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"Aging with a disability is something we have no record of,
and it's like facing the unknown; and doctors don't know or have
a lot of experience either."
Aging
with a disability: What's been learned?
FOR
THE FIRST TIME IN HISTORY, people who have experienced spinal-cord
injuries, polio, cerebral palsy, strokes and rheumatoid arthritis
are living nearly normal life spans. Like their peers without disabilities,
they go through both the positive and negative aspects of aging.
Some of the positive aspects include retirement, participation in
leisure activities and visits with grandchildren.
However,
research centers such as those at Rancho Los Amigos Medical Center
in Downey, California, have accumulated evidence indicating that
for a great many people, aging with a disability is accompanied
by numerous problems that usually do not occur until 10 to 15 years
later in nondisabled persons. Here's some of what has been discovered
and what can be done about it.
Medical
Problems: For reasons that are still not well understood, individuals
with disabling conditions are at heightened risk of new medical
problems as they age.
- Compared
to the national average for nondisabled persons, people with disabling
conditions have three to four times as many additional health
problems.
- The
most common problems are high blood pressure, diabetes, high cholesterol,
obesity, respiratory conditions, loss of bone mineral, and thyroid
disorders.
- Many
people do not know they have these problems because they don't
have a primary care doctor to monitor their health.
- Some
impairments appear to be strongly linked to certain medical conditions.
People with spinal cord injuries develop diabetes at nearly four
times the rate of nondisabled persons. Those with cerebral palsy
have many times the number of fractures per year compared to their
nondisabled counterparts.
- The
most important precaution consumers can take is to have yearly
examinations by a primary care doctor-an internist or family physician-who
is committed to their care.
Functional
Problems: The most common complaint of people aging with disabilities
is a complex of fatigue, new weakness and pain.
- There
is no single explanation for these problems. This complex occurs
across all impairments in anywhere from 25-80% of people studied.
- These
symptoms often progress and become severe enough to affect work,
social activities and the ability to do household or self-care
activities.
- It
is important to seek medical/therapy intervention to treat or
accommodate these changes. The recommended treatment for these
symptoms is to do less, not to try to work through them. Use of
additional assistive equipment or devices can also help.
- For
changes that affect work, job accommodations are usually helpful;
and many employers and coworkers are willing to make changes.
Psychological
Changes: The biggest psychosocial issues are maintenance of
quality of life and the impact of changes in health on the person's
family.
- For
many people, changes in health or functioning lead to episodes
of depression. Depression affects 15-40% of people aging with
disability, compared with 5-10% of people without disabilities.
Depression is a very treatable disorder. Prolonged changes in
mood, outlook, sleeping or behavior should be brought to the attention
of a doctor.
- Family
members and other care providers need to anticipate these multiple
changes and plan for them. Increasing needs for help will take
additional time and resources.
- For
most people aging with a disability, the longer they live with
it, the more satisfying life becomes. High life satisfaction appears
to relate to being able to maintain valued activities as one ages.
[By
Bryan Kemp, Ph.D., Director of the Rehabilitation Research and Training
Center on Aging with Spinal Cord Injury at Rancho Los Amigos Medical
Center, Downey, California. Article is reprinted courtesy of New
Mobility magazine at www.newmobility.com.]
See
also ...
A
Long and Healthy Life: It's Your Choice
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