Companions' dilemma of intervention when they mediate between patients with intellectual disabilities and health staff

Objective<br>We analyse, for the first time, how companions intervene in the answers that an adult patient with intellectual disabilities gives to their medical practitioner in primary care.<br><br>Methods<br>Video records of 25 health-check consultations in a large multi-ethnic city in the UK were analysed with the qualitative methods of Conversation Analysis.<br><br>Results<br>We found that companions' interventions in patients' answers fell along a gradient of low to high entitlement, from mere hinting to outright direct take-over.<br><br>Conclusion<br>Companions have to manage the dilemma of displaying information which is the proper domain of the patient: encroachment on the patient's epistemic rights versus the needs of the medical practitioner.<br><br>Practice Implications<br>Practitioners may need to check the patients themselves when their companions intervene at the most assertive end of the gradient of help.<br><br><br>