Aging Intellectual and Developmental Disabilities

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    09-Feb-2016

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Aging Intellectual and Developmental Disabilities. Presented by: Rita J. Murphy RN,BSN,CDDN Cathy N. Shaffer RN Jody Thomas RN. Why are People Living Longer ?. Life expectancy is unpredictable Remarkable advances over the past 50 years Public Health Sanitation Immunizations - PowerPoint PPT Presentation

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<p>Aging and Developmental Disabilities</p> <p>Presented by: </p> <p>Rita J. Murphy RN,BSN,CDDN</p> <p>Cathy N. Shaffer RN</p> <p>Jody Thomas RNAgingIntellectual and Developmental Disabilities1 Why are People Living Longer ?Life expectancy is unpredictableRemarkable advances over the past 50 yearsPublic HealthSanitationImmunizationsAntibioticsNutritionSocial policy EnvironmentHistoric group of individuals </p> <p>Please change unpredictable to changeable could you add IDD/DD are historic (they are different than the general population. Also add It is unsure the number of individuals living in the community with aging relatives who are not connected to our service system2Define: Developmental DisabilityA condition that occurs prior to , at birth or during childhood which affects normal growth and development Depends on the functional capabilities of the individual and affects on physical and /or cognitive abilities Condition may interfere with: MobilitySpeechADLsLearningMaking life decisionsLiving independentlyChange affect to effect in both 3Life ExpectancyLeading cause of increased life expectancy: Moving out of institutions Receive better medical careLife expectancy is now closely approaching that of the general populationMay have related conditions that affect life expectancySevere Impairments include: Cerebral PalsyDown Syndrome Epilepsy Please change severe to significant and then add specific issues such as CP,DS and Epilepsy4Dr. William Thomas &amp; Normal Aging</p> <p>Aging is not a chaotic mechanical breakdown ratherAging can be thought of as a symphonic physiological developmental process that extends across the decades</p> <p>5The ProcessOlder individuals with ID may exhibit relatively higher rates of:Mobility IssuesFracturesOsteoporosisVisualHearingMental health Poly-pharmacyDepression</p> <p>Older individuals with IDD may not have built reserves to support their aging and wellness- body, mind and spirit </p> <p>Older individuals with IDD/DD may have lead a sedentary life style and have not been encouraged to exercise</p> <p>6Maximum VitalityReach maximum vitality at an earlier ageThe body responds to stressorsMaximum vitality in the general population:Age 30</p> <p>Could you add Individuals with Down Syndrome, Cerebral Palsy and those with significant IDD/DD- reach maximum vitaliry7Common Factors Aging and IDD/DDThe aging process /factors of aging, can further alter function that has already been affected by a developmental disability.Down Syndrome, Epilepsy and CPLayering of Issues due to IDD/DD:HearingVisionMobilitySelf-care skillsCommunication and understanding Further complicates the aging process and an accurate diagnosisDifficult to differentiate disease vs. aging process for the severely impaired May have fragmented care with little medical and family historyChange affect to impacted8LifespanAccording to studies, causes of death are similar to those of the general populationCauses of death include: Cardiovascular diseaseRespiratory diseaseCancer</p> <p>(Janicki, Dalton, Henderson,&amp; Davidson,1999)9Identifying ChangesObserve facial expressionsAlertSleepyConfusedAnxiousPainfulObserve responseUsual response or off? </p> <p>Individuals may be poor reporters It is important to know:How they have presented throughout their lifeTheir storySupport and honor the Direct Support Professionals who know our individuals 10 The Integumentary System (SKIN)Our bodies first line of defense and the system that you notice first with ageIndividuals with IDD/DD have a higher risk for: ImmobilityLoss of thicknessLess insulationSkin tears and breakdownInability to report pain and discomfortPossible bowel or bladder issuesDiminished or elevated sense of touch Difficulty healing No access to water on their own or complain of thirstPoor hygiene skills </p> <p> skin should be under specific issues11Hearing, Vision and Oral</p> <p>GI/GU</p> <p>Vaccines</p> <p>Aspiration Pneumonia</p> <p>Sensory Processing</p> <p>Falls Specific IssuesHearing, Vision and OralIndividuals may experience: Impaired vision due to a neurological deficitUnable to voice changes in visionImproper use bifocals and hearing aidesHigher incidence of hearing issues (wax build up) Misplace or refuse to wear assistive devicesUnable to open their mouth Oral changes due to medicationsPoor oral hygieneLack of adequate dental careIll fitting denturesProblems with choking, aspiration and food consistencySmall group of Dentists who understand and can work these individuals Could you change these individuals to our13GI/GUIndividuals with IDD/DD have higher risk for:Bowel obstructionGERDSlower stomach emptyingPoor hygienePossible gluten intoleranceWheat sensitivity Full Celiac diseaseProblems with incontinence14VaccinesWho should get a pneumococcal vaccine, flu shot and possibly a shingles vaccine? Individuals age 65 or olderThose prone to respiratory problems, including:Myotonic DystrophyDown SyndromeThose who are medically frail Those with severe IDD/DDIndividuals with Down Syndrome:Carefully watch for signs and symptoms of an upper respiratory infection, it may lead to pneumoniaAntibiotics should be prescribed early on to prevent full blown pneumonia. Pneumonia is the leading cause of death in this population.</p> <p>15Aspiration PneumoniaCauses:Inhalation or the breathing in of fluids, vomit or foodsEat too fast, hoard and may fear the eating processPoor dentition - missing loose or decayed teethIncrease the incidence of aspiration and poor fitting denturesThe aging, both the general population and ID/DD population, are prone to aspiration if they have difficulty chewing and swallowingIndividuals with Down Syndrome Tongue thrust Mouth breathersDry mouthIndividuals with Cerebral Palsy &amp; Myotonic DystrophyIncreased incidence of aspiration</p> <p>16Sensory ProcessingThe SensesHearingTasteVisionSmellTouchProprio-ception Vestibular </p> <p>All 7 senses are needed and work together to help make sense of the environment</p> <p>Senses determine responses to the environment </p> <p>Information processed by senses can be changed by the process of aging Vision and hearing affected earlier for IDD/DD</p> <p>Preferred Senses:Everyone has onePossible loss due to aging</p> <p>Design the environment to enhance our senses as we age</p> <p>In order to minimize loss of our senses as we age:Continue to program pathways to the brain </p> <p>(Kathleen Bishop, PH.D.)17FallsIndividuals with IDD/DDAre living longerMay have a dual diagnosis (IDD,MH)Have underlying issues with mobilityIncrease risk of developing Osteoporosis, due to medicationLed sedentary lifestylesThis decreases bone density, increases prevalence of osteoporosis</p> <p>18Falls in the General PopulationEnvironmentalSlippery fallsPoor lightingThrow rugsCluttered walking pathsUneven sidewalks/broken curbsPoor fitting shoes</p> <p>PhysicalChange in balance controlVision and hearing changesMuscle weaknessOsteoporosis /osteoarthritisMedication side effectsTaking 3 or more medicationsDiabetes (decreased sensation in feet)Mental decline/confusionSeizures </p> <p>Please add AS in or similar to the general population reasons for falls may be further impacted by an underlying developmental disability19Aging and Down Syndrome</p> <p>What Can We Expect?</p> <p>Down Syndrome &amp; Alzheimers DementiaDown SyndromeAging and Down SyndromeDisorder of chromosome 21Chromosomes are usually found in pairsTrisomy of chromosome 21 Accelerated aging gene found on chromosome 21Aging and Down Syndrome not completely understood (ndss 2013)Appear to slow down in their 40s or 50s (ndss 2013)Have an increased risk for age related visual and hearing disorders, depression, seizure and Alzheimers disease, skin, endocrine and upper respiratory infections /pneumonia, celiac disease and sleep apnea</p> <p>21Individuals with Down SyndromeDanny at the Ball</p> <p>What Can We Expect?Lifespan:Less than general population and/or DD populationLiving into their 50s, 60s and 70s 22Down Syndrome &amp; Alzheimers DementiaRisk of developing Alzheimers increases with ageAt age 50: 30% of individuals At age 6050% of individuals Not all individuals will develop Alzheimers At age 30 and 40Changes in brain matter may occurWill not develop clinical symptomsDiagnosis:It is over diagnosed Cannot determine in one MD visitNTG is an early screening toolMaximum environmental supportsChange will Not to may not develop clinical symptoms23Aging and cerebral palsy</p> <p>Dr. Michael Henderson</p> <p>As People with Cerebral Palsy Age..Cerebral PalsyAging and Cerebral PalsyOne time injury to the immature central nervous systemCondition not a diseaseMay or may not have an intellectual or developmental disabilityAffects the central control of muscle functionMovement BalanceLife long neurologically induced motor impairmentAging is similar to general populationTiming of changes may vary</p> <p>Remove central in central control of muscle function25Dr. Michael HendersonSimple voluntary action or task may require increased effort Difficulty with muscle movementsPoor coordinationRapid muscle movementsWeakness in their musclesInvoluntary or writhing muscle movements.</p> <p>Cerebral palsy (CP) is one of the most common developmental disabilities. About 65% of people with cerebral palsy have an Intellectual or Developmental Disability. The majority of cases of cerebral palsy are caused by abnormalities of the developing brain that took place prior to birth. Cerebral palsy refers to a variety of conditions that are characterized by abnormal motor actions. (movements of the muscles and corresponding limbs). </p> <p>26As People with Cerebral Palsy Age..Individuals may experienceIncreased pain in muscles and jointsArthritisBursitisTendonitisPain due to fractures or sprains and osteoporosisPossibility to opt out of walking Problems with skin integrityDepression due to losses in functionConcerns with eating, swallowing, choking issues and GERDIncreased body weight, obesity and deconditioningConstipation and bladder issues Spasms may cause pain and decrease function/mobility</p> <p>27Down Syndrome &amp; Cerebral Palsy Observed acute or chronic loss of function in an individual with CP or Down Syndrome(or general population for that matter):A change in the way the person walksInability to use an armDecrease in hand writing skillsFeelings that hands do not function as they did beforeMust be reported to a medical professionalA prompt and thorough evaluation by an MD is essential to the health and wellness of the individual.28Cathy will share stories regarding the IDD/DD population from a mental health standpoint.</p> <p>Enjoy photographs from Ontario ARCs IDD/DD population. Mental Health29</p> <p>Contact InformationRita MurphyLearning &amp; Development Specialist - RN rmurphy@arcmonroe.org585-271-0660</p> <p>Cathy ShafferCoordinator of Clinical Services - RN cshaffer@lwarc.org585-658-2828</p> <p>Jody ThomasManager of Aging Services - RNjthomas@ontarioarc.org 585-919-216148</p>

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