Boomer’s Blog

Boomer’s Blog2018-05-18T08:58:16-05:00

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

Urinary Tract Infection

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Background

Urinary tract infections (UTIs), also called cystitis (inflammation of the bladder), are common among older adults and are more frequent in women. They are a primary cause of urinary incontinence and delirium. Catheter-associated urinary tract infections (CAUTIs) are more common among older adults (Fakih et al., 2012) and is mainly attributed to the use of indwelling urinary catheters. Many indwelling catheters are thought to be unnecessary (Cochran, 2007) and one study noted that physicians were often not aware of the purpose for which their patients had a catheter inserted (Saint, Meddings, Calfee, Kowlaski, & Krein, 2009). UTIs have been show to increase morbidity and mortality, length of hospital stay, and cost of hospitalization (Kleinpell, Munro, & Giuliano, 2008). CAUTI is considered preventable and is not reimbursed by Medicare. Therefore, hospitals will largely assume the financial costs for preventable infections of this type.

Risk factors/Signs and symptoms

Several risk factors are associated with UTIs in general. These include being female, having an indwelling urinary catheter, the presence of urological diseases, and hormonal changes associated with menopause in women. Signs and symptoms of UTIs include urinary frequency and burning or stinging felt during voiding. Pain may be felt above the pubic bone, and a strong urge to void but with small amounts of urine expelled. The most significant risk factor for CAUTI is prolonged use of an indwelling catheter. In hospital-acquired UTIs, 75% are associated with the use of an indwelling catheter (CDC, 2012). In women, signs and symptoms of CAUTI may be more severe than those reported by women by patients in the community who do not have an indwelling catheter. Lethargy, malaise, onset or worsened fever, flank pain, and altered mental status have been associated with CAUTI (Hooton et al., 2010).

Diagnosis

A thorough assessment should be done of the patient’s urinary output, including amounts, color, odor, appearance, frequency of voiding, urgency, and episodes of incontinence. A urine specimen should be obtained if UTI is suspected. Laboratory results will show the type of organism causing the infection, and the sensitivity will tell what medication the organism is susceptible to. These results should be reported promptly to the physician or nurse practitioner caring for the patient and so that a diagnosis and treatment plan can be made.

Treatments

Prevention of UTIs is considered a primary nursing strategy. Elderly female patients can be instructed to make lifestyle modifications such as: increasing their fluid intake; emptying the bladder after sexual intercourse; practicing good perineal hygiene, including wiping front to back after toileting; getting enough sleep; and avoiding stress (PubMed Health, 2011). Although many of these common sense strategies are recommended by primary care providers, there is a lack of scientific evidence to support some of them. Many UTIs will clear up on their own, particularly if the person increases oral fluid intake during early symptoms. However, with many older adults, antibiotic treatment may be needed. In general, a course of three 3 days for healthy adults is thought to be sufficient, but for more resistant bacteria, a longer course more than five 5 days may be needed (PubMed Health, 2011). For those with repeated or chronic UTIs, a low dose of antibiotics taken for 6– 12 months may be indicated (Hooton et al., 2010). If the underlying cause is CAUTI, treatment will be more aggressive. Monitor the patient’s temperature at least every 24 hours (Carpenito, 2013). Encourage fluids. Evaluate the necessity of continuing an indwelling catheter if one is in place.

Alternatives to indwelling catheters should be considered for appropriate patients. Intermittent catheterization, if appropriate, is preferred over indwelling catheter use, especially for long- term maintenance of bladder management (CDC, 2009; Hooton et al., 2010). Condom catheters may be an appropriate choice for some males. If an indwelling urinary catheter is necessary, the catheter should be removed as soon as possible, per the physician or nurse practitioner’s orders, to reduce the risk of CAUTI.

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.

 

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By |November 29th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Urinary Tract Infection

Guest Blog: Managing Family Dynamics with Geriatric Patients: A Guide for Nurse Practitioners

 

Gerontology nurse practitioners face a unique set of challenges within their field. It comes with the territory of caring for older adults that issues such as death, dying, terminal illness, and chronic illness are commonly addressed.

Common Challenges

There are many challenges families face when caring for an older relative. For example, the loss of independence a geriatric patient may have. Families may need to step in and care for the aging patient, which, unfortunately, can add stress to their daily lives. This buildup of stress can lead to caregiver burnout, depression, anxiety, tension within the family, and even anger or resentment.

Another possible challenge is the imbalance of perceived “power” within the family. A scenario for this would be if an elderly patient moves in with their adult child and their family. For many years, the patient was the head of household; the one who made decisions and ran the home. Now, the adult child is the head of household, while the aging parent/ family member is an occupant. The family may experience a “power struggle” which can lead to conflict and strife within the home.

Dealing with chronic illness is another prominent challenge – possibly one of the most significant. Dementia, for example, is a condition which does not improve over time. Dementia affects almost half of adults over age 85. The early stages are the most difficult, as patients experience forgetfulness which could lead to safety concerns (i.e., wandering away from home, leaving the stove on, etc.). Family members may become frustrated easy, but as the disease progresses, they may experience a prolonged “mourning” of the patient.

Along with situational components, there are other factors that contribute to a family’s dynamic. Socioeconomic level, education level, cultural differences, and even something as basic as personalities all contribute to how a family interacts with each other and deals with stress.

Tips for Geriatric Nurse Practitioners

When dealing with geriatric patients and their families, it’s important to first acknowledge that each family unit has unique dynamics. From there, utilizing the nursing process is a great way to address the individual needs of the patient and family. Below are some tips, using the nursing process, that can help geriatric NPs manage the sometimes-complicated dynamics within families.

Assess

The first thing geriatric NPs should do is assess the family’s interactions and communication skills. Ideally, meeting with both the family and patient is ideal. Assessing communication skills such as active listening, non-confrontational statements, and body language will help the NP determine how effective communication is within the family, and what needs to be improved. Geriatric NPs can also assess the patient and family’s knowledge base, readiness to learn, and if anyone is experiencing any of the stages of grief.

Diagnosis

After assessing the family dynamics and interactions, geriatric NPs can create a “diagnosis” of what they may need. For example, if the daughter of an elderly patient with dementia can no longer care for the patient, the NP will need to take action in terms of finding a suitable living arrangement. Another example is if the son of an elderly patient with a chronic disease becomes easily frustrated and angry with them. The NP would have to develop a plan to address the issue.

Planning

After assessing the family and patient’s needs and determining what is needed, the geriatric NP must create a plan to meet their individual needs. Because the needs of the patient and family are unique, breaking apart the needs of each family member will help tailor a plan to help create a healthy family dynamic. For example, using the first scenario above, the NP can create a plan to help the family find a care home for the patient, while assisting to help them manage the emotions involved with possible feelings of loss of control and fear. In the other example, the NP can consider arranging appointments for the son to see a counselor to deal with his feelings regarding his parent’s chronic illness, and how to communicate in a positive manner.

Implementation

The implementation phase of the nursing process is putting the plans into process. For the geriatric NP, this means arranging appointments, providing resources, and collaborating with the rest of the care team. Using the examples above, that could mean providing a list of care homes, putting the family in touch with a social worker, and/or recommending a counselor for the significant life change of transitioning to a care home. In the second example, the NP can recommend family counseling as well, and possibly provide tips for stress management for caregivers.

Evaluation

Evaluating a patient and family’s response to the recommended plan is one of the most essential pieces of dealing with altered family dynamics. This phase is a delicate process, as the NP needs to ensure the family has not only followed through with the treatment plan, but that it was effective as well. If not, the planning and implementation phase would need to be re-structured. In the examples used above, that would mean making follow-up calls to see how the elderly patient is doing in the care home, how the family and patient are doing with the transition, and if there are any other needs. In the second example, the NP can follow up with the elderly patient’s son to see how he is dealing with his parent’s chronic illness. It may also mean working to help manage the chronic illness as well.

Conclusion

Working with families is not unique to nurses and nurse practitioners. However, working with aging patients and their families presents a different set of challenges. While it’s impossible to provide tips on every potential challenge geriatric NPs may face, going back to basics using the nursing process will help identify each individual need so that a plan can be developed to address them. One of the most important things to remember is to include the family whenever possible in the decision-making process, and to maintain as much dignity and independence as possible for the geriatric patient.

By |November 28th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Tags: , , , |Comments Off on Guest Blog: Managing Family Dynamics with Geriatric Patients: A Guide for Nurse Practitioners

Thanksgiving is Good for Your Health

Close-up of Fresh Vegetables and Fruits

This time of year, many people pause to give thanks for the good things in their life, but did you know that giving thanks is good for your health?

Having an optimistic outlook on life and using positive coping skills to manage stress has been linked in numerous studies to a longer and happier life. One of the common themes among people over age 85 who report very good to excellent health (in spite of dealing with chronic illnesses) is just that – thinking positive. Norman Vincent Peale, in his famous book, “The Power of Positive Thinking” said:

The way to happiness: Keep your heart free from hate, your mind from worry. Live simply, expect little, give much. Scatter sunshine, forget self, think of others. Try this for a week and you will be surprised.

But what if you are not naturally a positive thinker, but more of a “the glass is half empty” kind of person? The good news is that you can begin to change your thinking to improve your health. If you are not sure where to start, consider some of these suggestions as a place to begin:

Count your blessings. There is an old hymn that was sung when I was girl. When I felt down and discouraged, I would sing this song. It went like this:

When upon life’s billows you are tempest-tossed. When you are discouraged thinking all is lost. Count your many blessings every doubt will fly. Then you will be singing as the days go by. Count your blessings. Name them one by one. Count your many blessings. See what God has done.

Sometimes it helps to list what you are grateful for on paper. If you need a place to start, an excellent resource is the book “One Thousand Gifts: Reflections on Finding Everyday Graces” by Ann VosKamp. Through a series of 60 short devotionals, the author walks you through a journey to greater appreciation and thankfulness for all that you have.

Learn to be content with what you have.  At the holidays, especially, it is easy to get caught up in thinking about what we wish we had and those things we don’t have. Try looking at it the other way- even in relationship to your health. For example, several years ago I had a catastrophic skiing accident, breaking my leg and tearing all of my knee ligaments. A subsequent blood clot complication meant that I couldn’t have surgery to repair the knee right away. After being in a wheelchair, on crutches, and in awful pain for months, with the help of countless hours of painful therapy and surgery a year later, I was finally able to walk almost normally again. Every day since then, when I am tempted to complain that I will never ski again, cannot kneel or squat, or do not have complete range of motion in that knee, I remind myself of those months when I couldn’t walk at all without help and how it felt to be completely dependent on others for everything. Each step I take, each walk in the sunshine, each little jaunt to the car, and the ability to ride a bicycle is a blessing. Every movement without pain is a bonus I never thought I would have again. Take time to recall when your situation was worse, and express joy that things are better than they were then.

Help others.  One of the best ways to stop feeling sorry for yourself and cultivate an attitude of gratitude is to serve others, especially those who are less fortunate than you. Volunteer to help serve food at the community Thanksgiving dinner or participate in Operation Christmas Child by making a shoebox for a boy or girl in a developing country who would otherwise have no gifts. Take food to your local food pantry. Mow the lawn or shovel snow for your widowed neighbor. Invite the single and lonely person to share Thanksgiving dinner with your family. Buy gifts through the Angel Tree Ministry for children of those in prison. Adopt a needy family. Even if you are homebound, you can encourage others by simple but meaningful tasks such as sending birthday or holiday cards to the people in your church or community group. A simple encouraging phone call can change a person’s day. By giving to others, you focus on positive parts of life and meaningful activities that in turn promote your positive mental health.

So, this Thanksgiving, push the pause button for a little while and take a moment to reflect on what you are grateful for. You may just find that Thanksgiving is good for your health.

 

By |November 24th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Thanksgiving is Good for Your Health

Guest Blog: Everything You Need to Know About Tooth Discoloration in Seniors

A perfect smile with pearly teeth can be a real confidence booster. However, as you age, you might experience teeth discoloration. Therefore, it becomes important to understand what causes the discoloration of teeth in the elderly and what you can do about it.

Tooth Discoloration in Seniors

Teeth naturally are not perfectly white, and the color may vary from person to person. It ranges typically from white gray to light yellow in hue. However, in rare cases, it may be a bit more yellow or brownish despite good dental health. This visible color is of tooth enamel. It is the hard substance that protects the underlying delicate tissue of the tooth.

Enamel is the hardest substance in the body and shields the teeth. The purpose of enamel is to protect the surface of the teeth from erosion or stains. It further defends the teeth from sensitivity caused by very hot or cold foods and drinks.

As you age, the outer layer of the enamel on your teeth gets worn out to reveal the natural yellow color of dentin. Since the enamel does not have living cells, once damaged, it cannot grow back. Other than aging, there are other factors that contribute to tooth discoloration in seniors. Here are some of them:

1. Disease and medication
A number of diseases and treatments, including procedures like chemotherapy and radiation, can affect the teeth color. In addition, infections may also cause the natural teeth color to fade. Medications like tetracycline, doxycycline, antihistamines, and drugs for hypertension are also known to cause teeth discoloration.
2. Poor dental hygiene
Not brushing the teeth properly and skipping flossing can lead to yellow teeth as it will allow plaque to develop.
3. Foods, drinks, and tobacco
Certain foods and drinks like coffee, tea, wine, fruits, and vegetables can lead to teeth stains.
4. Excessive fluoride
Use of excessive fluoride, often found in teeth whitening products like toothpaste or mouthwash can cause yellowing of teeth.
5. Genes
Genetics can also be a major factor. Some people have more yellow tooth color than others, while others have thinner enamel.

How to treat discoloration in old age

Enamel, once destroyed, cannot be repaired. Therefore, the first thing you can practice is prevention. Nevertheless, teeth discoloration with age is unpreventable. Some of the treatments to get rid of teeth stains are mentioned below.
– Practice good dental hygiene and brush your teeth properly.
– Avoid foods or drinks that may cause staining.
– You may consult your dentist and consider bondings or veneers to hide or remove yellow teeth.
– Your dentist may be able to help you through teeth whitening procedures.
– Over-the-counter whitening agents can be the saviors in some cases.

Author Bio: Dr. Anu Isaac, DMD, runs a successful dental practice in Salem, MA. As the founder of Coral Dental Care, she is dedicated to creating healthy, beautiful smiles for her patients and also to educating dental and non-dental community with her engaging articles on all things related to oral health, recent dental innovations, and latest treatment modalities.

By |November 19th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Tags: , , , , |Comments Off on Guest Blog: Everything You Need to Know About Tooth Discoloration in Seniors

Guest Blog: Self-Care for Seniors: 4 Best Ways to Prioritize Your Health

The golden years come with their advantages. There’s the newfound freedom, for example, and the chance to relax and revel in all that you have accomplished. But your retirement years also bring age-related challenges that can really put a damper on enjoying them. It’s important for seniors to place high priority on their health and well-being, but it can be difficult to know where to begin. Here are four ways that you can place yourself first.

Social Well-Being
Although retirement usually includes the benefit of having more free time, having extra time on your hands can also have its disadvantages, especially if you live alone. Too much idle or alone time can lead to boredom, unhealthy inactivity, and even depression. Here a couple of activities to consider if you’re feeling isolated or unstimulated.

Get a part-time job
Finding a part-time job in retirement has its advantages. Not only will you have a little extra cash coming in, but you’ll meet new people and feel a sense of responsibility that you may be missing from your working years.

Senior Citizen Groups and Clubs
Joining and participating in senior groups, clubs, and organizations is often free or inexpensive, and some will even provide transportation. You can find groups that are general interest as well as others that focus on specific activities and niches.

Ensure Home Safety
Making sure that your home is a safe place to be is important for anyone, but it’s perhaps especially vital for seniors who are more at risk of falling as well as those who live alone. Here are four simple ways to make your home a safer place.

Bathing
Installing grab bars is one way to provide added safety when bathing. You can also invest in hands-free toiletry dispensers that save you the hassle of slippery bar soap or handling bulky containers.

Air Quality
It’s impossible to know exactly what toxins may be lurking in your household air, but there are steps you can take to reduce them. You can protect your home’s air quality by replacing air filters regularly and having your HVAC system checked by a repairman.

Natural Cleaning Products
Because of the current social awareness of toxins found in many cleaning and hygiene products, it has become easier to find brands that make products using only natural ingredients. You can also easily mix your own natural cleaning products using things like vinegar or lemon juice.

Maintain a Balanced Diet
There are a number of things that can hinder seniors from getting proper nutrition. These include a lack of transportation, dwindling finances, and medications that cause nausea or reduce appetites. It’s important for you to make healthy food choices at all ages. Try eating foods high in omega-3 fatty acids, calcium, and fiber, as well as drinking plenty of water.

Gentle Exercise
As a senior, it’s more important than ever to exercise regularly, and the good news is that you don’t have to put out a lot of effort. Just 30 minutes a day, 5 days a week will suffice. Walking, yoga, or swimming are gentle and effective forms of exercise for seniors. If you don’t have access to a pool at home and don’t have your own transportation, you may be able to find a senior swimming group similar to the ones discussed above that offers transportation. Then, your exercise regimen could include a social outlet as well.

By |November 16th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Self-Care for Seniors: 4 Best Ways to Prioritize Your Health

Guest Blog: 5 Healthy Practices To Prevent Oral Disease

Oral health is apparently one of the most important aspects of health that many people take for granted. A lot of people today think that as long as their teeth are white and they can give away a bright smile, it already means that there is no problem with their oral health. But little did they know that oral diseases are very subtle.

Oral diseases such as tooth decay and gum problems are very much apparent to many people in the recent years. In fact, nearly all adults experience having these problems in their day-to-day living. Although these are quite treatable, even preventable, still, a lot of people do not pay attention to their oral health.

As it happens, having healthy teeth, gums, and mouth requires effort and time. And one must really invest when it comes to achieving oral health in its optimal state. But while it is considered as an investment, healthy practices for your oral health is quite simple and easy to do. Also, not only that these practices are convenient to do, but they would not require you with many expenses. And in doing these practices on a daily basis, you would certainly achieve healthy teeth and gums.

Here are the 5 healthy practices that you may want to start now to prevent oral diseases:

1. Brush properly
It is already common knowledge that brushing your teeth is important. But keep in mind that the way you are brushing is equally essential as well. The truth is – when you do not brush properly, it’s almost the same thing as not brushing your teeth at all.

All people brush their teeth and gums in several ways. But the most recommendable way of brushing is by gently stroking the toothbrush in a circular motion towards the teeth. Through this way, the plaque will be removed from all sides and corners of the teeth.

Additionally, keep in mind that unremoved plaque will result in hardening which contains numerous bacteria that are not good for your oral health. And once it hardens, this will eventually lead to the calculus buildup and other oral health problems like early stages of gum diseases.

2. Treat flossing as important as brushing
Practicing teeth whitening at home is much more prevalent than flossing as a routine for many people. In fact, 8 out of 10 individuals are found to neglect flossing and this is as bad as not brushing at all. Apparently, dentists and specialists require everyone to floss at least once a day. And whether you do it in the morning or the evening, it does not matter just as long as you floss.

Originally, flossing is a very effective way of dealing with the left plaque and food in between your teeth that are not pretty reachable for all kinds of toothbrushes. And thanks to floss, you can easily remove them and prevent your teeth from having buildups.

But today, new studies and reports suggest that flossing is not only ideal for removing the left plaque and food. As it happens, flossing is also found a great way to stimulate the gums and reduce inflammation. And these benefits are really helpful if one wants to pay attention to their oral health. Hence, it is recommended to treat flossing as important and as necessary as brushing.

3. Quit smoking
Another reason to quit smoking permanently is due to the fact that smoking actually does a lot of damage to your teeth and gums. As you may know, smoking kills. And one of the first things that smoking do to you aside from weakening your immune system is its capability of damaging your oral health.

Since smoking weakens dramatically the immune system, your immunity will no longer be able to prevent several infections to your body including your mouth and gums. Also, when your gums became damaged, it will be difficult for your teeth and gums to recover and heal quickly as smoking can only worsen the conditions.

Also, smoking causes nicotine stains on your teeth. Not only that these stains are unpleasing to look at, but they are also quite difficult to remove, especially if the mouth is already subjected to smoking for quite a long time now. In addition, smoking causes your breath to smell really bad. Hence, smoking does not provide anything good for your overall oral and physical health. And you must quit it now before it worsens your state.

4. Limit sugary and acidic foods
Sugar is as bad as smoking. But while sugar is known to be everyone’s ultimate guilty pleasure, sugar erodes the enamel of your teeth. And this not good for your oral health.

Apparently, when you take high amounts of sugar and sugar-rich foods, these components convert into acid to your mouth. And once the conversion has been successful, it then promotes the production of plaque and bacteria in your mouth. So, not only that sugar can damage your teeth, but it can also lead to various oral health complications.

However, it is quite difficult for some to stop taking sugar-rich foods like fruits and coffee. And if this is the case, then you must try to be mindful instead. It won’t actually hurt you to regard and consider what you’ve been eating, especially if you are really firm to change your oral health practices.

5. Visit your dentist at least twice a year
These healthy practices will definitely help you achieve much healthier teeth and gums. But even so, your oral health is still prone to several risks and potential diseases. And even if you are the most diligent brusher and flosser, the risk of having oral diseases is still at large. So, the best way to complement your healthy practices is to visit your dentist at least twice a year.

Your dentists know what’s best for your teeth and gums. And they will also tell you the condition of your oral health.

All in all, your oral health is as important as your physical health. This is where your daily supplementation starts. So, you must really take good care of it. And through these 5 healthy practices, you will surely decrease the risks of various oral diseases and even prevent them from happening in the future.

Josh Elizetxe is the inventor and founder of Snow. He is an accomplished philanthropist and successful entrepreneur with several 8-figure exits. His latest focus is on disrupting the $65 billion oral care market with revolutionary, patented products supercharged by celebrity partnerships.

By |November 15th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: 5 Healthy Practices To Prevent Oral Disease