ageing and adults with developmental disabilities catholic community services patricia auerbach,...
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Ageing and Adults Ageing and Adults with with
Developmental Developmental DisabilitiesDisabilitiesCatholic Community ServicesCatholic Community Services
Patricia Auerbach, R.N.Patricia Auerbach, R.N.
September 2005September 2005
Goal of ClassGoal 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
InstructorInstructor
Who I am
Why I have this passion
Objectives of classObjectives 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
LimitationsLimitations
• 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 RulesGround Rules
• Encourage discussion
• Encourage questions
• Respect for everyone’s feelings and opinions
Definition of ageingDefinition 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 Usual Changes in Neurological SystemSystem
• Brain size decreases
• Slowing of movement and reaction time
• Decrease in ability of senses: hearing, sight, smell
Usual Changes in Gastrointestinal Usual Changes in Gastrointestinal SystemSystem
• Difficult in swallowing
• Gastric juices diminish
• Constipation increases
• Potential decrease in weight
Usual Changes in Respiratory Usual Changes in Respiratory SystemSystem
• 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 Usual Changes in Musculoskeletal systemsystem
• Loss of flexibility
• Osteoarthritis
• Loss of strength 25-43%
Usual Changes in Psychiatric Usual Changes in Psychiatric SystemSystem
• 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 Similarities of ageing in normal population compared with DD population compared with DD
populationpopulation
• Numbers are growing
• Similar prevalence (12% of population)
• Die from similar causes
Differences of ageing in normal Differences of ageing in normal population compared with DD population compared with DD
populationpopulation
• 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 Neurological Changes in DD PopulationPopulation
• Decrease in sensory systems
• Seizure disorders are associated with a higher frequency of cardiovascular diseases and infectious diseases
Gastrointestinal changes in DD Gastrointestinal changes in DD PopulationPopulation
• 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 Respiratory changes in DD PopulationPopulation
• 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 Psychiatric considerations in DD populationpopulation
• “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 AspirationEffects of Aspiration
• Effects of aspiration on our clients
• Risk of our clients
• How aspiration risk changes with age
Feelings about ageing and deathFeelings about ageing and death
Normal feelings about deathNormal feelings about death
• Shock
• Denial
• Emotional release
• Depression, loneliness, sense of isolation
• Physical symptoms
• Panic
Normal feelings about deathNormal feelings about death(continued)(continued)
• Guilt
• Hostility
• Inability to resume usual activities
• Glimpse of hope
• Acceptance
Deaths at CCSDeaths at CCS
Stages of GrievingStages of Grieving
Ending…or Beginning?Ending…or Beginning?