As people with autism spectrum disorder (ASD) grow older, they face unique challenges and changes. Autism is a lifelong neurological condition that affects how a person communicates, interacts, behaves, and processes sensory information. The signs and symptoms of autism often change over time as a person moves through different stages of life. Many autistic adults see improvements in some areas as they age, while other skills and abilities may decline. Understanding what autistic seniors go through can help families and caregivers provide better support.
Do autistic symptoms improve with age?
For some people, autism symptoms may lessen to some degree with age, while others remain severely impaired throughout life. There is no “one size fits all” progression. Outcomes depend on the individual’s severity of autism, presence of co-occurring conditions, access to interventions, and support systems.
Some common improvements include:
- Better ability to control behavior and emotional outbursts
- Increased self-awareness and self-acceptance
- More effective self-advocacy skills
- Enhanced social awareness and maturity
- Expanded communication skills and vocabulary
- Greater independence in daily living skills
However, autistic adults may continue to face challenges in areas like:
- Social interaction and building relationships
- Understanding nonverbal cues and figurative language
- Transitioning and adjusting to life changes
- Anxiety, depression, and managing emotions
- Executive functioning difficulties with planning and organization
- Restricted interests, routines, and sensory issues
While some aspects of autism may improve, most autistic adults still require structure, predicability, and support in specific areas as they age.
Are there additional health risks?
Autistic adults are at higher risk for certain physical and mental health conditions, including:
- Gastrointestinal disorders
- Epilepsy
- Sleep disturbances
- Obesity
- Diabetes
- Autoimmune disorders
- Anxiety
- Depression
- Bipolar disorder
- OCD
- ADHD
- Schizophrenia
- Addiction
Managing co-occurring medical and mental health issues is an important part of care for aging autistic adults. Work closely with doctors to monitor physical and emotional health.
What are common living arrangements?
Many autistic adults live in a variety of arrangements:
- Independently
- With parents or family members
- In supported group homes
- Residential care communities
- Assisted living facilities
- Skilled nursing facilities
The level of support and supervision required depends on factors like:
- Severity of autism symptoms
- Ability to perform activities of daily living independently
- Presence of additional disabilities or medical issues
- Access to services and supports
- Financial resources
- Family involvement and availability
Many autistic adults thrive in supportive housing environments among their peers. But waiting lists for specialized housing are often long. Financial limitations and lack of services are ongoing challenges.
Independent living considerations
For higher-functioning autistic adults, living independently is often possible with preparation and support. Key steps include:
- Teaching practical life skills like cooking, cleaning, and money management
- Connecting with social services and disability resources in the community
- Making accommodations for sensory needs and mobility limitations
- Establishing structure, schedules, and clear routines
- Exploring options for in-home care services if needed
- Identifying advocacy and support networks
Even independent autistic adults benefit from regular check-ins and assistance from family, case workers, or health aides. Support networks are crucial.
Group home and assisted living facilities
Group homes and assisted living centers tailored for autistic adults provide more supervision and care. Benefits include:
- 24/7 staffing and trained caregivers
- Assistance with medical needs, hygiene, meals, etc.
- Social opportunities with peers
- Transportation
- Structured schedules and activities
- Security and safety monitoring
These facilities can foster independence while delivering support based on individual needs. But costs are often high and there are usually long waitlists.
How does the aging process affect autistic adults?
Growing older involves both physical and psychological changes that can be especially impactful for people on the spectrum.
Potential physical effects of aging
- Decreased mobility from conditions like arthritis or cerebral palsy
- Vision and hearing loss
- Medication side effects
- Menopause symptoms in women
- Onset of age-related diseases like cancer or heart disease
- Alzheimer’s or dementia
- Weakening immune system
Aging autistic adults are susceptible to the same medical conditions as the general aging population. Careful monitoring by doctors attuned to autism is key.
Potential cognitive/brain changes
For some autistic individuals, cognitive functions like memory, learning, and perception may decline more rapidly with age. Possible changes include:
- Impaired executive functioning affecting planning, focus, organization
- Short-term memory loss
- Reduced cognitive flexibility and ability to multi-task
- Slower processing speed and reaction time
- Diminished ability to focus and filter out distractions
However, lifelong neurodiversity may also equip autistic seniors with cognitive strengths:
- Enhanced long-term and visual memory
- Systemizing abilities
- Pattern recognition skills
- Attention to detail
Leveraging cognitive assets while accommodating any decreased capacities is key.
Potential psychological changes
Autistic adults may experience emotional difficulty coping with aging, including:
- Depression or anxiety about health changes or losing abilities
- Grief over loss of loved ones and caregivers
- Frustration or embarrassment about increased dependency
- Confusion and agitation from neurocognitive conditions like dementia
- Fear about the future as parents/caregivers age or pass away
- Isolation and loneliness from living alone or in long-term care settings
Maintaining continuity of care, social connections, and routines helps smooth the transition. Watching for signs of depression, anxiety, OCD, and other mental health issues that may emerge or worsen with age is also important.
What are the biggest lifestyle changes?
Assimilating major life changes can be especially challenging due to autism’s impact on adaptability, communication, and uncertainty. Some key transitions include:
Losing parents/caregivers
Many autistic adults rely heavily on parents or family for caregiving, housing, finances, transportation, and other support. The death of parents requires adapting to dramatic changes in living situation, finances, and independence levels—all areas already impacted by autism. Grief support and pre-planning can ease the transition.
Changing living environments
Moving from family homes to adult communities or long-term care facilities represents a major lifestyle overhaul. To reduce anxiety, optimize success, and honor preferences:
- Plan ahead and involve the person in decision-making.
- Prioritize consistency in staffing, schedules, and environments.
- Bring familiar possessions and sensory tools to support the transition.
- Implement strategies to promote social connections.
- Provide visual supports and social narratives to explain changes.
Losing abilities and independence
Many autistic adults pride themselves on skills that allow independent living, like driving or financial management. Losing independence from aging can lower self-confidence and increase isolation. Reinforce strengths, modify tasks, and provide tools to prolong independence.
Entering long-term care
Specialized long-term care facilities for autistic seniors are limited. Mainstream nursing homes often lack staff training and accommodations needed to support autistic residents. To avoid problems:
- Tour facilities and ask about autism experience.
- Educate staff about the person’s unique needs.
- Request environmental modifications to minimize disruptions.
- Advocate for maintaining programs and aids that foster independence.
- Check frequently that the person is receiving appropriate care.
Losing structure and activity
Many autistic adults thrive on predictable routines, schedules, and interests. Retirement or moving to supportive housing can remove enjoyable structures. Ensure activities, social connections, and hobbies stay integrated into daily life.
What are strategies for supporting autistic seniors?
Promoting health and well-being in older autistic adults requires tailored strategies and services based on individual strengths and challenges. Key tips include:
Provide continuity and consistency
Smooth transitions by maintaining familiar routines, staffing, living environments, communication styles, and sensory tools. Create schedules, timelines, and step-by-step plans for changes.
Prioritize clear communication
Use direct language and visual supports like picture schedules. Watch for signs of hearing or vision issues. Teach self-advocacy skills for expressing needs to caregivers.
Encourage physical activity and exercise
Build in appropriate exercise to maintain mobility, circulation, bone density, and mental health. Activities like walking, swimming, or gardening are engaging options.
Monitor diet and nutrition
Autistic adults are at higher obesity risk. Limit processed foods, simple carbs, and sugary snacks. Watch calcium and vitamin D intake for bone health. Verify adequate hydration.
Structure meaningful activities
Incorporate enjoyable hobbies, skills training, social opportunities, and outdoor time into each day. This maintains cognitive health and quality of life. Adapting activities to accommodate aging issues helps preserve engagement.
Manage medications carefully
Autistic adults often take psychiatric medications that have complex interactions and side effects. Frequently review drug regimens with doctors and watch closely for adverse reactions.
Provide grief and transition support
Autistic adults often benefit from professional counseling and peer support groups to navigate difficult life changes and loss. Social stories and literature can also explain the grieving process.
Coordinate comprehensive care
An interdisciplinary team including primary care doctors, therapists, psychiatrists, social workers, family, anddirect care staff best meets the medical and psychosocial needs of older autistic adults.
What does the future look like for aging autistic adults?
The number of autistic seniors is rising dramatically as children diagnosed in the 1990s reach older adulthood. This growing tide of older adults on the spectrum is spurring more research, programs, and services tailored to their needs.
Increasing lifespan
With earlier diagnosis, treatment advances, and better support, autistic life expectancy has risen significantly—from just 18 years beyond childhood in the 1960s to over 66 years today. More autistic adults are reaching their 60s, 70s, 80s, and beyond.
Improving health monitoring
Doctors are getting better at providing comprehensive healthcare that looks beyond autism to proactively treat preventable conditions. But more physicians trained in caring for aging autistic adults are urgently needed.
Expanding supportive housing
New assisted living facilities, senior communities, and long-term care centers specialized for autism are slowly increasing to meet growing demand. But availability remains limited and costly.
Customizing care and activities
Programs are evolving to help autistic adults maintain cognitive, physical, and social engagement in fun, adaptable ways. Technology, like touchscreen tablets and virtual reality, boosts accessibility.
Increasing research and guidelines
Experts are developing more evidence-based protocols to guide healthcare, treatment, and safe transition planning for autistic adults across the lifespan. But funding and research gaps remain.
Improving inclusion and integration
Networks like local autism chapters and online communities help autistic seniors feel connected. Mainstream aging services are learning to accommodate neurodiverse needs. But acceptance and inclusion are still lacking.
Enhancing advocacy and policy
More funding, programs, legal protections, and public awareness are still needed to fully integrate autistic adults into healthcare, housing, and communities. Advocacy groups like ASCEND are leading reform efforts.
Conclusion
The aging process presents unique challenges and changes for adults on the autism spectrum. But with comprehensive support, self-advocacy, advanced planning, and appropriate care, autistic seniors can continue to thrive and enjoy full, engaging lives. While gaps in policy, research, and services remain, ongoing efforts and innovations aim to improve aging outcomes and empower autistic individuals to age successfully.