24/02/2014 LEARNING OBJECTIVES WHY ADDRESS THIS ISSUE Participants - PDF document

24/02/2014 LEARNING OBJECTIVES WHY ADDRESS THIS ISSUE � Participants will have a better understanding of the � People with I/DD are living longer aging process (health, mobility, vision, hearing) and � Good health plays a vital role in their quality of life aging issues prevalent with people with � It is important that older men and women with I/DD Intellectual/Developmental Disabilities (I/DD) receive the health related information and access to preventative care to promote well-being and prevent � Participants will acquire knowledge on how to identify future health problems and manage aging issues within a community setting AGING WITH DEVELOPMENTAL DISABILITIES MARIE DAVIS MScN RN PRIMARY HEALTH CARE CONSULTANT University Center for Excellence in Developmental Disabilities RSA EPIDEMIOLOGY AND LIFE AGING FOR ADULTS WITH I/DD SYNDROME SPECIFIC EXPECTANCIES � Most individuals with I/DD had shortened life � Genetics, environment, and lifestyle choices affect how Down Syndrome Cerebral Palsy expectancies in institutional residences. Now, aging all people age � Alzheimer disease � Decreased muscle tone adults with I/DD are living longer in the community � How people with I/DD age is additionally affected by the � By 2021, seniors will form 18% of Canada's population, � Early Menopause � Increase of fractures nature and severity of their impairments, secondary compared to 12.5% in 2000. conditions arising from the inter-action of the aging � New onset of seizures � Increased dysphagia � The rate of I/DD among Canadians aged 15 years and process with their I/DD, coexisting medical conditions, � Increased incidence of � Increased pain threshold and their medication usage over in 2001 was 0.5 percent or 120,140 persons. Of sleep apnea � Increased incidence of � Therefore, persons with I/DD and their caregivers need these, an estimated 44,770 persons are aged 45-64 and � Early onset of visual constipation/bowel 11,080 are aged 65-74. to understand: and hearing loss obstruction � As persons with I/DD are living longer, geriatrics � How the general aging process affects the body � Obesity � Increased nutritional needs healthcare providers need to learn about the systems � Increased risk of heart � Breathing problems characteristics, healthcare needs, and common � The differences that may occur with people with disease clinical issues facing this population. I/DD AGING AND CEREBRAL PALSY SYNDROME SPECIFIC People aging with Cerebral Palsy (CP) have Prader–Willi Syndrome Fragile X Syndrome an increased likeli-hood of having: � Increase in � Increased rate of heart cardiovascular disease problems � Reduced mobility � Increase in diabetes � Increased rate of � Bone demineralization musculoskeletal disorders � Low hormone levels � Fractures � Early menopause � Hypogonadism � Decreased muscle tone � Increased visual � Increased pain AGE RELATED ISSUES impairments � Increased rate of epilepsy � Difficul-ty eating or swallowing � Increased risk of � Bowel and bladder concerns osteoporosis 1

24/02/2014 MEDICAL ISSUES DESERVING CHANGES ASSOCIATED BEHAVIOURAL ISSUES CHANGES ASSOCIATED CLOSE ATTENTION WITH AGING AND I/DD WITH AGING � Cognitive Decline Previous List Plus : ALWAYS RULE OUT MEDICAL FIRST � Early aging in those with I/DD and accelerated rate of � Heart Disease � Earlier development of some of functional decline � Diminished Eyesight the chronic conditions or diseases � Medication side effects � Earlier development of eye and ear abnormalities (e.g. dementia, arthritis) � Hearing Loss � Medical problems –anemia, high blood pressure � Higher incidence of seizures in elderly I/DD persons � More severe degrees of sensory � Osteoporosis � Metabolic problems –diabetes, thyroid dysfunction � Higher incidence of affective disorders, depression, impairment � Arthritis � Hearing or vision problems � More severe loss of flexibility in and bipolar disorders associated with aging and I/DD � Decreased Muscle � Mental Health � Increased incidence of thyroid disease and Alzheimer’s joint function Mass disease in people with Down’s Syndrome � Lack of basic knowledge about � Polypharmacy healthy lifestyle behaviors � Monitor for signs of abuse to individual but also to � Stroke caregiver � Receive less preventive � Cancer health measures (e.g., pap � Psycho-Social changes smears and mammograms ) COMMON HEALTH CONCER NS VISUAL DIFFICULTIES Considerations for People with I/DD � Auditory and Visual � Epilepsy COMMON HEALTH CONCERNS Difficulties � Obesity � Adults with Down Syndrome are at higher risk for vision IN THE ELDERLY I/DD � Pain � Diabetes problems and are more likely to experience age-related � Falls � Heart Disease eye disorders earlier than other older adults � Confusion � Polypharmacy � Blepharitis, keratoconus and cataracts are more common � 3 D’s � Gastrointestinal among adults with Down Syndrome � Alzheimer’s Disease � Incontinence � Because many vision changes occur gradually, � Sleep Disorders � Osteoporosis/Osteoarthritis individuals may have difficulty recognizing or communicating the problem TYPES OF VISION LOSS SUGGESTIONS FOR CAREGIVERS VISUAL DIFFICULTIES � Provide annual eye exams Loss of Central Loss of Peripheral Vision Symptoms of a Problem Changes in Function Vision � Watch for behaviors suggesting vision problems such as: � Stumbling � From glaucoma or retinitis � Rubbing eyes squinting, confusion, rubbing the eye, shutting/covering one pigmentosa � Squinting � Hesitancy on a step or eye, tilting /thrusting the head, holding objects closer. � Blind spot for central � Affects safe mobility curb � Shutting or covering one � Use bright (e.g., yellow, orange, red) and contrasting field � Holding page or object eye colours. Use contrasting colours or different textures at � Unable to see faces, closer to eyes � Tilting or thrusting head Loss across Visual Field stairs and other places to accommodate declines in depth read. � Refusing to participate perception. forward � From diabetes, cataracts, � Loss of acuity or in previous activities � Increase lighting levels and arrange lights to focus on � Redness of eye or area keratoconus clarity � Sitting close to TV individual tasks. around eye � Vision may fluctuate based � Caused by macular � Provide nightlights and large print books. on amount and direction of disease � Allow time for a person to adjust to changes in light. light � Reduce glare by using dull instead of highly polished finishes on furniture and floors 2