Shifting Autistic Characteristics Across The Lifespan: The Impact of Aging

Join Dr. Regan for the final episode in this series about how autistic characteristics may shift across the lifespan. This episode focuses on the life season of aging, including year 50 and beyond.

Recognizing Dysregulation on the Autism Spectrum

Gaining Momentum for Daily Activities

Email questions for Q and A podcast episode with Dr. Regan to adultandgeriatricautism@gmail.com

Executive function book series (choose the book with the age range you are interested in): Smart But Scattered

Dr. Regan's Resources

New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life

New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics

Book: Understanding Autism in Adults and Aging Adults, 2nd ed

Audiobook

Book: Understanding Autistic Behaviors

Autism in the Adult website homepage

Website Resources for Clinicians

Read the transcript:

1 00:00:02,540 --> 00:00:05,010 Hi everyone, 2 00:00:05,020 --> 00:00:19,460 this is dr Regan joining you again for our final episode here on autism in the adult in our series about shifts in the characteristics of autism across the lifespan. 3 00:00:20,330 --> 00:00:21,530 Many of you know, 4 00:00:21,530 --> 00:00:24,160 already that I am a neuropsychologist, 5 00:00:24,540 --> 00:00:27,360 I'm a certified autism specialist, 6 00:00:27,840 --> 00:00:38,850 an author podcast host here at autism in the adult and the founder and director of a diagnostic autism clinic for adolescents, 7 00:00:38,850 --> 00:00:41,960 adults and aging adults in central Illinois. 8 00:00:42,840 --> 00:00:46,760 We're going to get into this final episode of our series. 9 00:00:46,920 --> 00:00:48,560 But before we do that, 10 00:00:49,440 --> 00:00:53,850 I want to talk to you about our next episode. 11 00:00:54,240 --> 00:00:59,760 I do have some ideas for topics for more episodes and another series, 12 00:01:00,140 --> 00:01:06,040 but I'm thinking that what I'd really like to do is to make space for an episode, 13 00:01:06,040 --> 00:01:18,220 answering your questions or talking about um maybe a particular statement or question or term that you would like some feedback about. 14 00:01:18,230 --> 00:01:24,160 So I'm either going to do that for the next episode or sometime soon. 15 00:01:24,440 --> 00:01:30,400 If you do have a question you would like me to cover or something to comment on. 16 00:01:30,940 --> 00:01:42,060 You can email that to me at my professional email which is adultandgeriatricautism@gmail.com. 17 00:01:42,740 --> 00:01:47,260 adultandgeriatricautism@gmail.com. 18 00:01:48,340 --> 00:01:53,480 And I cannot comment on any particular personal issue. 19 00:01:53,480 --> 00:01:56,080 Like I can't give you personal advice. 20 00:01:56,090 --> 00:02:06,290 But if you have a general question about what something looks like in autism or an approach people take for a certain situation, 21 00:02:06,300 --> 00:02:09,760 you can certainly email those questions in. 22 00:02:10,340 --> 00:02:17,700 I will try to get as many as I can and respond to those in an episode. 23 00:02:17,710 --> 00:02:20,930 I may not get to all of the questions, 24 00:02:20,940 --> 00:02:24,860 but I can save them for future episodes. 25 00:02:26,040 --> 00:02:30,480 If there are questions that really should be a whole episode or series, 26 00:02:30,490 --> 00:02:32,850 I'll go ahead and save those as well. 27 00:02:33,440 --> 00:02:41,660 But I hope you will participate and will have kind of a question and answer session for those things that are on your mind. 28 00:02:43,640 --> 00:02:47,960 So as we round out the final episode in our series, 29 00:02:49,140 --> 00:02:53,610 those of you who have followed the other episodes, 30 00:02:53,620 --> 00:03:10,760 you'll know that the way that I've structured my thoughts is that I'm going to present first on issues related to the physical body and changes in the development um or aging of the body and also the biochemistry. 31 00:03:11,340 --> 00:03:20,540 And then I talk about things related to changing life circumstances that as we live life across seasons, 32 00:03:20,630 --> 00:03:27,460 the things that we are in charge of doing or striving to do these kinds of things shift. 33 00:03:27,840 --> 00:03:38,660 And we also just talk about the interchange of both the physical shifting and the changes in life circumstances. 34 00:03:39,840 --> 00:03:41,800 So during adolescence, 35 00:03:41,800 --> 00:03:45,560 we talked about how we have a lot going on in the physical body. 36 00:03:45,940 --> 00:03:58,320 We have development of the body as a whole and of the brain and we have hormone shifts and also a lot of increased demand on the individual with things like academics, 37 00:03:58,330 --> 00:04:04,760 independence and the social environment during pregnancy or menopause for example, 38 00:04:05,440 --> 00:04:18,710 there are lots of physical and biochemical changes and these intersect with this increased demand on the individual and changes in the environment like increased clutter in the household, 39 00:04:18,720 --> 00:04:19,710 more noise, 40 00:04:19,710 --> 00:04:20,550 more visitors, 41 00:04:20,550 --> 00:04:21,250 etcetera. 42 00:04:22,340 --> 00:04:28,140 Today we're going to focus on the life season that has to do with aging. 43 00:04:28,140 --> 00:04:40,550 So we're going to look at age 50 and onward and we'll use that same structure where we'll talk about the physical body and changes and we'll also talk about life seasons, 44 00:04:41,240 --> 00:04:42,560 circumstances, 45 00:04:42,560 --> 00:04:43,410 environments, 46 00:04:43,410 --> 00:04:49,060 etcetera when it comes to physical changes in the body and in the brain. 47 00:04:50,140 --> 00:04:57,250 One of the ways that the aging of the body can impact the autistic is with regard to regulation. 48 00:04:57,840 --> 00:05:01,950 So as we've talked about on other episodes about regulation, 49 00:05:01,950 --> 00:05:12,350 which is the centering of the individual with alertness with attention and with an emotionally calm and resilient state, 50 00:05:13,440 --> 00:05:22,650 the autistic often has to be more intentional about how to get sensory inputs to help them feel centered. 51 00:05:23,640 --> 00:05:24,860 For some people, 52 00:05:24,860 --> 00:05:27,860 these inputs are involving physical activity. 53 00:05:27,870 --> 00:05:30,750 So some may have realized that hey, 54 00:05:31,140 --> 00:05:37,850 I feel the best when I am able to get regular bike rides, 55 00:05:38,630 --> 00:05:41,560 I get that movement input into the brain, 56 00:05:41,560 --> 00:05:43,160 that vestibular input. 57 00:05:43,840 --> 00:05:49,440 And maybe this has even turned into a special interest with owning several bikes, 58 00:05:49,440 --> 00:05:58,440 with going on bike trips with bicycle enthusiasts and entering biking events like races well, 59 00:05:58,440 --> 00:05:59,870 when the body ages, 60 00:05:59,870 --> 00:06:09,860 the individual may feel like not only am I being kind of robbed of my special interest if I can't keep doing these physical things, 61 00:06:10,540 --> 00:06:13,510 which can be a big deal because, 62 00:06:13,520 --> 00:06:13,940 you know, 63 00:06:13,940 --> 00:06:18,360 perhaps life has revolved a lot around this hobby, 64 00:06:18,740 --> 00:06:24,250 but also I'm not able to get the appropriate receptive input, 65 00:06:24,250 --> 00:06:31,250 that pressure in the joints when you're pedaling the bike and the vestibular input into the brain. 66 00:06:31,260 --> 00:06:33,360 That's that movement input. 67 00:06:33,370 --> 00:06:37,810 And the combination of those two things really helped someone. 68 00:06:37,810 --> 00:06:42,550 Let's say that these are the things that their nervous system needed. 69 00:06:43,340 --> 00:06:50,140 These pressure and movement inputs have helped the person get momentum for daily activities. 70 00:06:50,150 --> 00:06:56,660 If you haven't listened to this series yet on daily activities and getting momentum, 71 00:06:57,240 --> 00:07:09,660 I'll put the link in the notes and perhaps this is a person where bike riding has also helped them feel centered emotionally and also more resilient for the day. 72 00:07:11,240 --> 00:07:18,730 So for the individual who experiences this real benefit from bike riding, 73 00:07:18,740 --> 00:07:23,860 aging can present this dilemma of how can I fill this void. 74 00:07:24,240 --> 00:07:32,150 And a lot of people experience this kind of need to shift with aging where oh, 75 00:07:32,150 --> 00:07:38,060 I can't do the same physical things that I have always done and enjoyed. 76 00:07:38,940 --> 00:07:51,500 But for the individual on the spectrum who may really need a lot more intentionality to get these inputs in order to feel just right and to feel okay, 77 00:07:51,510 --> 00:07:52,040 you know, 78 00:07:52,040 --> 00:08:07,610 that can have a big impact on how centered they're able to feel one of the recommendations for the aging individual is to be really intentional about realizing the role that bike riding played, 79 00:08:07,610 --> 00:08:08,660 for example, 80 00:08:09,240 --> 00:08:15,860 and that there's a void that the person may need to get creative to fill. 81 00:08:16,540 --> 00:08:21,750 So the ideal situation would be that the person has the self awareness. 82 00:08:22,340 --> 00:08:22,790 That hey, 83 00:08:22,790 --> 00:08:34,710 the reason that I love this in part is because my system really benefits from movement or it really benefits from pressure, 84 00:08:34,710 --> 00:08:35,620 input, 85 00:08:35,630 --> 00:08:37,390 pressure through my joints, 86 00:08:37,390 --> 00:08:39,050 pressure into the muscles. 87 00:08:40,440 --> 00:08:45,410 If the person is self aware about the role that bike riding plays for them, 88 00:08:45,420 --> 00:08:48,260 but they can't bike bike ride anymore, 89 00:08:48,320 --> 00:08:54,300 then they can start to think how else can I get pressure input, 90 00:08:54,310 --> 00:08:56,760 How else can I get movement input? 91 00:08:58,140 --> 00:09:05,060 So they may need to think about more forgiving ways to get their system, 92 00:09:05,440 --> 00:09:07,450 this type of thing that they need. 93 00:09:08,240 --> 00:09:14,240 Someone could get pressure and movement input by laying in a hammock. 94 00:09:14,240 --> 00:09:17,400 So they have pressure all along their back, 95 00:09:17,410 --> 00:09:21,410 all from the tips of their toes up to their neck, 96 00:09:21,410 --> 00:09:26,450 and their shoulders in their head and some movement rocking back and forth. 97 00:09:27,120 --> 00:09:53,750 Somebody might have a big swing in the backyard and maybe it's um an old fashioned tree swing or they've got um a tire swing that their grandkids plan maybe being able to sit in there and have this movement of swinging that might really hit the spot for their nervous system. 98 00:09:53,760 --> 00:09:56,680 It's not something that we automatically think of, 99 00:09:56,680 --> 00:10:02,960 but it takes this awareness, this intentionality to it doesn't it? 100 00:10:03,440 --> 00:10:07,920 Someone else might try yoga to get pressure in their joints. 101 00:10:07,930 --> 00:10:41,050 A down dog gives a lot of pressure throughout their or different parts of the sun salutation. yin yoga is something that offers a lot of holding of poses and it's supposed to be you know a very restorative kind of practice and that be really match where your body is at during that different life season that I need something that's restorative rather than something that ends up feeling a bit punishing to me at this stage of life. 102 00:10:42,740 --> 00:11:08,780 Some people get inputs through swimming or doing things in a pool where they feel that resistance through the water and that is some pressure input or they're able to you know still slide down the pool slide and that gives them some really nice vestibular input or movement input whatever it is that your nervous system needs. 103 00:11:08,790 --> 00:11:15,960 You may have to have some creativity about how else can I get my system, 104 00:11:15,960 --> 00:11:21,260 what it needs with regard to sensory inputs to feel just right, 105 00:11:23,640 --> 00:11:27,860 this is similar to other life seasons for example, 106 00:11:27,870 --> 00:11:39,890 high schoolers who graduate have to do a lot of that same intentional shifting like oh I used to be on the diving team or um you know I used to go to PE (physical education) 108 00:11:40,070 --> 00:11:40,820 Class, 109 00:11:40,820 --> 00:11:56,590 I used to have to do these running laps or this game or that game and now there isn't this physical activity built in to my existence and if there's not that self awareness, 110 00:11:57,140 --> 00:12:04,960 that movement and pressure played a role in centering and helping this person get going, 111 00:12:04,970 --> 00:12:09,650 helping them calm down when they were too elevated. 112 00:12:10,040 --> 00:12:10,950 You know, 113 00:12:10,960 --> 00:12:12,830 without that self awareness, 114 00:12:12,830 --> 00:12:14,580 they won't be able to shift. 115 00:12:14,590 --> 00:12:19,760 So this is not only something that happens in a later life season, 116 00:12:20,140 --> 00:12:31,390 but it often is part of that shifting mindset of what do I need and how can I get that now? 117 00:12:31,400 --> 00:12:42,740 The physical body is not the only thing that's changing as far as our aging joints or muscles or uh maybe our physical endurance, 118 00:12:42,750 --> 00:12:47,080 but the brain is also an organ that's going to be aging. 119 00:12:47,090 --> 00:12:50,050 Even for people who age really well, 120 00:12:50,060 --> 00:12:54,410 there will be age related changes in the brain as humans. 121 00:12:54,410 --> 00:13:00,560 We just all are going to experience that change as related to aging. 122 00:13:01,240 --> 00:13:07,260 One of the things that happens with the aging of the brain is a slowing of thought process, 123 00:13:07,840 --> 00:13:12,180 a difficulty with the efficiency of recalling information, 124 00:13:12,740 --> 00:13:15,440 that's the tip of the tongue phenomenon, 125 00:13:15,440 --> 00:13:22,850 or I forget the name of this thing or this person or I can't remember why I walked into this room. 126 00:13:24,140 --> 00:13:30,210 These changes have a lot to do with the center of the brain and its connections with the front of the brain. 127 00:13:30,230 --> 00:13:42,860 And one of the reasons there are changes with aging in this area is that the blood vessels that give the brain oxygen and energy are really large and open. 128 00:13:43,250 --> 00:13:56,020 They're the biggest on the outside of the brain and the vessels curve and twist and go deeper and deeper into the brain and as they enter the brain and go deeper, 129 00:13:56,020 --> 00:14:02,980 they also get smaller and smaller and in the center of the brain they end up being very small. 130 00:14:02,980 --> 00:14:21,050 You have little capillaries in there and with age our smallest vessels may have the most difficulty getting blood traffic through and we may have kind of a sensitivity in the areas of the brain that are fed by some of these small vessels. 131 00:14:22,040 --> 00:14:26,960 So we can start to have more problems with the thinking skills related to this area. 132 00:14:27,340 --> 00:14:34,560 And these skills that are related to that area often fall within the domain of executive function skills. 133 00:14:36,240 --> 00:14:36,610 Well, 134 00:14:36,620 --> 00:14:46,050 everyone on the spectrum will have some challenge in the area of executive function already more so than the neuro typical individual will. 135 00:14:46,640 --> 00:14:51,180 I'm planning on doing a series on executive function in the future. 136 00:14:51,740 --> 00:14:55,280 But if you would like a really good resource to look at now, 137 00:14:55,340 --> 00:14:58,640 I look the book series called smart but scattered, 138 00:15:00,140 --> 00:15:03,350 there are also lots of other books and resources out there. 139 00:15:03,540 --> 00:15:10,020 An executive function and you're welcome to choose one that fits your needs in short, 140 00:15:10,020 --> 00:15:15,420 executive function includes lots of brain skills like planning ahead, 141 00:15:15,430 --> 00:15:19,010 understanding what is most and least important. 142 00:15:19,020 --> 00:15:30,560 Thinking quickly getting started with the task finishing multiple steps of a task handling multiple things coming at you in succession. 143 00:15:30,940 --> 00:15:47,200 Retrieving memories etcetera because this is an ability that's sensitive to the aging process and every autistic individual has some pattern of difficulty developmentally. 144 00:15:47,210 --> 00:15:52,950 What we typically see with aging is that these areas of executive function, 145 00:15:53,440 --> 00:16:02,240 they become more difficult because executive function abilities impact thinking skills like attention, 146 00:16:02,240 --> 00:16:08,750 mental organization as well as behavior patterns like getting started with the task. 147 00:16:09,270 --> 00:16:13,800 The individual may show shifts in these areas. 148 00:16:13,810 --> 00:16:17,660 So the shifts are related to aging alone, 149 00:16:18,140 --> 00:16:26,060 although it's aging within an area of your ability that was already sensitive or already weak. 150 00:16:26,740 --> 00:16:35,750 So sometimes what happens is that we do see some increased difficulty with executive function in the autistic, 151 00:16:35,760 --> 00:16:39,760 more so than for the neurotypical, 152 00:16:40,540 --> 00:16:46,490 although everyone who's aging will experience more difficulty in that area than they did in their twenties, 153 00:16:46,490 --> 00:16:47,470 for example, 154 00:16:48,740 --> 00:17:02,570 I've had the privilege of working with autistic individuals into their eighth decade and I've worked with our dementia clinic to determine whether an individual has dementia or an undiagnosed autism spectrum condition, 155 00:17:02,580 --> 00:17:11,670 which is only just impacted by age that there's no um separate disease process that we would call a dementia. 156 00:17:12,240 --> 00:17:13,940 When I'm talking about dementia, 157 00:17:13,940 --> 00:17:20,460 I'm talking about the presence of changes in the cells that advance. 158 00:17:20,460 --> 00:17:25,760 So there's a degeneration that's part of a disease process itself. 159 00:17:26,540 --> 00:17:41,770 So what we're contrasting is that autistics may have increased difficulty with aging even in the absence of any kind of overlay of a new medical process like a dementia. 160 00:17:42,440 --> 00:17:44,150 If you look through the literature, 161 00:17:44,150 --> 00:17:52,270 there really are not good statistics about how frequently dementia occurs in autism, 162 00:17:52,740 --> 00:17:53,690 particularly. 163 00:17:53,690 --> 00:18:04,330 The reason for this is that we have not captured autism in adults and aging adults enough to actually look at this. 164 00:18:04,340 --> 00:18:05,120 Um, 165 00:18:05,130 --> 00:18:15,790 so I can only tell you what my personal experience has been in my own experience in seeing people from the dementia clinic. 166 00:18:15,800 --> 00:18:17,720 Seeing people who are aging, 167 00:18:17,720 --> 00:18:24,950 I don't tend to think that there's any increased risk of a disease process that we would call dementia. 168 00:18:25,340 --> 00:18:25,710 Um, 169 00:18:25,720 --> 00:18:27,350 I haven't seen this. 170 00:18:28,140 --> 00:18:35,500 I have seen people present with concerns that perhaps there is a dementia or disease process. 171 00:18:35,510 --> 00:18:38,100 And after assessing this, 172 00:18:38,110 --> 00:18:45,380 it seems to be that this is part of the aging process and not a separate disease process. 173 00:18:47,640 --> 00:18:52,460 This is not to say that they aren't noticing differences in their home environment. 174 00:18:52,840 --> 00:18:58,010 Executive function certainly does impact day to day life. 175 00:18:58,020 --> 00:19:03,100 So someone may be having more difficulty getting started with tasks, 176 00:19:03,110 --> 00:19:04,860 taking care of themselves, 177 00:19:04,890 --> 00:19:10,960 really engaging in life being active in what they're needing to get done during the day. 178 00:19:11,630 --> 00:19:19,170 This may be a feature that the autistic experiences or expresses during the aging process, 179 00:19:20,440 --> 00:19:20,930 but again, 180 00:19:20,930 --> 00:19:23,840 we don't even know how typical that is. 181 00:19:23,850 --> 00:19:31,300 So all the people that I see are patients who are presenting because they're experiencing some difficulty. 182 00:19:31,310 --> 00:19:45,590 So it would be such a wonderful thing if in the future we're able to capture people with neuro diversity across adulthood and aging and we can actually see, 183 00:19:46,140 --> 00:19:46,690 um, 184 00:19:46,700 --> 00:20:04,550 how many of these clients are really um doing well and aging well and participating in things and have good mood and engagement and how many perhaps are struggling or showing some increased difficulty. 185 00:20:05,140 --> 00:20:11,480 One of the recommendations for the autistic individual is to focus on living a healthy lifestyle. 186 00:20:11,490 --> 00:20:14,410 So this is a good recommendation for anyone, 187 00:20:14,420 --> 00:20:15,090 of course, 188 00:20:15,090 --> 00:20:22,710 but anything that helps the health of the blood vessels will be likely supportive during aging. 189 00:20:22,720 --> 00:20:25,060 And that's true for all of us. 190 00:20:25,540 --> 00:20:25,900 Um, 191 00:20:25,900 --> 00:20:30,650 but especially if a person has a weakness and executive function already, 192 00:20:30,660 --> 00:20:31,430 um, 193 00:20:31,440 --> 00:20:35,520 they may really want to focus on that even more intentionally. 194 00:20:35,530 --> 00:20:37,780 So watching things like cholesterol, 195 00:20:37,790 --> 00:20:38,890 high blood pressure, 196 00:20:38,890 --> 00:20:40,060 diabetes, 197 00:20:40,070 --> 00:20:44,050 these are all things that can stress the blood vessel systems. 198 00:20:44,440 --> 00:20:48,620 And although we can't stop the impact of aging on the blood vessels, 199 00:20:48,630 --> 00:20:54,490 there are probably choices that we can make to just help support the health of the vessels. 200 00:20:54,500 --> 00:20:59,010 And of course this does not constitute medical advice for anyone. 201 00:20:59,020 --> 00:21:04,360 I really encourage you to engage with your doctors about what would be healthy for you. 202 00:21:04,740 --> 00:21:10,510 But certainly if you want to give your body what it needs to age well, 203 00:21:10,520 --> 00:21:15,540 um things like healthy diet and movement and exercise and sleep. 204 00:21:15,550 --> 00:21:20,360 These are all things that may support your body as you age. 205 00:21:21,040 --> 00:21:33,950 Let's shift from talking about changes in the physical body and changes in the brain to talking about changes in our environment or what's going on in life during this season, 206 00:21:35,940 --> 00:21:44,440 one of the things I want to talk about is that there's often less built in structure to our life during that season, 207 00:21:45,340 --> 00:21:53,770 because people often are either cutting down on the number of hours they're working or they've retired, 208 00:21:54,750 --> 00:21:57,220 their kids aren't living at home anymore, 209 00:21:57,220 --> 00:21:58,810 they have an empty nest, 210 00:21:59,540 --> 00:22:08,860 um there are less daily activities to kind of move people forward that I have to get going because I have to go to this place, 211 00:22:09,340 --> 00:22:24,300 so work or the schedule of the Children may have provided some inherent structure to the day and cutting down on the structure that helps people get momentum for their day, 212 00:22:24,310 --> 00:22:29,660 can mean that it's harder for them to get momentum for activities. 213 00:22:30,440 --> 00:22:39,050 The autistic who lean toward anxiety or wanting to know what the day would likely bring benefited from structure because it felt supportive, 214 00:22:40,140 --> 00:22:41,160 in contrast, 215 00:22:41,160 --> 00:22:44,150 the autistic who had trouble with momentum, 216 00:22:44,160 --> 00:22:45,790 like I feel lazy, 217 00:22:45,790 --> 00:22:48,320 I feel like I just can't get going, 218 00:22:48,320 --> 00:23:01,360 I don't know where to start benefited from structure because it helped propel them forward with tasks and daily activities and without the propelling force of a schedule, 219 00:23:02,040 --> 00:23:10,260 this group of people on the spectrum find it really challenging to find an internal source of momentum. 220 00:23:11,640 --> 00:23:14,140 Um they often struggle to say, 221 00:23:14,140 --> 00:23:18,520 oh I can plan my day this way or these are things that need to get done. 222 00:23:18,530 --> 00:23:23,050 Even issues of self care may kind of be put on the back burner, 223 00:23:23,050 --> 00:23:23,360 like, 224 00:23:23,370 --> 00:23:23,630 oh, 225 00:23:23,630 --> 00:23:26,920 I used to take a shower before work every day, 226 00:23:26,920 --> 00:23:28,670 but now I don't have to work. 227 00:23:28,940 --> 00:23:33,170 So can they have this internal momentum towards self care? 228 00:23:34,320 --> 00:23:42,200 Some would say they used to shower and eat breakfast and take medication as part of their morning routine, 229 00:23:42,640 --> 00:23:45,060 but if they're not even leaving the house, 230 00:23:45,060 --> 00:23:48,090 the morning routine doesn't get done as consistently, 231 00:23:48,100 --> 00:23:52,660 so pretty soon doing one activity can really feel demanding, 232 00:23:52,670 --> 00:23:53,210 like, 233 00:23:53,210 --> 00:23:53,360 oh, 234 00:23:53,360 --> 00:23:56,860 I can't get groceries today because I'm also getting a haircut, 235 00:23:57,640 --> 00:23:58,870 whereas before, 236 00:23:58,870 --> 00:24:01,100 when our day was so scheduled, 237 00:24:01,210 --> 00:24:10,850 we had this just internal momentum and we didn't have to get our energy up to do something. 238 00:24:11,540 --> 00:24:18,770 One thing for the individual to consider then is their need to make an artificial structure during retirement. 239 00:24:19,640 --> 00:24:26,560 Some people may wish to volunteer or have other reasons to leave the house on a particular schedule. 240 00:24:27,240 --> 00:24:32,080 They may make a list of life areas that they want to attend to every week. 241 00:24:32,080 --> 00:24:35,340 So one person may say, 242 00:24:35,350 --> 00:24:40,620 I really benefit from saying I want to learn something new every week. 243 00:24:40,630 --> 00:24:45,610 I want to see a friend every week I exercise on the schedule. 244 00:24:45,620 --> 00:24:54,170 I do chores on this schedule in having a schedule or a structure helps them stay engaged in life, 245 00:24:54,540 --> 00:25:02,170 helps them have momentum for what needs to get done in order to have really a balanced and healthy lifestyle. 246 00:25:04,240 --> 00:25:16,560 Another thing that's changing during the season of life is that there's a lot more engagement that's required with doctors and a lot more instruction to change, 247 00:25:17,940 --> 00:25:22,260 even though there's less engagement with the external world. 248 00:25:22,270 --> 00:25:23,710 In some respects, 249 00:25:23,720 --> 00:25:34,670 there's increasing demand to engage in self care to visit and communicate with physicians and to change all of a sudden, 250 00:25:34,670 --> 00:25:41,620 people are telling you to change your lifestyle what you eat or drink what medicines you take, 251 00:25:41,630 --> 00:25:47,090 instructions to change or shift gears can feel really demanding, 252 00:25:47,100 --> 00:25:53,260 and sometimes the individual may kind of bow out of the whole process and say, 253 00:25:53,270 --> 00:25:55,000 I'm just not going to do this. 254 00:25:55,640 --> 00:26:03,860 Doctors and family can try to keep in mind the demands on the individual and how that may feel to the person on the spectrum, 255 00:26:04,640 --> 00:26:08,190 Maybe they're more likely to pick their battles, 256 00:26:08,200 --> 00:26:09,310 so to speak. 257 00:26:09,310 --> 00:26:09,910 So, 258 00:26:09,920 --> 00:26:17,660 understanding how hard it is for the person to engage with people to shift what they're eating. 259 00:26:17,660 --> 00:26:18,770 For example, 260 00:26:19,240 --> 00:26:19,820 you know, 261 00:26:19,820 --> 00:26:25,450 if somebody has lived on pasta because that's all they can tolerate with regard to texture, 262 00:26:26,040 --> 00:26:26,500 um, 263 00:26:26,510 --> 00:26:26,960 you know, 264 00:26:26,960 --> 00:26:36,350 harping on and um talking again and again about vegetables may not be the battle that they want to have for this person. 265 00:26:37,140 --> 00:26:37,450 So, 266 00:26:37,450 --> 00:26:43,390 there can be both this increased environmental demand in the sense of medical issues. 267 00:26:43,400 --> 00:26:48,270 Doctors waiting rooms calling people asking questions. 268 00:26:48,940 --> 00:26:49,590 Um, 269 00:26:49,600 --> 00:26:57,870 but there's also this decreased environmental structure that previously may have been supportive, 270 00:26:57,880 --> 00:26:58,250 like, 271 00:26:58,250 --> 00:26:58,370 oh, 272 00:26:58,370 --> 00:27:00,020 I know what I do next. 273 00:27:00,030 --> 00:27:01,950 This helps me get out of the house, 274 00:27:01,960 --> 00:27:09,450 I don't have to effort to get up and take a shower because that's just what I do every morning before I go to work. 275 00:27:10,340 --> 00:27:11,280 As you can see, 276 00:27:11,280 --> 00:27:29,370 the aging season of life presents similar challenges in the sense of changes in the physical person and the environment when we compare this to other seasons of life and these shifts can lead to shifts in the way that the autistic characteristics feel, 277 00:27:29,380 --> 00:27:35,390 how they're experienced by the individual and also how they are expressed. 278 00:27:35,390 --> 00:27:41,990 So how other people see that this person is doing A spouse may say, 279 00:27:41,990 --> 00:27:54,960 I don't understand because my husband would get up and do this whole routine every day for 40 years at his job and now he can't get going with anything. 280 00:27:55,440 --> 00:27:57,030 So is this a dementia, 281 00:27:57,030 --> 00:27:58,010 what's happening? 282 00:27:58,020 --> 00:28:03,600 And sometimes it's just the total lack of structure that's, 283 00:28:03,610 --> 00:28:04,050 you know, 284 00:28:04,050 --> 00:28:14,850 all these this momentum has been taken and we can see that the autistic characteristics that have always been there are expressed differently. 285 00:28:15,940 --> 00:28:31,950 It's nice to have an increased understanding that this is common and we can also have a context for what we might be seeing as well as more intentionality about how we might want to enter this season. 286 00:28:32,340 --> 00:28:35,450 So how else can I get sensory inputs? 287 00:28:35,450 --> 00:28:39,260 How else can I create structure and momentum? 288 00:28:39,270 --> 00:28:42,340 How can I communicate with my doctors? 289 00:28:42,340 --> 00:28:44,510 That a lot of change is really, 290 00:28:44,510 --> 00:28:47,160 really impossible for me. 291 00:28:47,170 --> 00:28:49,450 It's just I just, 292 00:28:49,460 --> 00:28:54,560 I have a limit on how much I can change and maintain over time. 293 00:28:55,640 --> 00:29:03,670 Let's be intentional about how we enter certain life seasons and also support each other during their life seasons. 294 00:29:04,640 --> 00:29:11,620 Thank you so much for joining me for this series and how autistic characteristics can shift over life seasons. 295 00:29:12,240 --> 00:29:26,960 I hope you join me again soon and please remember to write down questions that you want covered in future podcast episodes too, adultandgeriatricautism@gmail.com