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: Common Skin Conditions Affecting the Elderly
No matter how well we take care of ourselves, advancing age eventually takes its toll – especially on our skin. Over time, the various components that make up our bodies gradually become less able to resist the onset of decay. The epidermis, which is the body’s largest organ, is no exception. As we age, it dries out, grows thinner, and becomes more vulnerable to disease. These naturally-occurring difficulties are compounded when an elderly patient is confined to a long-term care facility.
In some cases, a skin problem may indicate an underlying condition that has gone undetected. Skin conditions can also arise from problems in positioning for patients who are confined to a bed or a wheelchair for an extended period. Once the wound has been healed, the caregiver should make sure that its cause is determined and addressed, and nothing else is being overlooked.
While there are many possible skin disorders that can affect the epidermis of an elderly patient, not all of them will require treatment. Some do, however, and the following are a few of the more common conditions and their possible treatments.
Allergic Reactions
It has been estimated that approximately 5-10% of people 65 or older suffer from an allergic disease. In addition to those who suffer from allergies throughout their lives, some individuals only develop allergies once they reach an advanced age. Underlying medical conditions, memory issues, the use of several medications simultaneously, and overall poor health, can also contribute to the late appearance of an allergy problem in an elderly patient.
Prescription medications are often the culprit when a geriatric patient develops a systemic allergic reaction. Because of this, anyone who does have allergies should be asked about any recent new medications he or she may have begun taking. However, there are other potential causes, including exposure to detergents or mites. Allergic reactions can present in a wide array of symptoms, making it difficult to sometimes narrow down a specific cause.
Allergic reactions should always be treated with topical steroids for one to two weeks. The caregiver should also make sure that the cause of the reaction has been addressed.
Fungal Infections
The most common fungal infection, regardless of a patient’s age, is candidiasis, which is a yeast infection that tends to appear on occluded regions of the epidermis, such as in the folds of the skin or under dressings. It’s most dangerous to older patients and most transmittable to patients who are confined to bed or a wheelchair. In geriatric patients, candidiasis presents with chills, fever, pustular skin lesions, and in some cases, symptoms indicating sepsis.
Fortunately, candidiasis can be prevented by applying miconazole powder to at-risk patches of skin. When it does appear, it should be treated by applying clotrimazole or nystatin cream to the affected areas. If it becomes a recurring problem for patients, bowel eradication using nystatin pastilles should be considered. The provider should also be sure to check the patient for signs of retinal lesions, as many elderly patients suffer from cataracts.
Another common fungal problem is seborrheic dermatitis, which is caused by infection from a different type of yeast, malassezia furfur. It presents as red and scaly patches of skin typically found in areas where hair is present; particularly the head, neck, and chest. It can be treated with ketoconazole (nizoral) 2% shampoo or selenium sulfide 2.5% (Selsun Blue).
Staph and Strep infections
Staph and strep infections are also among the most common problems health professionals will face in patients at a long-term care facility. Studies have estimated that, at any given time, 30-40% of long-term care residents are experiencing a fungal infection.
A staph infection typically results when bacteria enter the epidermis through a sore or a cut (including in areas where a patient may be attached to a catheter or other medical device). The infection presents painfully as a red, swollen patch on the skin. This may be accompanied by pus drainage, a skin abscess, warmth in the area, and a fever as well. In more severe cases, patients may even experience shortness of breath, chills, chest pain, fatigue, muscle aches, headaches, and rashes.
When a geriatric patient is suffering from a staph or strep infection, it should first be treated with a topical antibiotic such as mupirocin (bactroban). If this does not cure the infection and it enters the surrounding tissue, a tissue culture should then be taken to determine what organism is causing the problem. Depending on the results, a systemic antibiotic – usually augmentin, bactrim, ciprofloxacin, or tetracycline – should be given to the patient.
Guest Blog: 5 Signs of Mental Health Issues for Seniors
When you’ve started to notice changes in an elderly relative, you may wonder if a mental health issue is the cause. While it is important a mental health professional diagnoses these issues, some signs exist indicating that the time has come to make an appointment.
Depression
Depression can occur for a host of reasons. Elderly individuals may be suffering from the loss of a loved one, or they may feel alienated, isolated or otherwise separated from their friends or from their interests outside of the house. Individuals who seem filled with sadness and negative emotions or who are hinting about emotional turmoil may need outpatient or inpatient treatment for depression.
Anxiety Issues/Bipolar Disorder
You may also notice that your loved ones are having heightened periods of elevation followed by periods of deep sadness. They could be suffering from bipolar disorder. Serious anxieties could begin to manifest at this age too. For example, you may notice that your elderly relatives always seem to be thinking about their own death or about expected loss of other loved ones.
Memory Loss
As people age, you may think that it is a normal occurrence for them to forget information that they would have once remembered. However, these early slips could be signs of a more serious problem that is coming into fruition. Your loved ones might now be forgetting about certain dates or social events, but these struggles could turn into failures to take medication or complete other necessary medical tasks.
Personal Care
If you notice that your loved ones are not taking care of themselves as they used to, this situation could also be a sign of mental health issues. For example, you may have noticed that your relatives are no longer brushing their teeth or bathing on a regular basis. Seeking professional help can uncover the root of the issue so that a plan of treatment can be devised.
Social Withdrawal
Your loved ones might also seem to not want to participate in social activities anymore. Whether they are constantly declining invites to attend family functions or they do not want to participate in community activities any longer, these decisions could be signs that a mental health issue is present.
As your loved ones age, you may be the lookout for physical health issues. While addressing these problems is imperative, so is watching for signs of mental health struggles. May is mental health awareness month, get involved to help bring awareness to this important cause!
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.
Guest Blog: 7 Ways How Sustainable Sourcing Supports A Healthy Lifestyle?
Introduction
As mindfulness encompassing natural issues keeps on developing, more people are looking for ways of taking on eco-accommodating practices in their day-to-day routines. One region in which maintainability assumes an urgent part is in our food decisions. Selecting eco-accommodating eats helps the climate and supports a solid way of life. By zeroing in on maintainable obtaining rehearses, we can guarantee that the food we devour isn’t just great for us yet additionally created with deference for the planet. In this article, we will investigate what practical obtaining means for our food decisions and how it adds to a solid and ecologically conscious way of life.
1. Organic and sustainable agriculture
Sustainable sourcing encourages agricultural practices that are less harmful to the environment. It underlines natural cultivating strategies instead of ordinary ones that depend intensely on pesticides and engineered composts. Natural cultivating maintains a strategic distance from the utilization of these hurtful synthetic substances, diminishing water contamination, soil debasement, and damage to helpful bugs, birds, and untamed life. Consuming natural produce dispenses with possible openness to poisons and guarantees a higher substance of supplements because of the shortfall of destructive compound buildups.
2. Diminished Carbon Impression
Maintainable obtaining decreases fossil fuel byproducts related to food creation and transportation. By focusing on privately obtained fixings, less energy is exhausted in moving food from far-off areas. This implies fresher and more nutritious choices with a significantly lower carbon impression. Picking occasional and privately created food varieties upholds nearby ranchers and organizations and diminishes dependence on petroleum derivatives in food transportation.
3. Encouragement of Biodiversity
Practical obtaining adds to the conservation and insurance of biodiversity. It empowers the development and utilization of assorted and legacy crops, supporting seed banks and hereditary variety. This natural practice shields plant species, guaranteeing their reasonability and versatility despite environmental change and other ecological difficulties. We aid in the preservation of ecosystems and contribute to the maintenance of a balanced and resilient environment by consuming foods that are sourced sustainably.
4. Moral Creature Cultivation
Supportable obtaining stretches out to creature farming, advancing moral and capable practices. It places the humane treatment of animals first, ensuring that they are raised in sustainable natural settings. Natural and feasible cultivating frequently underscores unfenced and field-raised creatures, where creatures approach normal scrounge and are not exposed to packed or upsetting conditions. By consuming creature items from such practices, we support the compassionate treatment of animals and add to the strength of our planet.
5. Keeping Freshwater Resources Safe
Additionally, freshwater conservation is a primary focus of sustainable sourcing practices. Horticulture is a significant water customer, and impractical cultivating practices can drain dirty water sources. Conversely, supportable horticulture executes water protection methods, for example, dribble water system and water collecting that limit water squandering. By picking reasonably obtained food sources, we advance the safeguarding of clean water sources, helping us and people in the future.
6. Foods that are local and high in nutrients
Manageable obtaining supports the utilization of nearby and supplement thick food sources. Privately obtained produce frequently calls for less investment and assets to ship, bringing about fresher and more delectable choices plentiful in nutrients and minerals. Eating an eating regimen bountiful in new natural products, vegetables, entire grains, and reasonably obtained proteins advances, by and large, well-being and decreases the gamble of persistent sicknesses.
7. Kratom of the Red Sort: An Eco-accommodating Choice
Among the different eco-accommodating choices, red strain kratom is an imperative expansion. Kratom is a spice that numerous people use for its other properties, including relief from discomfort and unwinding. Selecting economically obtained red strain kratom guarantees that the sauce is collected and created utilizing harmless ecosystem strategies. This indicates that the plants are harvested ethically, processed without chemicals, and grown naturally. Picking a feasible red strain of kratom upholds a sound way of life while being aware of the climate.
Conclusion
Integrating supportable obtaining rehearses into our food decisions is a fundamental stage toward a sound and ecologically conscious way of life. From natural cultivating to diminishing fossil fuel byproducts and supporting biodiversity, maintainable obtaining offers various advantages. By choosing economically obtained food varieties, we focus on our prosperity while regarding the planet. Allow us to pursue cognizant choices that line up with maintainable acquiring works, selecting eco-accommodating eats that add to a better world for us and people in the future.
Alzheimer’s: Signs & Symptoms
Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.
Risk factors
Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.
Warning Signs
Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.
Diagnosis
Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.
The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.
Treatment
Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.
Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.
Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.
Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.
Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.
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.
Guest Blog: Adult day programs giving a new life to the adults
Those who had enjoyed a considerable amount of independence in their youth, the time has come
when they need help from others as they were migrated to old age. Life is never static, and it
keeps on changing from time to time because change is the integral and inherent part of life.
Once you cross the fancy days of your youth and step into adulthood, life becomes more
challenging than ever. It took a big leap when you get older and started calling by the people as
elderly.
The adult day care homes came up as a hope for many adults who are living a lonely and concise
life. They have given them many reasons to enjoy their adulthood, keeping aside all their worries
and tensions of life. Many daycare homes in the USA have gone to the extent of providing a
friendly and composite environment that even doesn’t get in their homes. The adult day
programs in Atlanta offer a welcoming environment to the adults by connecting them back to
mainstream society and expanding their outreach. They provide support and a needed break for
someone who cares for a loved one who is no longer independent.
Every adult is welcomed in an adult day care home.
The adult day care homes take care of every adult regardless of their religion, race, and ethnicity.
Caregivers in the Atlanta adult day care homes are not the ordinary people infect they are the one
who is not doing this just as a job but it’s is their passion and nature to help elders and share their
pain and joy. All the adults staying in the adult day care homes spent their day with loads of fun
and doing meaningful activities.
It is not that adult daycare homes only provide emotional or medical support to the adults; they
also facilitate adults by organizing musical events and taking them to cultural festivals. Some of
them hold weekly performances by local musicians and local entertainers. They also give them
the opportunity for interactions with pets and children, cooking projects, take them to nature
walks, games, parties, and yoga classes.
Who joins adult day care homes?
Adults in their 50s – 90s with some physical or cognitive behavioral problems.
Older adults who don’t wish to stay home alone all through the day.
Older adults can benefit from social interaction and a structured environment.
Adults who are abandoned by their family and they are forced to live alone.
Adults whose children are not living with them because either for work or study, they
have to live outside the town or country.
Loads of Surprises
It is not that the adults living in the Adult Daycare homes are entirely cut off from their families
and friends. This is not the case with every adult day care home because many Adult daycare
homes provide surprise adults’ by suddenly calling their family members and close friends for a
quick meet up or gathering.
As much as adults miss their family members, their family members also miss them equivalently.
Learn and earn schemes
Money adult Daycare homes also provide learning and earn schemes to the adults who want to
do something big in their life. It doesn’t mean that if you are elder or older, your professional life
is over. Many adults are still willing to work after their retirement from their professional life.
The adult Daycare homes provide equal opportunities for adults.