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The wrinkles of my autism

What brings you here this time? asks the doctor. Mrs Clotilde (fictitious name) did not answer. The doctor came closer. What brings you here this time? he asked again in a louder tone. Mrs Clotilde's grandson who had come to accompany her knocked on the door. He had heard the doctor speak louder and remembered that his grandmother doesn't hear well, but refuses to wear a hearing aid. May I come in? asked the grandson. The doctor agreed. My grandmother can't hear well, but it's not only that that makes life difficult for her, he said. Mrs. Clotilde didn't even realise that her grandson had come in.

Most of the time we have to remind her to take her pills, says her grandson. And do you have any idea whether the situation has worsened in recent years? asks the doctor. I can't answer that. My grandmother isn't one for having people around the house for too long. After a while she goes to her room and before you know it she's gone. We end up going out, she says. But my father tells me that she's always been like that for the forgetful, at least with some things, he says.

Granma, why don't you tell the doctor all the things? asks her grandson. Do you think he wants to know about me? she says. The grandson doesn't quite know how to continue his insistence. But Granma, it's important that you share things with the doctor or he won't be able to help you! he insists. Just like all the other doctors I have told things to? asks grandma. Do you think this is the first time I've been to the doctor? he asks her in a harsher tone. I've gone more than fifty years of my life without a doctor telling me what's really wrong with me, she says. They told me everything. That I had depression, generalised anxiety. There was even one doctor who told me that what I wanted was to get people's attention, he continues. Have you ever thought of something like that? asks her grandmother. Just me, who all my life has wanted to be left alone, she says. It took me until I was fifty-nine to take all the information I had gathered about autism to a psychologist so that I could be diagnosed with autism, she says. Fifty-nine years old, you know what I mean? Right now you are twenty-eight, she continues. Can you imagine if all your life up to then was suffering mixed with the unknown of not knowing what's wrong with you? he asks his grandson. But why doesn't the grandmother tell the doctor that you are autistic? asks the latter naively. And do you think it's worth it? she replies immediately. I can tell him about the difficulties I have to concentrate and he will think it's a degenerative thing when it's not, he says. And all the sensations I have because of the noises I hear. He'll probably think it's all in my imagination. You wouldn't be the first, you tell him. Have you tried asking the psychologist who diagnosed you if he knows any doctor who sees old people and knows about autism? The grandmother remained without an answer. She touched his hand and went to her room to rest. That was the signal for her grandson to leave.

Autism is a lifelong condition. And a significant percentage of autistic people will become adults. And if we know little about adult autistic people. We know even less about older autistic people.

However, we do know about the normative processes of development. And that, for instance, after 50 years of age we begin to observe a certain decline in some of the cognitive functions. Furthermore, we can think that a significant percentage of autistic people already have a lower cognitive profile. A fact that will have a greater impact when associated with the aging process.

And if we think that elderly people, or at least some of them, start needing some type of residential answer, it will be fundamental to think about the answers of support structures for autistic elderly people. This is because the needs that have been verified throughout life, namely the sensorial issues, may continue to be present. Furthermore, the very relationship with the carers in the residential homes, as well as with the other occupants of the homes, leads one to consider a necessary preparation so that this process may take place in the best way. But also in the case of those elderly autistic people who will remain in the care of their family it is important that informal caregivers can be aware of their needs.

Another very important aspect is health care provision in this group. We know that autistic people are more likely to have a wide range of comorbidities. And they will not only remain persistent throughout life, but will also have an increased impact over the years. In addition to mental health, physical health aspects are also a concern, not only because from the age of 65 onwards there are a greater number of aggravated health situations. But in addition, it is known that with autism there is a greater propensity for health conditions to compromise.

It is urgent to change the way we look at autism. And besides we can accept that this is a condition that accompanies people throughout their lives. It is essential that this is reflected in everyone's practice. Be it health professionals, and especially those who accompany adults and senior citizens. Not that an equal reflection is not necessary for those who look after children and young people. However, the disparity and lack of knowledge regarding autism in these phases of life is striking. And it leads to an even greater worsening of the living conditions and quality of life of autistic people in a rather long period of their lives. But it is not only health professionals. It is all of us Society who need to look at people and the expression of difference as an integral part of human expression.

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