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Karen Bowersox, left, with design graduate Jillian Jankovsky.Down's Designs

When Karen Bowersox couldn't find clothes to fit her granddaughter, she decided to make them herself – and her new company, Down's Designs, was born.

But a few years ago, if you'd asked the entrepreneur if she wanted to set up a new business, she'd have laughed at you. She was 61, running her husband's medical practice and a weight-loss coaching program, and had an ever-expanding number of grandkids and an 86-year-old mother to care for – but then everything changed.

"My daughter had given birth to twins about nine years ago, and they were very premature. The little girl weighed three pounds, and she was just perfectly healthy, and didn't even need oxygen. But the little boy, Brendan, he had Down syndrome – his lungs could not sustain his life, and he lived about eight and a half months. I was shattered.

"Two years later, they adopted this little girl with Down syndrome. At that point, I came out of my depression and my life turned around."

After running a successful housekeeping business for years, Ms. Bowersox helped her husband start a private practice in 2001 – but she has stepped back from the practice to start her new business.

The new venture combines her love for her granddaughter, Maggie, her business sense, and her willingness to throw herself headfirst into pretty much anything. The seeds of this venture began when she attended the annual Buddy Walk in Cleveland, Ohio, a national event that raises money for Down syndrome organizations.

There, she was struck by a common sight – people with Down syndrome in oversized clothes rolled up to fit. The nature of the condition means that the body develops differently, and finding suitable clothing is next to impossible.

"One day, my daughter looked at me, rolling up Maggie's pants, and said 'You know, Mom, you're a business woman. You want a really good business, why don't you make clothes for these people?'

"At that time, I was 61 years old. I didn't know a thing about clothes. I went home and said 'I'll just buy her something online.'"

But after extensive searching, she still couldn't find any solutions – and decided to tackle the problem herself.

Misconceptions about people with Down syndrome have diminished in recent decades, but there is still a startling lack of knowledge about the physicality of those with the condition. What started as a noble idea became a much more difficult task once Ms. Bowersox realized the enormity of what she was proposing – a new clothing line for a group of people who have entirely different body types.

"Their thigh bone is much shorter. Everything bends at the wrong places. Their shoulders slant down, and they have big thick necks and usually big tummies. But the entrepreneur in my head would not quit," she recalls.

With no background in design, she found it almost impossible to negotiate with international suppliers, until Chinese factory manager Andy Yen got in touch to form a relationship. Similarly, the inevitable trial-and-error process has been softened by the ongoing involvement of design graduate Jillian Jankovsky. In addition, the market has shown great patience.

"It sometimes brings me to tears, the appreciation of these people that someone is finally trying to do something for these kids. We go to conferences – I don't have much and I'm always apologizing. But you know what, they didn't have clothes all these years, they're just so grateful that they're coming. It's why I do this."

Surprisingly, Down's Designs is the first business of its type, though the market is significant – about 35,000 people with Down syndrome live in Canada, according to the Canadian Down Syndrome Society. Ms. Bowersox promises that Down's Designs will be "international, it will be worldwide. I will eventually have all clothes for all ages, and if others want to follow: bring 'em on."

At the moment, Down's Designs is in the final stages of their adult clothing line, and plans for the coming year include locking down their children's range and ramping up marketing. Because there is an in-built community in organizations worldwide, Ms. Bowersox plans to approach them with the chance to market to their members while also recouping 5% of sales. It will build the community and the business, and will match her ethos of always giving back.

The main thing, though, is that it makes people with Down syndrome feel accepted.

"Years ago, people with Down syndrome were stuck in institutions. But now my granddaughter goes to public school. These kids are mainstream; they're brought out of this. They're developing, they're functioning; they have jobs, they have girlfriends and boyfriends; they kiss, they go dancing, they go to proms."

With an attitude like that, it's easy to imagine that a few years from now, Maggie will be thanking her grandmother for all the work she's done – and for designing a prom dress that's a perfect fit.