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The life expectancy and age-related medical conditions of adults with Developmental Disabilities are similar to that of the general population unless they have severe levels of cognitive impairment, Down syndrome, cerebral palsy, or have multiple disabilities. Some research has indicated that sensory, cognitive, and adaptive skill losses happen earlier for adults with Down syndrome compared to the general population and other adults with intellectual disabilities (Heller, 2011). For adults with Down syndrome, indicators of dementia may often be caused by other conditions that are remediable such as hypo/hyperthyroidism, depression, and sensory impairments (Heller, 2011). The rising numbers of older adults with Developmental Disabilities will intensify the need for services and supports that allow them to maintain functioning and remain living as independently as possible, whether they are living with family or in other residential settings. Examples of such services and supports comprise of personal care services, assistive technologies, home health care, and other in-home supports (Heller, 2011).
Older adults with Developmental Disabilities differ widely in their desire to retire, with many preferring to continue participation in work or vocational activities. Major health issues for adults with Developmental Disabilities living in the community are proper nutrition and sufficient exercise (Heller, 2011). Because adults with Developmental Disabilities are living longer, families have a longer period of care giving responsibility. While there has been an increase in funding for family support programs in the last ten years, these programs represent a small portion of spending for Developmental Disabilities services, and often target families of young children (Heller, 2011).
Mindfulness of the growing numbers of individuals with developmental disabilities, who are aging, has directed service providers to focus on the needs of these individuals and the system’s capability to assist them suitably. The re-conceptualization of disability from a medical model to a social model significantly affects the service system, the supports required by an individual and the prospects society has for an individual with a disability as he or she ages (Kavarian & Long, 2008). Before entrance to a nursing home, a screening must be completed for every person with a developmental disability. Persons with developmental disabilities who are found to be unsuitably placed in a nursing home must be discharged (Kavarian & Long, 2008). Unless the individual has a substantial disability such as Down syndrome, cerebral palsy (CP), multiple disabilities, or a severe level of cognitive impairment, the life expectancy and age-related medical conditions of elders with developmental disabilities are similar to that of the general population (Kavarian & Long, 2008).
The growth of the service system is grounded in the belief that individuals with developmental disabilities will develop and function optimally if they are included in society and afforded the same skills with the appropriate supports as those without disabilities (Kavarian & Long, 2008). A needs-based service system provides customized, particular services, based on the exclusive strengths, needs, and preferences of the older individual, and is the favoured service system for elders with developmental disabilities. Specific health issues are associated with elders with developmental disabilities. However, as seen in the general population, obesity and cardiovascular disease (CVD) can affect all persons with developmental disabilities (Kavarian & Long, 2008). Individuals with an intellectual disability have the equivalent, if not a higher, occurrence of obesity than adults without an intellectual disability (Kavarian & Long, 2008).
Furthermore, it requires a larger effort on the part of caregivers to support obese individuals with intellectual disabilities, thus placing caregivers at greater risk for health problems such as lower back pain and injuries (Kavarian & Long, 2008). Individuals with developmental disabilities living in a community need right of entry to supportive care providers and skilled healthcare clinicians who are well-informed about the person, the disorder of the individual, and the arrangement of services and supports available to them (Kavarian & Long, 2008). These practices identify that adults with developmental disabilities are aging and with increasing life expectancies, there will be a need for a larger range of wide-ranging, unified services (Kavarian & Long, 2008).
Decisions about treatment, admission to care accommodations and personal support services, descriptions of ability to make decisions and the selection of a substitute decision maker are governed by the Health Care Consent Act (OPADD), 2008). The Substitute Decisions Act specifies that the substitute decision-maker for personal care may not be someone who is paid to deliver the individual with health care, residential, social, and training or support services unless the person is a spouse, partner or relative (OPADD, 2008). In the event that the person moving to the long term care home disagrees with the appointment of a substitute decision-maker he/she can go to the Consent and Capacity Board to request a review of his/her capacity to make choices for personal care. In a Power of Attorney for personal care, an individual appoints another person to make personal care decisions on his/her behalf in the event that the individual becomes unable to do so (OPADD, 2008).
Power of Attorney for personal care allows the substitute decision-maker(s) to make decisions related to personal care, such as health care, shelter, clothing, nutrition and safety. The person named as Attorney for personal care must not be someone who is paid to provide the individual with health care, residential, social, training or support services unless the person is a spouse, partner or relative (OPADD, 2008).
With federal and provincial government support, local health experts should develop community-based health promotion programs that are available and modified to aging persons with developmental disabilities. Also, families providing care to an adult with a developmental disability need improved access to the information and services that can support them in this role. Older adults with developmental disabilities themselves recognized the following features as significant for their social integration (Minister of Public Works and Government Services Canada, 2004).
The Reena Foundation structured an Ontario-wide conference in March 1999 to address the systemic barriers to gaining access to services by older persons with developmental disabilities and to facilitate partnership between specialists working in the long-term care and developmental disability divisions (OPADD, 2008). With provincial government support, local service agencies should deliver a variety of support services for aging adults with developmental disabilities that include outreach, information, support with activities of daily life such as shopping and banking, modified day programs and assistance in residence planning well in advance of the need for placement (OPADD, 2008). Home care providers should make available respite care and homemaking services to family caregivers of older adults with developmental disabilities. All individual and community service providers and specialists should provide care and services to aging persons with developmental disabilities in a way that respects their decisional abilities, their principles and their preferences in order to foster their empowerment (OPADD, 2008). The federal and provincial governments should offer greater safeguards for economically vulnerable older persons with developmental disabilities and their family caregivers. For instance, by increasing disability benefits to persons living at home with family and by permitting refundable tax credits for disability-related expenses (OPADD, 2008).
One recent national Canadian survey of developmental disability agencies in Canada puts forward that most remain to have group homes as their main model of residential services, followed by independent apartment living (mainly in Ontario) and then by other residential sites (Minister of Public Works and Government Services Canada, 2004). Services for persons with developmental disabilities are delivered in a way that reflects them as full citizens enabled to be treated with respect for their rights and fully incorporated in society. Cooperation between the “seniors” and the “development disability” sectors to deliver support to a mounting population of older persons with developmental disabilities is challenging (Minister of Public Works and Government Services Canada, 2004). This is because each sector has restricted resources and is disinclined to take on another group of clients. Coordinating service distribution between sectors is difficult and service providers are often deficient in the knowledge and practice with respect to either seniors or developmental disability (Minister of Public Works and Government Services Canada, 2004). All governments should increase the amount and diversity of housing choices for older adults with developmental disabilities and their caregiver parents, predominantly in rural or smaller urban areas. Options should contain supportive housing with access to community services and amenities. Service providers working in seniors and in disability sectors should cooperate to respond in a flexible and coordinated method to the needs of aging persons with developmental disabilities (Minister of Public Works and Government Services Canada, 2004).
Adult Day Centers are designed to meet the needs of individuals with dementia and to support their strengths, abilities and independence. Why use an adult day center (Alzheimers Association, 2007). One reason to use an adult day center is to give you a break from care giving. While your loved one is at a center, you’ll have time to rest, run errands or finish other tasks. Adult Day Centers also offer the person with dementia opportunities to be social with others and participate in activities in a safe environment (Alzheimers Association, 2007). Adult Day Centers can vary. To choose the best setting for the individual with dementia, consult a variety of sources to find an appropriate adult day center (Alzheimers Association, 2007). Call your local senior center or area agency on aging, too. Give the day center a chance. Occasional use won’t give you an accurate picture of how the center operates (Alzheimers Association, 2007). In addition, giving the person time to adjust to the experience of going to the center is beneficial. While some people may resist going to the center at first, they often look forward to the visit after several weeks of attending, meeting people and joining in activities (Alzheimers Association, 2007). At some point the person with Alzheimer’s may need more care than the center can provide. Center staff and support groups can help evaluate your needs for future care.
The aging population including those with disabilities are faced with many issues. These issues include who takes care of them, financial issues which at times lead to financial abuse, and they are also faced with other types of abuse (Valios, 2007). These other types of abuse may be neglect, physical, verbal, and emotional abuse. Many of the individuals in this population do not have families and have lived in an institution or the residential services all their lives. Others lived with families that are aging, and they can no longer provide the required support their loved one. Much of this population do not have children of their own that can assist with any additional support requirements. Therefore, the aging population are often neglected, isolated, and ignored (Lueders, 2002). When individuals aging with a disability are ill, they may have difficulty in getting a service. Because of this, the aging population become vulnerable to many issues like abuse because of their dependency on other people for personal care (Lueders, 2002). Additional difficulties may be with communicating, and sometimes they are faced with guilt and shame of being disabled (Valios, 2007).
With better and improved health status, many adults with development /intellectual disabilities are living to old age like ââ‚¬Å“typicalââ‚¬ adults. This population is now out living their parents (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Population aging and the deinstitutionalization of persons with developmental disabilities have given to situations where parents in their late adulthood, for example their eighties and seventies are still the primary caregiver of their disabled child in their fifties or sixties (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). As well, siblings often have an important role in providing functional, living and instrumental support. Sibling relationships are long lasting. According to the survey of National Adult Sibling Study, siblings of adults with disability they have special affection, and are more close to their brothers or sisters with disabilities (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Because of long life expectancy due to the developing health system than before , the major concern of adult siblings is who will assist their disabled sibling when the parent are no longer with them, and where they will go. The aged parent sometimes forces the sibling of their child with developmental disabilities, to take over part or the entire care-giving role. Some siblings may be able to accept this role from aging parents; however, the amount of expenses and time they can provide support can be limited (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Aging with disabilities and health issues have direct impact on family memberââ‚¬â„¢s ability to be direct care. In several recent studies, parents identified concerns surrounding their own relatives and ability to provide ongoing support to their family member. In some studies, several people talked about challenges of preparing themselves and their family members for separation (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). The family members of aging adult with disabilities are also concerned about secure housing, independency and dependency. This situation is more complicated for some older adult with intellectual and developmental disabilities because overall they are more dependent on their family members as well as agencies staff (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011). Older family members are also looking forward to planning, for when they will be not able to provide the care to their relatives. Because families are the principal caregiver for most people with developmental disabilities, they also share this caregiver role with service providers. As people with developmental disabilities age, the transition period brings required changes in the care giving and support provided by various family members and agencies (American Association on Intellectual and Developmental Disabilities (AAIDD) , 2011).
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