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
Total Knee Replacement
Background
Similar to hip replacement, knee replacement is done when a person is experiencing decreased range of motion, trouble walking or climbing stairs, and increased degeneration of the joint so as to impair quality of life. This most often occurs as a result of arthritis.
Treatment
Total knee replacement (TKR) surgery involves resurfacing or removing the distal portion of the femur that articulates with the end of the shin bone. The prosthesis consists of metal and plastic or similar materials that are cemented onto the newly resurfaced areas of the articulating bones. Although often done under general anesthetic, this surgery can also be performed under spinal anesthesia. Sometimes blood loss is significant, so patients may be asked to donate their own blood ahead of time to be given back to them in the event it is needed. In addition, a growing trend is toward bilateral knee replacement in those persons requiring both knees to be surgically repaired. The benefits of this are the one-time operative anesthetic and room costs, and many physicians feel recovery from bilateral replacement is similar to single replacement. However, the pain and lack of mobility, as well as the significant increase in the assistance needed after surgery when a bilateral replacement is done, may make this less than ideal for older patients. Surgical procedures for TKR have not evolved quite as rapidly as total hip arthroplasty.
Discomfort after knee surgery is generally severe in the first few days. Complications after surgery may occur, including pain, infection, and blood clots. Patients may use cold packs on the operative area and take pain and sleeping medications as ordered. In addition, alternative therapies such as guided imagery have been shown to help with pain management (Posadzi & Ernst, 2011). Many joint replacement patients feel a loss of control and independence.
Therapy will begin immediately in the acute care hospital. Although weight bearing does not usually occur until 24 hours after surgery, sitting in a chair and using a continuous passive motion machine (CPM) (if ordered), will ease recovery. The use of a CPM is generally based on the surgeon’s preference. There is research to support it, as well as studies indicating that walking soon after surgery has an equal effect and makes the CPM unnecessary. However, in cases of an older person who may not have the mobility skills initially after surgery that a younger person would, a CPM may be beneficial to keep the joint flexible and decrease pain.
Dr. Zann (2005) indicated that “patients undergoing total knee replacement do not achieve their maximum improvement until 2–4 years” (p. 1). This is attributed to the lack of muscular structures that surround and protect the knee and the need for the ligaments and tendons to adapt to the indwelling prosthesis. Recovery times vary and depend upon a number of variables, including the patient’s overall health, age, other preexisting health issues, and motivation. Patients report that the new knee joint never feels normal even years after the surgery, but that they experience an increase in function and generally much less pain than before.
Patients should be educated about signs and symptoms of infection, care of the surgical site (if staples are still present), pain management, and expectations for recovery. A range of motion from 0–90 degrees is the very minimum needed for normal functioning. Normal knee flexion is 140 degrees, but few older persons would get this amount of flexion after surgery, and may not have had full flexion even prior to the operation. After discharge, a walker is usually used in the first few weeks, followed by light activities 6 weeks after surgery. In addition, the patient’s spouse may experience feelings of being overwhelmed due to role transitions that occur after surgery and during the recovery period (Walker, 2012 ). Newer knee prosthetics are still going strong for the majority of patients 15 years after surgery.
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: 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.
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.
Guest Blog: Fraud, Scams, and Other Challenges Elders Face
Elder fraud is an enormous problem that involves massive financial loss and elder abuse. The misappropriation of finances and financial control is known as elder financial abuse or financial exploitation. Elders report losing approximately $1.17 billion each year, but the AARP estimates a more accurate number is probably closer to $40 billion.
Scams and Challenges Faced by Seniors
Elders face losing their independence, neglect and abuse, diminished physical ability, and age discrimination. Even healthy elderly individuals may fall prey to schemes at the hands of criminals or family.
Elderly individuals who require daily assistance may suffer abuse and neglect from caregivers and family members. Being left dirty and unbathed is one of the many signs of neglect that point to elderly abuse. Be on the alert for fraud and abuse perpetrated towards seniors.
What is Elderly Fraud?
Elder fraud is a scam operation that targets seniors. The scammer may be a family member or friend, or a stranger. The most common way for seniors to be targeted is over the Internet or email through phishing techniques, such as:
- Internet offers or emails advertising discount prescriptions and low-cost health coverage
- Internet offers that advertise financial support through home-equity loans or retirement savings
- Friendships evolving through email communications, phone calls, and social media
Telemarketing Frauds and Common Schemes
An FBI sting in 1980 involving specialized AARP members led to 1200 arrests and hundreds of convictions for fraudulent telemarketers selling water purifiers, vacations, sweepstakes, and environmental packages. Telemarketing fraud is still a large concern for seniors. Other typical elderly fraud schemes include:
Romance: Criminals seek to capitalize on elderly victims who desire to find a companion using dating websites and social media.
Grandparent: Criminals contact an elderly individual claiming to be a child or grandchild and needing immediate financial assistance.
Technical support: Criminals contact the elderly individual and offer to fix nonexistent technical issues to gain access to their devices and obtain sensitive information.
Sweepstakes or lottery scams: Criminals contact the elderly victim and claim they won a lottery or sweepstakes for which they require a fee.
Government impersonation: Criminals pose as government employees and threaten to arrest or prosecute elderly individuals unless they provide payments.
Home repair: Criminals appear in person at the elderly individual’s property to offer home-improvement services that they never provide.
Family or caregivers: Relatives and acquaintances of elderly individuals may seek to take advantage of them to obtain money or property.
TV/radio: Criminals seek to target potential victims using false advertisements for services such as reverse mortgages and credit repair.
COVID-19 Elderly Scams
During the COVID-19 pandemic, elderly fraud substantially grew as elders were separated from their close family and friends to avoid the virus. Some COVID-19 scams involved selling counterfeit products like air filters, vaccines, and testing, as well as contact tracing schemes designed to trick elders out of money and gain pertinent personal information.
Multiple scams continue to target the elderly concerning COVID-19, including Social Security Administration (SSA) scams and charity requests. One study estimated that one in 10 seniors fell victim to elderly fraud in 2018, and this number increased during the pandemic as elders faced:
Similar Concerns
Seniors tend to share similar concerns, including high medication costs, a need for healthcare coverage, dwindling retirement funds and plans to provide for their loved ones. Phishing emails on these specific topics grab personal information.
Isolated or Alone
Seniors are uniformly isolated and spend much of their daily lives alone. In many cases of elderly fraud, if the victim had spoken to a family member or a friend, the scam would not have happened.
Naïve and Trusting
While most individuals over the age of 30 do not have any memories without the Internet, most seniors have lived their lives without using email or the Internet and have misappropriated trust. They are unaware of the complexities behind a seemingly safe email.
Diminished Decision-Making Skills
Most seniors experience some diminished mental capacity, and this affects their decision-making abilities.
Elderly Schemes Based on Personal Info
Some schemes are more targeted and involve emails and phone calls using personal information to target the individual. These targeted attacks use information gleaned through general phishing attacks to draw the individual into a scam.
Elderly fraud has resulted in devastating losses for victims, and the US Consumer Financial Protection Bureau has found that victims suffer an average loss of $34,200 through such scams. The FBI elder fraud department is focused entirely on elderly scams.