Posts Tagged ‘health inquiries’

Communication with an Alzheimer’s Patient

Sunday, October 31st, 2010

It is a common symptom for an Alzheimer’s patient to get confused or forget words as the disease progresses. They may also speak less clearly in general. Understanding the needs of these patients can become challenging for caregivers as well as loved ones. The patient may also have difficulty interpreting the communication style of others. It is important to practice verbal and nonverbal techniques which take into consideration a patient’s unique circumstances; this can help break the communication barrier.

At the start of the conversation, identify yourself by name AND the loved one as well. This sort of to-the-point clarity can be soothing to Alzheimer’s patients as many experiences difficulty in identification of people as the disease progresses.

Always use a quiet and relaxing tone of voice when speaking to your loved one. Speak slowly and enunciate clearly. When asking a question, asking ONE question at a time, insuring to use the same wording if the patient asks you to repeat. Avoid references that may be confusing to the patient such as pronouns; avoid metaphors as well since the patient might interpret as literal.

It is important to approach an Alzheimer’s patient in a way that is non-threatening. This is a basic way to improve communication between you and the patient. Simply approaching the patient from the front rather than from behind removes uncertainty the patient may have regarding you and the general environment. Try to maintain calm and peaceful surroundings with a minimal amount of background distractions; this is to help avoid disorder or chaos. When speaking to your loved one, demonstrate sincerity by talking face to face, maintaining eye contact and using facial expressions to reflect the sentiment behind your conversation. Smiling, hugging or touching is EXCELLENT non-verbal communication that is gentle and should be well-received by the patient.

While visiting with the patient, be careful not to startle him or her; move about slowly and clearly explain what you are doing. Try to be sympathetic to what your loved one is trying to say to you through words and expressions.

Caregivers and loved ones of Alzheimer’s patients sometimes feel weighed down by the extreme personality and mood changes that are affecting the patient. Effectively dealing with these changes involves being instinctive and adjusting your own communication style to accommodate the changing needs of your loved ones.

Always remember that when speaking to an Alzheimer’s patient to speak clearly and concisely and be calm.

More on Arthritis

Wednesday, October 27th, 2010

Testing, or diagnosis, of arthritis might include:

  • Obtaining a detailed history to conclude if arthritis or another musculoskeletal problem is the cause of the symptoms.
  • Thorough physical exam to see if fluid is collecting in the joint (effusion); the joint might be tender when it is gently pressed and may be warm and red. It may also be painful or difficult to rotate the joints in some directions. This is known as limited range of motion (ROM).
  • Blood tests
  • X-rays
  • Extraction of fluid from the joint for further exam

Testing, however, will depend on the individual circumstances.

Medications without a prescription can include:

  • Acetaminophen (Tylenol) as a pain reliever; this is usually the first course of treatment that is used instead of a prescription.
  • Aspirin, ibuprofen or naproxen are used as an over the counter, nonsteroidal anti-inflammatory drug (NSAID). This will help reduce swelling and inflammation.

Prescription medications may include:

  • Biologics~most recent breakthrough for the treatment of rheumatoid arthritis. Such medications include etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) and they are administered by injection and can improve quality of life.
  • Corticosteroids (steroids) ~these are medications that suppress the immune system and inflammation. This is another injection and it is injected into the affected joint.
  • Cycloonygenase-2 (COX-2) inhibitors~these drugs block and inflammation-promoting enzyme called COX-2. This class of drugs was initially thought to work as well as traditional NSAIDs, but with fewer stomach problems. There have been numerous reports of heart attacks and stroke and this has prompted the FDA (Federal Drug Administration) to re-evaluate the benefits. Celecoxib (Celebrex) is still available but labeled with strong precautions.
  • Immunosuppressants~these drugs like azathioprine or cyclophosphamide are used for serious cases of rheumatoid arthritis when other medications have failed.

It is important to remember to take all medications as directed; if any difficulty is experienced, it is important to talk with the doctor. Do not stop taking medications unless directed to do so by a physician.

Check back on Thursday, October 28, 2010 for more information on Arthritis

Breast Cancer Screening

Saturday, October 23rd, 2010

Breast cancer screening simply means checking an individual’s breasts for cancer before there are signs or symptoms of the disease.  There are three tests used to screen the breasts for cancer. Talk to your doctor to determine the correct one for you and also when you should have them.

  • Mammogram: This is an x-ray of the breast. This is the best method for detecting breast cancer early. The earlier it is detected, the easier it is to treat. Having regular mammograms can lower the risk of fatal breast cancer. If you are 50-74 years of age, it is recommended to have a mammogram every two years.
  • Clinical Breast Exam: This is an exam by a doctor or nurse, who uses their hand to feel for lumps or other changes.
  • Breast Self-Exam: This is when an individual checks their own breasts for lumps, changes in size or shape of the breast, or any other changes in the breast or underarm.

Performing a breast self-exam or having a clinical breast exam have not been found to decrease the fatality risk of breast cancer. Presently, the most accurate way of detecting breast cancer is through a mammogram.  If you choose a clinical breast exam or self-exam, be sure to get regular mammograms.

Getting screened for breast cancer can be done at a clinic, hospital, or doctor’s office. If you want to be screened for breast cancer, call your doctor’s office; they can help you to schedule an appointment.

Don’t avoid getting screened; the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) offers free or low-cost mammograms and education about breast cancer. To find out if you qualify, call your local program.

Remember, the whole month of October is Breast Cancer Awareness Month, so remember to check the boobies!

Diverticulitis

Thursday, October 21st, 2010

Diverticulitis is a disorder that comes from diverticulosis, which is characterized by small, bulging pouches in the digestive tract.

These pouches are also called diverticula, and they are common in the United States. Over half of the population older than 60 years of age has them; however, it is not limited to just those over the age of 60 as those younger can get the disorder as well. The pouches don’t always cause problems and many times, people do not know that they are there; however, the pouches can become infected or inflamed (diverticulitis). This can cause severe pain in the abdomen, fever, nausea, and changes in bowel habits. Diverticulitis happens when the diverticula become infected. Cases can range from mild to severe; the milder cases can be treated with antibiotics for the infection as well as rest and diet changes. The more severe cases require hospitalization and in some cases, removal of the affected part of the colon (bowel resection).

There is good news-most people with diverticulosis do not develop diverticulitis. This condition can be prevented by eating a well-balanced diet with food rich in fiber.

Symptoms of diverticulitis include:

  • Pain in abdomen and lower left side
  • Tenderness
  • Fever
  • Nausea
  • Diarrhea and constipation

Other signs considered less common are:

  • Vomiting
  • Bloating
  • Rectal bleeding
  • Frequent urination
  • Pain while urinating
  • Tender abdomen

So what causes this in the first place? Diverticula are formed in weak places in the colon that give way under pressure. Then the pouches, which are about the size of a marble, protrude through the colon wall. The pressure in the colon can lead to infection of the diverticula. It was once thought that nuts, seeds, corn, and popcorn were to be avoided by those who had diverticulosis; however, recent research has shown that not to be the case and in fact, a higher intake of nuts and corn could possibly help to avoid diverticulitis in male adults.

Diagnosis is usually by CT scan and its 98% accurate in diagnosing diverticulitis. Other diagnostic studies include barium enema and colonoscopy; however, these are only done when the inflammation has subsided due to the possibility of perforation.

Flu in the Elderly

Saturday, October 9th, 2010

The flu puts the elderly and those with chronic diseases at risk for problems associated.  Those 84 and older are at the greatest risk, age 74 and older, the second highest, and children age 4 and under is the third highest risk.

The flu symptoms in the elderly may include:

  • Fever
  • Headache
  • Fatigue (can last 2-3 weeks)
  • Extreme exhaustion
  • General aches and pains
  • Chest discomfort, cough (can become severe)
  • Sore throat (not always)
  • Runny or stuffy nose (not always)

Although more common in children, the elderly can also suffer from symptoms like nausea, vomiting, and diarrhea with the flu; however, these symptoms tend to be more common with the swine flu.

Complications of flu in the elderly may include:

  • Pneumonia
  • Dehydration
  • Worsening of chronic medical conditions such as asthma, emphysema, and heart disease (Congestive Heart Failure)

It’s important to see your doctor immediate if you have any of these flu complications. The sooner you start medical treatment, the faster it can work to treat the more serious symptoms.

The best way to prevent the season flu is to get a flu vaccine annually. Getting a season flu shot helps reduce the risk of being hospitalized due to serious complications, however, the season flu viruses change each year, so the elderly need to get a new flu shot each fall. Flu shots can be obtained at your doctor’s office, drug stores, and various other locations.

The American Lung Association offers an online flu shot. Please visit here and enter your zip code and a date and you will receive information about flu shot clinics in your area.

Reporting Abuse

Thursday, October 7th, 2010

Are you an elder who feels you are being abused, neglected, or exploited? Then tell at least one other person that you trust—your doctor, a close friend, or a family member. Other people care and can help you.

There are thousands of reports of elder abuse recorded by authorities every year; the majority of those reported are proven true. This number is only the tip of the iceberg; according to data from different states, for every case of elder abuse reported, there are about a dozen more that go unreported. There is a great need for people to report suspected abuse.

In every state, physical, sexual, and financial abuses that target elders violate laws against assault, rape, theft, and other offenses are punishable as crimes. With some variation among states, certain types of emotional elder abuse and neglect are subject to criminal prosecution, depending on the perpetrators’ conduct and intent and the consequences for the victim.

States do differ on who is required to report suspected elder abuse (there is no federal standard), though the categories of mandatory reporters are expanding. Typically, medical personnel, nursing home workers, police officers, emergency personnel, public officials, social workers, counselors, and clergy are listed as mandatory reporters. That responsibility is spreading to financial institutions and other people that work with senior citizens.

While it is important for elders to seek help from abuse, either by calling a local agency or by telling a doctor or trusted friend, many seniors don’t report the abuse they face even if they are able to. Many fear retaliation from the abuser, while others believe that if they turn in their abuser, no one else will take care of them. When the caregivers are their children, they may be ashamed that their children are behaving this way or they blame themselves or they just may not want their children to get in trouble with the law.

Please note that the first agency a report of elder abuse goes to in most states in Adult Protective Services (APS). Its role is to investigate the claim, intervene and offer services and advice. Calling the local police department is also a way to get into contact with APS.

National Domestic Violence Hotline: 1-800 799-7233

Check back on Friday, October 8, 2010 for the final installment in this series

Power of Attorney

Friday, October 1st, 2010

Caring for an elderly parent can be draining both emotionally and physically. Many times, adults are taking care of their elderly parent or parents while still trying to raise their own children.

As the parent becomes less independent and unable to care for his or her own needs, it becomes clear that you will have to take the needed steps to ensure that legal, personal, medical and financial interests are protected. One way to do this is to get a power of attorney drawn up so that you or someone you trust can act on your elderly parent’s behalf to make decisions that he or she can no longer make independently.

This is not an easy thing for an elderly parent or the child of the elderly parent. So it is very important to involve the parent in the preparations as much as possible. This leaves the parent feeling less helpless or left out of the process. Honor the parents’ wishes when possible; however, do realize that you are entrusted to act in your parent’s best interest even if the parent disagrees with you. It is also not a good idea to rely on those generic self-help legal software programs. For a delicate matter such as this, an experienced attorney to help decide what needs to be done is the better option. There are many factors that come into play with issues such as a power of attorney such as the present and long-term medical condition of the parent as well as their own personal wishes for how affairs are to be handled. Moreover, do not pressure your elderly parent into making life-changing decisions, especially when he or she is tired, hungry, restless or upset. Choose a time to talk and present the information gradually instead of all at one time. Keep everything relaxed and don’t force the issue.

Check back on Saturday, October 2, 2010 to learn the process of obtaining a power of attorney.

Ways To Improve Heart Function

Tuesday, September 28th, 2010

As people get older, body systems do not seem to work as well as they did at a younger age. This makes it important to take care of ourselves the best we can; diet, exercise, and rest will all help to keep our bodies working well. Unfortunately, sometimes no matter how well we take care of ourselves, illness and disease can take hold of us. In the elderly, it seems that heart problems are prevalent.

Here are a few tips to help keep your heart in tip-top shape:

  • Loose weight~Your heart will not have to work as hard to send blood to all parts of a slimmer body.
  • Avoid hard exercise~This puts a sudden pumping demand on your heart.
  • Engage in mild exercise~Walking or joining a doctor approved cardiac rehab program could help strengthen your heart.
  • Wear loose clothing~Wear clothing that encourages good blood flow in the legs; tight socks or hose with tight tops could slow blood flow to your legs thus causing clots.
  • Avoid extreme temperatures~The body works harder to keep the body temperature normal when you are too hot or too cold.
  • Avoid colds/flus~Try to stay away from those who are sick; also ask your doctor about yearly flu shots and the pneumonia shot.
  • Limit alcohol~Talk with your doctor about how much alcohol is safe for you (though it should be avoided altogether) as alcohol weakens the heart; heart failure could improve if alcohol is eliminated.
  • Get plenty of rest~Your body needs 8 hours of sleep a day.
  • Drink plenty of water~8 (8oz) glasses per day is recommended.
  • Keep legs elevated when sitting~This will help to increase circulation. Having your legs hanging down for extended periods of time can cause the blood to pool in your lower extremities thus putting you at risk for blood clots.
  • Most importantly, LISTEN to your body and on days you feel well, do more and on days you feel sick, do less.

Skin Conditions in the Elderly

Sunday, September 19th, 2010

The main cause of damage to the skin comes from intense exposure from the sun. This damage is caused by the sun’s ultraviolet (UV) rays, which break down elastic tissue (elastin) in the skin. This causes the skin to stretch, wrinkle, sag, or become blotchy. This can also cause pre-cancerous growths or skin cancer.

Other contributing factors such as obesity, stress, or smiling/frowning per day effect skin aging. Remember hearing about how it takes more muscles to frown than smile? Or how about hearing one of your parents saying that your face will receive a certain way? There is a lot of truth as to how facial expressions can affect how elastic your skin is as you age.

Some skin changes that happen as you age include:

  • Rough or dry skin
  • Loose facial skin around the eyes, cheeks, and/or jawline
  • Transparent or thinned skin (skin that looks paper thin)
  • Easy bruising

Common skin conditions in the elderly include:

  • Wrinkles: follows chronic sun exposure; smokers also tend to have more wrinkles than non-smokers
  • Facial movement lines: called ‘laugh lines’ or ‘worry lines’ and these become more visible as you age; can be located at mouth corner, upper cheeks, and around eyes.
  • Dry/itching skin: oil glands are lost as you age so it is important to keep skin hydrated with moisturizer or lotions.
  • Skin cancer: Sun exposure (UV rays) is the most common cause so avoid over-exposure of sun and tanning beds.
  • Age spots: brown patches that appear on body parts (face, hands, and forearms)
  • Bedsores: these are also called pressure ulcers and these occur when you lie or sit in a bed, chair, etc for long periods of time

Can these skin conditions be treated? Unfortunately, nothing can be done to undo sun damage to skin; however, the skin can occasionally repair itself. Here are a few skin healthy tips:

  • Use sunscreen with an SPF of 30 or more
  • Wear a hat and long sleeves when outdoors and sunglasses that block UV rays
  • Avoid the use of tanning beds or sunlamps
  • Examine yourself on a regular basis for any change in moles or any new growths

Researching Home Care Options

Monday, September 6th, 2010

Elderly Care -

When looking into home care for a loved one, it is a good idea to look into all of the options and information you can find.  You of course want to assure that your loved one is properly taken care of and that the person who will be responsible and there when you need them.  You may also want to look into anyone that will be coming into your loved one’s home to assure that they will be respectful and responsible.

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