Aging with a Disability: What the Practitioner Needs to Know
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Aging with a Disability: What the Practitioner Needs to Know AACPDM Presentation Summary Sept 29, 2004 Bryan Kemp, PhD University of California at Irvine
description
Aging with a Disability: What the Practitioner Needs to Know. AACPDM Presentation Summary Sept 29, 2004 Bryan Kemp, PhD University of California at Irvine. % Capacity. 20 40 60 80 100 AGE. What is Aging? A Look at the Organ Systems. Rate of Aging = - PowerPoint PPT Presentation
Transcript of Aging with a Disability: What the Practitioner Needs to Know
Aging with a Disability: What the Practitioner Needs to Know
AACPDM Presentation SummarySept 29, 2004
Bryan Kemp, PhDUniversity of California at Irvine
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CapacityCapacity
2020 40 40 60 60 80 80 100 100
AGEAGE
What is Aging? What is Aging? A Look at the Organ SystemsA Look at the Organ Systems
Rate of Aging =Rate of Aging =1% per year 1% per year
Required CapacityRequired Capacity
4040
Reserve CapacityReserve Capacity
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CapacityCapacity
2020 40 40 60 60 80 80 100 100
AGEAGE
Aging with a Disability vs. Typical AgingAging with a Disability vs. Typical Aging
Non-Disabled =Non-Disabled =1% per year 1% per year
Disabled =Disabled =1.5% per year1.5% per year
4040
0
10
20
30
40
50
60
70
80
90
100
11 - 2011 - 20 21-2821-28 38-5038-50 >60>60
Walking Cessation by Age in CP Group Walking Cessation by Age in CP Group
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AGEAGE
n = 27n = 27
Murphy K, et al. Murphy K, et al. Dev Med Child Dev Med Child NeuroNeuro. 1995, 37, 1075-1084.. 1995, 37, 1075-1084.
Stopped by 30 due to:Stopped by 30 due to: • fatigue fatigue • inefficiencyinefficiency
Stopped by 50Stopped by 50 due to:• painpain• fatiguefatigue
Incidence of Pain by Impairment Group Incidence of Pain by Impairment Group n = 337n = 337
0
10
20
30
40
50
60
70
80
90
100
RA Polio CP SCI Control
%%
(120)(120) (23)(23) (60)(60)(9)(9) (125)(125)
SeveritySeverity
mild mild
mod/severemod/severe
RRTC on Aging with a Disability Natural Course of Aging with a Disability Study, 2002RRTC on Aging with a Disability Natural Course of Aging with a Disability Study, 2002
0
10
20
30
40
50
60
70
80
90 Fatigue
No Fatigue
Incidence of Fatigue by Impairment GroupsIncidence of Fatigue by Impairment Groups
%%
n = 351n = 351
RRTC on Aging with a Disability, Natural course of aging with a RRTC on Aging with a Disability, Natural course of aging with a disability study, 2001disability study, 2001
PolioPolio CPCP SCISCI ControlControl
Loss of Function with AgeLoss of Function with Age
30 40 50 60 70 80AGE
DisabledNon-disabled
Recreation Recreation
IADLs
IADLsEmployment
Employment
ADLs ADLs
Example of Typical DailyExample of Typical DailyFunctional DemandsFunctional Demands
for W/C users for W/C users
Rise and Shine -Up and out of bed!Rise and Shine -Up and out of bed!
Bathing/Toileting/Dressing/Pressure relief raises Bathing/Toileting/Dressing/Pressure relief raises
Transfers (cars, chairs, toilets, bathbench,Transfers (cars, chairs, toilets, bathbench,couches, floor, bed) couches, floor, bed)
Propulsion (hills, rough terrain,Propulsion (hills, rough terrain, ramps, curb cuts, distance) ramps, curb cuts, distance)
Outings (work, school, social,Outings (work, school, social,community chores, recreation)community chores, recreation)
Exercise?Exercise?
Household choresHousehold chores
To bed - Sleep?To bed - Sleep?
Two Important Psychological Issues
• Coping and the problem of depression
• Quality of Life and community involvement
Depression Scores Across Depression Scores Across GroupsGroups
0
10
20
30
40
Non-Disabled Post-Polio Spinal CordInjured
Stroke CP
Moderate Depression
Major Depression
PercentPercent
Why Depression Is Poorly Why Depression Is Poorly RecognizedRecognized
The symptoms of depression overlap The symptoms of depression overlap with the symptoms of chronic disease. with the symptoms of chronic disease.
Clinicians and others “normalize” Clinicians and others “normalize” depression.depression.
Clinicians believe depression is Clinicians believe depression is untreatable because of the disability.untreatable because of the disability.
Causes of DepressionCauses of Depression
Not caused by the disability or the
impairment.
Most likely caused by difficulties coping
with the disability and the societal
problems.
Factors Related to Positive QOL in Factors Related to Positive QOL in Persons Aging with a DisabilityPersons Aging with a Disability
Not related to age, severity of impairment or to Not related to age, severity of impairment or to
degree of disability. degree of disability.
The ability to engage in meaningful, enjoyable or The ability to engage in meaningful, enjoyable or
productive activities.productive activities.
The number and kind of community activities the The number and kind of community activities the
person does.person does.
Somewhat related to social support, attitude, and Somewhat related to social support, attitude, and
personality.personality.
QUALITY OF LIFE:QUALITY OF LIFE: The The
presence of a reasonable presence of a reasonable
amount of pleasurable, amount of pleasurable,
successful and meaningful successful and meaningful
experiences.experiences.
• Recognize the value of education about long-term life Recognize the value of education about long-term life issues. issues. Initial rehab may be the only teachable moment.Initial rehab may be the only teachable moment.
• Assist with finding the balance between the need for Assist with finding the balance between the need for exercise and the need for efficient movement.exercise and the need for efficient movement.The primary means of mobility should not be the means for The primary means of mobility should not be the means for exercise.exercise.
• Emphasize performance skills that protect the Emphasize performance skills that protect the musculoskeletal system and provide the rational for specific musculoskeletal system and provide the rational for specific performance techniques.performance techniques.
• Educate clients about potential changes and how to Educate clients about potential changes and how to recognize and respond to symptoms associated with recognize and respond to symptoms associated with functional change.functional change.
Initial Rehabilitation focusInitial Rehabilitation focus
• Instead of…
“Use it or lose it”
“No pain, no gain”
• Consider…
“Conserve it to preserve it”
Website Resources
• “Aging with a Disability: Putting Research into Practice and Education” March 2003– Video of presentations– Powerpoint slides
• http://www.cdihp.org/aging.html
Additional Readings
• Lankasky, K. (2004). A consumer’s perspective on living with a disability: How change in function affects daily life. In B.J. Kemp & L. Mosqueda (Eds.), Aging with a Disability: What the Clinician Needs to Know (pp. 9-18). Baltimore: The Johns Hopkins University Press.
• Murphy, K.P., Molnar, G.E., & Lankasky, KI. (1995). Medical and functional status of adults with cerebral palsy. Developmental Medicine and Child Neurology, 37, 1075-1084.
