Tag Archives: Seniors

News Flash! Our Seniors are Drowning in Drugs

I recently attended a conference and listened to a geriatrician share that the average number of medications her patients are on when they come to her practice is a shocking 18 – 24.  That’s per DAY! No doubt we have a serious epidemic in this country – our seniors are drowning in drugs.

According to the National Institutes of Health, although the term polypharmacy has evolved over time and is often used to mean many different things in different situations, its basic definition is quite simple;  more drugs are prescribed or taken than are clinically appropriate. The specific number of drugs taken is not itself indicative of polypharmacy as all of the drugs may be clinically necessary and appropriate for the patient; however, as the number of prescribed drugs increases, so do the chances of Polypharmacy.   The most worrisome consequence of polypharmacy is the occurrence of adverse drug reactions (ADRs), in addition to increased drug costs and patient quality of life are also significant issues.  The elderly population, which often suffers from multiple chronic diseases requiring multiple medications, continues to increase. These patients are much more likely to experience Polypharmacy and its negative consequences, especially ADRs.

ADRs are one of the most troubling issues surrounding medication use in the elderly, as this patient population is more likely to have poor outcomes than others.  ADRs affects approximately 10-20% of hospitalized patients and around 7% of the general population; this number increases when the population of interest is limited to the elderly.

The consequences of drowning in drugs are greatly exacerbated by the dramatic rise in older adults living with dementia.  Not only are they taking too many drugs, but often they are not taking the drugs as prescribed.  Statistics also point to a very low percentage of drugs to treat AD and other forms of dementia as being effective – less than 10% have positive outcomes.

Healthcare professionals across the spectrum are faced daily with the challenges of helping these older adults and their families sort through their medication maze.  It’s simply not easy when drugs are being prescribed on top of one another.

If you or a loved one are facing these challenges, find a healthcare professional who is compassionate and willing to sort through the maze of medications.  It will involve bringing in all prescribed medications, supplements and being willing to patiently partner with a caring healthcare professional.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  

http://www.AGEucate.com

 

Noise Pollution and Older Adults – A Real Health Hazard


When was the last time you walked into a restaurant hoping for a relaxing dinner only to feel like you were in the middle of a rock concert, and a bad one at that?  You’re not alone.  Noise pollution is a real health hazard, especially for older adults.  Yes, I’m in the AARP club myself, but don’t consider myself “old” (and not sure when that starts)  but I’ve noticed how noise has affected me as I’ve aged.

The EPA (Environmental Protection Agency) defines noise pollution as “unwanted or disturbing sound,” explaining that “sound becomes unwanted when it either interferes with normal activities such as sleeping or conversation or disrupts or diminishes one’s quality of life.  The annoyance can have major consequences, primarily to one’s overall health.”

Studies show that noise can have a direct and immediate effect on a person’s health.  Older adults are especially at risk simply because as human’s we often react with a “fight or flight” response.  With prolonged or obtrusive noise, physiological changes actually are taking place in the nervous, hormonal and vascular systems, resulting in potentially long-lasting consequences.

What can exposure to the constant and excessive level of noises cause to our health?  Stress-related illnesses, high blood pressure, speech interference, sleep disruption, depression and lost productivity, to name just a few.  Noise pollution is serious business.

The World Health Organization (WHO) identified the following categories of  adverse health effect of noise pollution on humans:

  1.  Hearing Impairment due to noise-induced hearing loss is the most common and often-discussed health effect.  This may be accompanied by abnormal loudness perception, distortion or tinnitus, which is inflammation of the ear.  Tinnitus may be temporary or may become permanent after prolonged exposure.
  2. Interference with spoken communication;  Noise pollution interferes with the ability to comprehend speech and may lead to a number of personal disabilities, handicaps and behavioral changes.  These might include problems with concentration, fatigue, uncertainty, lack of self-confidence, irritation, misunderstandings, decreased working capacity, disturbed interpersonal relationships and stress reactions.
  3. Sleep disturbances:  Uninterrupted sleep is known to be a prerequisite for good physiologic and mental functioning in healthy individuals.  Environmental noise is one of the major causes of disturbed sleep.  When sleep disruption becomes chronic, the results are mood changes, fatigue, depression, a decrease in quality of performance and other long-term effects on well-being.
  4. Cardiovascular disturbances: The nervous system can be temporarily, and even permanently affected by noise, acting as a biologic stressor, triggering a negative response to the cardiovascular system and increasing the risk of cardiovascular disease.
  5. Disturbances in mental health;  Noice can accelerate and even intensify the development of mental disorders;  however, it is not a direct cause of mental illness.  The elderly and those with underlying depression may be particularly vulnerable to these effects because they may lack adequate coping mechanisms.
  6. Impaired task performance: Noise pollution impairs task performance at school and at work, increases errors, and decreases motivation.  Reading attention, problem solving and memory are most strongly affected by noise.  Two types of memory deficits have been identified under experimental conditions; recall of subject content and recall of incidental details.

Older Adults are often at risk for increased vulnerability to noise pollution due to slower mental processing and sensory changes that take place in the aging process.  Persons living with dementia are at an even great risk as they often struggle with processing what is going on in their environment, decreasing stimuli can decrease certain behaviors.  Turning off the TV or radio in the evenings and reducing chatter or at any time you want them to wind down may help decrease agitation.

For care communities, shift change if often met with noise and chatter of oncoming and off going employees.  Even shuffling of papers during this busy time can add to agitated behavior, especially with persons living with dementia.

Not all noise is detrimental.  In fact, calming background music and can have a positive effect on mood, relaxation, reduced anxiety, and agitation.  This is especially true for meal times or helping to induce sleep before naps or bedtime.

Understanding sensory change in older adults, especially those living with dementia is critically important for care partners working in elder care communities, home care providers, families and for businesses who serve older adults.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and creator of the Dementia Live® simulation and awareness training being implemented by providers across the US and internationally.  

http://www.AGEucate.com

 

Holiday Traditions…Accepting Change and Transition

or christmas cooking and kitchen utensils on wooden table, top view

I love traditions, especially holiday traditions.  Being from a large Italian/Norwegian family food played a big part in these traditions.  We didn’t just make a few dozen Christmas cookies.  We made hundreds and hundreds of cookies.  The Friday after Thanksgiving was when the season’s serious cookie baking kicked off.

My mom and I would gather the old family recipe cards, many which were already decades old by that time.  We’d gather our shopping list, pull the tins (that were only used for Christmas cookies), clear the kitchen table and enthusiastically start the month long activity of creating sugary, buttery, nutty, chocolaty, almondy, gingery, cinamonny wonders.

My dad was only allowed the burned or “seconds” cookies, which he looked forward to at least one or two from each batch.  Other than that, the cookies were layered in tins and frozen, and not to be touched until Christmas eve.

As our family evolved, kids married and moved away,  Christmas gatherings were no longer always in the high double digits.  But for some reason, even when I too was married and starting my family, there was always the sense that it wasn’t Christmas without truckloads of cookies being lovingly created.  As the years past, I had to get a grip on the fact that 600 cookies was not necessary for a family of four, even with many plates for friends, shut-ins and church  events.

Traditions are certainly important.  They remind us who we are and they give us an identity and purpose in this big crazy world.  Accepting that traditions can evolve is also very important, or it can lead to feelings of disappointment and sadness.

How can we keep traditions alive while adjusting to changes in life, circumstances, and the people with whom we share these life memories?

Here are some suggestions that I came to grips with as my own parents aged and as physical and cognitive decline made us look at holidays at what was important.

  • Accept that change is a part of life, and be open to trying something new and different.  Wow, this was tough for me, but when I did – guess what?  It made me feel free.  Instead of a small shipload of cookies, I was happy to bake just my very very favorites.  In doing so, I freed myself up to enjoy other things during the Christmas season that I enjoyed.
  • Decide what is important and make that a priority, but know you may have to scale back.  Attending Christmas church services and festivals was and always will be at the core of my joy during the season.  As my mom’s Parkinson’s disease progressed, it became difficult to get out, so we chose just a few simple services and concerts that were more manageable and enjoyable for both of us.
  • Big is not always best.  In fact, I can say with conviction that in the years I’ve shared this with caregivers, it is almost a universal fact that if we focus on quality, quieter visits, it becomes much more enjoyable that large boisterous crowds.  We think that is a gift, but in actuality, most older adults begin to feel very overwhelmed and anxious is this environment.  So instead of ALL the family, set aside small bits of time to enjoy your loved one with conversation, touch and just the joy of presence… that is preserving the moment.
  • Accept last minute plan adjustments.  Illness, disability, cognitive decline or any other number of circumstances may mean that a holiday plan may need to be canceled or changed.  This is called life, and if we accept it with grace, it will be less stressful on caregivers, families and your loved ones.  Sometimes these unexpected changes are actually blessings in disguise for accepting what may be a new normal.

It has been 10 years since my mother’s passing, and while I hold these traditions near and dear, I have also been able adopt new traditions with my family that make life all that much richer.  My hope is that you may do the same.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who care for them.  

www.AGEucate.com

 

 

 

When Disaster Strikes – Are you Prepared to Care for Your Loved One?

The devastation we are witnessing in the wake of Hurricane Harvey is a reminder that we must all be prepared to care for a loved one, elderly or  disabled neighbor or friend when disaster strikes. Here is a list of 6 basic yet vital precautions that everyone should have in place, especially in the event of a natural or manmade disaster:

Communications Plan

How will you communicate with immediate and extended family members in the event of an emergency?  These discussions should include how to get in touch with neighbors, friends, a loved one’s church or other support systems that are in place.

If your loved one lives in a community setting,  discuss what response and evacuation plans they have in place, including their designated emergency shelters.

Prepare a comprehensive Healthcare and Medication Record that includes but is not limited to:

A healthcare record lists chronic illness, allergies, immunizations, disabilities, doctors and hospitals and emergency contact information (names, relationship and cell phone numbers of family members and/or primary caregivers).

Families can maintain this list on a spreadsheet and share electronically with family members, but also know that a hard copy should be accessible to first responders in  the elderly person’s home.  Placing a decal on the refrigerator door is advisable with all information kept in a baggie or vial inside the refrigerator.  Vialoflife.com is an excellent project and their website has valuable forms, tips and resources.

Have an emergency/escape plan in place

Talk with your loved one about what to do in case of emergency.  Write out simple, clear instructions where it is can easily be read.  If your loved one has any level of cognitive impairment and lives independently, a disaster can cause immediate confusion and anxiety.  In this case,  plans should immediately include receiving aid from someone else.

Emergency supply kits

Three days of food and non perishable food items are advisable to include in case of disaster.  Other items recommended include but are not limited to portable, battery powered radio, flashlight, sanitation and hygiene items, clothing, blankets, cell phone and charger, whistle and photocopies of identification, emergency contacts and healthcare/medication records.   If your loved one has any level of cognitive impairment, make sure food items are easy to open, kits are well marked and simple instructions included.

Plan for pets

Find out what veterinarians and pet services are available to shelter animals in emergencies.  Include in personal information phone and contact information of pet services in the area.

Learn CPR and train on using an automated external defibrillator (AED).  These classes are free and can save someone’s life.  Go to www.redcross.org for training information.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those that serve them.  

www.AGEucate.com