Older Adults and Medications – Part I

When you are younger and in need of medication for an illness or injury, things are pretty simple. You go to the doctor, get a diagnosis, fill your prescription, and a few days later you’re feeling better. If you get a headache or pull a muscle at the gym, you pick up some over-the-counter analgesics and in a bit you’re back to your busy life good as new. It never occurs to you to monitor what you’re taking because you’re not taking a lot of medications with a lot of frequency. That changes as you reach your senior years. As you get older, it’s typical to be dealing with more than one chronic condition resulting in taking multiple medications which are very often prescribed in multiple doses. In fact, the average older person takes at least four prescription medications and at least two over-the-counter drugs on a regular basis. Seniors over 65 are responsible for the purchase of 30% of all prescription drugs and over 40% of all over-the-counter drugs. You can see where this is going. As you get older or someone you care for enters their senior years, it becomes increasingly important to manage medications.

Seniors are particularly vulnerable to problems with medications for a variety of reasons. The more medications are taken, the greater the odds are that they may have an interaction that could be dangerous if not unpleasant. It’s not uncommon for a senior to simply stop taking a medication because of its side effects. Between 40% and 75% of seniors stop taking their medications at the right dosage and the right schedule. This issue is compounded by the fact that older adults are more sensitive to drugs because of their now slower metabolisms and organ functions, thus keeping drugs in their system for longer periods of time. Physical problems such as poor vision or a weak grip due to arthritis can result in dosing errors. Cognitive and memory issues can prevent the older adult from following the doctor’s orders and since so many seniors live alone there’s no one to assist them with nor monitor their use of drugs. Simply forgetting is a major reason medication doses are skipped by the elderly. With an increased number of chronic conditions the typical older adult sees a number of different physicians — the endocrinologist for their thyroid, the cardiologist for their heart problems, and so on. Multiple doctors equal multiple medications that can conflict with each other. You can see why studies have shown that any combination of these factors causes 30% of hospital admissions of older adults. It’s apparent that being able to manage an older adult’s medications is critical to their well being and even their ability to remain independently in their own home. Next time we’ll talk about which medications to be especially cautious about and what action you can take to help keep your senior safe with their medication. Visit us at www.trilliumhomecare.com

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Isolation In The Elderly

According to the study “A Review of Social Isolation” by Nicholas R. Nicholson, which was published in The Journal of Primary Prevention, over 40% of Seniors who live at home are living in isolation. This is an alarming statistic in light of the fact that there is an increasing trend for seniors to “age in place” and the senior population in the over 65 age group is predicted to more than double in the next 25 years. The alarming part is that social isolation is a major health problem in older adults and is expected to dramatically increase in the near future. Studies have proven that this isolation and resulting lack of social activities can be directly linked to an increase in cognitive decline. In addition, by not belonging to a social network seniors don’t benefit from the positive encouragement of their friends to comply with healthy practices such as not smoking or staying active. Another health risk of isolation is depression which can worsen many conditions that seniors suffer from such as chronic pain, diabetes, heart disease and dementia.

Isolation can happen for a variety of reasons—some by choice and some as a result of unexpected events. The death of a spouse often leaves the mate feeling alone and so sad that they can’t bear to keep up their old friendships with others. It’s also not uncommon for children to live a long distance away leaving get-togethers something that happens during the holidays or vacations. Getting older with now impaired vision or hearing can prevent a senior from driving and thus limit opportunities to get out. Problems with urinary incontinence may make it seem inconvenient to go anywhere and sleeping issues at night may make daytime drowsiness a deterrent from outside activities. If there are any safety issues with crime in the neighborhood, the senior may be reluctant to leave their home.

If you know or care for a senior living alone, there are things you can do to help prevent their isolation from the community. Encourage them to stay connected whether by phone or email or Skype. Make sure to regularly schedule and keep doctor and optometrist appointments so that vision or health problems are dealt with and won’t keep the senior house bound. Encourage involvement with others, whether it’s the local senior center or church group. If transportation is a problem, check into public transportation or community based volunteer drivers.If your senior is capable of and interested in caring for a pet it can give them a sense of purpose. It’s amazing how many people you meet just out walking the dog! You may also consider hiring a companion from a home care agency to assist with transportation and running errands or simply to provide some social contact and interaction. Small changes add up and make a big difference. Social isolation doesn’t happen overnight and can’t be remedied overnight. Do you have any tips on how to keep your loved one involved in life? Share below and visit us at www.trilliumhomecare.com

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Aging and Sleep

When we’re young we often burn the candle at both ends when it comes to our sleep habits. We stay up late watching TV, socializing with friends, or doing schoolwork and then get up the next morning and go to work or school. Weekends are “catch-up time” with some power sleeping —-or not. Somehow we survive these erratic sleep habits. That all changes as you get into your senior years and sleep becomes much more important. It allows your body to restore its energy levels and it refreshes the immune system so it can help prevent disease as we age. In addition, sleep improves concentration and memory function. As you get older your sleep changes and you can’t bounce back from lack of sleep as you once did. Your body produces less melatonin so you wake up more often at night. In addition, an aging internal clock makes you wake up earlier in the morning while making you sleepier earlier in the evening. You generally need more time to fall asleep and any noises you hear at night may awaken you more readily than when you were younger. The problem is that as you age you still need seven to nine hours of sleep at night, just as you did in your early adult life. According to the National Sleep Foundation, almost half of older adults experience insomnia at least a few nights per week. In the over 65 age group, 13% of men and 36% of women need more than a half hour to fall asleep.

As you get older, there are a lot of factors that can directly affect your sleep. Most seniors are dealing with multiple health issues such as arthritis, heartburn, lung disease, or heart problems and the pain and discomfort they result in can keep you awake at night. These health issues are usually accompanied by a litany of medications and they too can affect the quality of sleep. These medications include anti-depressants, diuretics, decongestants, and high blood pressure medications. Psychological issues like depression and neurological illnesses like dementia are an additional source of sleep problems.

There are steps you can take to ensure a good night’s sleep. Many of them are simple lifestyle changes such as avoiding caffeine and alcohol at least 6 hours before bedtime and not eating heavy meals late in the day. Sticking to a regular schedule for going to bed and getting up in the morning (even on weekends) gets your body into a regular routine. Getting regular exercise reduces stress and according to the Feinberg School of Medicine results in dramatic improvement in the quality of sleep. Limit the amount of liquids you consume for a couple of hours before you go to bed. Getting up to go to the bathroom is the major cause of waking at night for seniors. If you make these changes yet are unsuccessful in getting a good night’s sleep, it’s time to talk to your family doctor. Do you have any good sleep tips to share? Visit us at www.trilliumhomecare.com


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Falls Don’t “Just Happen”

As caregivers, I’m sure every one of us has a story they can relate about a senior or loved one who’s fallen and hurt themselves badly. In fact, among the elderly, falling is the major cause of injury and hospital admissions. According to the Centers for Disease Control, one in three adults in the over 65 age group will fall in any given year. These falls are the leading cause of both their fatal and nonfatal injuries with fractures of the spine, hip, and forearm taking the lead. Statistically, in the over 75 age group, falling more often then not results in an admission to a long term care facility for a year or longer. These are pretty frightening statistics.

We’re all pretty familiar with tips about how to prevent falls in an elderly person’s home. Making the home safer by eliminating hazards is the first line of defense since over half of all falls happen at home. Some things we need to do include tacking down loose carpets, removing any clutter from stairways and floors, installing railing in all the stairways, and making sure there is plenty of bright light in the home. We can also make additional modification to the home by installing grab bars near the toilet and in the shower/tub area. Shower chairs and transfer benches allow a senior a safe stable way to get in and out of the tub.

Besides modifying the home for safety issues it’s also important to try to determine what other factors may contribute to your loved one’s risk of falling. If your loved one is inactive they will certainly have muscle weakness. This lack of strength and flexibility is a very strong risk factor for falling. Helping them do some weight bearing exercises can reduce this risk. Vision problems like glaucoma and cataracts can contribute to falls. Make sure your loved one has a regular eye exam. Some medications can cause dizziness or confusion and should be discussed with the family doctor if you suspect this is happening. Proper nutrition to get adequate vitamin D and calcium can lower the risk of hip fractures. These are all steps you can take as a caregiver to help prevent falls. Just remember that falling isn’t an inevitable part of getting older. There’s a lot you can do to prevent these falls. Do you have any other tips? Share below and visit us at http://www.trilliumhomecare.com

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Senior Health and Depresssion

If you care for a senior you need to be on the lookout for signs of depression. With older adults, health issues and depression are often involved in a vicious cycle. Because many seniors deal with chronic health issues and pain on a daily basis, they end up being depressed. To complicate matters, depression can be manifested in seniors through increased aches and pains. It’s like the old question, “which came first, the chicken or the egg?” This problem is further complicated by the fact that many seniors take an assortment of medications to deal with their health issues. These medications also play a role in their depression.

Some of the signs of depression to look for in your loved one include a lack of energy or motivation, any aches and pains that can’t be explained or have become increasingly aggravated, problems with memory, increased irritability, and slowed speech or movement. Be especially mindful of any lack of personal care on their part. Are they eating regularly, taking their medications, or neglecting their personal hygiene?

A variety of medical issues can lead to depression or make it worse. Among them are Parkinson’s disease, thyroid disorders, dementia and Alzheimer’s disease, multiple sclerosis, or a vitamin B12 deficiency. Many prescription drugs also play a major role in causing depression. Included in the list of culprits are beta-blockers that treat high blood pressure, corticosteroids for lupus and rheumatoid arthritis, drugs to treat Parkinson’s, hormones for post-menopausal symptoms, and proton pump inhibitors to treat GERD.

As a caregiver you need to know that depression is not a normal part of aging. If you suspect that your loved one may be dealing with depression, no matter what you think may be causing it, it’s time to talk to the doctor. Perhaps a chronic condition can be better managed. If you suspect medication to be the culprit, your doctor may recommend something else. You can help your loved one by getting them involved in some social activities or encouraging them to follow interests or hobbies they once had. Make sure they eat properly and help them get some exercise. Don’t just assume it’s all part of getting older. Do you have any tips for dealing with a loved one’s depression? Comment below and visit us at: http://www.trilliumhomecare.com

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The Spring-Time Visitor

Now that it’s officially Spring, although you wouldn’t know it judging by the temperatures, it’ll soon be time for all the door-to-door salesmen to make their appearances in your neighborhood. Not all door-to-door salespeople are scammers, but many unfortunately are. If your elderly parent or loved one lives alone there are some alarming statistics you need to be aware of. According to the Federal Trade Commission, over 25 million Americans are victims of fraud every year. Over thirty percent of them are seniors despite the fact that they make up only eleven percent of the population. According to AARP seniors make especially good targets for a variety of reasons. For one thing, they’re easier to get to since more of them are at home at any one time than other age groups that aren’t retired. Statistically, they’re widows or widowers who may be lonely and more receptive to someone striking up a friendly conversation. Most importantly, older people own more than half of the assets, such as homes and savings accounts, in the United States. This all makes them the perfect target of scammers.

There are some warning flags to look for when that smiling face tries to sell you a magazine subscription or warns you that there are some exterior repairs your home needs that you didn’t know about. And don’t forget the uniformed “utility workers” offering the free energy audit. Be cautious about what personal or financial information is revealed if you hear any lines similar to these:

*This is a limited time offer and you need to act fast.
*You need to pay up front.
*We’re working in the neighborhood and noticed you have a problem.
*The price is discounted because we had leftover materials from a job down the street.
*We can take care of the paperwork when the job is done.
*If I sell the most, I’ll win a prize.

No matter what, don’t let a stranger into your home and be aware that all legitimate sales offers include documentation. This includes identification for both the sales person and the “company” they represent and a permit if required by the city you live in. Be sure there is a written contract and all the terms are spelled out clearly, including price and warranties. If you are inclined to being a soft touch, just don’t answer the door to strangers. No one’s life has ever been negatively impacted by not responding to a door-to-door salesperson. Be safe. Share any tips you may have and visit us at http://www.trilliumhomecare.com

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The Flower Shop

I was at the florist last weekend to order flowers for a special occasion. While there I noticed an elderly lady looking over the pots of daffodils and tulips. We struck up a conversation and she confided in me that she needed some flowers to boost her spirits. It has been such a long and cold winter that she just needed a reminder that spring really is coming. As we talked, she told me she could count on one hand how many endless winters like this one she had seen in her ninety two years. After she made her purchase, she asked if I would help her to her car. She had one of those four-pronged canes in one hand and a pot of daffodils in the other. I took the flowers from her and offered her my arm for support as we walked through the door, chatting the whole time and marveling at the warmth of the sunshine. She pointed out her vehicle, a massive old model Grand Marquis. As we approached the car she suddenly exclaimed “Oh no honey, I drove!” I had automatically escorted her to the passenger side, assuming someone had driven her to the florist and was waiting for her in the car. After making our way to the driver’s side she fumbled in her purse for her keys and I helped her get in, loading her daffodils and the cane on the passenger seat. We said our good-byes and I stood in dumbstruck silence noticing a variety of scratches and dents as she drove away. I kept thinking “there’s an accident, just waiting to happen”.

Hopefully, that lovely lady made it home in one piece and without incident. It seems to me that somewhere along the line a family member or friend should talk with her about assessing her driving. As you reach your senior years, at some point you may need to limit your driving or stop altogether. There are so many issues that can limit the ability to drive. Reaction time slows with age and mobility problems can make it difficult to look over your shoulder to change lanes or move your leg back and forth from the gas pedal to the brake. In addition, vision declines leaving many seniors to deal with glaucoma, cataracts or macular degeneration. Hearing problems would make it harder to hear the warning sounds of honking horns or ambulance sirens. Combinations of medications can affect the senses and reflexes. Everyone ages differently and some can drive later in life than others but if you have a senior in your life, it may be time to assess their driving. It certainly wouldn’t hurt to start that conversation before they got to the flower shop! Visit us at http://www.trilliumhomecare.com"

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A Test for Alzheimer’s

Earlier this year Ohio State University Medical Center released the Self-Administered Gerocognitive Examination (SAGE). This self administered test is meant to identify individuals with mild thinking and memory issues at an early stage. That’s really important because cognitive changes that are caught really early can be treated much earlier and generally have better treatment outcomes. This fifteen minute test can be taken at home and involves simple tasks like making change, listing items, making comparisons, and drawing geometric shapes. These activities test reasoning, problem solving skills and memory. When the Journal of Neuropsychiatry and Clinical Neurosciences released the study about the SAGE test, the demand for the test online was so huge it crashed the computer server at Ohio State University. That underscores the need for easily accessible and useful testing for cognitive issues like Alzheimer’s and other forms of dementia. Dr. Douglass Scharre, the neurologist who developed this simple test, claims it is just as accurate as other commonly used but lengthier and more complicated cognitive tests.

All this being said, you need to be aware that all the media hype surrounding this test is just that — hype. This test by itself can’t formally diagnose Alzheimer’s disease nor any other forms of dementia. At worst, you could interpret the results as a false positive and panic that you’re getting dementia. At best, it can identify some possible cognitive issues that may be developing. It could then serve as the needed push to have a frank conversation with your doctor. Taking the test can also provide a baseline for comparison with later testing. It can flag problems that can be monitored over time. Your family doctor remains the first and best source of information and evaluation of any cognitive issues that arise. How do you feel about taking a self-administered test for dementia? Share below and visit us at http://www.trilliumhomecare.com

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Mobility Matters!

As we get increasingly older, mobility is really important. And I’m not talking about cell phones. If you think about it, everything you do and every experience you have is very much related to how well you can move about. Movement translates into independence and that in turn reflects on quality of life. As we and our loved ones age it becomes increasingly clear what a devastating effect a simple fall can have on our lives. According to the National Institute of Health there are over 300,000 people admitted to hospitals every year for broken hips which are often caused by falling. According to the U.S. Center for Disease Control one out of every three Americans over the age of 65 falls each year. In seniors between the ages of sixty five and eighty four, these falls are responsible for eighty nine percent of fractures they receive. Those are alarming statistics. If you do nothing to stay active and don’t take measures to remain mobile it’s possible to lose up to forty percent of your muscle mass by the time you are eighty years old.

Fortunately, there are things you can do on a daily basis to keep from becoming a statistic. Small changes in your every day life can make a difference. Try to incorporate some of these practices in your routine and you’ll be rewarded with improved mobility and increased strength.

*Use the stairs whenever possible.
*Park you car in a spot further from the store.
*Exercise during TV commercials. You can practice getting up and sitting down or do calf stretches.
*Squeezing a small rubber ball repeatedly with one hand can help improve grip strength.
*Practice standing on one leg while holding on to a chair or standing at the kitchen counter.
*Switch up the way you do your daily activities. Try washing dishes or shaving with the hand you don’t normally use.
*To help improve balance, walk heel to toe down a hallway.
*Practice getting up and down on your tippy toes when reaching for something in the cupboard.

You don’t have to have a lot of free time for exercise sessions. Look around your home to see how you can force yourself to move more. It takes time to build your strength and increase your fitness level so be patient and don’t give up. As you become more mobile you’ll naturally want to do more and will be more inclined to go places and do things. Sounds good, doesn’t it? Do you have any tips for being more active at home? Share below and visit us at http://www.trilliumhomecare.com

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The Successful Caregiver

We all come to the role of caregiver in a variety of ways. Some of us are thrust into this role when someone we love has a medical crisis and needs us to care for them until they are better and can return to their former healthy status. Some of us start out by gradually taking on more responsibilities for an aging parent as they become less able to handle daily activities. And then there are those of us who have a family member or loved one who is dealing with a chronic condition or illness and who will always need some extra support. Regardless of how we come by our caregiver role, the goal is always the same. We’re trying to help our loved ones live as independently as possible and with the best quality of life as possible.

Being a caregiver is a very demanding and often stressful job. It takes a lot of physical, emotional, and mental energy and can lead to incredible fatigue, anxiety, illness, and ultimately depression and burnout. That’s the bad news. The good news is that there are things you can do to become a more effective and successful caregiver without compromising your own health and well being.

Educate yourself. Take a crash course in your loved one’s illness or condition. Remember the old adage “Knowledge is Power”. This is one of the most important things a caregiver can do. The more you know and understand about what your loved one is dealing with, the more you can successfully handle any challenges or changes in their health. This includes keeping an open line of communication with their doctor or health care team.

Take care of yourself. If you are worn out and/or physically ill, you certainly can’t be much help to anyone else. Being a caregiver is demanding work so you need to eat a nutritious diet, get enough sleep, and get some exercise. Don’t give up a social life. The last thing you need is to become isolated. Know your limits and don’t try to do more than you can in any given day. Be realistic about what you’re trying to get done. Try to schedule some “me-time” to help you relax.

Ask for and accept help. Tap family and friends for any help they can give you no matter how incidental it may seem. If they can run some errands for you or cook a meal, it’ll be less on your plate for a change. Don’t try to do everything by yourself. The goal is to keep from being overwhelmed and feeling trapped. Consider using the services of an experienced home care agency, even if on an occasional basis. This would give you a well needed and deserved break and an opportunity to recharge your battery. Just remember to ask for help before you are overwhelmed. Do you have any tips on being a successful caregiver? What has helped you? Share below and visit us at http://www.trilliumhomecare.com


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