I'm the parent of a 22-year-old son who has Down syndrome, and I'm also an RN developing a special needs caregiver program at my hospital. One of my goals is to create a program to support patients with developmental disabilities and to educate nursing staff about the specialized care these patients require.

Communication issues should be the primary focus. Nurses must recognize that behavior is communication, and interpretation of these behaviors is the responsibility of caregivers.

Health care providers should be striving to understand their patients' baseline neurologic and medical problems while treating any other conditions that arise (pneumonia, for instance). We need to better understand and to determine the baseline for these patients-and then we can plan their care.

Doreen Bestolarides, RN

Stockton, CA