Addressing Common Concerns of Aging Patients with Spinal Cord Injuries

Do you provide care to patients with spinal cord injuries?

We all experience changes to our health as we age, but those with spinal cord injury are at risk for developing complications that can seriously affect their health and lifestyle. Chest infection and heart disease are the leading causes of death in those with spinal cord injury.¹ While heart disease is the leading cause of death in the US² and worldwide,³ individuals with spinal cord injury have an increased risk of early onset of cardiovascular disease. Additionally, skin, bowel, and bladder problems can plague those with spinal cord injury and worsen as they age.⁴

As you care for your patients with spinal cord injury, make sure that any significant change in strength, sensation, pain, mobility, or body function, including skin, breathing, bowel, and bladder, is reviewed by the patient’s physician.

Assessing Your Patient with Spinal Cord Injury

Checking your schedule to plan your day, you discover that one of your older clients, who happens to have a spinal cord injury, is coming in today to discuss mobility assistance. When he arrives for his appointment, he tells you that he has been having some problems with moving around for several months and can’t figure out why.

What should you be looking for in your assessment? You need to find out what has changed for your patient over the last six months, and the following questions will provide guidance:

1. Has he gained weight? Has he had a respiratory illness (or any other kind of illness)? How is his skin? Has he had any issues with his bowel or bladder?
2. Has there been a change in his activity level?
3. Observe his respiratory rate while he talks and moves. Is he short of breath? What is his respiratory rate and heart rate, both resting and with activity?
4. Does he require help at home? What kind of help? Is this a new situation?
5. Watch his movements and note both his range of motion and his strength. When he transfers, is he clearing the chair or board? How does he complete his pressure relief movements?

What Should You Recommend?

Based on your conversation with your patient and your observations, you will need to direct him to the appropriate provider for in-depth assessments, as follows:

1. He may need to see his physician so that a further medical work-up can be completed.
2. He may need an evaluation with a physical therapist or occupational therapist, who can suggest changes to how he moves throughout the day or recommend an exercise program.
3. He may need an evaluation to see if his equipment needs have changed. Over time, most people find that things which were once easy become more difficult as they age. Examples include pushing a manual wheelchair and performing self-care or home activities. For this reason, it may be necessary to consider a power assist or power chair as well as other new assistive equipment or transfer devices. Additional caregiver support may also be required.

Your more frequent contact with your patients puts you in an ideal position to assess and guide them through their adjustment to aging with a spinal cord injury, as well as the complexities of the health care system. Your involvement, thorough assessments and attention to detail, makes a significant difference in your patients’ health and quality of life.

Want more detailed information regarding aging with a spinal cord injury? Be sure to watch the MedBridge course “Case Management: Aging with SCI, Chronic Illness, & Dementia.”