Are Emergency Rooms Senior-Friendly?

A report from the American College of Emergency Physicians calls for increased training in geriatrics for emergency room personnel, as well as ER features that support the needs of older patients. Researchers examined data from around the world and found that many senior patients experienced functional and cognitive problems after a trip to the hospital after a fall or other health event.

Said study author Dr. Leonard Gray of the University of Queensland in Brisbane, Australia, “These patients have complex profiles before they come to the ER, and even more complicated needs once they get there. Dependence on others and geriatric illnesses, such as cognitive impairment and mobility problems, affect the majority of older emergency patients across a wide range of nations with different health systems and cultural contexts. They require specialized care to avoid missed diagnoses, pressure ulcers and a range of other potential problems associated with this particular population.”

With the growing senior population, more hospitals in the U.S. have established specialized ER facilities for older adults. Said Dr. Gray, “Frailty, confusion and dependence on others make these our most fragile emergency patients. Specialized training in geriatric care and even specialized layout and procedures can help us provide the best assessment and care.”

The study appeared in the Annals of Emergency Medicine.

Source: AgeWise reporting on study from the American College of Emergency Physicians (www.acep.org)

Anxiety Linked to Higher Long-Term Risk of Stroke

Stroke is the No. 4 killer and a leading cause of disability in the United States. The greater your anxiety level, the higher your risk of having a stroke, according to research published in the American Heart Association journal Stroke.

In earlier studies, researchers found that depression was linked to greater risk of stroke. In contrast to anxiety, depression is a persistent feeling of hopelessness, dejection, and lack of energy, among other symptoms. This newer study is the first in which researchers linked anxiety and stroke independent of other factors such as depression. Anxiety disorders are one of the most prevalent mental health problems. Symptoms include feeling unusually worried, stressed, nervous or tense.

Over a 22 year period, researchers studied a nationally representative group of 6,019 people 25-74 years old. Participants underwent an interview and took blood tests, had medical examinations and completed psychological questionnaires to gauge anxiety and depression levels.

Researchers tracked strokes through hospital or nursing home reports and death certificates. After accounting for other factors, they found that even modest increases in anxiety were associated with greater stroke risk. People in the highest third of anxiety symptoms had a 33 percent higher stroke risk than those with the lowest levels.

“Everyone has some anxiety now and then. But when it’s elevated and/or chronic, it may have an effect on your vasculature years down the road,” said Maya Lambiase, Ph.D., study author and cardiovascular behavioral medicine researcher in the Department of Psychiatry at the University of Pittsburgh School of Medicine, in Pittsburgh, Penn.

Lambiase reports that people with high anxiety levels are more likely to smoke and be physically inactive, possibly explaining part of the anxiety-stroke link. Higher stress hormone levels, heart rate or blood pressure could also be factors, she said.

Source: American Heart Association (www.heart.org). The National Heart, Lung, and Blood Institute and the National Institute of Mental Health funded the study.

More Good News About the Health Benefits of Nuts

Nuts might be one of the most misunderstood foods. Many people avoid these delicious, protein-rich treats, fearing they are high in calories and fat. But ongoing studies show the health benefits of nuts. Nut consumption has been linked to heart health and to a reduced risk of cancer, diabetes, bowel disease and several other conditions.

Indeed, nuts offer such a health boost that a research team recently announced that people who ate a handful of nuts each day were 20 percent less likely to die from any cause than were those who didn’t consume nuts! The scientists, from Dana-Farber Cancer Institute, Brigham and Women’s Hospital and the Harvard School of Public Health, examined nut consumption in a large population over the course of 30 years—the largest study of its kind.

Said Dr. Charles Fuchs, director of the Gastrointestinal Cancer Center at Dana-Farber, “The most obvious benefit was a reduction of 29 percent in deaths from heart disease—the major killer of people in America. But we also saw a significant reduction—11 percent—in the risk of dying from cancer.”

Which type of nuts yield the best results? The team found that the reduction in mortality was similar in all the tree nuts—walnuts, hazelnuts, cashews, macadamias, pecans, pistachios and pine nuts. Peanuts, too, were found to have a protective effect.

The scientists also dispelled the commonly held misconception that nuts are a no-no if we are trying to avoid an unhealthy weight gain. In the study, those who consumed nuts were more slender than those who didn’t.

So, we can be forgiven for making the obvious pun: we’d be nuts not to eat nuts!

Source: AgeWise reporting on a news release from Dana-Farber Cancer Institute (www.dana-farber.org)
The information in this article is not intended to replace the advice of your doctor. Speak to your healthcare provider about a diet that is right for you, and if you have experienced symptoms suggesting an allergy to peanuts or tree nuts.

Could Exercise Make You a Better Driver?

According to The Hartford Center for Mature Market Excellence (http://www.thehartford.com/mature-market-excellence) and Exercise for Mature Drivers research from the MIT AgeLab (http://agelab.mit.edu), exercise can enhance certain aspects of flexibility and range of motion for mature drivers.

“Our focus with this research was to examine the impact physical exercise might have on driving skills as you age,” said gerontologist Jodi Olshevski, executive director of the Hartford Center for Mature Market Excellence. “Driving can be essential to older adults’ sense of independence and autonomy. We encourage drivers to consider exercise as one way to stay safe on the road.”

Drivers in the study who were asked to exercise daily for eight to ten weeks reported:

  • greater ease in turning their heads to see blind spots
  • better ability to rotate their bodies further to scan the driving environment
  • better ability to get into their cars.

MIT AgeLab director Joseph F. Coughlin, Ph.D., said that the team located specific driving issues associated with physical aging. Visit The Hartford’s website (www.thehartford.com) to find a detailed list of the beneficial exercises (http://www.thehartford.com/sites/thehartford/files/exercise-for-mature-drivers.pdf ) and a set of informational videos demonstrating four types of exercise that promote better driving (http://www.thehartford.com/mature-market-excellence/exercise-videos).

Source: AgeWise reporting on resources from The Hartford Financial Services Group

 

Understanding Frontotemporal Disorders

The National Institute on Aging offers information about these brain disorders that strike middle-aged adults, causing devastating changes in behavior, personality, emotions, language and movement.

Most Americans are familiar with Alzheimer’s disease. But few are aware of the impact of frontotemporal disorders, the cause of up to 10 percent of dementia cases. Unlike Alzheimer’s disease, these devastating disorders usually strike during middle age. Patients and families struggle to cope with changed relationships and the person’s daily needs.

Frontotemporal disorders are caused by changes in the frontal and temporal lobes of the brain.

The frontal lobes control higher-level thinking, such as planning, prioritizing and multitasking. This area of the brain also is involved in language and in motor functions, such as moving the arms, legs and mouth. The frontal lobes help manage emotional responses and enable people to control inappropriate social behaviors.

The temporal lobes play a major role in language and emotions. This area of the brain helps people speak, read, write and connect words with their meanings. It is involved in recognizing recognize objects, including faces, and in relating appropriate emotions to objects and events. When the temporal lobes are dysfunctional, people may have difficulty recognizing emotions and responding appropriately to them.

Depending on which area of the brain is affected, frontotemporal disorders may cause:

  • Physical symptoms—abnormal movement in hands and feet; tremor; loss of coordination.
  • Loss of language—a decline in the ability to speak, understand language, read or write.
  • Emotional changes—apathy; inappropriate emotional responses; lack of social inhibition.
  • Personality changes—problems with thinking; a decline in judgment and insight; embarrassing and uncharacteristic behavior.

The changes may be subtle at first. Families and friends often report that the patient “isn’t acting like himself.” According to the National Institute on Aging, frontotemporal disorders can be hard to diagnose because their symptoms are similar to conditions such as stroke, depression or other types of dementia. But early diagnosis allows patients to get the help they need and plan for treatment and future care. Family caregivers should learn all they can about their loved one’s condition to reduce frustration and cope with the challenges of caring for someone who is gradually losing many of their abilities.

Treatment to control symptoms

At present, there is no cure for frontotemporal disorders. Treatment cannot halt the progression of the disease, but it can help manage symptoms. Several classes of medications are currently used. Physical, occupational and speech-language therapy help patients with movement and speech problems. Physicians, nurses, social workers, and physical, occupational and speech therapists who are familiar with frontotemporal disorders help ensure that patients have the highest possible quality of life and receive appropriate medical treatment.

For More Information

Family caregivers of patients with frontotemporal disorders face a host of challenges, from day-to-day medical care to handling changing relationships. Visit the U.S. National Institute on Aging website to read “Frontotemporal Disorders: Information for Patients, Families and Caregivers” (http://www.nia.nih.gov/alzheimers/publication/frontotemporal-disorders) online, or call 1-800-438-4380.

Copyright © AgeWise, 2014

June is Scleroderma Awareness Month

Questions and answers from the National Institute of Arthritis and Musculoskeletal Diseases:

Q: What is Scleroderma?

A: Scleroderma is a group of diseases that affect connective tissue in the body. This tissue supports your skin and internal organs. Scleroderma involves tissue that become hard or thick. It can also cause swelling or pain in the muscles and joints. Some types of scleroderma lead to hard, tight skin. Other types affect blood vessels and major organs (such as the heart, lungs, and kidneys).

Q: What causes scleroderma?

A: The cause is unknown. You can’t catch it from other people. Doctors don’t think it is passed through genes.

Q: What are the types of scleroderma?

A: Scleroderma’s main types are localized and systemic. Localized means the disease only affects certain parts of the body, often skin tissues, and does not harm major organs. The systemic type affects the skin, tissues under it, blood vessels, and major organs.

Q: Who gets scleroderma?

A: Scleroderma is more common in women than men. Anyone can get it, even children. Most types show up before age 40.

Q: How is scleroderma diagnosed?

A: Doctors diagnose the disease using the patient’s medical history, a physical exam, lab tests and a skin biopsy. Scleroderma may be hard to diagnose, as other diseases have similar symptoms.

Q: How does scleroderma affect the lives of patients?

A: People with scleroderma may worry about the way their skin looks. They may have problems dressing, bathing or handling basic daily tasks. The disease may also affect a person’s relationships and self-esteem.

Q: How is scleroderma treated?

A: A rheumatologist (a doctor who treats arthritis and other diseases that cause swelling in the joints) may lead the healthcare team and refer the patient to health experts who treat problems with skin, kidneys, heart, digestion, lungs, teeth, movement and speech.

Q: Can scleroderma be cured?

A: At present, there is no cure for scleroderma.

Q: How is scleroderma treated?

A: It’s important for patients to follow the doctor’s recommendations about lifestyle, medication and treatment. Symptoms and damage can be reduced. Patients may receive treatment for:

Raynaud’s phenomenon. This condition affects the fingers, feet and hands, making them change color when the person is cold or anxious. Treatment may include medication and exercises.

Stiff, painful joints. Hard skin around the joints can cause discomfort and loss of motion. Treatment includes exercises, medication and learning to do things in a way that puts less stress on the joint.

Skin problems. With scleroderma, collagen builds up in the skin and can make skin stiff and dry. Treatment consists of creams and lotion, using sunscreen, following the healthcare provider’s advice about protecting skin, and regular exercise. Skin changes can also change how the skin looks, affecting a patient’s self-image. Laser treatment and plastic surgery may fix some skin damage and approve the appearance.

Dry mouth and dental problems. Tight skin on the face makes it difficult to care for the teeth, leading to decay and loss. The dentist can suggest ways to protect and clean the teeth.

Gastrointestinal problems. Problems include heartburn, trouble swallowing, diarrhea, constipation and gas. Patients should follow the doctor’s instructions about nutrition and ways to eat that may lessen the problem.

Lung damage. When the lungs are affected, patients may have loss of some lung function, high blood pressure, fatigue, shortness of breath and other breathing problems. Follow the healthcare provider’s advice and get regular flu and pneumonia shots.
Heart problems. Problems include scarring and weakness, swelling of the heart, and abnormal heartbeat. These problems can all be treated.

Kidney problems. Scleroderma can cause very high blood pressure and kidney failure in some people. It’s important that patients check their blood pressure often and notify the doctor right away if it is above normal.

Source:  The National Institute of Arthritis and Musculoskeletal Diseases (www.niams.nih.gov). Visit their website for more information about scleroderma and other diseases of the joints and skin.

Learn More

The Scleroderma Foundation (http://scfo.convio.net), sponsors of Scleroderma Awareness Month, offers information, resources and support for people who are living with this devastating disease.

The information in this article is not intended to replace the advice of your healthcare provider. Talk to your doctor with questions about your condition.

New Resource Helps Women Take Control of Urinary Incontinence

Over 25 million Americans experience urinary incontinence; most of them are women. Urinary incontinence (UI) is the inability to maintain control over the release of urine from the bladder. Women who suffer from this problem often withdraw from social connectedness and physical activity—both of which are so important for healthy aging. Yet many people think UI is “just part of growing older,” and that nothing can be done.

To dispel this notion, and to help women who are living with UI take charge of their own treatment, the Agency for Healthcare Research and Quality (AHQR) recently released an online, interactive decision-making tool to help women learn more about the causes and treatment of UI. (http://www.effectivehealthcare.ahrq.gov/ehc/decisionaids/urinary-incontinence).

The decision aid materials include easy-to-understand information and four sensitive, informative videos. For example, the well-known Kegel exercises are helpful for many women, but patients often leave the doctor’s office in embarrassment, clutching a sheet of how-to instructions that don’t adequately explain the correct technique—which is especially serious because performing these exercises incorrectly can actually make the problem worse. The AHQR offers a five-minute video of detailed instructions that women can watch in the privacy of their own homes. Other features of the site include a comparison of treatments and a list of questions patients should ask at medical appointments.

Copyright © AgeWise, 2014

How Are Today’s Seniors Adapting to Disability?

Only about a third of Americans ages 65 and older are fully able to take care of themselves and go about their daily lives completely independently, according to a recent study published online in the American Journal of Public Health.

Understanding that there are different ways older adults adapt to disability is a big step in developing public health policies that maximize the quality of life for all older Americans, said the study’s lead author, Vicki Freedman, a research professor at the University of Michigan Institute for Social Research.

Freedman and colleagues analyzed data on a nationally representative sample of 8,077 older men and women, part of the National Health and Aging Trends Study. The National Institute on Aging, part of the National Institutes of Health, funded the research.

Among the findings:

  • About a quarter succeed in accomplishing what they need to do on their own by using walkers or other assistive devices. Another 18 percent say they have trouble even when using these devices.
  • Six percent cope by reducing their activities—bathing or going outside less often, for example.
  • Twenty-one percent manage by receiving help from others.

The study is the first to provide national estimates of ways the Medicare-age population adapts to limitations in daily life.

“Nearly 80 percent of all older adults find ways to manage on their own without assistance from others,” Freedman said. “The group using devices on their own without difficulty is especially interesting. They seem to be able to participate in activities they enjoy and report well-being as high as those who are fully able to care for themselves.”

The researchers asked about seven activities of daily living: going outside, getting around inside, getting out of bed, eating, getting cleaned up, using the bathroom and dressing.

During face-to-face interviews, study participants were first asked whether they used devices or environmental modifications including canes, walkers, wheelchairs, scooters, grab bars, and bath/shower seats and whether they received help from another person during the previous month.

Then they were asked whether they experienced any difficulty doing any of the activities even when they used modifications, and about whether they had changed how often they performed any basic activities over the last year.

According to Freedman, the proportion of older adults able to function independently varies greatly by activity and by age. For example, 90 percent of older adults are fully able to eat by themselves, while only 54 percent are fully able to bathe by themselves. About 45 percent of those ages 65 to 69 are fully able to carry out all activities independently, compared with only 4 percent of those ages 90 and older.

Women are more likely than men to do things on their own by using devices to assist them (26 percent compared to 23 percent). But African Americans and Hispanics are much less likely than whites and Asians to do so. Older adults with low incomes are also less likely to successfully accommodate declines in their functional abilities.

“Two groups that we identified may be especially important targets for public health intervention,” Freedman said. “These are the seven million older adults who have difficulty carrying out activities alone with whatever accommodations they have already made, and the additional 2.1 million who have reduced their activity levels but do not experience or acknowledge that they are having difficulty.”

Source: University of Michigan Institute for Social Research (http://home.isr.umich.edu)

“Savory Salt-Free Seasonings” Wordfind

May is National High Blood Pressure Education Month—a great time to learn about the risks associated with high sodium, and ways to reduce salt in our diet.

Though some cooks fear their culinary creations will taste bland without added salt, you might be surprised at how little you miss it if you substitute other seasonings. And did you know that many spices have health benefits of their own? A spice rack’s worth of herbs and seasonings are hidden in this puzzle. Give your brain a workout and find all 25 of them !

If you need a little help, click here  for the puzzle solution.

Learn More

The American Heart Association recently reported that teaching patients to flavor their foods with spices and herbs is one of the most effective ways to lower salt consumption. Visit their website to find information and recipes to help meet sodium reduction goals. (http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Sodium-Salt-or-Sodium-Chloride_UCM_303290_Article.jsp)

Copyright © IlluminAge AgeWise, 2014

Older Americans Month 2014 Focuses on Senior Safety

Older adults have made countless contributions and sacrifices to ensure a better life for future generations.  Since 1963, communities across the country have shown their gratitude by celebrating Older Americans Month each May. This celebration not only recognizes older Americans, but also demonstrates our nation’s commitment to helping them stay healthy and active.

This year, the event focuses on injury prevention with the theme “Safe Today. Healthy Tomorrow.” The theme focuses on injury prevention and safety to encourage older adults to protect themselves and remain active and independent for as long as possible.

Unintentional injuries to this population result in at least 6 million medically treated injuries and more than 30,000 deaths every year. With an emphasis on safety during Older Americans Month, the U.S. Administration for Community Living encourages older adults to learn about the variety of ways they can avoid the leading causes of injury. Here are some safety tips to help seniors live longer, safer and better!

Talk to Your Healthcare Provider

  • Discuss physical activities that are appropriate for you. Regular exercise helps to improve endurance, strength, balance, and coordination.
  • Learn more about safely managing your medications, activities and lifestyle.
  • Have your vision checked regularly. Your sight plays a large part in preventing injuries at home, on the road, and in the community.

Manage Medications

  • Be aware of how your medications interact with other prescription and over-the-counter drugs, certain foods, alcohol, and other medical conditions.
  • Learn how medications may make you unsteady on your feet or impact your ability to operate a motor vehicle.
  • Create a medication schedule or use a scheduler box to make sure you take no less or more than prescribed.
  • Ask your pharmacist for help. Large-print labels, medication-tracking devices, and easy-open containers may be available.

Prevent Falls

  • Install handrails and grab bars wherever they are helpful, especially around stairs and in bathrooms.
  • Ensure ample lighting inside and outside of your home, particularly around frequently used walkways. Add one or more nightlights between your bedroom and bathroom.
  • Choose shoes with non-slip soles that provide support without bulk that could cause you to trip.
  • Use a walking aid, if needed to improve balance and stability.

Prevent Fires and Burns

  • Set your water heater to 120 degrees. You can also install anti-scald devices on sinks, tubs, and showers.
  • Test smoke detectors regularly. Be sure you have a smoke alarm in or very near your cooking area. Alarms should also be installed in all bedrooms.
  • When cooking, wear snug-fitting or short-sleeve clothing and high-quality oven mitts that cover the lower part of your arms.
  • Do not smoke in your home, especially if oxygen therapy is used.

Drive Wisely

  • Plan your route before you drive and use the safest routes that are well-lit, familiar, and offer easy parking. Daytime driving in good weather conditions is best.
  • Wear your seatbelt, even during short trips.
  • Eliminate distractions inside the vehicle and stay focused on the road.
  • Know when it might be time to limit or stop driving, and learn how to get around town without driving.

Live a longer, healthier life by taking control of your safety today!  Learn more about Older Americans Month at http://acl.gov/olderamericansmonth.

Source:  U.S. Administration for Community Living