Dr. Mauk’s Boomer Blog
Each week, Dr. Kristen Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.
Dr. Kristen L. Mauk, PhD, DNP, RN, CRRN, GCNS-BC, GNP-BC, FAAN
Guest Blog: Why The Golden Years Are the Best Years of Your Life
Portrait of a happy old couple sitting on quay by sea
For seniors, getting old is the new black. You can ask them yourself. Because according to a recent survey, 68% of seniors never feel offended for being treated like one, while 70.3% feel being called ‘old’ is hardly offensive. The truth is, getting old is blessing – not a curse.
For starters, age brings wisdom. By the time the grey hairs start popping up, you’ve had your fair share of experiences. You’ve likely travelled around a bit, held a few jobs, been through good and bad relationships, started a family, and made some life-changing decisions. But when it comes down it, you’re all the wiser for it. Going forward you can make better, more informed decisions, and even give your two cents to the younger generation.
As you mature, so too will your relationships. You’ll likely cut out the friendships that didn’t mean much, and work on the ones that do. Essentially, you’ll start seeking quality, not quantity, across all areas of your life – which isn’t a bad philosophy to live by. Plus, who said getting old isn’t fun?
Take LATA 65 for example, an art organisation in Portugal that’s destroying age stereotypes in the street art scene. By giving senior citizens the tools and knowledge to create their own stencils, the organisation’s goal is to connect the older and younger generations through art, as well as help the elderly get out and about to engage in contemporary culture.
But that’s just one example of how seniors are making the most of their retirement. What else are they getting up to?
How Aussies are living it up in their golden years
Gone are the days of knitting, card games and staying put. Seniors these days are proving to be one the most lively and radical bunch of seniors to date. According to the Golden Years Report, 85% of seniors consider themselves happy, while 80% are doing the things they really want to do.
In fact, most feel younger than they actually are. This can be attributed to being more physically active, learning new things, travelling to new places, having new experiences, being sociable, and having hobbies.
Seniors are also busting ‘old age’ stereotypes. For example, as technology becomes more prominent in our lives, Aussie seniors are no longer relying on others to show them the ropes. Instead, many are now technically savvy and spend plenty of time online. They also have no problem dressing like younger generations, speaking the same lingo (#YOLO), or even getting tattoos.
While they might not be huge spenders, today’s retirees are also spending more money than earlier generations. So instead of slowing down and disappearing modestly into retirement, they’re choosing to fork out just as much money (sometimes more) on their later lifestyles. And why not? Retirement isn’t an expiry date – it’s an excuse to live life to the fullest.
It’s safe to say, Australian seniors are reinventing the concept of ‘getting older’. They’re not confined to the activities and stereotypes usually associated with old age, and are instead open-minded, tech-savvy and progressive. They’re not just comfortable with the modern world, they’re enthusiastically making the most of it. So if there’s one take home message here, it’s this – there’s still plenty to look forward to.
What is a Seizure and Warning Signs?
Background
Once thought to be mainly a disorder of children, recurrent seizures or epilepsy is thought to be present in about 7% of older adults (Spitz, 2005) and is usually related to one of the common comorbidities found in older adults (Bergey, 2004; Rowan & Tuchman, 2003). Epilepsy affects up to 3 million Americans of all ages (Velez & Selwa, 2003). Davidson & Davidson (2012) summarized findings of most studies on epilepsy in older adults with these main points:
Seizures can be caused by a variety of conditions in older persons, but “the most common cause of new-onset epilepsy in an elderly person is arteriosclerosis and the associated cerebrovascular disease” (Spitz, 2005, p. 1), accounting for 40–50% of seizures in this age group (Rowan & Tuchman, 2003). Seizures are associated with stroke in 5–14% of survivors (Spitz, 2005; Velez & Selwa, 2003). Other common causes of epilepsy in the elderly include Alzheimer’s disease and brain tumor.
There are three major classifications of epilepsies, although there are many additional types. Generalized types are more common in young people and associated with grand mal or tonic-clonic seizures. A number of cases have an un¬determined origin and may be associated with certain situations such as high fever, exposure to toxins, or rare metabolic events. In older adults, localized (partial or focal) epilepsies are more common, particularly complex partial seizures (Luggen, 2009). In contrast to young adults, Rowan and Tuchman (2003) cite other differences in seizures in the elderly: low frequency of seizure activity, easier to control, high potential for injury, a prolonged postictal period, and better tolerance with newer antiepileptic drugs (AEDs). Additionally, older adults may have coexisting medical problems and take many medications to treat these problems.
Risk Factors/Warning Signs
Risk factors for seizures in older adults include cerebrovascular disease (especially stroke), age, and head trauma. The most obvious signs and symptoms of epilepsy are seizures, although changes in behavior, cognition, and level of consciousness may be other signs. Also, note that exposure to toxins can cause seizures that are not epilepsy. Complex partial seizures in older adults may include symptoms such as “confusion, memory loss, dizziness, and shortness of breath” (Davidson & Davidson, 2012, p. 16). Automatism (repetitive movements), facial twitching with following confusion, and coughing are also signs of the more-common complex partial seizure (Luggen, 2009).
Diagnosis
Diagnosis is made by careful description of the seizure event, a thorough history, and physical. Eyewitness accounts of the seizure incident can be quite helpful, although many community-dwelling older adults go undiagnosed because their seizures are never witnessed. In addition, complete blood work, neuroimaging, chest X-ray, electrocardiogram (ECG), and electroencephalogram (EEG) help determine the cause and type of seizure (National Institute for Health and Clinical Excellence {NICE}, 2012).
Treatment
Treatment for epilepsy is aimed at the causal factor. The standard treatment for recurrent seizures is antiepilepsy drugs (AEDs). The rule of thumb, “start low and go slow,” for medication dosing in older adults particularly applies to AEDs. The elderly tend to have more side effects, adverse drug interactions, and problems with toxicity levels than younger people.
Research has suggested that older adults may have better results with fewer side effects with the newer AEDs than the traditional ones, though about 10% of nursing home residents are still medicated with the first-generation AEDs (Mauk, 2004). The most common older medications used to treat seizures include barbiturates (such as phenobarbital), benzodiazepines (such as diazepam/Valium), hydantoins (such as phenytoin/Dilantin), and valproates (such as valproic acid/Depakene) (Deglin & Vallerand, 2005; Resnick, 2008).
Several newer drugs are also used, depending on the type of seizure. Second-generation AEDs, including gabapentin (Neurontin), lamotrigine (Lamictal), oxcarbazepine (Trileptal), levetiracetam (Keppra), pregabalin (Lyrica), tiagabine (Gabitril), and topiramate (Topamax), are generally recommended over the older AEDs; however, older AEDS such as phenytoin (Dilantin), valproate (Depakote), and carbamazepine (Tegretol) are the most commonly prescribed treatment options (Resnick, 2008). Each of these medications has specific precautions for use in patients with certain types of medical problems or for those taking certain other medications. Regarding side effects in older patients, watch for potential stomach, kidney, neurological (especially poor balance or incoordination), and liver problems. Additionally, some newer extended-release AEDs are thought to be better tolerated and have a lower incidence of systemic side effects (such as tremors) (Uthman, 2004).
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.Burlington, MA: Jones and Bartlett Publishers. Used with permission.
Pets Provide Significant Health Benefits
Pets Provide Significant Health Benefits By Rachel Blankmeyer, DVM
Some of our closest companions, especially as we age, are our four-legged friends. The human-animal bond provides many benefits to people who may otherwise be isolated due to emotional, behavioral, or physical problems. Research shows several health benefits of pet ownership for older adults, including lower blood pressure, triglycerides, and cholesterol levels. A study by Friedmann & Thomas in 1995 showed that pet ownership actually resulted in increased survival rates after a heart attack. Other studies have shown that pets may provide social support similar to that of a family member for older adults. Consider additional general health benefits such as weight control and stress reduction, and pet ownership seems like a win-win situation!
You may have heard of the Alzheimer’s patient study performed by Edwards & Beck in 2002, where persons with Alzheimer’s disease observed a facility fish tank and demonstrated improved relaxation, alertness, and eating habits. This is a huge deal for patients dealing with dementia because at least 50% experience weight loss, increasing the mortality rate and progression of disease. Stroke survivors may also specifically benefit from animal companionship through improved communication, dexterity, mobility and balance. As a veterinarian, I may be biased, but the facts don’t lie: animals help all of us have a more active daily life, and can enrich our lives emotionally! So, consider the cost-benefit ratio:
Adopting your new forever friend from your local shelter…$35
Pet food for one month…$10
Years of companionship and improved health…priceless.
Tips for Talking About Mental Health With a Loved One
According to the latest statistics from the National Institute of Mental Health Disorders, 1 in 4 adults in the U.S. face a diagnosable mental health condition. Sadly, many refrain from seeking help. When it comes to having a discussion about mental health with a loved one, it can be difficult to find a place to start. For the listener, it’s often difficult to find the right words to say or determine the best way to offer support. For the individual seeking help, it can be hard to describe just how they are feeling or even find the best course of action to do so. That is why we have compiled some advice to help you begin a conversation about mental health with your loved one.
Actively Listen
It’s a meaningful step for a loved one to open up about their mental health, so having an open ear to actively listen is key to understanding how you can best offer support. Being engaged in the conversation can be made easier by limiting distractions. Leave electronic devices turned off and put away when possible, and avoid bustling spaces like eateries or parks. Find somewhere private and comfortable. This will put you both at ease and also allow you to focus on what your loved one is expressing.
Don’t Judge
It’s also important to listen without judgment or comparison. It’s okay to share experiences that offer insight into coping mechanisms or that build trust and relatability, but try to refrain from making it a competition of who has it worse. This may make the individual seeking help feel as if their experience is not valid. Try your best as the listener to set opinions or biases aside to allow your loved one to express themselves without fear of disappointing you or feeling judged or embarrassed. Instead, listen with an open mind to learn and offer insight based on their specific mental health experience.
Do Your Research
When a loved one comes forward to discuss their mental health, it may be a challenge to really understand just what they are going through on a day-to-day basis. This is where ample research can help you as the listener. Find relevant online resources, like this example from WebMD, that give a digestible overview of specific mental health disorders that your loved one may be struggling with. Bring this research to the conversation and make note of their unique mental health experience and how it applies to what you have learned. This can allow you to be a better resource for next steps and set plans of action to help them cope with their mental health.
Be a Resource
Once you’ve determined the next steps based on the discussions you have had with your loved one about their mental health, set those steps in motion. Review everyday habits they can instill in their routine to feel a better sense of control over their mental health. Be present enough as well to know when to seek help that you, as the listener, can not provide yourself. This may include suggesting the need for professional help. Online psychiatry resources make it easier than ever to commit to routine help from professionals, all while staying in the comfort of your own space. As the listener, this can be a difficult topic to broach, but don’t be afraid to push your loved one to seek professional help if needed and reassure them that you will be with them every step of the way.
How To Make Aging In Place As Easy As Possible
Many seniors lead active lives after retirement, and while some individuals have physical or mental limitations that prevent them from doing so, most want to remain in their own home for as long as they can. When faced with the choice of moving toward assisted living or staying comfortable in the house they have lived in for years, there’s no question of which is the more appealing option. Yet for every senior, safety and comfort are two of the most important concerns when considering aging in place.
It can be difficult to think of all the things one must take into consideration when aging in place; not only does the home need to be assessed for hazards, it’s also important to think of how you will handle daily life should you choose to live alone. Think ahead and consider the changes you might go through in the next few years; will it be a problem to climb stairs? Take care of the garden or lawn? If so, there are things you can do to combat the issues, but it’s best to plan ahead.
Here are some of the best tips for aging in place safely.
Communication
It’s imperative to have a good communication system with friends or family members. If you have a cell phone, make sure to program the phone numbers of all the important people in your life so they will be easily accessible. Landlines should have a list of important numbers beside them, in large print. It’s also a good idea to install a phone in the bedroom and/or bathroom, in case of emergency.
Safety
If you have throw rugs in your home, consider discarding them or checking to make sure the corners don’t turn up to create trip hazards. They also need to have non-slip backs. Living areas and stairwells should be well-lit, and chairs and toilets need to be at a good height for getting up without risk of a fall. The bathtub should have a non-slip mat and a grab rail or shower seat.
It’s also a good idea to wear sturdy, rubber-soled shoes or slippers; this can prevent falls or other injury. Clear all walkways of clutter or furniture that could trip you up.
The reality is that your home may just not be a good fit for aging in place safely, particularly if you have any disabilities. Don’t be afraid to consider the option of moving. You can still buy a home to live in rather than going to an assisted living facility.
Accessorize
Think about the things you might need to assist you in daily activities, such as a long-handled shoehorn, a walker, a rubber-soled cane, and medication. It’s a good idea to keep these things organized, in reach, and in good working order.
Get some help
When it comes to living alone, from time to time you may need some help. Enlist a capable family member or friend to assist you in financial planning, cleaning, lawn work, or traveling if you aren’t comfortable driving yourself. You might also consider getting a service animal; they can be extremely helpful to seniors in daily activities and can provide comfort, company, and stress relief.
How to Prepare for Senior Living
As Americans age, they must face the prospect of what to do when maintaining their independence is no longer recommended or feasible. The following resources from Senior Care Central will help you and your family figure out how best to make decisions about retirement communities, assisted living facilities, and nursing homes.
How Do I Know When to Make a Change?
Sometimes it is difficult to know when it’s time to change your living arrangements or those of an aging loved one. Check out these sources for help in knowing when the time is right.
- Consumer Affairs lists 17 signs that it may be time to consider assisted living.
- If you’re still unsure about moving into senior care, perhaps aging in place is an option, at least for a little while.
How Do I Know a Facility is a Good One?
Once you are certain a senior care option is necessary, you have to choose the location. However, there are so many facilities in operation that it can be difficult to tell which one is best for you or your loved one. Utilize these tools to make sure you’ve made the best choice.
- There are several websites that rate retirement communities, so be sure to take these reviews into consideration.
- However, many people are more comfortable with consumer reviews, so don’t neglect this source of information.
- It also doesn’t hurt to check out what government inspection procedures are and to make sure the facility you’re considering has few if any citations against it.
How Do I Pay for Long-Term Senior Care?
It is hard enough figuring out senior care without even considering the costs associated with it, but sooner or later, the price of assisted living must be taken into consideration. Fortunately, there are many ways to make the cost affordable.
- Today’s low VA home loan rates make refinancing — and using the proceeds to pay for care — an attractive option.
- Understand what Medicare and Medicaid do and do not provide in terms of assistance.
- Look into the benefits of Long-Term Care Insurance (LTC).
It may not be pleasant as you investigate options for senior living, but it will likely be necessary. The process can be confusing and stressful, but the resources discussed in this article will make the process a little easier to understand and navigate.