Developmental disabilities and aging

Developmental Disabilities and Agingby Brenda McCreight Ph.D.

Everyone ages! Everyone ages differently People with developmental disabilities age the same as the

neurotypical population but:a) they may not have the capacity to tell you what is changing in their bodya) they may have existing physical challenges

that add challenges to the aging process Brenda McCreight Ph.D. training series

Prepare for aging… Document the current level of functioning,

either make a video or write down Watch for and recognize changes that

require attention, especially for non-verbal people

Have a family or agency plan for aging in place or for alternative care –do this before it’s needed

Have end of life planning and care in place Brenda McCreight Ph.D. training series

Observe for changes in behaviors as well as in body function

Vision Changes…Symptoms Loss of acuity Loss of

accomodation Decrease in light

transmission Change is colour

perception Decrease in dark

perception Decreased visual

field

Rubbing eyes Squinting Shutting or

covering one eye Tilting or thrusting

the head forward Redness of the eye

or around the eyes

Changes in Function Stumbling Hesitancy on a step or a curb Talking less, less involved with others Holding pages or objects close to the eyes Refusing to participate in activities she

previously enjoyed Sitting closer to the tv Generalized irritability, not previously part of

the person’s personality Brenda McCreight Ph.D. training sessions

Managing Vision Changes Regular eye exams Modify the environment ie use high contrast colors, use non-glare lighting, increase lights, use night lightso Organize belongings and keep locations consistento Check care of eye glasses Decide if activities need to be changed

Brenda McCreight Ph.D. training series

Support Strategies for Vision Modify activities by – engaging in daytime

activities, providing extra support for night time activities, allow eyes time to adjust to changing light, protect the good eye.

Hearing changes are caused by and result in… Loss of auditory never cells and fibers Reduction of blood supply to the auditory

nerve Thickening of ear drum Increased ear wax Loss of hearing for higher pitches Decreased tone discrimination Brenda McCreight Ph.D. training series

Possible Symptoms of Hearing Loss Can’t hear the tv Speaking loudly Inappropriate response to questions Confusion in noisy situations Isolating Self injurious behaviours Easily frustrated Refusing to engage in previously enjoyed

activities or conversation Brenda McCreight Ph.D. training series

Support Strategies for Hearing Loss Regular hearing exams Hearing aid if indicated Speak slower and lower Reduce background noise Face the person when speaking Keep hearing aid batteries fresh and keep

the device clean Brenda McCreight Ph.D. training series

How Aging Impacts The Mouth & Taste Decreases taste buds Gums recede, can cause pain and infection Thinning of dental enamel, can cause tooth sensitivity to heat and cold Decreased saliva from drugs or disease Dental caries and abscesses Gum disease Sores, infection, tumors, cancers Brenda McCreight Ph.D. training series

Managing Mouth care… Regular check ups Floss, caregiver may have to help with this Battery powered toothbrush, caregiver may have

to help Ask dentist about prescription mouth washes to

prevent infections Increase seasonings in food (except salt) Watch for changing tastes and accommodate to

ensure nutrition and appetite


Nose/Smell Decrease in nerve fibers Drying mucous membranes in nose Decreased sensitivity to odors Can result in decreased appetite

How to help… Use smoke detectors because the person may not smell

smoke on the stove or in the ashtray – prevent fires Assist with awareness of body odor, suggest baths or clothes washing Make sure clothing is regularly changed Checked for spoiled food or treats that may not be in plain sight


Changes in Skin & Touch Loss of pigment Decrease in sweat glands, subcutaneous fat,

blood supply, thickness of skin – all of these change body temperature control

Decrease in skill cell production and hair growth

Decreased sensation of touch and pain Dryer skin may cause itching or inflamations


Protecting the Skin Minimize use of harsh soaps and rinse well Dry well Moisturize the skin, including the legs,

buttocks, and back Reposition the person frequently Check skin for problems Label hot and cold water clearly Use sun protection in all weather Brenda McCreight Ph.D. training series

Aging of the GI System Decreased total calorie needs every

decade of life Risk of increased indigestion and ulcers Gum disease from decreased saliva Less of absorption of nutrients from

decreased smooth muscle tone


Managing GI changes…

Increase fluids, fiber Increase physical activity according to ability and interest Observe for constipation Encourage slower eating, more frequent and smaller meals Avoid empty calories Increased gas may indicate GI problems Consult a nutritionist or dietician who specializes in geriatrics


Urinary and Reproductive Decreased bladder capacity and muscle

tone may lead to frequency or incontinence

Kidneys become less efficient Enlargement of prostate Relaxation of pelvic muscles Effects of decreased hormones Brenda McCreight Ph.D. training series

Managing the changes… Observe for changes in voiding patterns and

incontinence or leakage, general discomfort or anxiety

Observe for signs of infection – frequency, urgency, accidents, discomfort, unusual odor, bleeding, fever, agitation or aggression or delusion

Notice odor and follow up Regular check ups Prompting for good hygiene Brenda McCreight Ph.D. training series

Heart and Blood Vessels Decreased responsiveness to stress, leading to difficult breathing, fatigue Heart rate decreases Slow return to normal heart rate after elevation of heart rate Build up of fat in arteries Decreased elasticity in arteries


Protecting the Heart Encourage moderate physical activity Slow the pace of activities Watch for signs of decreased endurance

ie dizziness, confusion, irritability Change positions slowly to prevent

dizziness Learn the signs of heart attacks for both

men and women – they are not the same Brenda McCreight Ph.D. workshop series

Signs of a Heart Attack Chest discomfort or pain that won’t go

away or returns Discomfort in the upper body including

jaw, one or both arms, neck, back, stomach

Shortness of breath Nausea, lightheadedness, breaking out in

a cold sweat

Lungs/pulminary System Lungs become less elastic, less able to take in oxygen Breathing is less efficient, tolerance for exercise decreases Decreased cough reflex, a problem with colds or lung conditions Decrease in cilia lining of the respiratory tract so more likely to get infections Brenda McCreight Ph.D. training series

Protecting the Lungs Avoid all forms of smoke Encourage deep breathing, use breathing

exercises Alleviate stress Proper diet and fluids Immunizations for flu and pneumonia Watch for signs of infection ie coughing,

shortness of breath, colored sputum, increased confusion, irritability


Nervous System Loss of nerve cells Decreased blood flow and decreased

oxygen to the brain Less REM sleep (need four REMs per night

= 8 hours of sleep) Altered pain response

Behavior and Cognitive changes… Intelligence and ability to learn don’t

necessarily change More difficulty processing and organizing new

information Easier recalling of old information Depression from illness and isolation and pain

or poor health Dementia


Managing cognitive changes… Accept the changes and the decline in

skills – don’t push the person to be the same as he was before

Add new activities that stimulate the person but don’t create frustration

Adapt the environment for reduced tasks


Balance and protective responses also change… Sense of balance decreases due to loss of

hair cells in middle ear Slow movement and less sensation lead ot

slower reaction time and decreased protective responses

Musculo-skeletal Changes Decrease in muscle mass, strength and tone Decrease in joint mobility Increased fragility of bones Shortening of the spinal cord Arthritis All of these can lead to pain and reduced

willingness to move or engage in previously enjoyed activities


Managing changes in the MS System Encourage independent movement and self

care but respect the person’s limitations, support as needed

Promote regular activity that the person can easily tolerate and enjoy

Improve safe guards to prevent falls Promote use of mobility aids Provide comfortable seating Adapt clothing Brenda McCreight Ph.D. training series

Down Syndrome Longer life span than in the past More rapid aging of cells impacts all of

the body Normal aging processes occur earlier Poor immune system functioning Early onset of Alzheimer’s Dementia First shows in daily function rather than in

memory and progresses rapidly

Down Syndrome continued Dry skin, fungal nail infections Increased risk of thyroid dysfunction Earlier onset of visual and hearing

problems Increased incidence of sleep apnea Joint problems Increased risk of heart valve disease

Cerebral Palsy Decrease in life expectancy related to

the severity of the condition Abnormal muscle tone leads to joint pain,

worsening bowel and bladder function Increased problem swallowing Dental erosion High incidence of constipation and bowel

obstruction

Cerebral Palsy continued Breathing difficulties increase Speaking problems increase More susceptible to pressure sores

Fragile X Syndrome Increased rate of mitral valve prolapse Early menopause Epilepsy Visual impairment Earlier osteoporosis

Seizure Disorder Change in frequency and duration Cumulative effects of long term seizure

medications Decreased bone density and increased

trauma and falls due to seizures may lead to more fractures


Dementia – what is it? Impaired brain function Problems with memory and judgment Often accompanied by confusion Loss of ability to process and use

information Increasing loss of basic ability to think and

understand Brenda McCreight Ph.D. training series

Early Signs of Dementia Loss of appetite leading to loss of weight Confusion and memory loss Disoriented in space and time Problems with routine tasks Sleep changes Loss of bladder control Changes in personality and judgment Loss of interest in previously enjoyed activities Brenda McCreight Ph.D. training series

What Else Causes These Symptoms? Medical problems ie high blood pressure,

brain tumor, infections Medication side effects Hearing and/or visual problems Thyroid or diabetes problems Depression Vitamin deficiencies

Change Aging client has aging parents or parents

who have died Sibling may have taken over the parent’s

role Sibling may resent the role or may live far

away Sibling may be older or aging as well Sibling may not be cooperative with the

current caregiving system Brenda McCreight Ph.D. training series

Change continued Sibling may have long standing

resentment toward the person

Disenfranchised Loss Decline in abilities Changes in caregivers – loss of long time

living situation and housemates Not allowed to attend funeral of family or

peers No recognition for early bonds with aging

or deceased parents Brenda McCreight Ph.D. training series

Accept that change brought about by aging = loss for the person who is aging and for those who love and care for him

Respect the loss of skills and ability and adjust his life accordingly

Continue involving the person in enjoyable and appropriate activities

Keep engaging with the person – she needs companionship and love at all stages of decline


Other resources by Brenda McCreight Ph.D.

Please check slideshare.net for more training materials and check Udemy.com for online courses.

Brenda’s web sites http://www.lifespancounselling.com http://www.theadoptioncounselor.com http://www.hazardousparenting.com

http://www.lifespancounselling.com/

http://www.theadoptioncounselor.com/

Brenda’s books

Brenda’s books continued…

Health & Medicine

Developmental disabilities and aging