Tips for aging with a brain injury

There are steps you can take to keep yourself as healthy and safe as possible as you age.

Do activities that are engaging and enjoyable

Keeping yourself engaged and entertained is good for your emotional well-being and your brain. This includes hobbies you enjoy, meeting with friends, and anything else that brings you joy. It’s also helpful to complete activities that pose a bit of a challenge. It stimulates your cognitive process, can have physical benefits, and can give you goals to work towards.

Have regular medical checkups

It’s important as we age to have regular medical checkups. Individuals often spend a lot of time in rehabilitation and treatment for brain injury, but the rest of the body needs checkups too. Medical professionals will give you advice on exercise, diet, and other parts of your overall health.

Make sure you’re in an appropriate living situation

In some cases, seniors are not able to live alone or at home. In these cases, long-term care homes may be the most appropriate option. Many long-term care homes are specifically equipped for seniors, making them a safe, and comfortable choice. Many are also equipped for individuals with specific needs, including the effects of brain injury.

If you are moving into a long-term care home or are completing rehabilitation while in a long-term care home, there may be some adjustments you need to make.

  • Establish new routines. Routines are a great way to reinforce memory, familiarize yourself with new places, and stay organized.
  • Create a plan for adjusting to the new environment.
  • Work with healthcare professionals on rehabilitation plans. You may have to complete activities and therapies a little differently in long-term care.

Make sure you’re well-rested

Fatigue is a common effect of brain injury. It’s also common in seniors; it takes more energy to complete actions or tasks. That’s why it’s incredibly important to prioritize a good night’s sleep and listen to your body. Take rests when you need to, and don’t overwork yourself.

Protect yourself from falls

If you struggle with balance or mobility or want to take extra precautions against falls:

  • Arrange furniture so you have plenty of space to walk
  • Avoid putting frequently used items on high shelves
  • Avoid wet, slippery floors, and don’t let water build up on walkways or driveways
  • Clean up any spills or dropped food right away
  • Have plenty of light so you can easily see where you’re going
  • Install gates and handrails on staircases
  • Keep drawers and cabinet doors closed
  • Never stand on a chair, a table, or any surface that has wheels
  • Remove clutter from your walkways outside, and keep the paths inside your home free from tripping hazards (boxes, books, clothes, toys, shoes, unsecured rugs)
  • Secure any cords safely out of the way
  • Wear shoes with good support and slip-resistant bottoms

Stay active within your community

Keep in touch with your friends, family, and community. Go for lunches, participate in community activities, volunteer, and stay in touch through phone calls, emails, and in-person get-togethers. You will reduce your risk of social isolation and cultivate a strong support system.

Take care of your mental and physical health

Staying healthy and active is an important part of aging. This includes eating well, exercising, and taking care of your mental health and wellbeing. There are many ways you can create a healthy lifestyle as you age.

  • Learning new, easy meals to make at home
  • Keep a journal to share your thoughts and feelings
  • Taking daily walks
  • Use appropriate correction equipment for hearing and vision loss. I.e. hearing aids and glasses
  • Use mindful meditation to help clear your mind

These ideas are just the tip of the iceberg. Find practices or activities that make you feel happy and fulfilled and work them into your routines.

Aging & brain injury

The process of aging can potentially have accelerated impacts on people with an existing brain injury. It can also lead to increased chances of brain injury for older adults.

Topics in this section include: 

Aging after a brain injury

While aging affects everyone, it can have more noticeable effects on someone living with a brain injury.

Ongoing cognitive challenges
It is normal for brain injury survivors to have lasting changes to their cognitive abilities. This includes memory loss, difficulty with concentration, and difficulty making decisions. For seniors, there may be a decline in cognitive abilities associated with aging. A senior with a previous brain injury may experience accelerated aging that affects cognition. This includes speed of processing information, decision-making, slower reaction times and memory. These effects can even lead to difficulty managing existing cognitive and behavioural challenges.

Multiple conditions
A person may develop comorbid medical conditions. Comorbid means conditions present at the same time. As we age, we are more prone to developing additional health conditions. This includes diabetes, hearing and vision problems, heart disease, osteoporosis, and high blood pressure. Co-morbid conditions can impact existing cognitive problems [1].

Any additional health challenges can impact a person’s mental, emotional and physical health. If you do experience additional health challenges, doctors will provide you with the appropriate information for treatments from different rehabilitation and medical professionals.

Increased risk of social isolation
While having a brain injury can increase the risk of social isolation, so can aging. Statistics Canada reported that several factors contributed to less socialization in older individuals. This includes hearing loss, emotional challenges, cognitive challenges, pain, and a fear of falling [2].

Humans are social creatures by nature, and this doesn’t change when you’re a senior. A lack of socialization can lead to loneliness, depression, and additional mental health struggles. Since health problems, brain injury, and aging can all contribute to social isolation, it becomes a difficult cycle to break.

It’s important to stay in touch with your family, friends, and the community you have created over the years. These people care for you and will be able to socialize with you in a way that makes you feel safe and comfortable. Look for community activities that are tailored for seniors. This includes clubs, community programs and fitness classes. If you are able, volunteering is also an excellent way to be social, stay busy, and help others.

Increased risk of Alzheimer’s and dementia
Studies have shown that moderate to severe traumatic brain injury is a risk factor for the development of Alzheimer disease and other dementias [3]. There is also an increased risk for Alzheimer’s and dementia with stroke and additional conditions such as epilepsy [4]. However, it’s important to note that many neurodegenerative diseases have genetic, lifestyle and environmental factors. Having a brain injury does not mean you will develop Alzheimer’s or dementia as a senior.

If you or a caregiver notice any cognitive declines, check in with a doctor.

Increased risk of falls
A person with an acquired brain injury may be at risk for falls as they age due to balance, mobility, and cognitive impairments. Falls could also occur because of the environment: for example, unsteady terrain or inaccessible buildings. All of these factors can increase a person’s risk of  fall, which increases their risk for another brain injury [5].

Seniors can reduce the risk of falling by using assistive devices such as canes, walkers, and wheelchairs. Walking poles can provide an extra level of support, especially if walking is a main source of exercise. They should also make sure to wear supportive, secure footwear, remove obstacles from traffic paths in the home, and ask for help if necessary.

Acquiring a brain injury as a senior

Whether you have an existing brain injury or not, the risk of acquiring a brain injury goes up as you age. According to data from the Canadian Institute for Health Information, older adults (60 years or older) account for 29% of all head injury hospitalizations in Canada [6]. A population study showed that the rate of traumatic and non-traumatic brain injury increases in older age groups, with the highest rates being in the 85 years and older range [7]. These numbers are the same for both males and females.

Some of the leading causes of brain injury in seniors include:

  • Falls
  • Increase in instances of non-traumatic brain injury
  • Motor vehicle accidents
As people get older, they are more at risk of falls. It is estimated that 1 in 5 Canadians aged 65 or older fall [8] and North American studies show that falls are the leading cause of traumatic brain injury in older patients [9]. Factors that can increase the risk of falls include substance use, medications, decreased balance, reduced attention and age-related neurological conditions such as dementia [10].

Falls generally occur due to uneven or slippery surfaces and a loss of balance. People can fall in doorways, ramps, on the stairs, and in areas with heavy traffic. There is also a relationship between falls and strokes. Unexplained falls sometimes turn out to be signs of ‘silent’ strokes, and a history of strokes further increases the risk of falling.

Increase in instances of non-traumatic brain injury
As a person ages, they are at a greater risk of experiencing a medical event that can cause a non-traumatic brain injury. This includes stroke, brain tumours, and encephalitis.

In a study completed in Ontario, hospitalization rates for non-traumatic brain injury increased with age; rates of 365 persons per 100,000 were reported for those 65-74 years old, compared to 561 persons per 100,000 for those above 85 years old (these rates did not include individuals with a primary diagnosis of stroke) [11].

Motor vehicle accidents
While not as prevalent as other causes of injury, motor vehicle accidents still impact seniors. This is in part due to the fact that a large portion of the driving population is 55 years or older. As individuals age, it is possible to experience vision problems, slower reaction times, and cognitive changes that can impact a person’s driving [12].

Impact of age on acquired brain injury recovery

Age is a significant factor when it comes to recovery after acquired brain injury. Multiple studies have shown that there are greater long-term effects and poorer prognosis after a brain injury (with most studies focusing on traumatic brain injury) in older populations. These studies report older patients have higher mortality rates and worse functional outcomes than younger patients that have more severe injuries. They also have evidence that older survivors need more rehabilitation, pay more for rehabilitation and experience greater levels of disability [13].

Mental health and behavioural changes

It is common for anyone with an acquired brain injury to experience a mix of mental health and behavioural changes such as depression, irritability, sleep problems, and mood swings. Mental health and behaviour have a direct effect on willingness and ability to perform rehabilitation. It is important to always speak with a medical professional or psychologist about symptoms, emotions and behaviours to receive an accurate diagnosis and develop a treatment plan.

Lack of rehabilitation

Many individuals with acquired brain injury, including seniors, may not be using rehabilitation services due to lack of availability, long wait lists, a lack of knowledge about cognitive and behavioural needs, and poor coordination of services [14]. More immediate access to rehabilitation, either in person or virtually, and more consistency could lead to better outcomes.

Your age doesn’t have to be a barrier to your recovery. By taking proactive steps and developing a continuing care plan with healthcare professionals and caregivers, rehabilitation and recovery can move forward. Some of the ways you can support your recovery include:

  • Asking for help. Family, friends, and healthcare professionals are there to help you. Go to them with questions, concerns, or ideas. They can help you find supports or just listen when you need someone.
  • Becoming a self-advocate. Advocating for the services and supports you need will make sure your voice is being heard. Learn more about becoming a self-advocate
  • Learning more about brain injury. The more you know about your injury and the effects you’re experiencing, the more you can share with your support system.
  • Work with multiple healthcare providers. There is no one size fits all for brain injury rehabilitation. When you experience multiple effects of brain injury, you need multiple therapists and professionals to help you learn adaptive techniques and coping methods.

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