As with any other normal individual function of CP individual also declines significantly as result of aging but proportion of problems can be more. They can have job, married, have a children and retire like their other peers. Adults with CP may have a shorter lifespan due to existing co-morbidities not because of cerebral palsy. Recent statistics show that nearly 50 percent of people aged 65 or older have some type of physical, psychiatric, or cognitive disability.
Problem faced by adult & older population with CP are Musculoskeletal, Cardiovascular, Psychological Status , Gastrointestinal, Social issues and Reproductive health etc.
Effect on Musculo-skeletal system: With age muscles become tighter and there is decrease in flexibility, limited muscle strength, endurance & restricted movement. Energy expenditure is 3-5 time more, since it is difficult to perform tasks of daily routine & take longer time as a result fatigue is frequent. The problem get worse by development of muscle Sore anti epileptic drugs, sun exposure, poor intake lead to Vit D deficiency (osteomalacia). Less Wt. bearing & poor muscle lead to osteoporosis and abnormal muscle tone lead to deformity and other complications.
End result is loss of stamina, loss of physical functioning, obesity more need of support during standing & walking, fracture with trivial trauma and some other complications.
Effect on general health: As with all other they also may suffer from old age diseases like diabetes, obesity or under nutrition, hypertension & coronary artery disease, problem in bladder control like Urinary retention, incontinence, recurrent chest infection & restrictive lung disease, pressure sores
Effect on GI system: there is earlier onset of disturbance in gastrointestinal functions, combination of mouth breathing, poor hygiene, tooth grinding, mal-occlusion & abnormalities in tooth enamel, cavities & periodontal disease, problem in chewing, swallowing, feeding & nutritional issues, heartburn, hemorrhoids, Gastro-esophageal reflux, frequent vomiting, poor general nutrition, retarded physical growth & aspiration, constipation
Effect on psychological state: because of prolonged illness and suffering by time old age so many psychological problems like early memory loss, sleep deprivation, fluctuating emotional state, depression, loss of self-esteem, self neglect
Reproductive health: as they are growing it becomes difficult to counsel of women with cerebral palsy, pregnancy related, problem of menstrual cycle, menopausal problems. Also there is also natural biological need of sex, STD, birth control, problem of body image.
Social issues : many social issues also become prominent if they are not dealt with in time like lower level of education, higher level of poverty, higher level of unemployment, less disposable income, self care, lesser social activities and communication problem due to ambulatory & speech problem, social abuse, drug and alcohol abuse etc.
Management: – Management includes continuation of therapy programme in adulthood, yoga & swimming, standing and walking with any support is much better than wheel chair, more use of assistive devices, sufficient intake of vit D and calcium, treatment of osteoporosis, good nutrition intake with sufficient protein, fiber intake, sufficient intake of water, vitamin and minerals, medical treatment for pain & Spasticity, maintains of Oral hygiene, control of body weight with social support system & health checkup at regular interval.
- Continuation of therapy programme in adulthood
- Yoga & swimming
- Standing and walking with any support is much better than wheal chair
- More use of assistive devices
- Sufficient intake of vit D and calcium
- Treatment of osteoporosis
- Good nutrition intake with sufficient protein and minerals
- Medical treatment for pain & Spasticity
- Maintains of Oral hygiene
- Control of body weight
- Early intervention in any cardiovascular & pulmonary problem
- Good nursing care in severely disable patient
- Barrier free environment at home and public places
- Social and independence skills
- Schooling along
- Education of Reproductive health
- Proper care of sanitation & hygiene
- Social support
- Implementation of life planning including health insurance & guardian ship declaration .
- Group discussion
- Detail counseling & meeting with other cerebral palsy affected adults who have more confidence & balanced mind like parent’s forum.
- Academic and extracurricular activity like sport, drawing, music and literary work to maintain stamina & moral
It is not only important to live long but it is the quality of life which matters, so by good knowledge and well planned strategy we can prevent impending problems and miseries of life. It is the parents / guardian /affected person himself who can change the whole life and the can make their life beautiful by knowing & preventing future problem ahead.
DR JITENDRA KUMAR JAIN
CONSULTANT PEDIATRIC ORTHOPEDIC SURGEON,
TRISHLA ORTHOPAEDIC CLINIC & REHAB CENTER &
SECRETARY, SAMVEDNA TRUST, & chairman trishla foundation, ALLAHABAD, UP, INDIA-211002
www.samvednatrust.com, www.trishlafoundation.com www.trishlaortho.com
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