Aging with a Developmental Disability

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disabilityIn addition to serving clients with chronic physical and cognitive disabilities associated with aging, Elder Care Guides provides care management and home care services to older adults with mental health diagnoses, and older adults with developmental disabilities. These two populations are not always well-served through the programs and organizations targeted at the general adult population. People with a developmental disability or mental health diagnosis will likely have specific concerns and issues as they age that may be different than that of an older adult without a developmental disability or mental health diagnosis.

People with developmental disabilities are living longer as they typically have better health care and supports than earlier generations. Older adults with developmental disabilities have unique health care needs. The normal aging process is often complicated by a lifetime of reduced mobility, poorer general health, medications, surgeries, etc. It is not uncommon to experience symptoms such as pain, arthritis, joint problems, and fatigue at a younger age.

The more severe the developmental disability, the greater risk – and earlier onset – of the diseases commonly associated with aging. Most health practitioners are not prepared for these unique challenges. This includes a lack of knowledge about aging in persons with developmental disabilities, lack of available services in a system that has generally concentrated on services for younger people, and lack of available information on good health habits for these older adults.

Some of the challenges of aging associated with this population include:

  • Reduced levels of social interaction with age. This normal process may mimic the symptoms of dementia to a health care professional.
  • Difficulty communicating visual and auditory decline, resulting in isolation, anger, and/or depression.
  • Adults with Down syndrome are very vulnerable to hypothyroidism, which is frequently misdiagnosed as Alzheimer’s disease.
  • Older men with developmental disabilities may experience reduced ability to urinate but not be able or willing to tell anyone. The resulting discomfort frequently leads to behavioral changes.
  • Menopause is often not considered by health care professionals in their treatment of older women with developmental disabilities.
  • Increased likelihood of multiple medication, and medications that are not commonly used by the general population such as psychotropics.
  • Earlier onset of sensory impairments and mobility challenges, often resulting in a physical environment that is more difficult to navigate.
  • Adults with Down syndrome and cerebral palsy experience the same changes associated with aging but at an earlier age than both the general population and as other older adults with developmental disabilities.

Elder Care Guides’ experienced care managers can support adults with developmental disabilities and their families as they age. Care managers can help with medical advocacy at doctor appointments to ensure the specific needs of this population are identified and properly addressed as they age. Elder Care Guides can also help with referrals to other community resources and provide oversight of your loved ones care. We are here to help, so please call us today.

References

State of California Department of Developmental Services: www.dds.ca.gov

San Diego Regional Center: www.sdrc.org

United Cerebral Palsy: www.ucp.org

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Prescription Drug Abuse: Not just a problem of the young

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Prescription drug abuse is on the rise in the older adult population.

Prescription drug abuse is on the rise in
the older adult population.

Prescription drug abuse has become a dramatic public health concern in the United States, and it is not limited to “young people.” Mental health providers, physicians, and government agencies are noting increasing problems with the misuse and abuse of prescription medications amongst older adults, including the Baby Boomers. While there have not been many studies on the subject, some research shows that up to 26% of people over the age of 65 misuse or abuse their prescription drugs.

Why are so many older adults misusing or abusing their medications?  Older adults who have cognitive decline, including dementia, may experience confusion about how and when to take their medications. Pain, anxiety, depression and sleep problems are common in the elderly, and the medications prescribed for these conditions can lead to abuse or dependence. Some older adults on limited incomes may “borrow” or share medications. In most cases, the abuse or misuse is not intentional, and the medication is obtained legally, by prescription.

Older adults face some particular risks if they misuse their medications. According to The Substance Abuse and Mental Health Services Administration (SAMHSA), older adults are more vulnerable to this problem because as a group they use more prescription drugs than younger adults. Due to the slowing metabolism and elimination associated with aging, even small amounts of medication can impact older adults in dramatic ways. Many older adults take multiple medications, increasing the likelihood of medication interactions. The abuse or misuse of “psychoactive drugs” taken for depression, anxiety, and insomnia is of particular concern as these drugs act on the central nervous system. If used inappropriately, or mixed with alcohol, these medications can cause sedation, memory problems, functional impairment, and/or falls.  Those older adults most vulnerable to psychoactive medication abuse are socially isolated women with histories of substance abuse and mental health problems, especially depression.

What can older adults and their families do to avoid prescription drug misuse and abuse?

  • Read and follow prescription drug usage instructions and ask your health care provider for information on side effects.
  • Do not rush to increase the strength of your medication, especially pain medication. Talk to your doctor if your symptoms are not improving, and explore non-prescription methods to address your symptoms (such as massage, acupuncture or stretching/exercise). For depression and anxiety, consider talk therapy as well as medication therapy.
  • Let your doctor and pharmacist know about every medication you are taking, prescription and over-the-counter, including supplements.
  • If you are taking more than five medications, it is likely you will experience some drug interactions. Consider working with a senior care pharmacist to review your medication list and identify possible changes to discuss with your doctor.
  • Never use another person’s medications. If the cost of medication is a concern for you, ask your doctor for samples and talk to your pharmacist about medication assistance programs.
  • If you suspect you may have a problem with prescription drug abuse or misuse, know that you are not alone and help is available.  Talk to your doctor, mental health professional, or geriatric care manager for local resources.

Information gathered from fact sheet from SAMHSA: http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs2/Issue%20Brief%205%20Prescription%20Med%20Misuse%20Abuse.pdf

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