Dr Seeta Durvasula. 30 th October 2012

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1 Dr Seeta Durvasula 30 th October

2 How old is old?

3 What happens with ageing? Ageing and health in people with intellectual disability How does ageing affect people with intellectual disability and their carers? Healthy ageing

4 Eyesight may be more blurry Hearing may become more difficult Higher frequencies; difficulty with understanding speech Sense of smell can fade May affect taste of food and appetite Skin, nails, hair Skin thinner, more easily bruised; wrinkles, age spots Hair thinner, nails more brittle Bones, muscles and joints Bones get thinner, break more easily Muscles lose mass, become weaker Wear and tear in the joints may become painful, stiff

5 May have poor balance risk of falls Teeth and gums Gums pull back from teeth (recede), teeth more weak and brittle, less saliva, so dry mouth Bowel and bladder changes May have incontinence Constipation common Immunity less more prone to infections Sleep patterns may change Less sleep, frequent waking

6 Have some health problems more commonly than others Hearing difficulties Vision problems Epilepsy (fits) Mental health problems Weight underweight, overweight Reflux Constipation Problems with bones, joints, muscles

7 People with intellectual disability living longer Same health problems as other older people Some ageing changes may happen earlier Some existing health problems may get worse

8 Hearing and vision problems develop or worsen High blood pressure, high cholesterol Heart disease Constipation / Bladder problems Swallowing problems may develop or worsen Problems with teeth and gums may lose teeth Diabetes Osteoporosis, falls, broken bones Mental health conditions Skin changes and temperature control Multiple medications adverse effects

9 People with cerebral palsy Scoliosis may increase problems with sitting, comfort, independence, breathing Chronic pain Joint and muscle pain from contractures, spasms Arthritis Hip dislocation Osteoporosis, fractures Swallowing problems may increase Fatigue / tiredness increases Less mobile with age may stop walking Less independence

10 People with Down syndrome Dementia at an earlier age than others in the community Increased vision and hearing problems

11 Need for more health monitoring Mobility decreases Decrease in functional abilities Increased dependence on others affects families and other carers Changing social circumstances Retirement, family members, friends, housing May be more lonely and isolated

12 If I knew I was going to live this long, I would have taken better care of myself George Burns (Lived to be 100 years)

13 Healthy diet - may need smaller portions Physical activity Weight control, bone density, mood, cardiovascular fitness, improve balance and function Falls prevention Check vision, review medications, balance and strength training, environmental changes (e.g. no rugs, remove obstacles, good lighting, grab rails in bathrooms, at steps, avoid shiny surfaces), supportive footwear Sleep hygiene Regular bedtime, quiet time before bed, no TV watching in bed, no meals close to bedtime, dark room, right temperature, no long naps in the day

14 Safe sun exposure Avoid overheating, being too cold More susceptible to heat (less sweat glands) and cold (thinner skin) Ensure adequate fluids in hot weather Regular health assessments Check vision, hearing Breast and cervical screening Bowel cancer screening Check blood pressure, cholesterol Medication review Personal health record

15 Immunisations influenza, pneumococcal vaccines Support to maintain social relationships Support to maintain hobbies and interests Support for families and carers

16 Family members, other carers may be more stressed, maybe ageing as well Respite care Aged care packages for home based assistance Equipment needs

17 Changes in physical and mental health with ageing Functional skills may decrease Some people with intellectual disability have age related changes at younger ages than others in the community There are many things people can do to be healthy, active and happy in older age Anticipate changes and put in place supports for a healthy lifestyle and practical supports for carers

18 ADHC - Home and Community Care Program (HACC) Commonwealth Respite and Carelink Centres Specialised intellectual disability health clinics Geriatricians Physical activity guidelines for older people nsf/content/phd-physical-rec-older Australian dietary guidelines for older people /attachments/n24.pdf

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