Ageing and SCI

Life Expectancy

Life expectancy following SCI has greatly improved in the last 50 years due improvements in health care, particularly bladder management. Life expectancy depends on your age when the accident happened, the level of injury and whether you are ventilator dependant.

In Australia at two years post-injury a complete quadriplegic has a life expectancy 70% of normal, a complete paraplegic 84% of normal. With this increase in life expectancy the major causes of death have changed from renal problems to pneumonia, heart disease, pulmonary embolism (a complication of deep vein thrombosis) and septicaemia. Your life expectancy is greatly reduced if you smoke, abuse alcohol or use psychotropic drugs.

Problems Associated With Ageing

It is important to remember that loss of function is a natural process for all people whether they have a spinal cord injury or not, with SCI this functional decline may start earlier than in the general population. Studies have shown that as people age with SCI they give the same perceived health rating (ie how healthy they think they are) as someone of the same age in the general population. Your quality of life is generally unrelated to your degree of impairment, it is related to participation in social, recreational, family and productive activities. Self-neglect behaviours will inevitably lead to an increase in medical complications.

Studies have shown the following complications tend to increase with age:

  • Shoulder pain
  • Urinary tract infections
  • Bowel problems
  • Pressure sores

A summary of a report on ageing with SCI can be found here.

Shoulder Pain

There is an excellent publication on shoulder function for wheelchair users which is available free from the Paralyzed Veterans of America (Preservation of Upper Limb Function Following Spinal Cord Injury:

What You Should Know

This guide gives exercises for maintaining shoulder strength as well as suggestions for reducing the load on shoulders and wrists.

Some other useful tips for reducing strain on your shoulders:

  • Keep your weight at an acceptable level
  • Keep tyres on your chair pumped up to make it easier to push
  • Try aids for transfers (eg slide boards/hoist)
  • Look at add-on power pack or e-motion wheels to assist with pushing manual wheelchairs (video 1, video 2)
  • Use a power chair part-time (eg power chair at work, manual chair at home)
Urinary Tract Infections

If you experience more frequent urinary tract infections than usual you should discuss this with your GP or urologist.

Tips for reducing the incidence of UTIs:

  • Drink plenty of fluid
  • Keep hands and equipment clean
  • Have regular urology check ups
  • Exercise on a regular basis
Bowel Problems

With age your gut transit time can slow down ie it just takes longer for things to move through your digestive system. This can lead to problems with excessive bowel care program times (ideally your bowel care program should be a maximum of 1 hour long) and incontinence.

Tips for reducing bowel problems:

  • Use a regular bowel care program
  • Drink plenty of fluid to prevent constipation
  • Eat plenty of fibre (fresh fruit and vegetables)Exercise on a regular basis
  • Discuss changes in bowel habits with your GP
Pressure Sores

With age your skin becomes less elastic and more fragile and may become more susceptible to pressure sores.

Tips for reducing skin problems:

  • Eat healthily to aid skin repair
  • Clean and dry skin thoroughly after bladder/bowel accidents
  • Moisturise dry skin
  • Check your skin twice a day for redness/skin breakdown
  • Pressure relief every 20 minutes
  • Review your wheelchair cushion every 6-12 months
  • Maintain a healthy weight (neither overweight or underweight)
  • Change position in bed every 2 hours
  • Do not smoke

If you notice signs of a pressure area developing start on bed rest until the mark disappears.

Contact the Spinal Liaison Nurse to discuss any further treatment .The service is available Monday to Friday, tel: (08) 9381 0124 between 8am and 9am or during the day on the following numbers: Northern suburbs/northern country 0409 683 603, Southern suburbs/south-west country 0417 977 299