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Shingles (Herpes Zoster)

Background

Commonly known as shingles, herpes zoster is the reactivation of the varicella virus that causes chicken pox. Older persons may be infected with this latent virus after initial exposure to it in the form of chicken pox. The virus then lays dormant in the neurons until it is reactivated, often due to immunosuppression, when it appears in the form of painful vesicles or blisters along the sensory nerves. This reactivation tends to occur once in a lifetime, with repeat attacks occurring about 5% of the time (Flossos & Kostakou, 2006). Herpes zoster occurs in both men and women equally, with no specific ethnic variations, but is more common in the elderly.

Risk Factors

Risk factors for developing shingles are age over 55 years, stress, and a suppressed immune system. For many older women particularly, emotional or psychological stress can trigger recurrence.

Warning Signs

Signs and symptoms of herpes zoster include painful lesions that erupt on the sensory nerve path, usually beginning on the chest or face. They may appear as initially as a rash, looking much like chicken pox, often wrapping around the chest area in a band-like cluster. These weepy vesicles get pustular and crusty over several days, with healing occurring in 2-5 weeks (Kennedy-Malone et al., 2004; NINDS, 2013).

Diagnosis

Diagnosis is usually made by viewing the appearance of the lesions and a history of onset. A scraping will confirm some type of herpes virus. The most common complaint of those with herpes zoster is the painful blisters that usually subside in 3–5 weeks (NINDS, 2013). Postherpetic neuralgia, a complication of herpes zoster, may last 6–12 months after the lesions disappear and may involve the dermatome, thermal sensory deficits, allodynia (the perception of pain where pain should not be), and/or severe sensory loss, all of which can be very distressing for the patient (Flossos & Kostakou, 2006).

Prevention

Zostavax, a vaccine for shingles, has become available, and it is recommended for all persons age 60 or older who have already had the chicken pox. A person can still get shingles even after having the vaccine, but the symptoms and complications would be less severe. The vaccine has also been approved for persons age 50 – 59, and research has shown that receiving the vaccine significantly decreases the rate of shingles in the population (NINDS, 2013; PubMed Health 2012).

Treatment

Antiviral medications (such as Acyclovir) are used to treat shingles, but must be given within 48 hours of the eruption of the lesions. Topical ointments may help with pain and itching. Pain medications, particularly acetaminophen (Tylenol), are appropriate for pain management in older adults. If a fever is present, rest and drinking plenty of fluids is suggested. Persons with pain that lasts past 6 weeks after the skin lesions are gone and that is described as sharp, burning, or constant require re-evaluation by a physician. Postherpetic neuralgia may be a long-term complication lasting years (PubMed Health, 2012).

The person should be advised to seek medical attention as soon as he or she suspects shingles, in order to receive the best results from Acyclovir. The virus will run its course, but the person is contagious while vesicles are weepy. Persons should not have direct contact (even clothing) with pregnant women, people who have not had chicken pox, other elderly persons, or those with suppressed immune systems. The older person with shingles may experience concerns with pain management and feel a sense of isolation, particularly if they live alone. Arranging for a family member or friend who does not have a high risk of infection to check on the older person at home is advisable.

Visit the National Institute of Neurological Disorders and Strokes (NINDS) for an informational page on Shingles at: http://www.ninds.nih.gov/disorders/shingles/shingles.htm

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.

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By | 2017-08-16T09:40:18+00:00 August 16th, 2017|News Posts|Comments Off on Shingles (Herpes Zoster)

Guest Post: How to Reduce Loneliness for the Elderly in Your Life

Reaching the golden age does not always come only with a great life experience but also with reasons to make you feel lonelier than ever. Years have passed by and many of those people you encountered and loved so much may have passed away over time. This is something that remains in your heart forever.

Feeling lonely is not something to be ashamed of but also not something to control your life. Discover below the best ways in which to reduce loneliness for the elderly in your life. They deserve to live happy during this new stage in their existence. Help them rediscover the joy of living!

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 Develop a Strategy to Defeat Seclusion

If you have elder people you love, you must engage more in their life. It is unavoidable for them to feel lonely from time to time. This is why they need your love and support more than ever. Make them feel loved and an important part of your life. Offer them reasons to smile and continue every day. Do not forget about them or ever leave them feeling like no one has time for them anymore.

Allow Them to Feel Useful

Feeling like there is nothing left for you to do in life is the worst possible feeling. Older people should be treasured because they have a life experience to share. Learn to listen to them more often, spend more time with them and allow these amazing people to teach you what they know. Engage with them in activities that are suitable for their age and help them keep themselves active. Never leave them alone for too much time and always advise them on how to stay clear of sadness and depression.

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 New Bridge for the Generation Gap

The generation gap between young people and older ones is obvious. However, there should always be a bridge built with love, compassion, and respect or understanding to help keep these two generations together. Teach your children to appreciate the elderly. If they have grandparents, guide them towards building close relationships with them. Spending time together and sharing experiences will be a great way in which to reduce loneliness for the elderly in your life. It will also be a great life lesson for your children.

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To ensure a better life experience for them at this stage you can also consider professional help in care homes in Maidstone. The main stages of life are the same for all of us. We may go through them differently and face varied challenges, but we all get to the same place sooner or later. Let’s treasure the amount of experience and life stories these amazing people have to share. We will learn more from them than from any other experience in our life.

 

 

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By | 2017-08-14T10:23:27+00:00 August 14th, 2017|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Post: How to Reduce Loneliness for the Elderly in Your Life

Peripheral Artery Disease

Background

Peripheral artery disease (PAD), the most common type of peripheral vascular disease (PVD), affects 8–12 million Americans, 12–20% of those over the age of 65, and could reach as many as 9.6 million Americans by the year 2050 (Cleveland Clinic, 2012).

Risk Factors/Warning Signs

The risk factors for PAD are the same as those for coronary heart disease (CHD), with diabetes and smoking being the greatest risk factors (AHA, 2005). Ac¬cord¬ing to the American Heart Association, only 25% of those older adults with PAD get treatment. PAD increases the risk of CHD, heart attack, and stroke.

Diagnosis

The most common symptoms of PAD are leg cramps that worsen when climbing stairs or walking, but dissipate with rest, commonly called intermittent claudication (IC). The majority of persons with PAD have no symptoms (AHA, 2005). PAD is a predictor of CHD and makes a person more at risk for heart attack and stroke. Left untreated, PAD may eventually lead to impaired function and decreased quality of life, even when no leg symptoms are present. In the most serious cases, PAD can lead to gangrene and amputation of a lower extremity.

Treatments

Most cases of PAD can be managed with lifestyle modifications such as those for heart-healthy living. This includes maintaining an appropriate weight, limiting salt intake, managing stress, engaging in physical activity as prescribed, quitting smoking, and eating a heart-healthy diet.
Patients with PAD should discuss their symptoms with both their healthcare provider and a physical therapist, because some patients find symptom relief through a combination of medical and therapy treatments (Aronow, 2007; Cleveland Clinic, 2012).

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.

For more information on PAD, visit NIH at:
www.nhlbi.nih.gov/health/health-topics/topics/pad/

 

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By | 2017-08-11T09:19:41+00:00 August 11th, 2017|News Posts|Comments Off on Peripheral Artery Disease
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