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Active Ageing with a Brain Injury

Transitional life stages like ageing are recognised as “at risk times”, with men experiencing earlier mortality and greater morbidity than women (White & Holmes, 2006; as cited by Wilson et al., 2015; Department of Health and Ageing, 2010; as cited by Wilson et al., 2015).

Active ageing is incorporating activities as per an older persons’ goals, abilities, and opportunities to strive for a positive ageing process (Rantanen et al., 2018). There must be a focus on finding opportunities to support health, participation in society, and security so there is an overall enhanced quality of life. Older people may find it difficult to meet activity targets. Therefore, more realistic and meaningful strategies need to be considered (Guell et al., 2018).

Actively engaging in physical activity and social engagement tests resilience. When someone is ageing with a brain injury, there are several factors that must be considered to provide a positive ageing experience:

  • The person’s disability and self-reflection of their disability
  • Environmental and social support
  • Mobility
  • Health behaviour and health literacy
  • Resilience to adverse events
  • Having a positive attitude

Understanding an older person’s disposition, aspirations and life experiences can help us understand their barriers and underlying behavioural patterns.

Below are some examples of activity status and the barriers that an older person might come across:

  • Active: Has traditionally enjoyed sport and exercise but now experiences physical ill health and limitations as barriers.
  • Out and about: Has enjoyed social activities and interests but now experiences disruption through retirement, loss of companions and limited social opportunities later in life.
  • Sedentary and solitary: Enjoys solitary pursuits but struggles to find motivation to be physically and socially active and prefers quiet rest at home.

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Having an age-related brain injury

Brain injury incidence rates for older adults significantly rise after the age of 70. Geriatric-specific factors must be considered, where a brain injury is acquired in older age.

As age increases, the rate of achieving good recovery decreases (Griesbach et al., 2018; Rothweiler et al., 1998). If an older person suffers a brain injury, they will often require longer to recover and show less complete recovery and participation in rehab after brain injury than in younger adults. Longer and acute hospital admissions contribute further neurological decline. There are poorer health outcomes related to levels of dependence on others in daily life and changes in living situation.

Acquiring a brain injury at any age unfortunately increases the likelihood of developing dementia. Older adults with brain injury experience limited working memory and episodic memory impairment. They are less likely to experience detailed recollection of events or show impaired recall when events have occurred rather than for the events themselves. This cohort is more likely to have sleep disorders than those without a brain injury; before and after injury.

How to keep active

Combining social engagement and physical activities help link people together. It is important to examine the persons:

  • Goals
  • Functional capacity
  • Autonomy
  • Perceived opportunities to do the valued activities

Example questions to assess the above:

  • What is your perceived age? (This Indicates a person’s experience on their own ageing at a personal level (Rantanen et al., 2018)
  • How old do you feel are?
  • What age do you think you look like?
  • Do you feel mentally younger, as old as, or older than your chronological age?
  • What are your everyday activities?
  • What motivates you?
  • What opportunities are available for social and active engagement?
  • What are the differences in activities throughout the year?
  • What are your aspirations as you get older?

Additional purposeful activities that can help with active living:

  • Being engaged in paid or voluntary work
  • Participating in social and leisure activities
  • Complete daily household tasks
  • Accessing transport to and from familiar places
  • Occupational or incidental physical activities
  • Active mentoring (being mentored or mentoring others)

 

Where to get support

  • Accessing allied health supports such as, but not limited to, occupational therapy, physiotherapy, psychology, and exercise physiology, may assist you to plan appropriate strategies to keep active.
  • Contact My Aged Care to discuss and arrange aged care supports.
  • Seek information from your local community groups or sports clubs to participate in physical activity or activities that you enjoy
  • Contact our National Information Line

References

Griesbach GS, Masel BE, Helvie RE & Ashley MJ 2018, ‘The Impact of Traumatic Brain Injury on Later Life: Effects on Normal Ageing and Neurodegenerative Diseases’, Journal of Neurotrauma, no. 35, pp. 17 – 24.

Guell C, Shefer G, Griffin S & Ogilvie D 2015, ‘Keeping your body and mind active: an ethnographic study of aspirations for healthy ageing’, British Medical Journal, pp. 1 – 10.

Guell C, Panter J, Griffin S & Ogilvie D 2018, ‘Towards co-designing active ageing strategies: A qualitative study to develop a meaningful physical activity typology for later life, Health Expectations, pp. 919 – 926.

Peters ME 2020, ‘Traumatic brain injury in older adults: shining light on a growing public health crisis’, International Review of Psychiatry, vol. 32, no. 1, pp. 1 – 2.

Rantanen T, Saahanaho M, Karavirta L, Siltanen S, Rantakokko M, Viljanen A et al. 2018, ‘Active ageing – resilience and external support as modifiers of the disablement outcomes: AGNES cohort study protocol’, BioMed Central Public Health, vol. 18, no. 565, pp 1 – 21

Rothweiler B, Temkin NR, Dikmen, SS 1998, ‘Ageing Effect on Psychosocial Outcome in Traumatic Brain Injury’, Archives of Physical Medicine and Rehabilitation, no. 79, pp. 881 – 887.

Wilson, NJ, Stancliffe, RJ, Gambin, N, Craig D, Bigby C & Balandin, S 2015, ‘A case study about the supported participation of older men with lifelong disability at Australian community-based Men’s Sheds’, Journal of Intellectual and Developmental Disability, vol. 40, no. 4, pp. 330 – 341.