Dr. Mauk’s Boomer Blog

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

Guest Blog: Spotting the Signs of Substance Abuse in the Elderly

Those who are at the twilight of their lives are vulnerable not just to illnesses but also to addiction, as well. This is especially true for the elderly who are residents of various healthcare facilities as the prevalence rate of alcohol abuse disorder jumps up to 22%.

Sadly, most symptoms of substance abuse are misinterpreted for depression, natural signs of aging, and other unrelated causes.

Here are just some of the warning signs that would tell you to get some help:

1. Lack of hygiene – People with substance abuse problems hardly care about their hygiene as the priority is when they can have their next fix.

2. Slurred speech – This is quite obvious and when you see them slurring their speech every time you check up on them, chances are they have an alcohol problem.

3. Extreme mood swings – The addicted individual becomes emotionally unstable. They can lash out at you for no reason at all.

4. Hyperactivity – Stimulants like meth and cocaine trigger hyperactivity.

5. Lethargy and excessive sleeping – Prescription opioids are the most commonly abused drugs by the elderly. Abusing their medications can take a toll because of their slowed metabolism.

6. Sudden weight loss – Addicted individuals are not really eating right because, again, their priority is sustaining their addiction. Instead of buying food, they buy drugs instead.

7. Alienation – They will isolate themselves from everybody else because they don’t want to be answering questions about their physical appearance and behavior.

8. Constant lying – When they do get confronted, they lie and lie. They will also feign illnesses in order to trick their doctors into adding into their dosage of prescription opioids.

9. Frequent accidents – Their motor skills will depreciate as they grow older and that’s understandable. However, when they fall more times than usual, it could be a sign that they have an alcohol abuse disorder.

10. Mental health issues – Over time, abusing drugs and alcohol will mess up with the chemistry in their brains. They may develop depression, feeling of isolation, extreme anxiety, among others.

Senior living facilities are not equipped to deal with substance abuse. However, they do have protocols on how to deal with these situations. However, if your parents and grandparents are living on their own and you think they need help, you can search for the rehab facilities in Colorado.

By |2024-04-23T11:16:46-05:00June 14th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Spotting the Signs of Substance Abuse in the Elderly

Do You Need a Medical Alert System?

White clock with words Time for Action on its face

Medical alert systems can provide an added layer of protection that can help you lead an independent life. No matter your age, falling or being caught in a situation where you’re unable to summon medical help in the case of an emergency can be a very real concern. Though medical alert systems are closely associated with senior citizens, they’re a great asset that can offer assistance for a variety of ages and medical conditions.

It’s important to note that medical alert systems are not the same thing as medical ID jewelry. Medical ID jewelry may come in the form of a bracelet or necklace engraved with personal information that identifies medical conditions first responders need to know in order to attend you. These are commonly used for responders to know if a patient has specific drug and food allergies, prescribed medicines, emergency contacts or conditions that could impair judgment such as Alzheimer’s. A medical ID should have the medical emblem also known as the Star of Life that contains the snake and staff symbol.

Medical alert systems, on the other hand, are small electronic devices that allow you to connect with a dispatcher who can seek emergency help or contact a designated family member or friend to come to your aid should you need medical assistance.

Most of these devices can be worn as aw or necklace and function by utilizing wireless voice, data, and geographic location technology to allow for accurate location-tracking and real-time monitoring.

This is ideal for anyone from an unaccompanied minor walking to the bus, a senior living alone that would like more autonomy, or a person that would feel safer walking home late from work.

If you’re considering medical alert devices, there are a variety of features and service options to choose from, including:

Environmental monitoring: Some medical alert systems have integrated carbon monoxide monitoring that contain sensors that measure concentration of gas in the environment.

Mobile caregiver tools: Some medical alert systems offer real-time monitoring apps for caregivers to view on their mobile devices. These features will notify caregivers should there be any unusual patterns, periods of inactivity, or low battery life on the user’s medical alert device.

GPS location services: The GPS accuracy level for certain medical alert systems may suffer interference if used inside a multilevel building. It’s recommended that you let your medical alert company know the layout of the building where the user is residing so that when help is summoned, it arrives at the right place.

Language support: Medical alert systems are becoming popular, and many companies now offer real-time translators that are able to communicate in up to 180 languages. If you need assistance in another language other than English, ask an agent if they offer translation services before purchasing the device.

Fall Detection: Some alert systems come with fall detection technology that constantly monitor the speed and direction of the user’s movements. If it detects an unusual movement, such as a fall, the device will alert the monitoring center after a specific period of inactivity.

Waterproof: Most slips and falls can happen when you’re in the shower. Luckily, the majority of medical alert devices are waterproof to help ensure your safety at all times.

A quality medical alert system will provide you the peace of mind to go about your life feeling secure and independent. To learn more details regarding the equipment, contract, price, reputation and certifications for the best medical alert systems nationwide please read this in-depth study at ConsumersAdvocate.org. At the end of the day, this is a good investment for your health and wellbeing.

By |2024-04-23T11:16:32-05:00June 12th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Do You Need a Medical Alert System?

Guest Blog: Home Improvements and Modifications for Aging in Place

January 5, 2021 by Julia Weaver

Now more than ever before, we’re seeing more adults choosing to live at home as they grow in years, or what is known as aging in place. Living at home helps aging adults maintain their lifestyle for as long as possible, rather than moving into a nursing home or assisted care center. In fact, three-quarters of adults 50 years and older would prefer to remain in their homes as they age, according to a survey by AARP. Though many of us won’t be able to live independently forever, home modifications will allow your loved ones to continue to live in their home longer by creating a more manageable environment. Whether they’re living in a single-story condo in Dallas, TX  or a three-story home in Portland, OR, there are modifications that can be made to every home to help make daily tasks a little easier.

Helpful home modifications

As we grow older our bodies and capabilities change, and not all homes are designed to support this challenge we’ll face. A lot of times doorways are too narrow, bathrooms too small, floors too slippery, and kitchen cabinets too high to reach. For aging adults, a home designed for optimal accessibility, convenience, and safety is imperative to avoid falls or serious injuries.

Optimizing a home for safe and comfortable living while creating a home environment that makes getting around easier is essential for aging in place. That’s why we’ve gathered the most common home modifications, from simple adjustments to larger remodeling projects.

General Home modifications to aid in mobility

  • Install handrails. For aging in place, add handrails to stairs, hallways, bedrooms, and bathrooms for extra balance.
  • Upgrade the lighting. Replace existing bulbs with LED bulbs to increase visibility. Consider installing touch-activated lamps, and placing night lights in the bedroom, bathroom, and hallways.
  • Install lever door handles. Switch out standard round doorknobs for lever-style handles. These do not require the same level of grip.
  • Install a stairlift. This is a great alternative when walking up stairs becomes more difficult. Install light switches at the top and bottom of the stairs to prevent your loved one from using the stairs in the dark.
  • Install automated blinds. This style of window treatment allows aging adults to adjust their blinds without having to stand up.
  • Create an open floor plan. Make wide passageways throughout the home with little obstruction. Widen doorways and hallways if your loved one uses a walker or wheelchair to navigate their home.
  • Replace hardwood, tile, laminate, or vinyl flooring for carpet. If your loved one doesn’t use a wheelchair, carpet will be most forgiving and provides more floor consistency.

For the living room

  • Rearrange furniture and remove clutter. To avoid tripping hazards, be sure furniture placement leaves plenty of space to move about the room safely.
  • Install anti-slip mats. Add strips to the bottom of rugs to increase traction and reduce the chances of tripping.
  • Replace unsteady furniture. Discard furniture that wobbles to prevent falls, and add plastic bumpers to the sharp edges on furniture pieces.

For the kitchen

  • Keep daily-use items accessible. Store small appliances, cookware, and tableware between waist and shoulder height to avoid the need to crouch down or use a step stool.
  • Consider purchasing a stovetop with an automatic shut-off feature. Once the sensors fail to detect motion for an extended period of time, the stove will shut off.
  • Install a hands-free faucet and anti-scald device. Easily turn the water on and off with the wave of a hand, and install an anti-scald device to avoid the possibility of burns.
  • Replace kitchen cabinets and adjust counter and sink height. For more convenient storage space, install drawers, open shelving, or pull out shelves. Choose a counter height where it’s easy to prepare meals and wash dishes while sitting.
  • Adjust the location of major appliances. Place the oven, sink, and refrigerator as close to each other as possible.

For the bathroom

  • Add adhesive strips to a bath mat in showers and tubs. This can help prevent slipping on wet surfaces.
  • Install non-skid strips in case the flooring becomes slippery. Try to avoid ceramic tile as this can become slick when it’s wet.
  • Install a walk-in bathtub or a shower transfer bench. This can greatly reduce the chances of slipping and falling. Climbing in and out of a traditional bathtub or standing for an extended period of time may become more difficult.
  • Install grab bars or rails in bathtubs and near the toilet. This will improve mobility and help to prevent falls.
  • Install a raised toilet seat. An elevated toilet seat decreases the distance between standing and sitting.

For the home’s exterior

  • Create at least one no-step entry into the home. Replace exterior stairs with a removable ramp for a smooth transition into and out of the home.
  • Add exterior lighting and landscape lighting. To avoid falling or tripping, add outdoor lighting to walkways and stairs.
  • Install handrails. Add handrails on both sides of walkways for extra support and balance.
  • Choose low maintenance materials. Opt for vinyl siding, metal roofing, composite decking, and low maintenance landscaping.
  • Install a security system. A home security system can give your loved one a sense of security and protection.

How to pay for home modifications 

While in the end, it’s generally less expensive to age in place as opposed to living in a senior living community, the upfront costs for a remodel can add up. Luckily there are resources and programs available, such as home improvement grants, equipment loans, and low-interest loans.

You should also consider researching programs like Medicare Advantage, Non-Medicaid Government assistance and Medicaid HCBS Waivers, Veterans programs, and non-profit organizations for financial help. As you’re crunching the numbers, it’s important to remember that the cost associated with home modifications has two components: the labor cost and the materials cost. Oftentimes, the cost of labor for installing the equipment will not be covered by insurance.

Create a support system with senior care and services

Forming a support system for your loved one is a big part of aging in place. Besides the support from family members, it’s a good idea to consider senior care and services for your aging parent. There is a network of services available, including meal delivery, nurses, transportation, and house cleaning services.

In-home care services are also offered at various levels depending on the situation. On days when you’re unavailable, an elder companion could spend time with your loved one to prevent social isolation. In-home caregivers can provide help with day-to-day activities like cooking, grooming, or shopping, while also making sure your loved one is safe in their home

Introduce technology into your loved one’s home

Assistive technology solutions, smart home features, and tech gadgets can be used to help simplify everyday tasks, promote independence, and stay safe while aging in place. There are all sorts of devices, like medical alert devices to signal for help, assistive seating devices to lift your loved one into the standing position, and smart bulbs that can be controlled remotely.

Individual results may vary.
This is not intended as a substitute for the services of a licensed and bonded home services professional.

Redfin does not provide medical advice.
All of the material provided on Redfin’s blog, such as text, treatments, dosages, outcomes, charts, patient profiles, graphics, photographs, images, advice, messages, forum postings, and any other material provided on Redfin’s blog are for informational purposes only and are not a substitute for professional medical advice or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on Redfin’s blog.

If you think you may have a medical emergency, call your doctor or 911 immediately. Redfin does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on Redfin’s blog. Reliance on any information provided by Redfin’s blog, by persons appearing on Redfin’s blog at the invitation of Redfin’s blog, or by other members is solely at your own risk.

By |2024-04-23T11:16:19-05:00June 10th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: Home Improvements and Modifications for Aging in Place

Parkinson’s Disease

 

Background

Parkinson’s disease (PD) is one of the most common neurological diseases, affecting at least 1.5 million people in the United States (American Parkinson Disease Association {APDA}, 2010). The average age of onset is about 59 years of age (APDA, 2010), and the likelihood of developing PD increases with age (National Institute of Neurological Disorders, 2008). It affects both men and women, particularly those over the age of 60 years (American Parkinson Disease Foundation, 2012). Parkinson’s disease was first described by Dr. James Parkinson as the “shaking palsy,” so named to describe the motor tremors witnessed in those experiencing this condition.

Parkinson’s disease is a degenerative, chronic disorder of the central nervous system in which nerve cells in the basal ganglia degenerate. A loss of neurons in the substantia nigra of the brainstem causes a decrease in the production of the neurotransmitter dopamine, which is responsible for fine motor movement. Dopamine is needed for smooth movement and also plays a role in feelings and emotions. One specific pathological marker is called the Lewy body, which under a microscope appears as a round, dying neuron.

Signs and Symptoms

Parkinson’s disease has no known etiology, though several causes are suspected. There is a family history in 15% of cases. Some believe a virus or environmental factors play a significant role in the development of the disease. A higher risk of PD has been noted in teachers, medical workers, loggers, and miners, suggesting the possibility of a respiratory virus being to blame. More recent theories blame herbicides or pesticides. An emerging theory discusses PD as an injury related to an event or exposure to a toxin versus a disease. Interestingly, coffee drinking and cigarettes are thought to have a protective effect in the development of PD (Films for the Humanities and Sciences, 2004).

The signs and symptoms of PD are many; however, there are four cardinal signs: bradykinesia (slowness of movement), rigidity, tremor, and gait changes such as imbalance or incoordination. A typical patient with PD symptoms will have some distinctive movement characteristics with the components of stiffness, shuffling gait, arms at the side when walking, incoordination, and a tendency to fall backward. Not all patients exhibit resting tremor, but most have problems with movement, such as difficulty starting movement, increased stiffness with passive resistance, and rigidity, as well as freezing during motion (NINDS, 2012). Advanced PD may result in Parkinson’s dementia.

Diagnosis

Diagnosis of PD is made primarily on the clinician’s physical examination and thorough history taken from the patient and/or family. Several other conditions may cause symptoms similar to PD, such as the neurological effects of tremor and movement disorders. These may be attributed to the effects of drugs or toxins, Alzheimer’s disease, vascular diseases, or normal pressure hydrocephalus, and not be true PD. There is no one specific test to diagnose PD, and labs or X-rays rarely help with diagnosis.

Treatment

Management of PD is generally done through medications. Levodopa, a synthetic dopamine, is an amino acid that converts to dopamine when it crosses the blood–brain barrier. Levodopa helps lessen most of the serious signs and symptoms of PD. The drug helps at least 75% of persons with PD, mainly with the symptoms of bradykinesia and rigidity (NINDS, 2008). One important side effect to note is hallucinations. A more common treatment, and generally the drug of choice, involves a medication that combines levodopa and carbidopa (Sinemet), resulting in a decrease in the side effect of nausea seen with levodopa therapy alone, but with the same positive control of symptoms, particularly with relation to movement. Patients should not be taken off of Sinemet precipitously, so it is important to report all of a patient’s medications if they are admitted to either acute or long-term care. Dopamine agnoists trick the brain into thinking it is getting dopamine. This class of medications is less effective than Sinemet, but may be beneficial for certain patients. The most commonly prescribed dopamine agonists are pramipexole (Mirapex) and ropinirole (Requip) (Parkinson’s Disease Foundation, 2012). Medications such as Sinemet show a wearing-off effect, generally over a 2-year period. During this time, the person must take larger doses of the medication to achieve the same relief of symptoms that a smaller dose used to bring. For an unknown reason, if the medication is stopped for about a week to 10 days, the body will reset itself and the person will be able to restart the medication at the lower dose again until tolerance is again reached. This time off from the medication is called a “drug holiday” and is a time when the person and family need extra support, because the person’s symptoms will be greatly exacerbated without the medication. The earliest drugs used for PD symptom management were anticholinergics such as Artane and Cogentin, and these medications are still used for tremors and dystonias associated with wearing-off and peak dose effects (Parkinson’s Disease Foundation, 2012).

There are many other treatments for Parkinson’s disease being explored. These include deep brain stimulation (DBS), with electrode-like implants that act much like a pacemaker to control PD tremors and other movement problems. The person using this therapy will still have the disease and generally uses medications in combination with this treatment, but may require lower doses of medication (NINDS, 2012). Thalamotomy, or surgical removal of a group of cells in the thalamus, is used in severe cases of tremor. This will manage the tremors for a period of time, but is a symptomatic treatment, not a cure. Similarly, pallidotomy involves destruction of a group of cells in the internal globus pallidus, an area where information leaves the basal ganglia. In this procedure, nerve cells in the brain are permanently destroyed.

Fetal tissue transplants have been done experimentally in Sweden with mild success in older adults and more success among patients whose PD symptoms were a result of toxins. Stem cell transplant uses primitive nerve cells harvested from a surplus of embryos and fetuses from fertility clinics. This practice, of course, poses an ethical dilemma and has been the source of much controversy and political discussion.

A more recent development includes the use of adult stem cells, a theory that is promising but not yet well researched. Cells may be taken from the back of the eyes of organ donors. These epithelial cells from the retina are micro-carriers of gelatin that may have enough cells in a single retina to treat 10,000 patients (Films for the Humanities and Sciences, 2004). In addition, cells modified from the skin of patients with PD can be engineered to behave like stem cells (NINDS, 2012). Both of these alternatives present a more practical and ethically pleasing source of stem cells than embryos.
Other research includes areas include those related to alternative therapies. For example, Tai Chi has been shown to be effective in improving balance and reducing falls for PD patients (NINDS, 2012). Rehabilitation units have been using Tai Chi for similar benefits in other patients with neurological deficits. Simple interventions such as using Wii games to promote activity and exercise may be explored. The role of caffeine in PD is also being examined. In a small randomized control study of 61 patients with PD, caffeine equivalent to 2–3 cups of coffee per day was given to subjects and compared with a control group of those taking a placebo. Those patients receiving the caffeine intervention showed little improvement in daytime sleepiness, but modest improvement in PD severity scores related to speed of movement and stiffness (Postuma et al., 2012). Further study with larger groups was recommended by the researchers.

Much of the nursing care in PD is related to education. Because PD is a generally chronic and slowly progressing disorder, patients and family members will need much instruction regarding the course of the disease and what to anticipate. Instruction in the areas of medications, safety promotion, prevention of falls, disease progression, mobility, bowel and bladder, potential swallowing problems, sleep promotion, and communication is important. Most of the problems seen as compli¬cations of PD are handled via the physician as an outpatient, but certainly complications such as swal¬lowing disorders as the disease progresses may require periods of hospitalization. When persons suffer related dementia in the final phases of the disease, they are often cared for in long-term care facilities that are equipped to handle the challenges and safety issues related to PD dementia. In ¬addition, access to resources and support groups is essential.

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.

For more information on Parkinson’s Disease, visit the Michael J. Fox Foundation Website:
https://www.michaeljfox.org/

 

By |2024-04-23T11:16:01-05:00June 8th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Parkinson’s Disease

Guest Blog: The 5 Most Important Vitamins for Seniors

No matter what your age may be, you’ll need to stay healthy by eating right and staying fit. However, as your body gets older, it’s more challenging to hit your target quotas for certain vitamins and minerals because of hormonal changes. Check out the 5 most important vitamins for seniors:

1. Vitamin A

While you may be familiar with vitamin A’s importance for your vision, reproduction, and immune system, you’re probably not aware that it also helps many of your organs to function properly. You can get preformed vitamin A from meat and poultry including salmon and dairy products. On the other hand, you can get provitamin A (such as beta-carotene) from fruits that include apricots, cantaloupe, mangoes, green leafy vegetables, broccoli, squash, and carrots. You can also find vitamin A in your fortified breakfast cereals.

It’s important to note that Vitamin A supplements may interact with Orlistat, which is a weight-loss drug. Also, you shouldn’t take supplements at the time you’re taking prescription medicines that use synthetic forms of vitamin A in them.

2. Vitamin B-12

Vitamin B-12 will further enhance your metabolism, brain processes, and your body’s creation of new red blood cells. Furthermore, it’s also important for repairing genetic material. The best sources for vitamin B-12 are fish, meat, eggs, and dairy products.

However, as your body ages, your stomach doesn’t make as much hydrochloric acid that helps break away this vitamin from animal foods. Without this stomach acid, unabsorbed vitamin B-12 just passes through your digestive tract. Therefore, seniors are advised to get vitamin B-12 from supplements rather than whole food sources.

3. Vitamin D

Although bone loss can’t be prevented as you get older, you can slow it down by taking more vitamin D. With regular intake of a vitamin D supplement, your body’s absorption of calcium will significantly improve. The result would be stronger bones with fewer chances of getting fractures. Good sources of vitamin D include whole eggs, cod liver oil, salmon, and fortified dairy foods, fortified orange juice, and fortified breakfast cereals.

When you were younger, some vitamin D was made as you exposed yourself in direct sunlight. However, this process isn’t as efficient as it used to be when you’re in your senior years. In fact, by the time you turn 50, your body will require 600 international units of vitamin D every day. This increases to 800 IUs per day when you hit 70.

4. Vitamin K

You’ll need vitamin K to make your blood clot. When you injure yourself or fall, this vitamin helps promote proper wound healing. Furthermore, it also prevents bone loss to seniors who suffer osteoporosis. Aside from your daily multivitamin with a huge portion of your vitamin K requirement, you’ll need to ear more spinach, broccoli, Brussels sprouts, cauliflower, cabbage, kale, and Swiss chard, liver, fish, meat, eggs, and cereals. if you want to your vitamin K levels to be elevated even more.

5. Vitamin C

Vitamin C is an antioxidant that wards of the free radicals that destroy your body’s healthy cells. Aside from this, it also protects your eyes, reduces your chances of developing heart disease, and boosts your immune system. You can get your supply of vitamin C from fruits and vegetables such as strawberries, oranges, broccoli, and red peppers. However, it’s best to take vitamin C supplements to meet your daily requirement of 90 milligrams (for women) and 75 milligrams (for men).

Stay on Top of Your Game

It would’ve been ideal if you could get all of the nutrients you need from fruits, vegetables, and other unprocessed whole foods. Unfortunately, science can’t perfectly recreate all that nature has to offer into whole foods. This means that if you want to stay on top of your game, you’ll need to supplement your diet with these 5 most important vitamins for seniors.

Independent at Its Finest

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By |2024-04-23T11:15:24-05:00June 6th, 2024|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: The 5 Most Important Vitamins for Seniors