keep us from acknowledging the importance of the patient's private spiritual life.
For these reasons and others, the secular service network has tended to ignore or overlook spirituality in the client's life. This means that people who work in pastoral care have not been members of clinical assessment and treatment teams, that a formal spiritual assessment has not routinely been done for each patient, and that solutions to problems and caregiving options have not been sought in the realm of the spiritual. We sought, in the Aging Project, to change this focus by including the spiritual dimension in our approach to our clients.
We sought, also, to fulfill the other tenets of a holistic perspective by providing each client with a generalist case manager (actually two case managers, a faculty member and a student, acting in harmony) and by empowering the client to speak for herself in telling her history, what was going well in her life and what was a problem, and what her hopes were for the future. Our goal was as broad and comprehensive a sense of health and well-being as we could muster.
PRIMARY HEALTH CARE NEEDS OF ADULTS WITH MENTAL RETARDATION
Ninety percent of adults who are mentally retarded are only mildly to moderately retarded, and most are not institutionalized. For approximately 75 percent, the cause of retardation is unknown; Down syndrome is the most common known cause. Thus, in considering the health care needs of adults who are mentally retarded, one is typically looking at people who do not have unusual syndromes and who are not severely retarded. Their health care problems are usually not exotic,