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What is COPD?

Background

COPD Chronic obstructive pulmonary disease (COPD) refers to a group of diseases resulting in airflow obstruction due to smoking, environmental exposures, and genetics. However, smoking is clearly the most common cause of COPD. The two disorders most commonly included under the umbrella of COPD are emphysema and chronic bronchitis. Although the disease mechanisms contributing to airflow obstruction is different in these two disorders, most patients demonstrate features of both emphysema and chronic bronchitis.

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In 2008, the CDC recently released a report naming COPD as the third leading cause of death in the United States (National Vital Statistics Reports [NVVS], 2010). There are more than 12 million people in the United States U.S. diagnosed with COPD. However, due to the under diagnosis of the disease, only estimations of the prevalence of COPD are available, which suggest that approximately 24 million people are living with COPD (ALA, 2012). Slightly more females than males are affected, with female smokers having a 13 times greater chance of death from COPD than nonsmoking females (ALA, 2004).

 

Chronic Bronchitis

Chronic bronchitis is a common COPD among older adults. It results from recurrent inflammation and mucus production in the bronchial tubes. Repeated infections produce blockage from mucus and eventual scarring that restricts airflow. The American Lung Association (2012) stated that about 8.5 million Americans had been diagnosed with chronic bronchitis as of 2005. Females are twice as likely as males to have this problem.

Emphysema

Emphysema results when the alveoli in the lungs are irreversibly destroyed. As the lungs lose elasticity, air becomes trapped in the alveolar sacs, resulting in carbon dioxide retention and impaired gas exchange. More males than females are affected with emphysema, and most (91%) of the 3.8 million Americans with this disease are over the age of 45 (ALA, 2004).

Risk Factors

The major risk factor for COPD is smoking, which causes 80–90% of COPD deaths. Alpha-1-antitrypsin deficiency is a rare cause of COPD, but can be ruled out through blood tests. Although “COPD is almost 100% preventable by avoidance of smoking” (Kennedy-Malone et al., 2003), environmental factors play a strong role in the incidence of COPD. Approximately 19.2% of people with COPD can link the cause to work exposure, and 31.7% have never smoked (ALA, 2008).
Warning Signs

The signs and symptoms of chronic bronchitis include increased mucus production, shortness of breath, wheezing, decreased breath sounds, and chronic productive cough. Chronic bronchitis can lead to emphysema. Signs and symptoms of emphysema include shortness of breath, decreased exercise tolerance, and cough.

Diagnosis

Persons with COPD often experience a decrease in quality of life as the disease progresses. The shortness of breath so characteristic of these diseases impairs the ability to work and do usual activities. According to a survey by the American Lung Association, “half of all COPD patients (51%) say their condition limits their ability to work [and] . . .” and “. . . limits them in normal physical exertion (70%), household chores (56%), social activities (53%), sleeping (50%), and family activities (46%)” (2004, p. 3). Diagnosis is made through pulmonary function and other tests, and a thorough history and physical.

Treatments

Although there are no easy cures for COPD, older adults can take several measures to improve their quality of life by controlling symptoms and minimizing complications. These include lifestyle modifications such as smoking cessation, medications (see below), oxygen therapy, and pulmonary rehabilitation. Older adults should have influenza and pneumonia vaccinations (National Heart Lung and Blood Institute, [NHLBI], 2010). Oxygen therapy may be required for some people.

Medications are used to help control symptoms, but they do not change the downward trajectory of COPD that occurs over time as lung function worsens. Typical medications given regularly include bronchodilators through oral or inhaled routes. Antibiotics may be given to fight infections and systemic steroids for acute exacerbations.

In extreme cases, lung transplantation may be indicated. Older persons with severely impaired lung function related to emphysema may be at higher risk of death from these procedures and have poorer outcomes.
Reducing factors that contribute to symptoms, use of medication usages, alternating rest and activity, energy conservation, stress management, relaxation, and the role of supplemental oxygen should all be addressed. Many older adults with COPD find it helpful to join a support group for those who are living with similar problems.

For more information on COPD, visit the American Lung Association:
http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html

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 |2020-01-20T09:48:05-05:00January 21st, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on What is COPD?

Guest Blog: Multigenerational Living

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Ever heard of multigenerational living? It’s a hot topic these days because many seniors are looking for ways to remain independent longer. As more people enter their advanced years, they and their families are faced with difficult decisions of how to provide the best care possible. For seniors hoping to keep their independence, living with family is the next best option to aging at home. Even if your house isn’t big enough to handle more people living in it, there are companies who remodel homes specifically for seniors moving in.

 As noted in NYU Professor Eric Klinenberg’s “Aging alone in America,” 33% of American seniors make the decision to remain out of care facilities. With medical progress and healthier living, remaining out of a care home has become more practical than it once was.  Among the rest of the world’s population, living with the elderly is more common, but as Americans, we tend to stay separated from our parents once we move out. With the economic downturn of 2008, however, young adults are staying in their parents’ homes longer and older people are moving back in with their children. Seems like we’re becoming more European every day!

Since elder care facilities commonly drain assets, there are obvious cost benefits to bringing your parents to you. Even more importantly than saving money, living at home helps seniors stay healthy by maintaining a routine. Things we take for granted like housekeeping, cooking, or yard work are types of physical and mental exercise that people do not receive in assisted living centers. After years of retirement it’s easy to lose one’s routine. If someone completely loses their routine they can develop what is called aging atrophy, which means increased dependence on those around them. Doing small chores helps combat aging atrophy. Plus, they can perform the cleaning duties or home upkeep you might not have time to do yourself.

Lastly, living in a multigenerational setting allows seniors to maintain control over their environment. At facilities, there is contact with nurses, other residents, and even other residents’ families that cause exposure to illness. Keeping a clean environment at home without strangers around can help ward off sickness. If your loved one begins to require too much care to remain healthy at home, however, you should look into home-health services or other living options. Aging is often associated with making major decisions, but keeping parents close can help reduce stress.

Jacob Edward is the manager of both Prime Medical Alert and Senior Planning in Phoenix, Arizona. Prime Medical Alert allows seniors to stay in their homes longer and sells equipment throughout the country. In his spare time, Jacob enjoys dining out and supporting his alma mater Arizona State’s Sun Devil sports teams. Jacob lives in Tempe, Arizona.

 

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By |2020-01-20T09:47:47-05:00January 20th, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Multigenerational Living

My not-bucket List

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Some people, when they get to be my age, make a bucket list – that is, those activities they would like to do before they die. Well, I decided to make a list of the things I don’t ever care to do and am happy that I haven’t done…so here is my short not-bucket list:

Go sky diving. While this might be one many people’s bucket list, I have no desire to go skydiving. I just can’t imagine that the euphoria at having survived jumping out of plane and relying on a parachute for my life would ever override the sheer terror of the falling feeling. In fact, I would probably have a heart attack and die of fright on the way down.

Own a snake. I hate snakes and would never call one a pet. I would always be worried that it would escape and I would find it in my shoes one day all dried up, or worse yet, that it would curl up in the shower or hide in my closet. A big snake might eat my little dog or cat. Snakes seem like tricky creatures that would give me nightmares. Nope, no snakes for me.

Smoke a cigarette. No, I have never smoked a cigarette. In fact, when I was about 8 years old and my Dad was once smoking a cigar, which he did only occasionally (being more of a pipe man himself), I wanted to be like him and try a smoke. Dad said okay, and told me to take a big deep breath to inhale that delicious cigar smoke. As you might imagine, the fitful coughing after that one drag, combined with his laughter, cured me of ever wanting to smoke anything – thus Dad’s lesson. He did, however, teach me great technique in stuffing his pipe, though not smoking one!

Go bungee jumping. Even if we set aside all the health hazards of having your hips and knees nearly yanked out of their sockets, your pelvis twisted and jolted, or the risks of having a stroke from all the blood rushing to your brain as you hang upside down, this is not appealing at all to me. Those with hiatal hernias or GERD should not put this on their bucket list. Similar to my feelings about sky diving, I just would not trust that the bungee cord would be strong enough or short enough to make it worth the thrill. Even with a go-pro camera to record the event, I’m sure that my screaming would overshadow any future comedic home movies that would come from it.

Get drunk.  I can’t see the attraction of getting drunk and not remembering what you did the night before. I guess that it makes for funny big screen movies, but vomiting all over the carpet and having to clean it up the next day when sober just doesn’t make it onto my list of anything remotely resembling fun. Besides, if I ever got inebriated, I would probably be found dancing on a table in a nightclub, make the evening news, and embarrass my kids to death.

Get a kidney stone.  I have already had one kidney stone and they are definitely not fun. I don’t care to have another, so I drink plenty of water throughout the day. It is true what they say, that the pain can be excruciating and intractable. Kidneys stones should be on the “avoid at all costs” list of everyone.

So, what’s on your not bucket list?

By |2020-01-18T10:06:29-05:00January 18th, 2020|Dr. Mauk's Boomer Blog, News Posts|Comments Off on My not-bucket List