Developmental Disabilities and Aging by Brenda McCreight Ph.D.
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda McCreight Ph.D. training series
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
Brenda’s books
Brenda’s books continued…