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Cataract Warning Signs and Treatment

Cataracts are responsible for 51% of world blindness, representing about 20 million people (World Health Organization [WHO], 2010). More than 90% of cataracts are age-related. Cataracts are so common in older adults that some almost consider them an inevitable consequence of old age and often fail to report to the doctor. According to the University of Washington, Department of Ophthalmology (2008), 400,000 new cases of cataracts are diagnosed each year, over 3 million visits to a doctor are related to cataracts each year, and 5,500,000 people have some impaired vision due to cataracts. Although about half of people between 65 and 75 years of age have cataracts, they are most common in those over age 75 (70%), and there are no ethnic or gender variations (Trudo & Stark, 1998).

Risk Factors

Advancing age is the biggest risk factor for the development of cataracts. Other risk factors include diabetes, tumor, long-term use of medications such as corticosteroids, excessive exposure to sunlight, blunt or penetrating trauma, and excessive exposure to heat or radiation. Tobacco use, family history of cataracts, high alcohol intake, diabetes, and lack of dietary antioxidants also puts the person at risk for cataract development (Gerzevitz, Porter, & Dunphy, 2011).

Warning Signs/Diagnosis

Cataracts cause no pain or discomfort and may be manifested by gradual opacity of the lens, which affects the ability to see clearly. This causes decreased visual acuity, sensitivity to glare, and altered color perception. Older adults may not be aware of the problem until visual changes occur. They may report blurred or distorted vision or complain of glare when driving at night. The person may present with a fall due to visual changes. Some older adults will disclose that their reading vision has improved and they no longer need reading glasses, something called “second sight”. Eventually the pupil changes color to a cloudy white. Generally, the most common objective finding is decreased visual acuity, such as that measured with a Snellen eye chart. The patient should be referred to an ophthalmologist for further evaluation and consideration of surgery.


Although changes in eyeglasses are the first option, when quality of life becomes affected, the most effective treatment for cataracts is surgery. Surgery is relatively safe and usually is done as an outpatient procedure. The opaque lens is removed through an incision in the eye and an intraocular lens is inserted. The surgical incision is either closed with sutures or can heal itself. This is the most common operation among older adults, and more than 95% of them have better vision after surgery (Trudo & Stark, 1998). After surgery, patients will need to avoid bright sunlight; wear wrap-around sunglasses for a short time; and avoid straining, lifting, or bending. They may need to use eye drops as instructed by the doctor (National Eye Institute, 2013). The benefits of surgery include improved visual acuity, depth perception, and peripheral vision, leading to better outcomes related to ADLs, quality of life, and reduced risk of falls. Complications associated with surgery are rare but include retinal detachment, infection, and macular edema. Cataract surgery today offers a safe and effective treatment to maintain independence and improve quality of life for older adults.

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 | 2018-06-12T10:33:11+00:00 June 15th, 2018|News Posts|Comments Off on Cataract Warning Signs and Treatment

Stroke Warning Signs and Risk Factors

Portrait of Worried Senior Couple


Stroke, also known as cerebrovascular accident (CVA) or brain attack, is an interruption of the blood supply to the brain that may result in devastating neurological damage, disability, or death. Approximately 795,000 people in the United States have a new or recurrent stroke each year (American Stroke Association [ASA], 2012a). Stroke accounts for 1 in 18 deaths, making it the fourth leading cause of death in the United States. A death from stroke occurs every 4 minutes and the cost of stroke treatment and disability was over $73 billion dollars in 2010. Death from stroke is generally higher among females, with higher rates in Black males (67.7/100,000) and females (57.0/100,000) than in Caucasians (ASA, 2012a). In Canada, stroke is the fourth leading cause of death, affecting 50,000 people each year (Heart and Stroke Foundation of Canada, 20059).
There are two major types of stroke: ischemic and hemorrhagic. The vast majority of strokes are caused by ischemia (87%), usually from a thrombus or embolus (ASA, 2012a). The symptoms and damage seen depend on which vessels in the brain are blocked. Carotid artery occlusion is also a common cause of stroke related to stenosis

Risk Factors

Some risk factors for stroke are controllable and others are not. The most significant risk factor for stroke is hypertension. Controlling high blood pressure is an important way to reduce stroke risk. Those with a blood pressure of less than 120/80 have half the lifetime risk of stroke as those with hypertension (ASA, 2012a). Smoking 40 or more cigarettes per day (heavy smoking) increases the stroke risk to twice that of light smokers. If a person quits smoking, their risk after 5 years mirrors that of a nonsmoker, so older adults should be particularly encouraged to stop smoking.

Warning Signs

Several warning signs are common. These include:
SUDDEN numbness or weakness of face, arm or leg – especially on one side of the body.
SUDDEN confusion, trouble speaking or understanding.
SUDDEN trouble seeing in one or both eyes.
SUDDEN trouble walking, dizziness, loss of balance or coordination.
SUDDEN severe headache with no known cause (National Stroke Association, 2013)


There are several tools for assessing for signs and symptoms of stroke. One easy acronym is FAST:
F stands for facial droop. Ask the person to smile and see if drooping is present.
A stands for arm. Have the person lift both arms straight out in front of him. If one is arm is drifting lower than the other, it is a sign that weakness is present.
S stands for speech. Ask the person to say a short phrase such as “light, tight, dynamite” and check for slurring or other abnormal speech.
T stands for time. If the first F-A-S checks are not normal, then one is to remember F-A-S-T that Time is important and the emergency medical system should be activated (National Stroke Association, 2012).
Older adults experiencing the warning signs of stroke should note the time on the clock and seek immediate treatment by activating the emergency response system in their area calling 911 (American Stroke Association, 2012). Transport to an emergency medical facility for evaluation is essential for the best array of treatment options. A history and neurological exam, vital signs, as well as diagnostic tests including electrocardiogram (ECG), chest Xx-ray, platelets, prothrombin time (PT), partial thromboplastin time (PTT), electrolytes, and glucose are routinely ordered. Diagnostic testing imaging may include computed tomography (CT) without contrast, magnetic resonance imaging (MRI), arteriography, or ultrasonography to determine the type and location of the stroke. The CT or MRI should ideally be done within 90 minutes so that appropriate emergency measures may be initiated to prevent further brain damage.


The first step in treatment is to determine the cause or type of stroke. A CT scan or MRI must first be done to rule out hemorrhagic stroke. Hemorrhagic stroke treatment often requires surgery to evacuate blood and stop the bleeding.
The gold standard at present for treatment of ischemic stroke is t-PA (tissue plasminogen activator). At this time, t-PA must be given within 3 hours after the onset of stroke symptoms. This is why it is essential that older adults seek treatment immediately when symptoms begin. Only about 3 – 5% of people reach the hospital in time to be considered for this treatment (ASA, 2012d). t-PA may be effective for a select group of patients after the 3-hour window (up to 4.5 ½ hours), and this treatment window has been approved in Canada (Heart and Stroke Foundation of Canada, 2009). The major side effect of t-PA is bleeding. t-PA is not effective for all patients, but may reduce or eliminate symptoms in over 40% of those who receive it at the appropriate time (Higashida, 2005). Other, much less common procedures such as angioplasty, laser emulsification, and mechanical clot retrieval may be options for treatment of acute ischemic stroke.
To prevent recurrence of thromboembolic stroke, medications such as aspirin, ticlopidine (Ticlid), clopidogrel (Plavix), dipyridamole (Persantine), heparin, warfarin (Coumadin), and enoxaparin (Lovenox) may be used to prevent clot formation. Once the stroke survivor has stabilized, the long process of rehabilitation begins. Each stroke is different depending on location and severity, so persons may recover with little or no residual deficits or an entire array of devastating consequences.
The effects of stroke vary, and some persons may recover with no residual effects. But more often, stroke survivors may have problems that include hemiplegia or hemiparesis (paralysis or weakness on one side of the body), visual and perceptual deficits, language deficits, emotional changes, swallowing dysfunction, and bowel and bladder problems. Ninety percent of all dysphagia (swallowing problems) results from stroke (White, O’Rourke, Ong, Cordato, & Chan, 2008).

Poststroke Rehabilitation

Rehabilitation after a stroke focuses on several key principles. These include maximizing functional ability, preventing complications, promoting quality of life, encouraging adaptation, and enhancing independence. Rehabilitation emphasizes the survivor’s abilities, not disabilities, and helps him or her to work with what he or she has while acknowledging what was lost.
Stroke survivors go through a unique recovery process. This model shows the process of stroke recovery where forward progress after stroke lead to acceptance and adaptation:

If significant functional impairments are present, evaluation for transfer to an intensive acute inpatient rehabilitation program is recommended. Inpatient rehabilitation units offer the survivor the best opportunity to maximize recovery, including functional return. An interdisciplinary team of experienced experts, including nurses, therapists, physicians, social workers, and psychologists, will help the survivor and the family to adapt to the changes resulting from the stroke. Outcomes for geriatric stroke survivors are enhanced by intensive rehabilitation programs, whether offered in rehabilitation units or in skilled nursing facilities (Duraski, Denby, Danzy & Sullivan, 2012; Jett, Warren, & Wirtalla, 2005).
A large amount of teaching is often done by stroke rehabilitation nurses who work with older survivors and their families. These include knowing the warning signs of stroke and how to activate the emergency response system in their neighborhood, managing high blood pressure, understanding what medications are ordered as well as how often to take them and why, the importance of regular doctor visits, preventing falls and making the home environment safe, available community education and support groups, and the necessity of maintaining a therapeutic regimen and lifestyle to decrease the risk of complications and recurrent stroke. All survivors will need assistance in re-integrating into the community. This is generally begun in the rehabilitation setting.

For more information on Stroke, visit American Stroke Association at:




By | 2018-06-12T10:32:40+00:00 June 13th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Stroke Warning Signs and Risk Factors

8 Fun Activities for Seniors with Mobility Issues

Do mobility issues have your aging parent down in the dumps? Losing the ability to get around independently can definitely strike a blow to confidence and wellbeing levels. Mobility issues don’t need to stifle a senior’s sense of purpose or enjoyment of life though. Don’t miss these 8 fun activity ideas for seniors with mobility issues:

Board games – bring on the board games and give your loved one a cognitive boost. Everything from cards to Scrabble to Monopoly, Dominos, and Checkers is a great place to start. Stock up on gently used board games from local re-stores like Goodwill and invite friends and family to join in on the fun.

Puzzles – putting puzzles together stimulates critical thinking and problem-solving skills as well as engages spatial awareness and concentration. Don’t reserve your fun to jigsaw puzzles either; games like Sudoku and Jenga have similar brain-boosting effects too!

Cooking – maybe standing at the stove to stir a big pot isn’t feasible, but mixing a green salad at a lower table is. Or helping scoop cookie dough onto a baking sheet. Cooking with your aging parent not only gives them something fun to do but helps them feel like a productive contributor in the home too.

Chair exercises – routine workouts are critical for all older adults, even people who are limited to canes, walkers or wheelchairs. Physical fitness helps prevent unwanted weight gain and lifestyle diseases like diabetes and heart disease. Guides to chair exercises and exercises for those recovering from injuries like fractured hips can be found online.

Art project – get the creative juices flowing and find an art project geared towards your loved one’s interests. Perhaps it is painting on a canvas, collaging, knitting, coloring, making jewelry, or even simply framing family photos – the act of creating something can is truly invigorating.

Planting – potting plants is easy and accessible when your loved one can sit in a chair at a table. Mixing soil, placing plants inside pots, and even snipping dead leaves or picking herbs are monthly activities that your loved one can do with minor assistance.

Reading – Nothing beats a good book. If your loved one is unable to hold a book or see words on a page, audiobooks are a great alternative (and can be borrowed for free at your local library).

Video chatting – for seniors with mobility limitations, social isolation is a very prevalent and dangerous reality. Technology makes it easy, however, to connect with friends and family near and far via free services like Skype, Google Hangouts or Facetime. You simply need a smartphone or webcam with speakers for your computer.

By | 2018-06-09T18:54:35+00:00 June 9th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on 8 Fun Activities for Seniors with Mobility Issues

Guest Post: Natural Treatment of Psoriasis Through Oil Therapy

Psoriasis is a chronic skin ailment caused genetically, triggered by environmental factors. A psoriasis patient shows symptoms like scaling, itching, abrasions and localized redness. P

Affected people are also prone to other health problems like diabetes and heart diseases. It is not contagious, but difficult to cure completely. There are many effective remedies for Psoriasis like medications and skin therapy using essential oils.

Essential oils are used for aromatherapy and oil therapy to treat psoriasis. A lot of research is still needed in the direction of skin treatment using essential and carrier oils. One must also test skin sensitivity for side effects of oils. One should consult a doctor prior to having oils in their treatment regime for psoriasis.

Coconut oil

With its natural anti-inflammatory properties, coconut oil can help in reducing scalp pain. Lauric acid, the primary ingredient in coconut oil blocks bacteria and viruses from getting inside the body. Coconut oil can be taken internally or applied externally over the affected dry scalp surface. One can ingest 2 tablespoons of virgin coconut oil in food every day. Else, coconut oil can be applied on skin directly after taking bath.

Tea tree oil

Tea tree oil is an exotic product, as it is produced using leaves of a native Australian plant. Its natural properties protect body from infestation of bacteria, fungi and viral action. Applying tea tree oil over a psoriasis affected area minimizes any risk of infection. It also brings down the inflammation caused due to Psoriasis. Not only this, tea tree oil also enhances body immunity.

Tea tree oil is available in lotions and soaps. One should however be careful of allergic responses. One must apply only limited quantities to prevent its side effects. It is preferable to test tea tree oil over a small area of skin to find if the person is allergic to it. A lot of research is still to be done to find the benefits and side effects of tea tree oil.

Castor oil

Castor oil is used as the base for essential oils and has a softening or lubricating effect on the skin. It reduces flaking on Psoriasis affected skin if used regularly. It also increases the healing speed of skin. Castor oil when directly applied on skin detoxifies it. By raising lymphocyte count, it raises body immunity.

Lavender oil

It is one of the best known therapies for Psoriasis and other skin problems. Lavender oil has treated skin problems in cases where other forms of medication have failed. The application of Lavender oil upon skin protects it from bacterial and fungal infestation. In addition, it also protects skin from abrasions, muscular pains and headaches.

By applying Lavender oil on your temples, stress is minimized. It reduces itching sensation on skin. Diabetic patients should use Lavender oil in limited amounts. If the oil is used beyond prescribed limits, it may cause irritation, nausea, vomiting or headaches.

It can be mixed with lotion before application. A few drops of Lavender oil may be added to a carrier such as coconut oil to moderate the effects. Lavender oil may be added to water while taking bath for getting best results.

Geranium oil

Geranium oil reduces inflammation due to Psoriasis. It also improves circulatory system and helps in bringing down the stress levels. Geranium oil also enhances cell regeneration and renewal.

Geranium oil can also stop blood flow. So, people suffering from high blood pressure and those prone to cardiovascular ailments must use it with caution. Mixing geranium oil with carrier oil can be applied on psoriasis hit areas for best results.

It is better to test for side effects before applying it on skin. It can be diluted using a carrier oil for reducing side effects.

Peppermint oil

Peppermint oil is an effective cure for Psoriasis and other skin ailments. There are 25 species and 600 varieties of Peppermint, through which the oil is extracted. The curative ability of peppermint oil is attributed to menthol, its main ingredient.

Peppermint oil is harmless in limited dosages. But, otherwise there are chances that its application may cause allergic reaction on skin. One should rather test by applying over a small area of skin before actual use.

As a home remedy, 5 or 6 drops of peppermint oil are mixed with distilled water. The mixture is then sprayed on painful and itch-prone areas to stimulate skin relief.

Argan oil

Argan oil has anti-inflammatory as well as antiseptic properties. Because of such properties, it provides effective treatment for Psoriasis. Argan oil is a Vitamin E rich carrier oil. It helps in skin hydration and in enhancing skin’s metabolism.

It also reduces inflammation and protects skin from adverse effects of solar heat intensity. The oily part fights psoriasis symptoms such as redness, swelling, dryness and itching sensation. Argan oil can be applied directly over the Psoriasis affected parts. It can also be mixed with essential oils for proper action upon skin.

Black cumin seed oil

Black cumin seed oil protects skin from attack of bacteria, fungi, worms and viruses. It brings down intensity of skin inflammation in Psoriasis affected people. Simultaneously, it enhances skin’s healing process. It helps in minimizing scale thickness and also has a moisturizing effect on skin.
Black seeds have natural blood clotting properties. In addition, they bring down blood pressure levels. So they are safe for people affected with high blood pressure. Low pressure patients must first consult a doctor before using black seed oil for Psoriasis treatment.

One should also be wary of the intoxicating effect of overusing black seed oil. Black seed oil can be applied directly on human skin. Alternately, it can be mixed with a carrier oil prior to application on skin.

Consideration of risk factors

While applying a specific oil for psoriasis treatment, one should first research about it.
Essential oils and carrier oils have pharmaceutical properties. Hence, it is mandatory to follow the precautions for effective therapy . Essential oils must never be used beyond a certain quantity.

Also, it is better to consult a doctor to find the safe limits of essential oils to be applied for psoriasis treatment. Females must not use them in state of maternity or lactation.

Before application, one must meticulously go through product labels and follow attached instructions. One must know how the particular essential oil reacts with skin in order to meet the therapeutic purpose.

Michael Swift is a connector with Caffeinated who help businesses find their audience online. In his spare time, he reads books, writes for his blog and commits to do any activities that take place outdoors.

By | 2018-06-05T17:14:08+00:00 June 8th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Post: Natural Treatment of Psoriasis Through Oil Therapy

5 tips for making an elderly relative’s home more accessible

Within the next ten years, the number of people and families with elderly relatives to care for is likely to exponentially increase, with the old in some Western populations actually likely to outnumber the young by the early 2020s. This means that more and more families will have to make long-term plans to care for a relative into old age. The added pressure of a rising elderly population will manifest itself in more money needed for public and social care provision.

In order to both save money and (more importantly) provide a more comfortable and enjoyable experience for our elderly loved ones who are in need of social care, it’s going to be necessary to make more provisions for our older friends and relatives to be cared for in their home.

There are a number of different types of accessibility alterations which may be required if your elderly loved one suddenly has difficulty getting around the house. These include:

• Help accessing a home (e.g. ramps or hand rails when approaching the front door).
• Help getting around a home (e.g. ramps, stair lifts, more grab rails and handles for getting up and down stairs/ in and out of rooms.)
• Help with mobility in the kitchen and bathroom.
• Help with visibility/poor vision in the home
• Alarm/warning systems in the event of an accident or fall.

These are the main types of obstacles which an elderly relative may face as they deal with the difficult challenges and lifestyle alterations caused by decreased mobility in old age. Below are 5 of the most useful tips which could make all the difference, and hopefully ensure that your elderly friend or family member lives a much happier and fulfilled life.

1. Move the essentials downstairs

Moving all the essential facilities in your house to the ground floor can be the simplest way to improve overall access and ease any potential mobility issues which an elderly loved one may face. If there’s a way of suitably renovating the house so that there’s access to a bedroom, dining area and living quarters on the ground floor, then this will minimize the risk of any trips, falls, emergencies or accidents.

The decision to move all the major facilities/core rooms in a home to one floor may form part of a wider conversation about whether an elderly relative may wish to downsize to a bungalow, or a house with easier accessibility built in to the design.

2. Make bathrooms easier to use

Bathing and washing are the most private and essential of daily rituals, and a person’s ability to bathe and wash safely and easily is arguably central to their sense of dignity and self-esteem. This means that accessibility improvements to a bathroom are arguably some of the most urgent alterations you can/should be making to a home.

Helpful structural changes to a bathroom include:
• Level access/walk in showers, ensuring that an elderly person doesn’t have any immediate trip hazards, and minimising the risk of falls as they get in or out of the bath/shower.
• Handrails mounted to the walls, should an elderly relative require help getting up off the toilet.
• Removing any other extraneous trip hazards, such as bath mats or even ripping up tiled surfaces which may inadvertently mean a person could slip or trip when the surface becomes wet.

3. Stair/wheel chair lifts

These can be an essential addition to any household and are once again an invaluable tool for minimising trips and falls. If your elderly friend or loved one is adamant that they don’t want to make too many major changes to their day-to-day lifestyle and want to keep their room layout broadly the same, then a chair lift can be a great way to maintain both continuity and guarantee safety. Installation and maintenance are increasingly simple.

4. Replacing household accessories

By this, we mean replace everyday household accessories which control the day-to-day operation of the house. These include light switches and door handles. Switching your existing light switches to touch lights or dimmer switches can give an elderly relative an opportunity to take advantage of more subtle lighting states, which is especially useful if they are partially sighted/having difficulty seeing in darker rooms. Likewise, replacing any door knobs with lever handles is an easy way to ensure that your elderly relative can enjoy easier mobility when moving between rooms.

Likewise, re-arranging kitchen drawers and storage to make it more easily accessible is another straightforward way of improving accessibility and minimizing risk.

5. Installing a personal alarm system

This may be a source of understandable reluctance for someone who may be having to confront problems with mobility. After all, conceding that you need some of kind of emergency back-up system can, in turn, feel like an admission of vulnerability, and preparing for a worst-case scenario that none of us want to think about as we get older.

Nevertheless, installing a personal alarm system in the event of any serious accident or fall is a vital last line of defense in ensuring that your elderly relative or loved one is safe and secure in their own home.

A number of telecare systems allow a homeowner to alert a carer or member of the emergency services should they find themselves falling victim to a trip, fall or major accident.

Encore Care Homes offer care homes across the south of England. Their private homes offer palliative care, short-term respite care, long-term residential, and nursing care.

By | 2018-06-05T16:50:07+00:00 June 6th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on 5 tips for making an elderly relative’s home more accessible