Hypothyroidism results from lack of sufficient thyroid hormone being produced by the thyroid gland. Older adults may have subclinical hypothyroidism, in which the TSH (thyroid-stimulating hormone) is elevated and the T4 (thyroxine or thyroid hormone) is normal; 4.3–9.5% of the general population has this problem (Woolever & Beutler, 2007). In this condition, the body is trying to stimulate production of more thyroid hormone. Some older adults with this condition will progress to have primary or overt hypothyroidism. This is when the TSH is elevated and T4 is decreased. Hashimoto’s disease is the most common cause and represents 90% of all patients with hypothyroidism (American Association of Clinical Endocrinologists [AACE], 2005; Woolever & Beutler, 2007), though certain pituitary disorders, medications, and other hormonal imbalances may be causal factors.
Older adults may present an atypical picture, but the most common presenting complaints are fatigue and weakness.
Diagnosis should include a thorough history and physical. Bradycardia and heart failure are often associated factors. Lab tests should include thyroid and thyroid antibody levels (common to Hashimoto’s), and lipids, because hyperlipidemia is also associated with this disorder.
Treatment centers on returning the thyroid ¬hormone level to normal. This is done through oral thyroid replacement medication, usually L-thyroxine. In older adults with coexisting cardiovascular disease, starting with the usual doses may exacerbate angina and worsen the underlying heart disease, so it is important to start low and go slow. Titration should be done cautiously, with close monitoring of the older adult’s response to the medication. The does should be adjusted on 6- week intervals until normal levels of thyroid hormone are achieved. Once the TSH is within normal limits, then checking the TSH should be done every 6 to 12 months to monitor effectiveness and blood levels, because hyperthyroidism is a side effect of this therapy and can have serious implications on the older person’s health.
Patients need to learn the importance of taking thyroid medication at the same time each day without missing doses. Sometimes older adults have other problems associated with hypothyroidism, such as bowel dysfunction and depression. Any signs of complicating factors should be reported to the physician, and doctors’ appointments for monitoring should be religiously kept. Strategies for managing fatigue and weakness should also be addressed, because some lifestyle modifications may need to be made as treatment is initiated.
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.
The NIH Senior Health reports that one in three people over the age of 65 experience a fall each year. Because of the non-porous, easy clean surfaces, more than 80% of these falls happen in the bathroom. The proper equipment will help to keep everyone safer. Be sure to check your loved one’s for the following:
Grab Bars. One of the simplest solutions to preventing bathroom falls is to install grab bars. Choose bars that have a grip-like surface and contrast to the color of the shower, so they are easily visible. Anchor these bars to the studs behind the wall for the best support. Have your loved one step into the tub and show you where the best place to install a safety bar is located. Adding a grab bar next to the toilet is another simple way to prevent falls.
Non-Skid Surfaces. Placing a non-skid floor mat in front of the shower and sink soaks up excess water and prevents slips. Adding a non-skid shower mat to the bathtub will prevent your loved one from sliding on the slippery tub surface when bathing. For additional safety, place non-skid adhesive strips around the sink and vanity area.
Raised Toilet Seat. Adding a raised toilet seat prevents your loved one from losing her balance and falling while trying to sit on the toilet or get up. It is also helpful for those who are losing strength.
Lighting. Many seniors lose depth perception, having brighter lighting will help your senior to judge distances better, such as stepping into the bathtub. Adding motion lights on the path to the bathroom, as well as in the bathroom, will help your loved one to see where she is walking. Having plenty of lighting will help your loved one to locate toiletry items quicker and easier as well.
Declutter. Because many older people end up needing to use a walker or cane, it is important to make sure walking paths are clean and clutter-free. It is important to keep items such as towels off the floor and out of the way as much as possible. The less items your loved one can get hooked on, the safer the home will be.
Preventing a fall from happening is ideal. However, there are times when accidents happen. Consider getting your loved one a medical alert system as an additional layer of safety. The best systems offer waterproof pendants, so they can be worn while bathing. If your loved one does fall, she can press the button and get help immediately, which may save her life.
One of the common health complaints of the elderly is chronic sinusitis. About 14.1% of Americans 65 and older report suffering from chronic sinusitis; for those 75 years and older, the rate is slightly lower at 13.5% (American Academy of Otolaryngology, 2012). Age-related physiological and functional changes that occur can cause restrictions to the airflow. This results from irritants blocking drainage of the sinus cavities, leading to infection.
Symptoms include a severe cold, sneezing, cough (that is often worse at night), hoarseness, diminished sense of smell, discolored nasal discharge, postnasal drip, headache, facial pain, fatigue, malaise, and fever (Kelley, 2002). The person may complain of pain around the sinus areas, and swelling and redness of the nasal mucosa may be evident.
Allergies, common cold, and dental problems should be ruled out for differential diagnosis. When symptoms continue over a period of weeks and up to 3 months and are often recurring, chronic sinusitis should be suspected. A CT scan of the sinuses will likely show areas of inflammation.
Treatment for chronic sinusitis is with antibiotics, decongestants, and analgesics for pain. Inhaled corticosteroids may be needed to reduce swelling and ease breathing. Irrigation with over-the-counter normal saline nose spray is often helpful and may be done two to three times per day. The person with chronic sinusitis should drink plenty of fluids to maintain adequate hydration and avoid any environmental pollutants such as cigarette smoke or other toxins. Chronic sinusitis is a condition that many older adults wrestle with their entire life. Avoidance of precipitating factors for each individual should be encouraged.
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.
Running a marathon is one of the toughest things that you can do. Doing the full 26.2 miles requires grit, determination and a bit of luck. Luck in the sense that it reaches a point along the marathon whereby your will to run is gone and all you can do is hope that your body doesn’t give in. You require a lot of energy to run a marathon but the fact that it is a competitive event makes it difficult for stop and snack up. You, therefore, have to do with the food reserves stored in your body. The problem with this, however, is that the body can only store a limited amount of food reserves. This reserve is depleted way before you complete the marathon and it is at this point that the “wall” appears.
To provide you with the energy to run, food is broken down to supply you with this energy. The primary food item that broken down to generate energy is carbohydrates since it requires very little oxygen to do so. When you are running, you let in very little oxygen into the blood stream and that is why carbohydrates are broken down first. The body can hold about 2000 calories of carbohydrates at any given time and this reserve can only last up to the 20th mile. From this point, the body turns to the fat deposits in the body for energy generation. Breaking down fats to produce energy generates a lot of waste products and this contaminates your interior. It also requires a lot of oxygen but since you are not taking in enough air, the body resorts to burning your muscles to generate the needed oxygen. This has the effect of making you feel like you are pulling a heavy load with your feet. Since your body is concentrating on generating energy, your focus shifts from running to this activity. You, therefore, find it difficult to concentrate on running and those who are not of strong will find it easy to give up.
Marathon caring and ‘The Wall”.
Aging brings with it a lot of challenges and at some stage in life, we would be expected to take care of our loved ones. It could be our parents, grandparents or other family members. Most would think that it will only be for a short period of time but the truth is that it usually stretches several years and this is what makes it a marathon. Taking care of another person is very challenging and it will overwhelm even those claiming to be strong willed. It requires that you feed, clothe as well as clean up the person under your care. You are in charge of their medication as well and this means that you have to monitor their pills to make sure they never run out. See how overwhelming that can be?
When compared to a marathon, all these responsibilities represent the various stages of a marathon. It is easier at the beginning since you are all psyched up and full of energy. It gets difficult with time as your ‘energy reserves’ are depleted and your enthusiasm fades. At this point, it is only a matter of time before you ‘hit the wall’.
The wall of a marathon caregiver.
The wall to a marathon caregiver represents that point when you see your dependent as a burden. This is that point when you are no longer excited to see those in your care. The wall is a very difficult point since it could see you neglect those in your care.
Keeping the wall at bay.
There are a few things that you can do to keep the way at bay. The first thing is to understand the course and this entails understanding your dependents better. If they have any illnesses, get to understand them as this will make it easy for you to manage them. Learn how to take care of old people and you can do that by checking out care homes near me. This will make you a better care giver and better equipment to avoid the wall.
Have you felt like your increasing age is taking a toll on you? As men increase in age, their normal hormone levels decrease and result in different types of male hormone imbalances. One of which is andropause or “male menopause” – a decline in a man’s levels of testosterone, their primary male sex hormone.
A gradual but significant decline in a man’s testosterone begins at age 30 at a rate of 1 to 2% per year. By about age 70, a man’s testosterone levels may have declined by 50%. Because testosterone plays a huge role in a man’s overall health, low T levels may produce different adverse effects.
Andropause and senior health
Here are the most common symptoms and changes you can expect from andropause in your senior years:
- Sleep disturbances: Sleeping difficulties or disturbances in andropause men include insomnia, sleep apnea, night sweats, and restless leg syndrome (RLS).
- Emotional changes: Different changes in emotions during andropause often result to a lack of motivation, depression, forgetfulness, and lack of concentration.
- Sexual dysfunction: During andropause, a man’s sexual function also weakens and lays low, which may result in low sex drive, infertility, and erectile dysfunction.
- Osteoporosis: With declining testosterone levels, men become more susceptible to osteoporosis. Low levels of testosterone lead to loss of bone tissue and mass.
- Physical changes: Other physical manifestations of andropause in men include increased abdominal fat, decreased muscle mass, hair loss, and swollen breasts.
Dealing with andropause
Although andropause can’t be escaped, it can be managed. Men can deal with the different symptoms and risks brought about by andropause with these simple steps:
- Weight management: Stored extra fat, especially in the belly, can convert testosterone to estradiol. Healthier lifestyle choices such as proper diet and regular exercise are greatly recommended.
- Physical activity: Engaging in physical activities can help alleviate unpleasant symptoms of andropause, such as mood swings and sleeping difficulties, while helping manage your weight.
- Proper nutrition: Practice eating healthier food choices including fiber-rich foods, omega-3 fatty acids, lean meat, and fruits and vegetables for overall health, increased energy, and strength.
- Getting checked for depression: Depression is one of the symptoms of andropause that you should keep an eye on. Beware of signs of depression or have your primary care provider screen you for possible depression.
- Expert consultation: The best way to deal with andropause is through an expert doctor’s help. Be honest about your symptoms for proper diagnosis and treatment. For some, testosterone replacement therapy can be given as an effective treatment.
Get equipped and be ready for the andropause battle!
The younger generation may think that all of today’s technology is reserved only for their use, but that’s simply not the truth. Many areas of this digital age can greatly benefit senior citizens, and here are just five ways that older folks can use technology to enhance their lives.
1. Cellphones: Today’s seniors aren’t typically sitting home in rocking chairs or baking cookies. Active senior citizens may enjoy travel or fast-paced social lives, and this makes a cell phone the perfect way to keep in touch wherever you roam. While many phones are difficult to use and feature tiny buttons, there are some very easy to use cell phones for seniors that utilize large, easy-to-see buttons that are just perfect for the older population.
2. Advanced Recliners Nothing beats a hot massage at the end of the day. New technologies in recliners are ready for the 21st century. Today some power lift recliners heat, massage, and much more. They can even help you get up after your snooze.
3. Medical Alert Systems: If you’re a senior citizen who has been afflicted with health issues, then you can still live alone in your own home without fear. Many companies offer medical alert systems that allow you to wear a pendant-style device that can summon help with the press of a button. Others are programmed to call for assistance if a fall is detected, and there are even companies that track your movements through GPS so that you can be helped even when you’re away from home.
4. Computers: Internet companies are keeping senior citizens connected throughout the world. It’s a wonderful method of making new friends, joining groups with those who share your favorite hobbies and keeping up with local and worldwide news. Seniors may also keep up with their extended family and see related pictures through social media, shop online, research medical concerns and arrange for local services online.
5. Electronic Readers: Aging eyes can lose the ability to read normal-size print, and this is a great loss to those who have loved to read their entire lives. With the help of various tablets and e-readers, senior citizens can download books, newspapers and magazines, which can be read at any size that the individual requires. These e-readers can also change the brightness to suit your visual needs.