Issues with ageing with SCI
Age-related changes are intensified by the type of bladder problem, how you manage your bladder and length of time after injury. Potential backflow of urine with kidney damage can result from an overactive bladder and poor emptying
Actions to take
- Drink plenty of water to flush through kidneys and bladder.
- Monitor kidneys and bladder function regularly.
- If problems, discuss different options for emptying the bladder with your doctor.
Issues with ageing with SCI
The function of your digestive system naturally declines with age and spinal cord injury makes slowing of the gut worse.
Actions to take
- Maintain a regular bowel routine
- Eat a well-balanced diet (including fibre from grains, fruit and vegetables).
- Drink an adequate amount of fluid (between 2-3 litres per day).
- Avoid long-term use of irritant medications containing Senna.
- Consider other options if bowel care becomes ineffective.
Issues with ageing with SCI
The secretion of hormones is vital for metabolism, growth, sleep and tissue healing and repair. People with a spinal cord injury have lower levels of certain hormones that decrease with age, including growth hormone and testosterone leading to changes in body composition, obesity and metabolic disorders, with impaired glucose tolerance and higher rates of diabetes.
Actions to take
- See your doctor for a regular health check-up, with monitoring of your weight and blood glucose level.
- You may need to be weighed at local hospital.
Issues with ageing with SCI
Heart disease may occur as the metabolism slows down, with weight gain over time (may eventually become obesity), reduced exercise tolerance, changes in lipid profile (increase in “bad” cholesterol or LDL with decrease in “good” cholesterol or HDL), and diabetes.
Actions to take
- See your doctor for a regular health check-up and monitoring of blood pressure, cholesterol and glucose levels.
- Eat a heart healthy diet and seek help from a dietitian to lose weight. Dietary management is an essential component of controlling weight, serum lipids and blood sugar levels.
- Stay as active as possible.
Issues with ageing with SCI
Worsening lung function due to respiratory or abdominal muscle weakness, spinal curvature or spasms with increased risk respiratory tract infections and clots. Risk of obstructive sleep apnoea increases with age, more so in people with tetraplegia.
Actions to take
- Periodically, have your breathing function and lung vital capacity test assessed.
- Perform inspiratory muscle training.
- Stop smoking.
- Have a sleep study test if you develop symptoms of obstructive sleep apnoea, which includes:
- severe snoring
- periods when stop breathing
- waking up gasping for air
- early morning headaches
- excessive daytime fatigue or sleepiness
- reduced concentration or memory disturbance.
Issues with ageing with SCI
People usually live fulfilling and pleasurable lives without experiencing major emotional problems as they age. In fact, most older adults, with and without a spinal injury, are resilient and adjust well to changes in their physical abilities. They also note improved relationships with loved ones, increased appreciation for life, and changes in priorities.
Actions to take
To keep a positive outlook:
- Connect with others.
- Engage in regular physical activity.
- Participate in enjoyable activities.
- Learn something new, and
- Volunteer or seek services and supports provided by community-based organizations, such as independent living centers, ageing and disability resource centres, and faith-based organisations.
Issues with ageing with SCI
Overuse (‘wear and tear’) of muscles, tendons and joints occurs particularly in the upper limbs (shoulders, arms, and hands) due to the demands of everyday living, leading to injuries (e.g., shoulder rotator cuff tears), inflammation (e.g., tendonitis), arthritis and pain. These changes impact on level of functioning and independence in performing daily activities (such as transfers and wheelchair mobility).
Actions to take
- Modify activity and review transfer techniques.
- Perform regular stretching and strengthening exercises to improve/maintain range of movement and muscle balance across joints (e.g., shoulder).
- Maintain a healthy weight.
- Regularly review equipment, such as wheelchair and seating, and consider use of assistive devices (e.g., sliding board, hoist and power-assist) to maintain posture, function and independence.
- Get your bone mineral density tested for osteoporosis every 3-5 years.
Issues with ageing with SCI
People with spinal cord injury are already susceptible to pressure injuries due to altered sensation and mobility. In addition, with progressive tissue thinning due to ageing, becomes even more prone to breakdown and harder to heal once a pressure injury has developed.
Actions to take
- Check skin for pressure injuries
- Perform pressure reliefs
- Avoid injury and leakage from bladder and bowel
- Use moisturisers and drink plenty of liquids
- Routinely examine your equipment for breakdown or wear and tear that may cause extra pressure on skin.
Issues with ageing with SCI
Late onset weakness or sensory loss, increasing muscle weakness, pain or spasticity can occur with ageing due to normal nerve drop out or problems from:
- Over- or misuse of muscles and bones leading to nerve damage.
- Changes within the spinal cord itself (such as a cyst).
Actions to take
- Refer to transfer guidelines to make sure you are using the correct technique, reduce the number of transfers, make home and work modifications to minimise stress on the arms, use sliding boards.
- See your doctor for an assessment of the tone and strength of your muscles, nerve reflexes, and different types of sensation (e.g., light touch, pin prick).
