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Each week, Dr. Mauk shares thoughts relevant to Baby Boomers that are aimed to educate and amuse.

Guest Blog: Why You Need a Geriatric Nurse Practitioner

It is no surprise that baby boomers are entering the elderhood phase of their lives, which often means seeking medical care or advice for themselves or for their aged parents. The role of the Adult-Gerontology Nurse Practitioner (AGNP) is quickly becoming more relevant as America’s older population is expected to grow from 15% to 24% over the next 30 years. With life expectancy increasing from 68 years old in 1950 to 79 years in 2013, the expertise of the AGNP is more valuable than ever as healthcare faces this “Silver Tsunami.”

AGNPs are trained to provide care across the continuum of adulthood from young adults to the frail elderly as a reflection to changes made to the national certification exams in 2013, which combined the adult and gerontological specialties into one certification. However, many AGNPs and still-certified Gerontological NPs choose to specialize in the elderly population, (those older than 65) with specific focus areas or competencies related to the aging adult.

Nurse practitioners who specialize in adult and gerontological care can further their specialization by choosing a primary care or acute care concentration. No matter the setting, the AGNP provides multi-disciplinary care to treat the entire individual, not just their health concerns. As there are many facets of aging to consider, the AGNP addresses the physical, psychological and social aspects of aging not only to treat conditions, but to educate patients and the community on preserving function and preventing injury or further decline. Depending on the state in which they practice, AGNPs typically work with a supervising physician under standardized procedures in order to assess, diagnose, treat and prescribe medications.

Many studies have shown that patients are very happy to receive care from nurse practitioners in a variety of settings, including palliative care. Education regarding options for end-of-life care is typically managed by AGNPs in the acute care, post-acute care, home care, long-term care and primary care settings. As educating patients and populations is a cornerstone of the nursing profession, advanced-practice nurses such as AGNPs offer expert knowledge to guide patients and their families through the challenging maze of end-of-life planning. The role of the Adult-Gerontological Nurse Practitioner has never been more valid or necessary as the U.S. begins to feel the surge of the silver tsunami.

Catherine Burger, BSN, MSOL, RN is a board-certified nurse executive leader and contributing writer for www.registerednursing.org.

By |2021-02-10T15:45:35-05:00February 24th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Why You Need a Geriatric Nurse Practitioner

Guest Blog: How to Get Care with These Common Chronic Illnesses

Understanding health insurance in America can sometimes feel like it requires its own specialized degree, even if you are at an advanced age and have navigated the red tape for years. As we age, and more health conditions become apparent, and navigating treatment options and cost can become increasingly tedious. About 40 million Americans are limited in their daily lives due to effects from one or multiple chronic illnesses.

The questions can become daunting: Can I get coverage if I have chronic conditions? Does my coverage include treatment and/or therapy? Is my coverage capped or limited at any point? What if I have multiple afflictions? Luckily there are resources out there to help you navigate these obstacles, you just need to know how to find them. We’ve compiled some tips and resources to help you get treatment and care with common chronic illness.

Heart Disease
Chronic heart disease which is an umbrella term that includes coronary heart disease, atherosclerosis, cardiomyopathy, and others is the leading cause of death for men, women, and most racial groups in the United States (about 655,000 deaths a year). The average age for a first heart attack in the US is 65, which is why it is commonly labeled a disease of senior citizens. However, with the right treatment options, many people survive heart disease for years.

Luckily, Medicare offers both medical and hospital coverage for heart disease patients which includes one free heart screen every five years, along with cardiovascular behavioral therapy visits annually with a primary care physician for preventative care. These screenings cover blood tests for cholesterol, lipids, and triglycerides along with dialogues that cover risk factors.

Chronic Kidney Disease
The CDC estimates that 15% of US adults have chronic kidney disease, which translates to around 37 million people. Depending on when it is caught, and how diligent you are with treatment options, the impact of CKD can range from minor diet restrictions to organ transplant. Most patients do not experience kidney function loss until stage three of the disease or later. These patients should still regularly meet with their primary care physician, address underlying conditions that could be contributing to the problem such as a fatty diet, lack of exercise, or smoking, but they typically do not need treatment options.

However, those who suffer from End Stage Renal Disease (stage five) have lost sufficient function in both kidneys and must regularly receive dialysis treatment until they can receive a transplant. Medicare covers inpatient, outpatient, and home dialysis treatment options under their part B and part C coverage plans. This includes supplies, nursing services, lab testing and in some cases transportation to and from treatment centers.

Degenerative Brain Disease(s)
While CKD is a very specific diagnosis that highlights kidney efficiency, neurodegenerative brain disease is more of a general term that is meant to include other specific diagnoses such as Alzheimer’s, Huntington’s, Parkinson’s, ALS, dementia and Spinal Muscular atrophy. Unfortunately most degenerative nerve diseases have no cure, and treatment coverage options vary based on diagnosis. For example, Medicare overs PET scans for those with FTD (fronto-temporal dementia) and Alzheimer’s, but only if patients meet eight additional conditions. In general, government assistance will cover hospital visits for any patient that has Part A coverage (thankfully), and most home care is also covered by Part B coverage.

However, like with previous examples, specific stipulations have to be met in order to receive the necessary coverage and treatment. Generally speaking, you should consult with your primary care physician and his staff to understand the right process for you.

Multiple Diagnoses
If the red tape with Medicare and a chronic illness is hard to comprehend, understanding how they prioritize and rank coverage based on multiple illnesses is akin to learning a new language. The CDC estimates that roughly 40% of adults in the US have two or more chronic diseases, and for those on medicare that represents a drastically different approach to how they receive coverage.

For those with multiple chronic conditions, Medicare Advantage coverage combines all the differences in parts A, B, and D and lumps them into one single service umbrella of coverage.
In 2018 the Senate passed the CHRONIC Care Act which expanded Medicare Advantage coverage and paved the way for those who require an elevated number of services like adult day care, caregivers, meal delivery, and more. To learn more about Medicare Advantage, we recommend this comprehensive write up here.

Susan is a guest writer on behalf of InsuranceFAQ.net. Susan wants to spread awareness on understanding health care and insurance coverage.

By |2021-02-22T15:35:15-05:00February 22nd, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: How to Get Care with These Common Chronic Illnesses

Chronic Sinusitis

Sinus pain

Background

One of the common health complaints of the elderly is chronic sinusitis. About 14.1% of Americans 65 and older report suffering from chronic sinusitis; for those 75 years and older, the rate is slightly lower at 13.5% (American Academy of Otolaryngology, 2012). Age-related physiological and functional changes that occur can cause restrictions to the airflow. This results from irritants blocking drainage of the sinus cavities, leading to infection.

Warning Signs

Symptoms include a severe cold, sneezing, cough (that is often worse at night), hoarseness, diminished sense of smell, discolored nasal discharge, postnasal drip, headache, facial pain, fatigue, malaise, and fever (Kelley, 2002). The person may complain of pain around the sinus areas, and swelling and redness of the nasal mucosa may be evident.

Diagnosis

Allergies, common cold, and dental problems should be ruled out for differential diagnosis. When symptoms continue over a period of weeks and up to 3 months and are often recurring, chronic sinusitis should be suspected. A CT scan of the sinuses will likely show areas of inflammation.

Treatment

Treatment for chronic sinusitis is with antibiotics, decongestants, and analgesics for pain. Inhaled corticosteroids may be needed to reduce swelling and ease breathing. Irrigation with over-the-counter normal saline nose spray is often helpful and may be done two to three times per day. The person with chronic sinusitis should drink plenty of fluids to maintain adequate hydration and avoid any environmental pollutants such as cigarette smoke or other toxins. Chronic sinusitis is a condition that many older adults wrestle with their entire life. Avoidance of precipitating factors for each individual should be encouraged.

For more information on Sinus Sinusitis, visit The Mayo Clinic at:
http://www.mayoclinic.com/health/chronic-sinusitis/DS00232/DSECTION=risk-factors/

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.

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By |2021-02-10T15:45:11-05:00February 22nd, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Chronic Sinusitis

The Role of the Rehabilitation Nurse

 
You may have heard of rehabilitation nursing, but are you familiar with what rehabilitation nurses do and their essential role in health care? According to the Association of Rehabilitation Nurses (ARN), there are four major domains within the new competency model for professional rehabilitation nursing (ARN, 2016) that can help us understand what rehabilitation nurses do.  In this blog, we will look at the ARN model from a layperson’s viewpoint to help explain the role of the rehabilitation nurse. Rehabilitation nurses:
kris2

Promote successful living

Rehabilitation nurses do not only care for people, but they promote health and prevent disability. This means that rehab nurses engage in activities that help patients, families and communities stay healthy. Proactively, you might see rehab nurses helping with bike safety (such as promoting the wearing of helmets), car seat fairs (to keep children safe from injury), or stroke prevention through community screenings and teaching about managing risk factors. As rehab nurses, we also help patients towards self-management of existing chronic illness or disability, teaching them how to be co-managers with their health providers so they can maintain independence and have a good quality of life. Another key activity is facilitating safe care transitions. This means that rehabilitation nurses have a special skill set to know which setting of care is best for the patient to move to next and how to make this happen smoothly. For example, if Mrs. Smith has had a stroke and finished her time in acute rehabilitation in the hospital, but she lives alone and is not quite ready to go home, what is the best care setting or services for her to receive the help she needs?  Many errors, such as those with medications, happen when patients go from one place to another in the health system. Rehabilitation nurses can help persons successfully navigate these complexities and be sure that clients get the continuity of care they need and deserve.

Give quality care

The interventions or care that rehabilitation nurses provide to patients and families is based on the best scientific evidence available. Part of being a rehab nurse is staying current on the latest technology, strategies for care, and best practices. This is to ensure that all patients receive the highest standard of care possible. We stay current in many ways, including reading journal articles, attending conferences, obtaining continuing education, and maintaining certification in rehabilitation. Research shows that having more certified rehabilitation nurses on a unit decreases length of stay in the hospital. In addition, all of rehab care focuses on the patient and family as the center of the interdisciplinary team. To this end, rehabilitation nurses teach patients and families about their chronic illness or disability across many different areas including: how to take medications; managing bowel and bladder issues; preventing skin breakdown; dealing with behavioral issues that might be present with problems such as brain injury or dementia; coping with changes from a disabling condition; sexuality; working with equipment at home; and ways to manage pain.

Collaborate with a team of experts

Rehabilitation nurses are part of an interprofessional team of physicians, therapists, psychologists, nutritionists, and many others who work together for the best patient outcomes. For persons who have experienced a catastrophic injury or illness, the work of this team of experts sharing common goals will provide the best care, and rehab nurses are the ones who are with the patient 24/7 to coordinate this process. Through effective collaboration, excellent assessment skills, and communication with the rest of the team members, rehab nurses ensure that patient and families are getting well-coordinated care throughout the rehabilitation process. Remember that rehabilitation takes place in many settings, whether on the acute rehab unit, in skilled care, long-term care, or the home. The nurse’s role is to be sure that the holistic plan of care is followed by all staff and that the physicians overseeing medical care are continually informed of patient progress for the best decision-making possible.

Act as leaders in rehabilitation

 Not only do rehabilitation nurses provide direct patient care, they are also leaders in the rehabilitation arena. You might be surprised to learn that rehabilitation nurses advocate at the highest level for legislation surrounding funding and policy for those with disabilities and chronic illness, talking with Senators and Congressmen about key issues. ARN has professional lobbyists that continually watch health policy movement in Washington and keep rehab nurses informed. Rehab nurses help patients to advocate for themselves in holding government and communities accountable for needed care services. Lastly, rehab nurses share their knowledge with others. This is done in a variety of ways through conducting and publishing research, presenting at conferences, serving on local and national committees, and serving in public office. All of the leadership activities done by nurses in rehabilitation are to promote the best quality of care for patients with chronic illness and disability.

 

 

 

 

 

 

 

 

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By |2021-02-10T15:44:57-05:00February 21st, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on The Role of the Rehabilitation Nurse

Quick Guide to Yoga for Senior Citizens

 

Are you on the hunt for low impact exercise ideas that will help lower your risk for common killers like heart disease? If you have been interested in yoga but hadn’t worked up the nerve to “hit the mat” yet, don’t miss this quick guide:

What is Yoga for Seniors?
Yoga at its core is an ancient practice in breathing, stretching, meditation, and guided poses. Originating in eastern culture, yoga made its way to the U.S. in the late 20th century, building quite a following across the country as different modalities and styles were developed and specialized studios popped up in more and more places.

Yoga has been adapted for seniors specifically by incorporating more seated movements for those with mobility issues, as well as gentler and more educated approaches to limit joint stress and other common age-related ailments. Common yoga styles for seniors include:

Chair yoga – practiced entirely with the use of a chair, either to sit on or support yourself with, this type of yoga incorporates poses that are modified for seniors who cannot bear weight for long periods of time on their legs.

Water yoga – yoga in a pool is the name of this style’s game and offers a weightless, low-impact practice that is hard to find anywhere else.

Restorative yoga – spend extended periods of time practicing stillness and aligning the body and mind in this yoga style that embraces mental wellbeing.

What are the Benefits of Yoga for Seniors?
In addition to offering generous physical exercise for seniors, routine yoga practice also touts a handful of health benefits including:

Weight management
Pain relief
Stress relief
Social interaction
Lowered blood pressure
Joint mobilization
Skin rejuvenation
Better sleep

Senior yoga can be adapted for older adults with a range of ailments including arthritis, diabetes, mobility issues, and even Alzheimer’s.

Where Can I Find a Senior Yoga Class?
Because of the continued boom of the retiree demographic, more and more yoga classes are being offered to seniors in a variety of environments. You can look for senior classes at your area senior or community recreation center as well as at boutique yoga studios, fitness gyms, health clubs, and even within your own retirement community.

If you would rather see what senior yoga is all about at home, try streaming free instructional yoga videos online either on your computer, tablet, smartphone, or smart TV. You can conduct a quick search for “senior yoga tutorial” on Youtube.com or check sites like DoYogaWithMe.com.

By |2021-02-10T15:44:45-05:00February 19th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Quick Guide to Yoga for Senior Citizens