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2 This training was made possible by generous grants from the New Jersey Council on Developmental Disabilities and from Spectrum for Living’s Endowment Fund.

3 Do not regret growing older. It is a privilege denied to many. ~Author Unknown

4 The great secret that all old people share is that you really haven't changed in seventy or eighty years. Your body changes, but you don't change at all. And that, of course, causes great confusion. ~Doris Lessing

5 We've put more effort into helping folks reach old age than into helping them enjoy it. ~Frank A. Clark Old age ain't no place for sissies. ~Bette Davis

6 What is Aging (in America, at least) ? – The “normal” aging process – Factors that influence the aging process Lifestyle choices Genetics Environment

7 Aging with a Developmental Disability: People with DD have the same goals and desires for aging as anyone else: – Healthy aging & maintaining independence – Emotional and psychological stability – Personal and Social control – Continued engagement with life (Pugh, G., 2004)

8 Factors that complicate aging with a DD – The normal effects of aging – Limited access to/inadequate funding for quality health care – Negative attitudes about people with DD – Lifestyle choices and opportunities – Lack of knowledge about aging for people with DD – Effects of the disability and its treatment

9 Other factors that complicate aging with a DD – Decreased quality of life – Absence of emphasis on healthy aging – Aging adults with DD often have difficulty expressing changes in their health status – The risk of dementia

10 Vision changes that accompany aging (In the general population and in adults with DD) Decrease or loss of peripheral vision Decreased ability to judge depth and distance Decreased clarity of colors, such as greens, pastels and blues.

11 Vision changes that accompany aging (In the general population and in adults with DD) – Decrease in ability to see in low light (that is, dark adaptation). – Less able to adapt to glare – Not as quick to transition from lighted area to darker surroundings It is important to maintain regular eye check-ups as we age and to adapt the living environment to accommodate these changes.

12 Vision Changes: Signs & Symptoms to be mindful of: – Squinting – Rubbing eyes – Shutting or covering one eye – Tilting or thrusting head forward – Redness of the eye(s) or area around the eye

13 Vision Changes: Signs & Symptoms to be mindful of (cont’d): – Hesitancy on a step or curb – Holding a page or object closer to the eye – Sitting close to the television – Refusing to participate in previous activities

14 Supports for adults experiencing vision problems – Regular eye exams and medical consultation for symptoms when they appear – Modify the environment: Use high contrast colors and non-glare lighting and surfaces Large prints for labels, reading materials, signs Provide more lighting, and use night lights Remove clutter, organize belongings and keep locations of belongs constant Yellows, oranges, reds, are better colors for aging eyes than blues, greens, violets.

15 Other Supports For Vision Challenges – Keep eyeglasses clean and free of scratches – Organize activities during the day time whenever possible – Provide supports for night-time activities (E.g. more lighting, etc) – Allow the person time to adjust to change in lighting, when moving from a lighted area to a darkened area, and vice versa – Protect the “good eye”

16 Aging and hearing/auditory changes – Loss of hearing is very gradual, and starts around middle age. – There is a loss of hearing acuity, especially sounds at the higher end of the spectrum (higher pitched sounds). This is known as Presbycusis. – Decreased ability to distinguish sounds when there is background noise.

17 What factors cause our hearing to change as we age? Loss of auditory nerve cells and fibers Reduction of blood supply to auditory nerve transmission area Thickening of eardrum Increased ear wax

18 Hearing/auditory changes: Signs and symptoms Turning tv or radio up loud Speaking loudly Inappropriate responses to questions Confusion in noisy situations Isolating Self injurious behavior.

19 Supports for aging adults experiencing hearing problems Regular physician exams Hearing aid if recommended by the hearing professional Keep hearing aid batteries fresh, back-up always available, and hearing aid clean

20 Supports for aging adults experiencing hearing problems, (cont’d) Speak slower, speak clearly, speak with lower tones Reduce background noise When speaking, face the person, with light on your face, not behind you.

21 Effects of Aging on the mouth and Taste Decrease in taste perception and in saliva production A decrease in taste perception can also be caused by certain medications and/or dosages. It is important to speak to a physician about these changes. Thinning of dental enamel Recession of the gums.

22 Support Strategies for the Mouth/Taste Maintain regular dental checkups Good oral hygiene, even if there are no teeth. Floss or use proxy-brush Consider using electric toothbrush Alcohol-free mouth wash Ask dentist about prescription chlorhexidine mouthwash

23 Effects of Aging on the Sense of Smell Decrease in the nerve fibers located in the nose Decreased sensitivity to odors – Important to maintain good personal hygiene because of this decrease in sensitivity to odors Drying up of the mucous membranes in the nose

24 Supports for managing the effects of Aging on the sense of Smell Smoke detectors Put in extra safety measures if using gas/propane stoves or water heaters Discard food after “Best By“ date, check food for spoilage. Assist with awareness of body odor or the over-use of fragrances.

25 The Skin changes as we age… Decreased elasticity, subcutaneous fat, Decrease in cell production and hair growth. Decreased sensation to touch.

26 Protecting the skin… Use sun screen; wear hats Implement safety precautions such as labeling hot & cold water; install anti-scald devices Use soaps that won’t dry out the skin; rinse well Reposition frequently if mobility is limited; check skin often for problems

27 The Gastrointestinal System & Aging Decreasing total calorie needs every decade Less gastric juice may lead to increased indigestion Slower emptying of stomach and slower digestion Less absorption of nutrients Slowing of elimination of waste from the body

28 Support Strategies Encourage slower eating Smaller, more frequent meals Avoid empty calories Observe for constipation Fiber and fluids Physical activity

29 Other changes that come with Aging Our organs lose some of their efficiency. The heart begins to require more oxygen to carry out its function, Thickening and hardening of the arteries (arteriosclerosis) and other blood vessels usually cause blood pressure to rise slightly. Lungs lose some of its elasticity, which affects the amount of oxygen it can take in.

30 Other changes that come with Aging, cont’d It takes longer for the kidneys to remove waste products from the body, particularly medications. Bladder tissue loses some elasticity; the bladder muscles become weaker with age, which decreases the amount of urine the bladder can hold. These changes affect the bladder’s ability to get rid of all the urine it contains and this may cause an older person to urinate more frequently.

31 Other changes that come with Aging (Cont’d) Important: urinary incontinence (not being able to hold one’s urine) is NOT a normal change with aging, and should be evaluated by a medical provider. Women go through menopause, vaginal lubrication decreases and sexual tissues atrophy slightly. In men, sperm production decreases and the prostate enlarges slightly. Minor decrease in the levels of the male hormone, testosterone.

32 FINAL NOTE… It is important to stress that staff and caregivers must pay attention to how each client normally presents, in order to know and recognize when a client has a medical issue that is out of the norm.


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