This training was made possible by
generous grants from the New Jersey
Council on Developmental Disabilities
and from Spectrum for Living’s
Endowment Fund.
Do not regret growing older. It
is a privilege denied to many.
~Author Unknown
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
~Doris Lessing
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
• What is Aging (in America, at least) ?
–The “normal” aging process
–Factors that influence the aging
• Lifestyle choices
• Genetics
• Environment
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)
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
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
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.
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
– Less able to adapt to glare
– Not as quick to transition from lighted area to darker
• It is important to maintain regular eye check-ups as we
age and to adapt the living environment to
accommodate these changes.
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
Vision Changes: Signs & Symptoms to be mindful of
– 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
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
• 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.
Other Supports For Vision Challenges
– Keep eyeglasses clean and free of scratches
– Organize activities during the day time whenever
– 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”
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.
What factors cause our hearing to change as we
• Loss of auditory nerve cells and fibers
• Reduction of blood supply to auditory
nerve transmission area
• Thickening of eardrum
• Increased ear wax
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.
Supports for aging adults experiencing hearing
• Regular physician exams
• Hearing aid if recommended by the hearing
• Keep hearing aid batteries fresh, back-up
always available, and hearing aid clean
Supports for aging adults experiencing hearing
problems, (cont’d)
• Speak slower, speak clearly, speak with lower
• Reduce background noise
• When speaking, face the person, with light on
your face, not behind you.
Effects of Aging on the mouth and Taste
Decrease in taste perception and in saliva
• 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.
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
Effects of Aging on the Sense of Smell
• Decrease in the nerve fibers located in the
• 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
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.
The Skin changes as we age…
• Decreased elasticity, subcutaneous fat,
• Decrease in cell production and hair growth.
• Decreased sensation to touch.
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
• Reposition frequently if mobility is limited;
check skin often for problems
The Gastrointestinal System & Aging
• Decreasing total calorie needs every decade
• Less gastric juice may lead to increased
• Slower emptying of stomach and slower digestion
• Less absorption of nutrients
• Slowing of elimination of waste from the body
Support Strategies
• Encourage slower eating
• Smaller, more frequent meals
• Avoid empty calories
• Observe for constipation
• Fiber and fluids
• Physical activity
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.
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
• 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.
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,
• 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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