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Developmental
Disabilities and
Aging
by 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 body
a) 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       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
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 lights
o Organize belongings and keep

  locations consistent
o 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
 Breathingdifficulties 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…
Developmental disabilities and aging
Developmental disabilities and aging

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Developmental disabilities and aging

  • 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 body a) they may have existing physical challenges that add challenges to the aging process Brenda McCreight Ph.D. training series
  • 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. Observe for changes in behaviors as well as in body function
  • 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. 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. Managing Vision Changes  Regular eye exams  Modify the environment ie use high contrast colors, use non-glare lighting, increase lights, use night lights o Organize belongings and keep locations consistent o Check care of eye glasses  Decide if activities need to be changed  Brenda McCreight Ph.D. training series
  • 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. 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
  • 10. 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
  • 11. 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
  • 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. 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. Nose/Smell  Decrease in nerve fibers  Drying mucous membranes in nose  Decreased sensitivity to odors  Can result in decreased appetite
  • 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. 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. 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. 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. 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
  • 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.
  • 22. 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
  • 23. 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
  • 24. 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
  • 25. 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
  • 26.
  • 27.
  • 28. 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
  • 29. 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
  • 30. 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
  • 31.
  • 32. 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
  • 33. 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
  • 34. 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
  • 35. 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
  • 36. 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
  • 37. 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
  • 38. 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
  • 39. 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
  • 40. Cerebral Palsy continued  Breathingdifficulties increase  Speaking problems increase  More susceptible to pressure sores
  • 41. Fragile X Syndrome  Increased rate of mitral valve prolapse  Early menopause  Epilepsy  Visual impairment  Earlier osteoporosis
  • 42. 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
  • 43. 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
  • 44. 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
  • 45. 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
  • 46. 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
  • 47. Change continued  Sibling may have long standing resentment toward the person
  • 48. 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
  • 49.  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
  • 50. 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