Adapting as you age

Small adaptations can make ageing with a spinal cord injury much easier as Jessica Morris, spinal unit manager at Rita Henn & Partners Rehabilitation, explains

Rolling Inspiration
5 Min Read

Small adaptations can make ageing with a spinal cord injury much easier as Jessica Morris, spinal unit manager at Rita Henn & Partners Rehabilitation, explains

Spinal cord injuries (SCI) across South Africa have devastating effects on individuals given the multitude of secondary conditions that can arise from these injuries or illnesses.

In addition to this, one must consider the many environmental and psychosocial barriers imposed on South Africans when considering many of these injuries occur in those from low economic-income classes.

It is well recognised that with the advances of medicine across the globe, people are able to live longer and healthier lives when managed adequately.

This is known as ‘healthy ageing’. We often undervalue the benefits of small yet crucial changes or adaptations into everyday to accommodate the ongoing physical changes we experience throughout our lives as a means to remaining comfortable.

These small adaptations allow us to live with as little residual disease and disability as possible considering the already imposing functional limitations the ageing process brings.

Those living SCI are not immune to this ageing process. In fact, it is thought that this process in conjunction with the limitations brought on by disability often accelerates ageing given the many co-morbidities associated with SCI.

Rehabilitation and maintenance plans often aim to encompass this unavoidable phenomenon in a bid to reduce the effects of premature ageing and its consequences on the individual and look to promote active and healthy ageing thereby preventing pathological ageing.

Two common influencing factors which affect the rate at which SCI individuals are prone to ageing include the age at which one was injured and the length of time since the injury.

Fatigue, weakness and weight gain also influence ageing as this affects the amount of help an individual may require and therefore not only affects the SCI individual’s ageing, but also that of their family/carer.

Common areas of concern that tend to accelerate ageing or complications in persons with SCI include:

Shoulders and upper limb joints: Increased loads are placed onto these joints and therefore they are prone to additional wear and tear which can increase pain and restrict movement.

Bladder: The ageing bladder often loses its muscle tone, which is further heightened with an abnormal bladder such as that with SCI. This poses an increased risk of developing urinary tract infections (UTIs) or bladder stones which may cause further illness.

Bowel Dysfunction: The bowel system tends to become slower with ageing which can result in complications such as constipation, incontinence or leaking, haemorrhoids, bleeding and pain and even bowel cancers.

Skin: Skin fragility is common with any ageing process and frail skin in SCI can cause complications such as increased pressure injury risk which leads to infection and severe wounds.

Managing these risk factors becomes an important part of therapy to minimise early- onset ageing and increased complication risk. Such management includes:

  • Maintaining healthy weight to avoid unnecessary strain on arms during propelling of wheelchairs or transferring, which in turn reduces early osteoarthritis;
  • Ensuring equipment is ergonomically safe;
  • Maintaining hand hygiene during bladder and bowel management;
  • Going for frequent doctor or medical reviews to monitor a changing bladder or bowel programme;
  • Drinking plenty of water to remain hydrated and ensure healthy organs (including the skin and kidneys); and
  • Stopping “bad” habits that hasten the ageing process, such as smoking which impacts blood flow.

 

The journey of ageing is unavoidable but is more comfortable if one is well prepared and realistic about the future. Asking for advice from others with SCI, and discussing appropriate home adaptations or routine changes to implement with the multidisciplinary team is useful.

Being honest and realistic about what the situation will be like in three to five years can better prepare one for the unavoidable changes with age.

Remember, prevention is better than cure. Ageing is a normal human phenomenon but it is accelerated with SCI. So, it is important to be prepared and to monitor changes in the body to prevent secondary complications where possible.

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