The Effects of Aging and Cerebral Palsy
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Studying the effects of aging on people with cerebral palsy is a short course as there simply is not much research on the subject. Until recently (with in the past 15 years) people with Cerebral Palsy have not lived that long. Today, improved medical care is extending our lives. Therefore, we need answers to what we can expect as time wears on us. Older adults with CP have come to experience the natural aging process in combination with other impairments which has imposed a number of physical, emotional, and financial consequences on their lives (UCPA, 1993). It is essential that health and human services are dedicated to the needs of this population. The health concerns and psychosocial issues must be addressed so that older individuals with CP may continue to live independently with peace of mind.
The transition into adulthood is a challenge for most young adults, and the degree of additional challenges in the course of this stage depends on the individual and his or her family, as well as the severity of impairment. Physiologically, an adolescent who has CP undergoes the same changes as their peers, however, psychologically, having a disability makes it difficult to develop a positive and healthy self-image. Fatigue is commonly a result of psychological stress in response to the enormous array of changes that take place in one's life during this period. Employment and development of social skills that foster intimate relationships are seen as pressing issues for the majority of young adults. Independence is a key component of success in the aspirations of people at this age, and for an individual who is disabled, the psychosocial implications of dealing with inclusion and discrimination are pervasive.
As the adult experiencing the effects of normal aging, there are many physiological and psychological factors which impact the course of this period. Literature which examines the issue of older adults with CP agree that the aging process begins to affect them more quickly and at a younger age than non-disabled people (UCPA, 1993; Overeynder et al., 1994; Miller & Bachrach, 1995). The physical challenges of CP intensify with age, frequently resulting in increased spasticity, fatigue, and the loss of strength and mobility (CPA, 1994). Rapid aging in combination with a lack of assistance and professional awareness increases anxiety for older adults.
A total of 279 adults with cerebral palsy from across Australia responded to a survey which sought information about their health, modes of communication, access to information and perception of their own aging process. Results indicated:
Adults with Cerebral Palsy and those who deliver services to this population have both expressed some concern that individuals with Cerebral Palsy may experience negative effects of the aging process earlier than non-disabled individuals. People with CP generally notice the effects of aging at an earlier age, with a more rapid decline in function than in the non-disabled majority. Disabilities which have a long duration can produce excessive wear and tear on the muscular, skeletal, and other body systems. As such, individuals with CP are experiencing unexpected declines in function and energy levels prematurely. These effects have been found to occur as early as thirty years of age (UCPA, 1993).
Arthritis is a common condition found in people with cerebral palsy. Statistics show that 40% of the people with cerebral palsy get arthritis at an early age. Other secondary health problems often appear at a more serious level because of cerebral palsy, the primary disability. I have personally experienced this as I have become older, particularly in my knees. On rear occasions it can be pretty unbearable.
Even without the complication of another disability, the aging process itself has its impact. As people with Cerebral Palsy get older, they take longer to do things such as walking, dressing or eating. They may require a personal assistant to complete the task. They slow down physically and can't do as many things as they once did when they were young. I personally have tried to keep myself in shape as much as is physically possible, but I have noticed over the years it has taking me longer to do daily activities. I have especially noticed this in trying to get dressed each day.
Depending on lifestyle and type of disability, living 20 to 30 years with a disability can produce wear and tear on the muscles and other body systems. Most people with major physical disabilities of a 30-year duration note some tenderness and soreness in joints, as well as muscles and tendons that have been carrying an extra load because of impaired physical functioning in other parts of the body.
Most people born with a disability know from early childhood that they are differently able than their non-disabled peers. This somewhat prepares them for the effects of aging. Others with disabilities, however, are sometimes very surprised when the aging process accelerates and they experience an unexpected decline in their energy and activity levels.
The work place is often where social supports and other resources are developed. So the transition to retirement causes a variety of concerns for people with cerebral palsy including health care, loss of income and loss of contact with friends. They are often forced to retire due to physical limitations and lack of flexible work schedules.
Furthermore, the transition from being able to walk either independently or with a device to not walking at all has profound psychological effects. Some people have been raised with the thought that if you walk you will pass. For today's generation, dependence means more than giving up freedom and social status; loss of dependence raises the threat of being placed in an institution. Given this threat, it is no wonder that there is a fear of growing old in the CP community.
Unfortunately, there is not much authoritative information available to help deal with these problems. The combination of aging and a disability is an unexplored area and each person is different, depending on the severity of the disability. There are doctors who specialize in children with CP, but very few doctors specialize in adults with cerebral palsy, let alone health concerns associated with advancing age.
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