Boomer’s Blog

Boomer’s Blog 2018-02-06T23:01:56+00:00

Dr. Mauk’s Boomer Blog

Each week, Dr. Kristen Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.

Dr. Kristen L. Mauk, PhD, DNP, RN, CRRN, GCNS-BC, GNP-BC, FAAN

What is a Seizure and Warning Signs?

Background

Once thought to be mainly a disorder of children, recurrent seizures or epilepsy is thought to be present in about 7% of older adults (Spitz, 2005) and is usually related to one of the common comorbidities found in older adults (Bergey, 2004; Rowan & Tuchman, 2003). Epilepsy affects up to 3 million Americans of all ages (Velez & Selwa, 2003). Davidson & Davidson (2012) summarized findings of most studies on epilepsy in older adults with these main points:
Doctor - Taking Notes
Seizures can be caused by a variety of conditions in older persons, but “the most common cause of new-onset epilepsy in an elderly person is arteriosclerosis and the associated cerebrovascular disease” (Spitz, 2005, p. 1), accounting for 40–50% of seizures in this age group (Rowan & Tuchman, 2003). Seizures are associated with stroke in 5–14% of survivors (Spitz, 2005; Velez & Selwa, 2003). Other common causes of epilepsy in the elderly include Alzheimer’s disease and brain tumor.
There are three major classifications of epilepsies, although there are many additional types. Generalized types are more common in young people and associated with grand mal or tonic-clonic seizures. A number of cases have an un¬determined origin and may be associated with certain situations such as high fever, exposure to toxins, or rare metabolic events. In older adults, localized (partial or focal) epilepsies are more common, particularly complex partial seizures (Luggen, 2009). In contrast to young adults, Rowan and Tuchman (2003) cite other differences in seizures in the elderly: low frequency of seizure activity, easier to control, high potential for injury, a prolonged postictal period, and better tolerance with newer antiepileptic drugs (AEDs). Additionally, older adults may have coexisting medical problems and take many medications to treat these problems.

Risk Factors/Warning Signs

Risk factors for seizures in older adults include cerebrovascular disease (especially stroke), age, and head trauma. The most obvious signs and symptoms of epilepsy are seizures, although changes in behavior, cognition, and level of consciousness may be other signs. Also, note that exposure to toxins can cause seizures that are not epilepsy. Complex partial seizures in older adults may include symptoms such as “confusion, memory loss, dizziness, and shortness of breath” (Davidson & Davidson, 2012, p. 16). Automatism (repetitive movements), facial twitching with following confusion, and coughing are also signs of the more-common complex partial seizure (Luggen, 2009).

Diagnosis

Diagnosis is made by careful description of the seizure event, a thorough history, and physical. Eyewitness accounts of the seizure incident can be quite helpful, although many community-dwelling older adults go undiagnosed because their seizures are never witnessed. In addition, complete blood work, neuroimaging, chest X-ray, electrocardiogram (ECG), and electroencephalogram (EEG) help determine the cause and type of seizure (National Institute for Health and Clinical Excellence {NICE}, 2012).

Treatment

Treatment for epilepsy is aimed at the causal factor. The standard treatment for recurrent seizures is antiepilepsy drugs (AEDs). The rule of thumb, “start low and go slow,” for medication dosing in older adults particularly applies to AEDs. The elderly tend to have more side effects, adverse drug interactions, and problems with toxicity levels than younger people.
Research has suggested that older adults may have better results with fewer side effects with the newer AEDs than the traditional ones, though about 10% of nursing home residents are still medicated with the first-generation AEDs (Mauk, 2004). The most common older medications used to treat seizures include barbiturates (such as phenobarbital), benzodiazepines (such as diazepam/Valium), hydantoins (such as phenytoin/Dilantin), and valproates (such as valproic acid/Depakene) (Deglin & Vallerand, 2005; Resnick, 2008).
Several newer drugs are also used, depending on the type of seizure. Second-generation AEDs, including gabapentin (Neurontin), lamotrigine (Lamictal), oxcarbazepine (Trileptal), levetiracetam (Keppra), pregabalin (Lyrica), tiagabine (Gabitril), and topiramate (Topamax), are generally recommended over the older AEDs; however, older AEDS such as phenytoin (Dilantin), valproate (Depakote), and carbamazepine (Tegretol) are the most commonly prescribed treatment options (Resnick, 2008). Each of these medications has specific precautions for use in patients with certain types of medical problems or for those taking certain other medications. Regarding side effects in older patients, watch for potential stomach, kidney, neurological (especially poor balance or incoordination), and liver problems. Additionally, some newer extended-release AEDs are thought to be better tolerated and have a lower incidence of systemic side effects (such as tremors) (Uthman, 2004).

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care.Burlington, MA: Jones and Bartlett Publishers. Used with permission.

 

By | February 11th, 2018|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on What is a Seizure and Warning Signs?

Guest Blog: 12 Best Senior Fitness Blogs

The fitness market is booming and senior fitness is no exception. Today’s older adults enjoy the physical challenges of better fitness for increased health and mobility. Improving fitness levels and staying active plays an important role in senior safety and maintaining a healthy, strong body.

With so many people getting outdoors, to the gym, or just finding time to exercise at home, it can be a mental challenge to sort through an abundance of information. These 12 blogs on senior fitness and related issues are worth following for daily tips and pointers.

 

 

1. Silver Sneakers – One of the most up-to-date and best-maintained blogs on senior fitness, Silver Sneakers offers tips on health, nutrition, exercise, and living well. Silver Sneakers is a must-read for mature adult athletes.

2. Philips Lifeline – From exercises to improve strength and balance to Yoga for seniors, The Lifeline blog covers a variety of fitness topics for older adults.

3. Senior Fitness – With articles on fit eating, relationships between cognitive ability and exercise, and muscle building, Senior Fitness is a comprehensive blog for seriously active seniors.

4. 50Plus – Focusing on fitness at home, 50Plus is a good resource for Boomers just embarking on their fitness journey.

5. Sportscience – Educational and informative, the Sportscience site features detailed technical information on aging and fitness.

6. The American Senior Fitness Association – This archive includes comprehensive senior fitness articles for mature adults.

7. ElderGym Senior Fitness – With an emphasis on physical therapy exercise and fitness, this blog covers a wide range of topics related to special needs and rehabilitative exercising.

8. Simply Senior Fitness – Focusing on quality of life and the medical aspects of fitness, Simply Senior Fitness is a valuable go-to for exercise related insights.

9. Prime of Life Fitness – Featuring advice for more than just the typical 55+ crowd, Prime of Life presents topics for fitness buffs from 40 to 100.

10. Life in Motion – This is a fun and motivational blog for seniors curious about beginning a fitness routine and those with a moderate level of activity.

11. Incremental Fitness – Moderated by an aging specialist and promoting movement as a key fitness value for older adults, Incremental Fitness tackles a variety of important exercise topics.

12. Senior Exercise Central – In addition to daily topics on health, nutrition, benefits of continued fitness, and others, seniors can find workout routines and individual descriptions of various exercises and lifts.

By | February 10th, 2018|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: 12 Best Senior Fitness Blogs

Guest Blog: Four Ways to Make Travel Easier for Seniors

Traveling is stressful for everyone, but traveling as a senior citizen comes with its own unique challenges. In order to make your next trip as easy and enjoyable as possible, be sure to keep these four easy tips in mind.

1. Prepare for Security Checkpoints

If you have to go through a TSA checkpoint before your trip, make sure you plan for it ahead of time.

TSA agents typically try to make things as easy and efficient as possible for seniors, especially those who are in wheelchairs or have other mobility limitations.

To help them do their job properly, make sure you let the agent know about any medical conditions — like pacemakers or implants — that might set off alarms. You should also try to get a physician’s statement verifying your implant to avoid delays.

2. Invest in Quality Pillows

Hotel pillows are often not as comfortable as the ones you have at home. Either bring one with your or invest in a quality pillow before you go to make sure you sleep comfortably at night.

You’ll also want to invest in a neck and back pillow for car and plane rides. This way, you won’t have to deal with any pain on your way to your destination.

3. Pack Light

Try to fit everything you need in a roll-aboard suitcase and a medium-sized carry on bag. Don’t bring more than you can carry — otherwise, you’ll be setting yourself up for a lot of discomfort.

If possible, bring both your bags on the plane and stash one in the overhead rack. This will make things easier when you land since you won’t have to hang around the baggage claim area.

4. Manage Your Medication

Make sure your medications are safe and accessible throughout your trip. Store them in a zip-lock bag and keep that bag in your carry-on. Keep copies of your prescriptions and physician statements in the bag as well.

When you get to your destination, you may want to ask for reminders from the hotel or cruise staff to help you take your medication at the same time each day. You can also set an alarm on your watch or cell phone so you stay on top of everything.

Traveling as a senior doesn’t have to be stressful. Keep these tips in mind to stay safe and comfortable throughout your trip.

 

By | February 9th, 2018|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Four Ways to Make Travel Easier for Seniors
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