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Age-specific disability

Growing older can be a time when you gain more respect in your family and community. However, it can also be a time when you become more vulnerable to poverty, mistreatment, and health problems. Whether or not you have a disability, you will experience many changes as you grow older.
As your body ages, you will probably have to change the way you do many things. Some activities will have to stop because you can no longer do them. You may develop health problems or disabilities you did not have when you were younger. Some women may start using a cane or wheelchair to get around because they do not walk as well any more. Some may start to need glasses or use a hearing aid.
Whether you were disabled as a child or became disabled later in life, this chapter has information on how some disabilities can develop or change and how you can care for your health as you age.

Health Problems Caused by Aging

Women often do not think about themselves as growing older until their children are grown or until their bodies start to change. You
may also notice that your body gets tired more often, that you are not as strong as you used to be, or that it is not as easy for you to move about.
The better you understand the changes that can happen as women grow older, the easier it will be for you to know if changes in your body are part of aging or are caused by your disability. For information on taking care of your body, see page 85. Here are problems women with some disabilities may have as they get older:

Weaker or painful muscles and joints
If your disability means that part of your body does not work as well as another part, over time you have probably overused the part that works better to make up for the part that does not work as well. For example:
•if one of your legs is paralyzed, you probably use the ‘good leg’ more than someone who has use of both legs, and the joints may become weak from overuse.
•if you use a wheelchair or crutches for a long time, the joints in your hands, arms, and shoulders can become painful from overuse and start to wear out.
•if you are a very small woman (dwarf), you may 䏗nd you start to get pains in your shoulders, knees, and hips from all the reaching and climbing you have done over the years.
If you are using a wheelchair or spending more time in bed, it is very important to move around and change positions as much as you can to prevent pressure sores.
For women who use wheelchairs
Women who use wheelchairs usually get less exercise as they age. Ask other people to help you stand or use a standing frame so you can put weight on the bones in your legs. Also try to keep the bones in your arms strong by lifting things. For more exercise ideas.
Post-polio syndrome
If you had polio earlier in your life, you may start to have severe weakness, tiredness, pain, and trouble breathing many years after the polio virus has gone. This means you must be very careful when you exercise. Using your muscles too much may damage them and make your weakness worse. Instead, do gentle stretching and movement to help keep your body from getting stiff.
Post-polio syndrome
If you had polio earlier in your life, you may start to have severe weakness, tiredness, pain, and trouble breathing many years after the polio virus has gone. This means you must be very careful when you exercise. Using your muscles too much may damage them and make your weakness worse. Instead, do gentle stretching and movement to help keep your body from getting stiff.
Walking and balance
If you use an artificial leg (prosthesis), you may need to get it adjusted because it may not fit as well any more, especially if you do not move about or exercise as much as you used to and your muscles get weaker and softer.
If you are used to walking with no aids, you may need to start using a cane, crutches, or a wheelchair. Many women wait a long time before deciding to use aids that will help them. But starting to use a stick or wheelchair early can protect you from falls and injuries, and help you move about more easily. The better you can get around, the more you can take part in the life of your community.
Arthritis is a painful swelling and stiffness of the joints. It affects many people and can make many daily tasks painful or more
difficult. If the arthritis is in the hands, it can cause special problems for people with some disabilities. For example:
•If you are blind and use your hands to ‘see’ or to read things by touch, you may not be able to do this as well.
•If you are deaf, you may not be able to use sign language as well.
•If you use a catheter to pass urine, or a bowel program to pass stool, it may be more dif䏗cult for you to do this by yourself.
•If you have leprosy (Hansen’s disease) and your hands are already affected, arthritis will make using your hands even more difficult.
Skin problems
Your skin will become thinner as you get older, and you may find that you bruise more easily. This happens to most women.
•If you sit or lie down for most of the day, thinner skin means you can get pressure sores more easily .
•If you use arti䏗cial legs or arms, check your skin more often where it touches the prosthetic to make sure it does not become red and irritated.
• If you have leprosy (Hansen’s disease), check your skin every day. Thinner skin will make it easier for you to get sores and infections.
•If you have a spinal cord injury or a paralysis and have no feeling in your skin, ask someone to check your skin every day to prevent pressure sores, especially in areas you cannot see, such as your back .
Eyesight and hearing
Many older people cannot see as well as when they were young. If you are deaf, it will be dif䏗cult for you to understand if someone is speaking to you in sign language or if you are used to lip-reading.
If you have leprosy, aging may cause an inĝammation in your eyes that can cause
blindness if it is not treated.If you are blind and also start to lose your hearing, communicating and moving
around safely will be more difficult.
Ask your family to make changes that will help you see, hear and move around more easily. For example, if you do not see as well, try to make the house lighter inside by painting the walls white, or getting a brighter light bulb. Mark steps and doorways with different colors so you can see them better and not trip or bump into them.
If your hearing gets worse, ask people to sit facing you when talking and to speak clearly but not shout. Turn off radios or
televisions when speaking so you can hear better.
Weak bones (osteoporosis)
After your monthly bleeding stops, your body starts to make less of the hormone estrogen  and your bones may become weaker. Weak bones break more easily and heal slowly. If your balance is affected by aging, or if you have epilepsy seizures or cerebral palsy you have a greater risk of falling and breaking weakened bones. You can prevent weak bones by:
•eating foods rich in calcium (see page 86), with foods that
have vitamin C, such as fruits and yellow-colored vegetables.
•doing regular exercise that puts weight on your bon
Mental confusion
Some older people have dif䏗culty remembering things or have difficulty concentrating. For most people, this is not a serious problem. But some people develop more serious problems with memory or thinking (Alzheimer’s disease, dementia, senility) and eventually become so confused they no longer recognize friends and family members. They can become very frightened and confused by everyday things they used to know well. An older person with Down syndrome may become confused more easily and
may start to have epileptic seizures.
Find new ways to do things
The changes that come with growing older may mean you will need to find new ways to do things and to get other people to help you. And you may need to use more aids, like a hearing aid, a walking stick, or a wheelchair. As you feel your body begin to change, start now to find the best way to do things. Knowing what to expect can help you take better care of your body and continue to remain as healthy as possible as you grow older.
Seek assistance
If you find it is getting harder to do certain things, such as eating, bathing, dressing, or getting up from lying down, show or explain to friends, family members, caregivers, and to others you trust how they can help you. You might also arrange to have a relative or friend come to live with you. For her assistance, the person will get a place to live. If you find you are forgetting things, it may help to make a list of the things you want to do each day, and cross them off when they are done. Or each day talk with your family members about things you want to do that day so they can remind you of them.
Depression (extreme sadness or feeling nothing at all)
Some people start to feel unhappy and depressed as they grow older. This is often because of loneliness, changes in health, or not being able to do as much as they used to. Some women with disabilities who suffer from low self-esteem may feel even more lonely and depressed as they grow older.
Some of the signs of depression are:
•feeling sad most of the time
•difficulty sleeping or sleeping too much
•difficulty thinking clearly
•loss of interest in pleasurable activities, eating, or sex
•physical problems, such as headaches or intestinal problems, that are not caused by illness
•slow speech and movement
•lack of energy for daily activities
•thinking about death or suicide
What to do to help prevent depression
Try to stay as active as possible, to exercise, and to eat well. Above all, try not to be alone too much. Help take care of younger children in your community. Meet with other older women with disabilities to talk and to pass time together. If you are
often feeling sad or are unable to sleep, talk to someone in your family you trust or with a health worker. For more information about mental health.

When monthly bleeding stops (menopause)
Usually monthly bleeding stops gradually over 1 or 2 years, most often between 45 and 55 years old. This happens because your ovaries stop making eggs, and your body makes less of the hormones estrogen and progesterone. Women with Down syndrome often stop their monthly bleeding earlier than other women.
•Your monthly bleeding changes and you may bleed more often for a while.
Or you may stop bleeding for a few months and then bleed again.
•At times you may suddenly feel very hot or sweaty (‘hot ňashes’).
•Your vagina may become less wet and smaller.
•Your feelings change easily.
These signs will start to go away as your body gets used to less estrogen.