-243-5254
DrugInfo@umontana.edu

National Memory Resources

Brain Injury Association of America
800-444-6443

Resources and links for professionals, consumers and family members.

AbleData Assistive Technology Database

Enter “memory” and/or “reminder” into the search box to bring up a long list of resources and devices, including memory-training software, medication reminders, audible or vibrating message watches, talking alarm clocks, vibrating reminder disks, braille and voice note-taking systems, “cognitive prosthetics”, environmental control units and more.

Return to Table of Contents


#9 Fatigue

Fatigue is a tired, but not necessarily sleepy feeling after minimal exertion. Fatigue is a common problem for individuals with congenital muscle disorders. Fatigue may also be a side effect of medication or the result of two or more medications interacting. People with fatigue often are inexpressive, unmotivated, and/or inactive. They may need more breaks, naps, and increased sleep. Daytime fatigue, nighttime snoring or failure to sleep through the night may indicate that an individual has an undiagnosed or unobserved sleep disorder.

Twenty-eight percent of Life Quality and Health for Adults with Developmental Disabilities Survey respondents had problems with fatigue.

Fatigue Resources in Montana

Sleep Center at St. Vincent Healthcare
1233 N. 30th St., Billings, MT 59101
406-238-6815 or 866-4-SNORES
sleepcenter@svh-mt.org

Sleep Disorders Center
Bozeman Deaconess Clinic, Bozeman, MT 59715
406-585-5058
mphipps@bdh-boz.com

Rocky Mountain Sleep Disorders Center
401 S. Alabama, Suite 3A, Butte, Montana 59701
406-782-7570

Montana Sleep Diagnostics
Liberty County Medical Center, 315 W. Madison Ave., Chester, MT 59522

Montana Sleep Diagnostics
Pondera Medical Center, 805 Sunset Blvd, Conrad, MT 59425

Montana Sleep Diagnostics
Barrett Memorial Hospital, 90 Hwy 91 South, Dillon, MT 59725

Montana Sleep Diagnostics
Frances Mahon Deaconess Hospital, 621 Third Street South, Glasgow, MT 59230

Rocky Mountain Sleep Disorders Center
1917 4th St. South, Great Falls, MT 59405
406-453-7570
pauls@rockymountainsleep.com

Northern Montana Sleep Disorders Center (Havre)
30 W. 13th St., Havre, MT 59501
406-262-1437 or 800-352-5097

Rocky Mountain Sleep Disorders Center
2271 Deerfield Lane, Helena MT 59601
406-442-7700

Montana Sleep Diagnostics (Rocky Mountain Sleep Disorders Center)
Lewistown, MT
406-538-7711

Sleep Disorders Center
620 S. Haynes Ave., Miles City, MT 59301
406-255-8400 or 800-252-1246
health@billingsclinic.org

Sleep Center at St. Patrick’s Hospital and Health Sciences Center
500 W. Broadway, Missoula, MT 59802
406-329-5650
info@saintpatrick.org

The University of Montana Department of Pharmacy Practice
Skaggs Building 316, Missoula, MT 59812
406- 243-6796

Drug Information Service: 406-243-5254
DrugInfo@umontana.edu

National Fatigue Resources

Chronic Pain and Fatigue Research Center
Univ. of Michigan Health System, Dept. of Internal Medicine,
Division of Rheumatology, Domino’s Farms, Lobby M, Box 385,
24 Frank Lloyd Wright Dr., Ann Arbor, MI 48106
734-998-6961

This multi-disciplinary center is committed to better recognition, understanding and management of chronic pain and fatigue disorders. Its web site describes the Center’s research and opportunities to participate as a research subject, and provides information on fibromyalgia, other chronic multi-symptom illnesses, evidence-based treatment, exercise, stress, and other related topics.

Rehabilitation Research and Training Center in Neuromuscular Diseases (RRTC/NMD)
MED: PM&R TB 191, University of California, Davis, CA 95616

RRTC/NMD improves the lives of individuals with neuromuscular diseases and their families by developing and evaluating new strategies for health care, rehabilitation, psychosocial well-being, education, employment, and independent living. The Center also provides a comprehensive consumer-focused training and information dissemination program.

Return to Table of Contents


#10 Depression

Depression is more than “feeling blue”. Symptoms include extreme, long-term sadness; frequent or unexplained crying; loss of interest in personal appearance; less laughing or smiling than usual; withdrawal from favorite things, activities, or people; sleep difficulties; unintentional weight loss or gain; change in behavior (such as increased anger or aggressive behavior); and/or suicidal comments or actions. In many individuals with intellectual and developmental disabilities, depression often is reactive and responds well to treatment.

On the Life Quality and Health for Adults with Developmental Disabilities Survey, 27.6 percent of respondents reported a problem with depression.

Depression Resources in Montana

Montana Mental Health Association (MMHA)
P.O. Box 6133, Great Falls, MT 59401
406-727-6642
info@montanamentalhealth.org

MMHA works to eliminate the stigma of mental illness, to improve care and treatment of Montanans with mental illness, such as depression, to preserve the rights of Montana’s mental health consumers and their families and to support programs and individuals providing direct mental health services.

National Alliance for the Mentally Ill (NAMI): Montana Chapter
616 Helena Ave., Suite 218, Helena, MT 59601
406-443-7871 or 888-280-6264
406-862-6357 fax
namimt@ixi.net

NAMI Montana maintains a library of hundreds of books, audio-cassettes and video tapes about serious mental illness, such as depression, and the people who suffer from them. The web site helps visitors locate local resources and affiliates.

(Also see the list of Developmental Disabilities Program Quality Improvement Specialists under Persistence Problems.)

National Depression Resources

National Association for the Dually Diagnosed (NADD)

NADD provides professionals, educators, policy makers, and families with education, training, and information on mental health issues of persons with intellectual/developmental disabilities.

National Institute of Mental Health (NIMH)
800-421-4211

Provides free information in both English and Spanish on depression and other mental illnesses.

National Mental Health Association (NMHA)
800-969-6642 

NMHA addresses all aspects of depression and other mental health issues and mental illnesses.

All About Depression

This web site offers accurate, authoritative, relevant and current research-based information about depression, its causes, self-help techniques (including seeking professional medical help), and self-tests to determine if an individual is depressed.

Return to Table of Contents


References

Brandt, E. N. & Pope, A. M. (1997). Enabling America: Assessing the role of rehabilitation science and engineering. Washington, DC: National Academy Press.

Horowitz, S. M., Kerker, B. D., Owens, P. L., & Zigler, E. (2001). The health status and needs of individuals with mental retardation. New Haven, CT: Yale University School of Medicine.

Lollar, D. J. (Ed.). (1994). Preventing secondary conditions associated with spina bifida or cerebral palsy: Proceedings and recommendations of a symposium. Washington, DC: Spina Bifida Association of America.

Lollar, D. J. (2001). Public health trends in disability: Past, present, and future. In G. L. Albrecht, K. D. Seelman, & M. Bury (Eds.), Handbook of disability studies. Thousand Oaks, CA: Sage Publications.

Marge, M. (1988). Health promotion for persons with disabilities: Moving beyond rehabilitation. American Journal of Health Promotion, 2, 29-44.

Pope, A. M. (1992). Preventing secondary conditions. Mental Retardation, 30, 347-354.

Pope, A. M. & Tarlov, A. R. (1991). Disability in America: Toward a national agenda for prevention. Washington, DC: National Academy Press.

Seekins, T., Clay, J. A., & Ravesloot, C. (1994). A descriptive study of secondary conditions reported by a population of adults with physical disabilities served by three independent living centers in a rural state. Journal of Rehabilitation, 60, 47-51.

Turpin, L., Rice, D. P., & Max, W. (1995). Medical expenditures for people with disabilities in the United States, 1987. Washington, DC: U.S. Government Printing Office.

US Census Bureau. (2000). Census 2000 Summary File 3, Matrices P18, P19, P21, P22, P24, P36, P37, P39, P42, PCT8, PCT16, PCT17, and PCT19. Retrieved July 1, 2004, from http://factfinder.census.gov .

Williams, B. (1998). Keynote address. Presented at the National Conference on Disability and Health: Building bridges for science and consumers, Dallas, TX.

Return to Table of Contents

For more information, contact:

Meg Traci, Director  matraci@ruralinstitute.umt.edu
Montana Disability and Health Program
The University of Montana Rural Institute
52 Corbin Hall, Missoula, MT 59812-7056
888-268-2743 toll-free;
406-243-5467 Voice;
406-243-4200 TTY
406-243-2349 (fax)
http://rtc.ruralinstitute.umt.edu
http://mtdh.ruralinstitute.umt.edu

Opinions expressed are those of the authors, and not necessarily those of the funding agencies.
This report is available in Braille, large print and text formats on request.

This Resource Directory was prepared by Diana Spas, Meg Traci, and Lisa Brennan © RTC: Rural, 2005.