Developmental disabilities and aging


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Developmental disabilities and aging

  1. 1. DevelopmentalDisabilities andAgingby BrendaMcCreight Ph.D.
  2. 2.  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 processBrenda McCreight Ph.D. training series
  3. 3. 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
  4. 4. Observe for changes inbehaviors as well as in bodyfunction
  5. 5. Vision Changes…Symptoms Loss of acuity  Rubbing eyes Loss of  Squinting accomodation Decrease in light  Shutting or transmission covering one eye Change is colour perception  Tilting or thrusting Decrease in dark the head forward perception  Redness of the eye Decreased visual field or around the eyes
  6. 6. 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
  7. 7. 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
  8. 8. 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.
  9. 9. Hearing changes are causedby 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
  10. 10. Possible Symptoms of HearingLoss 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
  11. 11. Support Strategies for HearingLoss 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
  12. 12. 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
  13. 13. 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 Brenda McCreight Ph.D. training series
  14. 14. Nose/Smell Decrease in nerve fibers Drying mucous membranes in nose Decreased sensitivity to odors Can result in decreased appetite
  15. 15. 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 Brenda McCreight Ph.D. training series
  16. 16. 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 Brenda McCreight Ph.D. training series
  17. 17. 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
  18. 18. 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 Brenda McCreight Ph.D. training series
  19. 19. 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 geriatricsBrenda McCreight Ph.D. training series
  20. 20. 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
  21. 21. 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
  22. 22. 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 Brenda McCreight Ph.D. training series
  23. 23. 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
  24. 24. 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
  25. 25. 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
  26. 26. 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 Brenda McCreight Ph.D. training series
  27. 27. 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
  28. 28. Behavior and Cognitivechanges… 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 Brenda McCreight Ph.D. training series
  29. 29. Managing cognitivechanges… 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 Brenda McCreight Ph.D. training series
  30. 30. Balance and protectiveresponses 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
  31. 31. 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 Brenda McCreight Ph.D. training series
  32. 32. Managing changes in the MSSystem 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
  33. 33. 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
  34. 34. 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
  35. 35. 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
  36. 36. Cerebral Palsy continued Breathingdifficulties increase Speaking problems increase More susceptible to pressure sores
  37. 37. Fragile X Syndrome Increased rate of mitral valve prolapse Early menopause Epilepsy Visual impairment Earlier osteoporosis
  38. 38. 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 Brenda McCreight Ph.D. training series
  39. 39. 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
  40. 40. 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
  41. 41. What Else Causes TheseSymptoms? Medical problems ie high blood pressure, brain tumor, infections Medication side effects Hearing and/or visual problems Thyroid or diabetes problems Depression Vitamin deficiencies
  42. 42. 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
  43. 43. Change continued Sibling may have long standing resentment toward the person
  44. 44. 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
  45. 45.  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 Brenda McCreight Ph.D. training series
  46. 46. Other resources by Brenda McCreight Ph.D. Please check for more training materials and check for online courses. Brenda’s web sites
  47. 47. Brenda’s books
  48. 48. Brenda’s books continued…