Persons with Disabilities

CEREBRAL PALSY
Decline in energy and activity levels. Some bladder difficulty and spinal stenosis reported. More bone fractures per year compared to non-disabled.
DEVELOPMENTAL DISABILITIES
Aging process is affected by the nature and severity of the impairment, secondary conditions , medical issues, and medication usage.
DOWN SYNDROME
· Increased chance of hypothyroidism, hypertension, and arteriosclerosis.
· Shorter life expectancy of 55 years old, but many live into 70s.
· Most adults over age 40 have some neuropathological changes characteristic of Alzheimer’s Disease, but only some develop dementia.
INTELLECTUAL DISABILITIES
Outlive parents and can’t rely on adult siblings. Must plan for the future.
MULTIPLE SCLEROSIS
· There has been little research on this topic. Doesn’t reduce life expectancy. Limited ADLs and IADLs.
· Common issues: urinary tract infections,
pneumonia, and septicemia.
· Loss of mobility (fatigue, falls), dependency on caregiver/family, or possibility of moving into nursing home; most require multiple mobility devices. Rehabilitation therapy has shown to help functioning.
· Controversial study found that MS
doesn’t get worse with age and seems        to disappear in the 70s, but MS remains         unpredictable and attacks can occur in           this age group.
TRAUMATIC BRAIN INJURY
Effects of aging vary greatly. Memory
impairment, slower learning of new material, gait and balance problems, ataxia, decreased sensory acuity, diminished executive functions, reductions in appetite and libido.
POST-POLIO SYNDROME (PPS)
· Develops several decades after a person has had polio. Affects the muscles and nerves, causing weakness, fatigue, pain, and other symptoms. Start to experience onset of new symptoms and functional limitations, which threaten to further erode health and independence and an  increase need for services.
· Mean age of 63-Age of person at acute onset and historical period are significantly related to the severity of the initial impairment as well as the physical and psychosocial wellbeing. Contracted at a younger age and earlier in the century were less impaired. Measured by the number of limbs affected vs. contracted later during the peak of the epidemic and at an earlier age. Timing and initial severity have a big impact.
· Excessive fatigue, slowly progressive muscle weakness with or without decrease in muscle bulk, muscle pain or twitching where effected by original disease. Joint pain and respiratory problems reported.
· Severity and experience polio after 1940 at older ages most at risk for depressive symptoms and low scores on acceptance of disability.
SPINAL CORD INJURY
· Effects begin around age 40  with SCI for 20 years. Effects of aging depend on nature and duration of injury—quad early 40s, lower injuries early 50s.
· More pain, fatigue, effort to do activities, weakness, unable to do things previously done independently.
· Diabetes at 4x the rate of nondisabled persons.
· Changes ranging from decline in health and physiologic functioning to sociologic changes, ie, increasing financial stresses, changing relationships, perception of self and roles, and spiritual growth.

Older adults age 65 and over are at higher risk for many types of injuries that can have devastating effects. In some cases, leading to loss of independence, disability, or death. Falls are the leading cause of injury death for Americans 65 years and older. Twenty percent to 30% of people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. They are also the most common cause of nonfatal injuries and hospital admissions for trauma. People age 75 and older are in one of the age groups at highest risk for Traumatic Brain Injury.
What happens when someone suddenly becomes disabled? How do you react? What do they go through? What resources can help both the accident victim and the caregiver?
The individual with a new disability may be in shock, disoriented, and confused about the future. They may be asking themselves  “how  am I going to go on with my life, remain independent, or get help? “ They may experience a variety of emotions such as anger, denial, sadness, or depression.
Family members may experience similar feelings. They may feel isolated, not knowing what the future will bring or who can help them in this time of crisis.
Elizabeth Kubler-Ross identified five stages of grief that the person with a disability or family members may experience: denial, anger, bargaining, depression, and acceptance. A person can go through these stages in any  order and they may be repeated.  Each stage may last different amounts of time.
Various things affect how people live with their disability:
·         Type of disability
·         Cause of disability
·         Severity of disability
·         Visibility vs. invisibility of the particular disability
·         Coping abilities of the patient and family
·         Previous attitudes toward disability and illness
·         Reactions of family, friends, and health care professionals
·         Personality
·         Availability of supportive services
When illness or disability strikes the patient and families may become overwhelmed with questions and information. Your doctor is key to the process of treatment and recovery, whether you have a progressive illness that develops over time, or a sudden disability caused by an accident.
Becoming disabled means you may need support from health and social service agencies. The hospital social worker or case manager can assess your needs and connect you with services. These services may include home health care, financial aid, counseling and support groups, and other services for older adults.
Patients and families need to ask their health care professionals questions about the disability or health condition, treatment and recovery, and what services are available to help the individual and the family.
Caregivers need to take care of themselves. You need to take breaks, enjoy your own leisure activities, and delegate responsibilities to others if possible.
 
The following services are available in the community:
For general information: Call 211 or the Area Agency on Aging (Elder Helpline) 561-684-5885
 
For people with certain health conditions:
Alzheimer’s Association 24-Hour Crisis Line 1-800-272.3900
 
American Parkinson’s Disease Association
954-786-2305
Arthritis Foundation
561-833-1133
MS Society for South Florida 800-344-4867
 
For people with visual impairments:
Lighthouse for the Blind 561-848-7200
Talking Books Library 888-780-5151
Radio Reading Service 800-273-6677
 
For people with hearing impairments:
Deaf Service Center 561-278-6444
 
Caregiver assistance and support:
Palm Healthcare Foundation 561-840-4222
Caregiver Magazine www.caregiver.com
National Family Caregiver Association 800-896-3650
Well Spouse Association 800-838-0879
 
Counseling and Support Groups
Ruth Rales Jewish Family Services 561-852-3333
Center for Group Counseling  561-483-5300
 
 
 
Transportation:
Palm Tran Connection 877-870-9849

By Robert Goodman, MSW

Have you recently lost your vision, become disabled, in need of services to help you become more independent? Are you living with a lifelong disability and notice changes in your functional capacity? There are services available to help you become and maintain your independence. Some of these services are listed at the end of this article.
It is difficult to be functioning independently one day, suddenly end up in a hospital, and have to learn to walk or function independently over again. There are services that can help you learn activities of daily living (walking, bathing, eating, personal care, etc). Other agencies help with the psychological aspects of adjusting to a disability. There is no harm in asking for help. Support groups offer support, friendship, and love.
Perhaps you have reached a point where it is becoming dangerous for you to continue driving. There are options available to help non-drivers. First, Boca Raton has several bus routes that take you to most places. The 91 bus that leaves from the clubhouse will help you connect to these routes. Century Village has buses (with steps) that go into the community. Palm Tran Connection provides door to door service throughout Palm Beach County for people who cannot use public transportation. If you are concerned about keeping your driver’s license for identification purposes, you don’t have to worry. Florida offers a non-driver’s ID card for those who need a form of identification to replace a driver’s license.
There has been a lot of research in recent years on what changes occur in the physical functioning of persons living with lifelong disabilities, such as polio, cerebral palsy, multiple sclerosis, developmental and intellectual disabilities, and mental illness. The research has found that some people with lifelong disabilities have noticed more joint pain/arthritis, problems with balance, and fatigue at an early age.