Transcript Aging and Adults with Developmental Disabilities

Ageing and Adults
with
Developmental
Disabilities
Catholic Community Services
Patricia Auerbach, R.N.
September 2005
Goal of Class
 Talk about ageing
 Talk about ageing in adults with developmental
disabilities
 Talk about aspiration, ageing and our residents
 Talk about our feelings about ageing in
ourselves and in our residents
 Talk about death
Instructor
 Who I am
Why I have this passion
Objectives of class
• Describe normal ageing
• Describe ageing in our clients
• Describe how aspiration affects the ageing
process
• Express our feelings about the ageing of
our clients
• Express our feelings about the dying
process of our clients
Limitations
• Cannot give a comprehensive review
about ageing
– So many factors come into play with a limited
time to address the subject
• Examples are limited to our current clients
Ground Rules
• Encourage discussion
• Encourage questions
• Respect for everyone’s feelings and
opinions
Definition of ageing
• General definition
– Chronological age of 65 years
– “any change in an organism over time”
• Ageing in adults with
developmental disabilities
– Chronological age of mid-50s
– Dependent upon changes in functional status
Usual Changes in Neurological
System
• Brain size decreases
• Slowing of movement and reaction time
• Decrease in ability of senses: hearing,
sight, smell
Usual Changes in Gastrointestinal
System
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Difficult in swallowing
Gastric juices diminish
Constipation increases
Potential decrease in weight
Usual Changes in Respiratory
System
• Decline in elasticity of the bony thorax
• Loss of muscle mass with weakening of
the muscles of respiration and reduced
mechanical advantage
• Decrease in alveolar gas exchange
surface
• Decrease in CNS responsiveness
Usual Changes in Musculoskeletal
system
• Loss of flexibility
• Osteoarthritis
• Loss of strength 25-43%
Usual Changes in Psychiatric
System
• Cognitive function declines
• Depression is a common ailment
• Dementia can be side effect of
medications
• “Many changes in mental health are
difficult to attribute to ageing per se: they
are often the result of disease”
Similarities of ageing in normal
population compared with DD
population
• Numbers are growing
• Similar prevalence (12% of population)
• Die from similar causes
Differences of ageing in normal
population compared with DD
population
• Earlier ageing trends
• Average life expectancy is less
• Adults with DD have not been exposed to
same ageing influences:
– Not had same stress, tobacco, alcohol
exposure as general population
– Have had uneven health care
Neurological Changes in DD
Population
• Decrease in sensory systems
• Seizure disorders are associated with a
higher frequency of cardiovascular
diseases and infectious diseases
Gastrointestinal changes in DD
Population
• Long term problems with constipation lead
to more problems
• Esophagus lining thickening leading to
difficulty swallowing
• Decreased production of saliva
• Fewer calories needed
• Decreased smooth muscle tone which
leads to problems with moving food
through tract
Respiratory changes in DD
Population
• Age-related change in joint function and bone
density is added to immobility
• Inactivity accelerates loss of bone density and
mass
• AED link with osteoporosis
• Arthritis is noted at an earlier stage than in
“normal” people
• DD population have increased pain, soreness,
weakness of muscles and energy decline
Psychiatric considerations in DD
population
• “Alzheimer’s Disease represents a major
health concern for adults with DD.”
• More difficulty processing, organizing new
information, recalling old information
• Mental illness more prevalent in those with
developmental disabilities than in general
population
Effects of Aspiration
• Effects of aspiration on our clients
• Risk of our clients
• How aspiration risk changes with age
Feelings about ageing and death
Normal feelings about death
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Shock
Denial
Emotional release
Depression, loneliness, sense of isolation
Physical symptoms
Panic
Normal feelings about death
(continued)
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Guilt
Hostility
Inability to resume usual activities
Glimpse of hope
Acceptance
Deaths at CCS
Stages of Grieving
Ending…or Beginning?