Dr. Mauk’s Boomer Blog

/Dr. Mauk's Boomer Blog

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

The Promise of Smart Home Technology for Seniors Living at Home : Brooklin Nash

“With the IoT, we’re headed to a world where things aren’t liable to break catastrophically – or at least we’ll have a hell of a heads’ up. We’re headed to a world where our doors unlock when they sense us nearby.”

~ Scott Weiss

This quote from famous venture capitalist Scott Weiss highlights how much the Internet of Things (IoT) is changing our lives. It’s not just about connected devices and smart refrigerators. It’s about making smart home technology a norm. And it can be a norm that makes independent living for seniors much better in the long run. Here are a few ways smart home technology can directly benefit seniors living at home.

#1: Smart Home Technology Makes Independent Living Safer

Caring for seniors living at home can be both rewarding and challenging. With independent living, safety is always a concern. What happens when a senior loved one needs to be left alone, for example?

By introducing smart home technology into the mix, you can help ensure that your loved one is safe while home alone. The IoT means that seniors living at home can easily access everything they need – from the medicine cabinet to the front door to a voice command for emergency services.

#2: Alerts & Real Time Monitoring Make Independent Living More Realistic

More immediately, smart home technology and IoT makes independent living both safer and more realistic. Tech innovations now allow the control, monitoring and reception of alerts from physical devices in the home. With the touch of a button on an app, you can control appliances, security systems and more.

Users can also receive alerts on heart rate, blood pressure and a host of other health factors. You can have a safe amount of control over the home while letting your senior loved one live their independent life.. With this level of innovation, there is less of a necessity of back and forth.

#3: IoT Makes Independent Living More Accessible

In the past, there were generally two options: moving seniors into assisted living homes or having them move in directly. Smart home technology empowered by IoT and a fine tuned UX means seniors can access the tools they need to remain independent. There is no need for fancy tech that is difficult to understand.

What other ways do you see the promise of smart home technology taking hold for seniors living at home?

Brooklin Nash writes about the latest tools and small business trends for TrustRadius. When he’s not writing, you can find him reading YA dystopian fiction (with guilty pleasure) and cooking.

By |2018-07-23T11:54:41+00:00July 23rd, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The Promise of Smart Home Technology for Seniors Living at Home : Brooklin Nash

Guest Blog: 5 Simple Ways for Seniors to Combat Hip Pain

Almost one-fourth (23.9 percent) of seniors between the ages of 60 and 90 suffer from frequent hip pain.

Whether it’s the result of a bad fall or is brought on by a combination of poor mechanics and old age, it’s important for seniors to know that they’re not doomed to suffer from hip pain for the rest of their lives.

Read on to learn some simple tips to help seniors combat hip pain.

1. Do Hip Bridges
A hip bridge is one of the best exercises you can do to combat hip pain.

To do this exercise, simply lie on your back with your feet hip-distance apart and planted on the ground. Press into the ground and lift your hips in the air, trying to form a straight line from your shoulders to your knees (don’t arch your back).

Hold for 3-5 seconds, then return to the beginning. Complete ten repetitions.

2. Use Ice Daily
Icing your hip can work wonders for relieving pain and inflammation, especially if your hip pain is brought on by bursitis or arthritis. Depending on your pain level, you can ice your hip up to 4-5 times per day in 10-15-minute increments.

3. Raise the Seat
Many seniors find that their hip pain is aggravated when they try to lower themselves onto and raise themselves up from a chair, sofa, or even a toilet. Devices like a chairlift or a raised toilet seat can help reduce hip strain for seniors as they stand up and sit down.

4. Stretch Consistently
Consistent stretching is also important for relieving pain and improving hip mobility. The figure 4 stretch is one of the best for hip pain.

Start by lying on your back with your knees bent. Lift the leg that’s bothering you and cross it over your other leg so that your ankle is resting on your opposite thigh. Pull the bent leg in toward your chest, clasping your hands around the back of your thigh if possible. Hold for 10-15 seconds, then release and switch sides.

5. Use Natural Anti-Inflammatories
Finally, instead of using over-the-counter anti-inflammatories, which can cause serious issues for seniors, try using a natural anti-inflammatory like curcumin (found in turmeric). Turmeric is safe for most people, and research shows it works just as well as ibuprofen for improving joint pain and function.

By |2018-07-19T15:26:18+00:00July 20th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: 5 Simple Ways for Seniors to Combat Hip Pain

Diabetes Risk Factors and Treatments

Diabetes mellitus type 2

Background

Diabetes mellitus is a common metabolic disorder that affects carbohydrate, lipid, and protein metabolism. It is estimated that about 4.4 to 17.4% percent of adults in the United States have diabetes mellitus (Cory , Ussery-Hall, Griffin-Blake et al., 2010). It is estimated that 11.5 million women and 12.0 million men over the age of 60 have diabetes, but many do not know it. The Indian Health Service reported via the National Diabetes Survey of 2007 that of the 1.4 million Native Americans and Alaska Natives in the United States, 14.2% age 20 years or older have diagnosed diabetes. Rates vary by region, from 6.0% of Alaska Natives to 29.3% of the Native Americans in southern Arizona (CDC, 2007). There are two major types of diabetes, type 1 (T1DM) and type 2 ( T2DM). T1DM is characterized by autoimmune destruction of the insulin-producing beta cells of the pancreas, leading to a deficiency of insulin. New-onset of adult T1DM in older adults rarely happens; however, due to better treatment of T1DM, older adults who have been diagnosed at an earlier age are living longer. About 90% of older adults with diabetes have T2DM, which is often related to obesity. T2DM is characterized by hyperglycemia and insulin resistance; however, impaired insulin secretion may also be present. Diabetes mellitus is a major cause of disability and death in the United States, and is the seventh leading cause of death among older adults.

Risk Factors

The risk of diabetes increases with age (45 years and older). Other risk factors include family history, obesity, race (African Americans, Hispanics, Native Americans, Asian Americans, Pacific Islanders), hypertension, less “good” cholesterol (less than 35 mg/dl), lack of exercise, having a history of delivering large babies (≥9 pounds), personal history of gestational diabetes, and pre-diabetes in men and women (Laberge, Edgren, & Frey, 2011). Type 2 is the most common type in older women (CDC, 2007). The risk of death from DM is significantly higher among older ¬Mexican American, African American, and Native American women when compared to Whites. The Centers for Disease Control CDC (2005) names obesity, weight gain, and physical inactivity as the major risk factors for DM among women.

Diagnosis

The most common presentation for older adults with T1DM is hyperglycemia (high blood sugar). Older adults may not have the classical symptoms such as polydipsia, polyuria, polyphagia, and weight loss. Instead, they may have an atypical presentation (Halter Chang & Halter, et al., 2009). They may first present with falls, urinary incontinence, fatigue, or confusion. Because older adults may have T2DM for years before it is diagnosed, they often have macrovascualar and microvascular complications at the time of diagnosis, so evaluation of these should be considered at that time.

Treatment

Prevention is the best approach to care, which involves identifying those at risk and encouraging lifestyle change. Older adults with diabetes mellitus have a high risk for complications related to macrovascular disease, microvascular disease, and neuropathy. Macrovascular diseases include coronary heart disease, stroke, and peripheral vascular disease, which can lead to amputation. Microvascular diseases are chronic kidney disease, which is the most common cause of end-stage renal disease, and diabetic retinopathy, that which can lead to blindness. Peripheral neuropathy presents as uncomfortable, painful sensations in the legs and feet that are difficult to treat. A lack of sensation may also be present and contribute to the risk of falls. There is no cure for peripheral neuropathy, and it tends to be a complication for which patients experience daily challenges trying to manage the symptoms. A combination of medication to address pain and interventions by a physical therapist seems to be the best current treatment.

Treatment is aimed at helping patients to achieve and maintain glycemic control to decrease risk of complications. The initial treatment approach is to work with the older adult to establish treatment goals aimed at reducing long-term complications. This often requires working within an interprofessional team. Aggressive treatment may be appropriate for most older adults; however the risk of hypoglycemia (low blood sugar) is higher in older adults. Older adults with hypoglycemia may have an atypical presentation with acute onset of confusion, dizziness, and weakness instead of tremors or sweating. The best measure of good blood glucose management and controlled blood sugars is HgbA1c levels (glycosylated hemoglobin). This measure of hemoglobin provides insight into the previous 3 months of blood sugar control. If HgbA1c is elevated, it indicates that the blood sugar has been high over time. For most people, a HgbA1c ≤ 7% indicates optimal glycemic control; however, due to poor health outcomes, for frail older adults or those with a life expectancy ≤ 5 years this may not be the best, and a Hgb A1c of 8% might be more appropriate.

Management is successful when a balance is achieved among exercise, diet, and medications. Medications may be oral hypoglycemics or insulin injection. Insulin injection is used in T1DM and may be prescribed for T2DM because as the person ages, beta-cell function declines. If insulin is needed, it is important to consider if there are visual problems and or hand arthritis that limits the dexterity that is necessary to prepare and inject the medication. For some, a simple regimen, such as premeasured doses and easier injection systems (e.g.,insulin pens with easy-to-set dosages) is the best.

Thorough evaluation of readiness to learn and of the ability of an older person to manage his or her medications must be done. Older adults who need to give themselves insulin injections may experience anxiety about learning this task. Demonstration, repetition, and practice are good techniques for the older age group. Adaptive devices such as magnifiers may help if the syringes are hard to read. A family member should also be taught to give the insulin to provide support and encouragement, although the older adult should be encouraged to remain independent in this skill if possible. Williams and Bond’s (2002) research suggested that programs that promote confidence in self-care abilities are likely to be effective for those with diabetes. A plan for times of sickness and the use of a glucometer to monitor blood sugars will also need to be addressed. Additionally, the dietician may be consulted to provide education for the patient and family on meal planning, calorie counting, carbohydrate counting, and nutrition. Many patients benefit from weight loss, so the nutritionist can assist with dietary planning in this regard also.

Due to the increased risk of infection and slow healing that result from diabetes, foot care is an essential component in teaching older adults to manage DM. Some experts believe that good preventive foot care would significantly reduce the incidence of amputation in the elderly. Older persons with DM should never go barefoot outside. Extremes in temperature should be avoided. Shoes should be well fitting and not rub. Socks should be changed regularly. Elders should be taught to inspect their feet daily, with a mirror if needed. Corns and ingrown toenails should be inspected and treated by a podiatrist, not by the patient. Older persons should see their podiatrist for a foot inspection at least yearly. Patients should be cautioned that even the smallest foot injury, such as a thorn or blister, can go unnoticed and unfelt—and often results in partial amputations that lead to a cascade of lower extremity problems.

For more information on living with Diabetes, visit the American Diabetes Association:
http://www.diabetes.org

 

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. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

By |2018-07-19T16:51:54+00:00July 19th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Diabetes Risk Factors and Treatments

End of Life: Palliative Care and Hospice

Kris Mauk2_print

The human survival instinct is strong and our spirits are made to embrace life. But what happens when your loved one is diagnosed with a terminal illness that has no cure? How do you reconcile the certain death of your spouse, parent, or child? Where can you turn when death is close or imminent?

We are fortunate to live in a society that supports excellent care for those who are coming towards the end of their life. As difficult as this journey is for persons and their family members, the appropriate level of service can provide the needed care and comfort to make the end of life a time of peace and reflection rather than pain and suffering.

Two major services are readily available to bring comfort and promote quality of life even until the end of life. These are palliative care and hospice.

Palliative care is a consultative service for those with life-limiting illnesses who may not yet meet the criteria for hospice or who do not wish to enter hospice yet. The focus of palliative care is comfort and symptom management, but patients may still continue treatments such as radiation, chemotherapy, dialysis, home health, or other therapy.  Palliative services can be provided in the acute hospital setting, in the home, or in a long-term care facility. A new program called PRIME (Progressive Illness Management Expertise) by AseraCare, focuses on symptom management, goals of care planning, medication management, and transition management. PRIME provides palliative care through nurse practitioners and social workers who coordinate care with your regular medical providers. For persons with serious chronic illnesses who experience recurring rehospitalizations, palliative care management can provide care coordination and smooth transitions to other settings, including hospice, at the appropriate time.

Hospice is a supportive and comprehensive service for those who are dying. The National Hospice and Palliative Care Organization states that the foundation of hospice and palliative care is the belief that “each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so”. Generally, to qualify for hospice a patient is expected to live 6 months or less. Hospice uses an interdisciplinary team of physicians, nurses, social workers, home health aides, chaplains, bereavement counselors, trained volunteers and others to provide comfort and support to the dying patient and family. These services are covered by Medicare, Medicaid, and most private and commercial insurances. Hospice care can be provided wherever a patient lives, with 24-hour on-call availability.

End of life decisions are often difficult for families to discuss, but palliative care and hospice programs provide the help that is needed to have these conversations. Their aim is to help provide quality of life until death, helping people “live until they die”. If your loved one may qualify for assistance, don’t delay in seeking this support. It may be the best way you can help your family member have a peaceful end of life.

 

 

 

 

 

By |2018-07-12T12:46:24+00:00July 17th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on End of Life: Palliative Care and Hospice

Signs of Depression

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In the wake of the sad news about the suicide death of beloved actor Robin Williams, discussions about depression, its recognition and treatment seem appropriate. Depression is common in American society, with 10% of men and 18% of women over the age of 65 in the United States reporting current symptoms associated with clinically significant depression. These statistics have been relatively stable since about 1998. Severe depression is one of the major causes for suicide attempts.
Sometimes it is hard to understand why a person would become so depressed that suicide seems like the only option. There are many reasons that depression occurs. These may include losses of various types such as outliving a spouse, friends, or loved ones. There may have been loss of health, financial difficulties, loss of a job, or a drastic unwanted change in living situation. Maybe the person has experienced a trauma that was life-changing. For some people, these losses can be overwhelmingly painful and persons may lack the support or coping mechanisms to successfully deal with their extreme feelings.
Men and women may display depression differently. Men express depression in the form of irritability, anger, agitation, controlling behavior, blaming others, or expressions of despair. In contrast, women may appear anxious, scared, apathetic, and express feelings of worthlessness.
Other common signs of depression include:

• No interest or pleasure in enjoyable activities
• No interest in sexual activities
• Feeling sad or numb
• Crying easily or for no reason
• Feeling slowed down
• Feeling worthless or guilty
• Change in appetite; unintended change in weight
• Trouble recalling things, concentrating, or making decisions
• Problems sleeping, or wanting to sleep all of the time
• Feeling tired all of the time
• Thoughts about death or suicide

While depression can be associated with suicide, persons with depression may not actually want to die. They simply feel they cannot live with the pain they feel and may express wanting that pain to end. This pain can be physical or emotional or both. In the United States, the highest rate of suicide is among white males over the age of 85. These men often visit their doctors within the month prior to their suicide, and give few other signs of their suicidal thoughts. They most often use lethal means to carry out suicide such as hanging or firearms. In women, suicide attempts are more often by nonlethal means such as taking pills, and should be considered a cry for help. If you have a loved who is at high risk for depression or suicide, be sure to take special note of the warning signs listed here.
The good news is that depression can be successfully managed and treated with the right help. Early recognition and treatment of depression is important and generally includes medication therapy and counseling. Talk to your doctor if you or your loved one is feeling depressed. Your primary care provider can assist you in diagnosing depression and can refer you to a reliable mental health professional to help address your symptoms and promote a better quality of life.

Tips for helping your loved one who is experiencing depression are provided on SCC’s care page that can be found at http://senior-care-central.com/category/dr-mauks-boomer-blog/

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By |2018-07-12T12:45:21+00:00July 15th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Signs of Depression