Seizures
Background
Once thought to be mainly a disorder of children, recurrent seizures or epilepsy is thought to be present in about 7% of older adults (Spitz, 2005) and is usually related to one of the common comorbidities found in older adults (Bergey, 2004; Rowan & Tuchman, 2003). Epilepsy affects up to 3 million Americans of all ages (Velez & Selwa, 2003). Davidson & Davidson (2012) summarized findings of most studies on epilepsy in older adults with these main points:
Seizures can be caused by a variety of conditions in older persons, but “the most common cause of new-onset epilepsy in an elderly person is arteriosclerosis and the associated cerebrovascular disease” (Spitz, 2005, p. 1), accounting for 40–50% of seizures in this age group (Rowan & Tuchman, 2003). Seizures are associated with stroke in 5–14% of survivors (Spitz, 2005; Velez & Selwa, 2003). Other common causes of epilepsy in the elderly include Alzheimer’s disease and brain tumor.
There are three major classifications of epilepsies, although there are many additional types. Generalized types are more common in young people and associated with grand mal or tonic-clonic seizures. A number of cases have an un¬determined origin and may be associated with certain situations such as high fever, exposure to toxins, or rare metabolic events. In older adults, localized (partial or focal) epilepsies are more common, particularly complex partial seizures (Luggen, 2009). In contrast to young adults, Rowan and Tuchman (2003) cite other differences in seizures in the elderly: low frequency of seizure activity, easier to control, high potential for injury, a prolonged postictal period, and better tolerance with newer antiepileptic drugs (AEDs). Additionally, older adults may have coexisting medical problems and take many medications to treat these problems.
Risk Factors/Warning Signs
Risk factors for seizures in older adults include cerebrovascular disease (especially stroke), age, and head trauma. The most obvious signs and symptoms of epilepsy are seizures, although changes in behavior, cognition, and level of consciousness may be other signs. Also, note that exposure to toxins can cause seizures that are not epilepsy. Complex partial seizures in older adults may include symptoms such as “confusion, memory loss, dizziness, and shortness of breath” (Davidson & Davidson, 2012, p. 16). Automatism (repetitive movements), facial twitching with following confusion, and coughing are also signs of the more-common complex partial seizure (Luggen, 2009).
Diagnosis
Diagnosis is made by careful description of the seizure event, a thorough history, and physical. Eyewitness accounts of the seizure incident can be quite helpful, although many community-dwelling older adults go undiagnosed because their seizures are never witnessed. In addition, complete blood work, neuroimaging, chest X-ray, electrocardiogram (ECG), and electroencephalogram (EEG) help determine the cause and type of seizure (National Institute for Health and Clinical Excellence {NICE}, 2012).
Treatment
Treatment for epilepsy is aimed at the causal factor. The standard treatment for recurrent seizures is antiepilepsy drugs (AEDs). The rule of thumb, “start low and go slow,” for medication dosing in older adults particularly applies to AEDs. The elderly tend to have more side effects, adverse drug interactions, and problems with toxicity levels than younger people.
Research has suggested that older adults may have better results with fewer side effects with the newer AEDs than the traditional ones, though about 10% of nursing home residents are still medicated with the first-generation AEDs (Mauk, 2004). The most common older medications used to treat seizures include barbiturates (such as phenobarbital), benzodiazepines (such as diazepam/Valium), hydantoins (such as phenytoin/Dilantin), and valproates (such as valproic acid/Depakene) (Deglin & Vallerand, 2005; Resnick, 2008).
Several newer drugs are also used, depending on the type of seizure. Second-generation AEDs, including gabapentin (Neurontin), lamotrigine (Lamictal), oxcarbazepine (Trileptal), levetiracetam (Keppra), pregabalin (Lyrica), tiagabine (Gabitril), and topiramate (Topamax), are generally recommended over the older AEDs; however, older AEDS such as phenytoin (Dilantin), valproate (Depakote), and carbamazepine (Tegretol) are the most commonly prescribed treatment options (Resnick, 2008). Each of these medications has specific precautions for use in patients with certain types of medical problems or for those taking certain other medications. Regarding side effects in older patients, watch for potential stomach, kidney, neurological (especially poor balance or incoordination), and liver problems. Additionally, some newer extended-release AEDs are thought to be better tolerated and have a lower incidence of systemic side effects (such as tremors) (Uthman, 2004).
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.
Cataract Warning Signs and Treatment
Cataracts are responsible for 51% of world blindness, representing about 20 million people (World Health Organization [WHO], 2010). More than 90% of cataracts are age-related. Cataracts are so common in older adults that some almost consider them an inevitable consequence of old age and often fail to report to the doctor. According to the University of Washington, Department of Ophthalmology (2008), 400,000 new cases of cataracts are diagnosed each year, over 3 million visits to a doctor are related to cataracts each year, and 5,500,000 people have some impaired vision due to cataracts. Although about half of people between 65 and 75 years of age have cataracts, they are most common in those over age 75 (70%), and there are no ethnic or gender variations (Trudo & Stark, 1998).
Risk Factors
Advancing age is the biggest risk factor for the development of cataracts. Other risk factors include diabetes, tumor, long-term use of medications such as corticosteroids, excessive exposure to sunlight, blunt or penetrating trauma, and excessive exposure to heat or radiation. Tobacco use, family history of cataracts, high alcohol intake, diabetes, and lack of dietary antioxidants also puts the person at risk for cataract development (Gerzevitz, Porter, & Dunphy, 2011).
Warning Signs/Diagnosis
Cataracts cause no pain or discomfort and may be manifested by gradual opacity of the lens, which affects the ability to see clearly. This causes decreased visual acuity, sensitivity to glare, and altered color perception. Older adults may not be aware of the problem until visual changes occur. They may report blurred or distorted vision or complain of glare when driving at night. The person may present with a fall due to visual changes. Some older adults will disclose that their reading vision has improved and they no longer need reading glasses, something called “second sight”. Eventually the pupil changes color to a cloudy white. Generally, the most common objective finding is decreased visual acuity, such as that measured with a Snellen eye chart. The patient should be referred to an ophthalmologist for further evaluation and consideration of surgery.
Treatment
Although changes in eyeglasses are the first option, when quality of life becomes affected, the most effective treatment for cataracts is surgery. Surgery is relatively safe and usually is done as an outpatient procedure. The opaque lens is removed through an incision in the eye and an intraocular lens is inserted. The surgical incision is either closed with sutures or can heal itself. This is the most common operation among older adults, and more than 95% of them have better vision after surgery (Trudo & Stark, 1998). After surgery, patients will need to avoid bright sunlight; wear wrap-around sunglasses for a short time; and avoid straining, lifting, or bending. They may need to use eye drops as instructed by the doctor (National Eye Institute, 2013). The benefits of surgery include improved visual acuity, depth perception, and peripheral vision, leading to better outcomes related to ADLs, quality of life, and reduced risk of falls. Complications associated with surgery are rare but include retinal detachment, infection, and macular edema. Cataract surgery today offers a safe and effective treatment to maintain independence and improve quality of life for older adults.
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: Why Elderly People Should Keep Pets?
Are you thinking whether you should be taking care of your pet as you age?
When you age, you wonder if you should adopt a pet?
This guide will help you decide on the best choice for you. Studies have shown that having a pet can be advantageous both physically and psychologically for people of all ages. In the case of senior citizens, only 15 minutes of bonding with an animal causes a chemical chain reaction in the brain, reducing rates of fight-or-flight hormone, cortisol, and the development of nostalgic hormone serotonin.
The result: a sudden decrease in heart rate, blood pressure, and stress rates. Long-term relationships between pets and humans can minimize cholesterol levels, fight depression, and even help protect against heart disease and stroke.
Getting a pet or engaging with one will enhance elderly people’s health and wellness, improving both physical health and mood. Get emotional support animal registration for trained animals as per your requirement.
There are a few key reasons why elderly people should keep pets.
Lower blood pressure
Scientists think stroking a dog or cat will help you relax and therefore reduce blood pressure. A 2002 study revealed that dog or cat owners had lower resting heart rates and blood pressure than those who did not have pets.
Reduced risk of heart attack and stroke
According to scientists, owning a dog can relieve stress and anxiety and therefore reduce the risk of heart disease. A study that looked at over 4400 adults aged between 30 and 75, including half who owned a dog, showed that 3.4% had died from a heart attack over ten years. 5.8 per cent had died from heart attacks in the community who had never owned a pet.
Better mood
Stroking a dog can be comforting to both parties. If you stroke a dog, a hormone called oxytocin is released, which is linked to anxiety relief. A study conducted at Uppsala University in Sweden presented at the 12th International Conference of Human-Animal Interactions in 2010, showed that friendly human-dog interaction releases oxytocin in both humans and dogs. It is interesting if you walk down the street with a dog how many people look at him and it brings a smile to their face. That really stimulates a positive emotional response.
Fewer visits to the doctor
According to Pets for The Elderly Foundation in the US, 21% of older people with a pet have fewer veterinarian visits. Owning a pet like a dog will make you more active. Being regularly active is noted for reducing heart disease and the risk of having a stroke, as well as reducing the risk of developing diseases like dementia and some cancers. Experts also agree that post-sickness or surgery pets will help us heal faster.
Better social contact
Walking a dog is more likely to promote social interaction and conversations with others and lead to an increased likelihood of new friendships. When you walk a dog, there is more risk of starting up conversations with pet owners in parks and other public areas.
Less stress
Stroking a pet is thought to reduce the level of stress-related hormones in the blood according to Professor Adnan Qureshi from Minnesota University. Reducing stress can help protect against heart disease by lowering blood pressure and reducing heart rate.
More affection and love
Focusing on taking care of an animal is a great way to give and receive love. Recognizing the treatment and bonding value of owning a dog and focusing emotional energy on a pet is a good thing.
More active
Dog walkers will naturally be active. A 1991 study showed that pet owners typically had higher rates of activity and less mild health issues.
A greater sense of comfort and security
The pets can be their key source of support for many elderly people who lack daily social contact and company. Ninety-five percent of the elderly people talked to their pets in a survey by Pets for the Elderly Foundation, while 82 percent said that their pets support them when they felt sad.
A positive focus and a sharper mind
A researcher noticed a marked improvement in her late mother, who had vascular dementia when caring for her dog. ‘My mother loved her dog and was always happier when she was around. When her dog passed away, mum was understandably distraught, but I also noticed a change in her mood and mental function. Her dementia seemed to get worse – she became less focused, more detached, and more easily confused. Her dog had given her a sense of purpose and focus.’
Animal therapy
Animal therapy is common in care homes, as it has been shown to reduce anxiety and enhance social contact in people with dementia. Alzheimer’s Society actively encourages those with dementia to keep pets for as long as they can or interact with them as much as possible. However, if you are taking a pet into a care home or to a person’s home, make sure they have the right temperament and will comfort the person rather than cause more stress. Make sure dogs are unlikely to leap or bark excessively and make sure pets are friendly and unlikely to bite when stroked.
Improved overall health
According to researchers, pet owners look safer than those who don’t own pets. According to pet study Allen R McConnell, a psychology professor at Miami University, people with a strong relationship with their pets are on average happier than those who do not have pets.
Hope this article gave you the reason to keep a pet for yourself or for your elderly loved ones. Spread love!
Dental Care Tips for the Elderly People of Age 55+
1. Introduction to Oral Health
An increase in education about oral health, as well as better access to toothbrushes, fluoride toothpaste and floss, have led to more older adults retaining their original teeth. However, as you age, your teeth and gums require a little extra attention. Read on to learn about how to care for your teeth after 55.
2. Oral Health Challenges in Aged People
– Dry mouth
Hormonal changes and many medications contribute to reduced saliva production resulting in dry mouth. Dry mouth can increase the risk of tooth decay and gum disease by allowing bacteria to breed more easily and can also lead to difficulty speaking and eating, fungal infections and problems wearing dentures.
– Attrition
Attrition refers to general wear and tear on teeth that occurs as you age. Years of chewing and grinding wears down tooth enamel increasing the risk of cavities.
– Diseases
Older adults over the age of 55 years old have an increased risk of developing thrush, a fungal infection of the mouth, as well as oral cancers.
– Root Decay
Gums can recede as you age exposing the base of the tooth to bacteria which can decay your teeth from the roots.
3. Common Conditions Found in Aged of 55+
Even with a good oral care routine, adults over the age of 55 years old have an increased risk of developing some problems with their teeth and gums. Some common conditions include:
• Darkened teeth which is often due to enamel erosion and changes in the dentine inside the teeth, but can also be caused by regular consumption of dark foods and beverages.
• A reduced sense of taste which may be due to the side effects of some medications but can also be caused by dentures.
• Gum disease which is most often caused by plaque build-up but can also be caused by cancer, anaemia and diabetes.
• Misaligned jawbone as a result of tooth extraction or loss without replacing the missing teeth which lets remaining teeth drift.
4. What Can You Do to Maintain Your Oral Health?
To keep your natural teeth strong and bright for many years to come, there are several ways you can protect your teeth and gums.
– Increase Fluoride
Fluoride is present in most drinking water and in dental products like toothpaste and mouthwash. Increasing your use of fluoride can help to protect your teeth from cavities by helping to remineralise your teeth after acid wear.
– Eliminate Tobacco Chewing
Tobacco chewing has been linked with several negative oral health issues including cavities and discolouration. But quitting tobacco can be a challenge. Talk to your doctor about resources to help you quit and make an appointment with your dentist in Southend for a tooth whitening treatment for a brighter smile.
– Increase Oral Hydration
Staying hydrated is a great way to combat dry mouth as a result of medication. Keep a water bottle close by and sip throughout the day. You can also improve your oral hydration by chewing sugarless gum and limiting your intake of alcohol.
– Antibacterial Wash
Improve your oral health by reducing the build-up of plaque with antibacterial wash. Swish a small amount of alcohol-free mouthwash in your mouth after brushing at night.
5. Conclusion
With proper oral care your teeth and gums will last your lifetime but take extra care of your teeth after the age of 55. If you interested in learning more about how your oral health changes as you age, call your local dentist for an appointment.
Author bio:
Located on the Southchurch Road, Parmar Dental is a multi-award winning
Southend Orthodontics offering high standard and quality dental treatments that
patients always expect. Parmar Dental provides dental care in a very relaxed and
tranquil environment, where each visit would be a unique experience for their
patients.
Sonya Grace: 7 Health Tracking Devices Perfect for Seniors
Advancements in technology have changed how people of all ages monitor their health. While the latest gadgets are generally seen as a trend aimed at younger generations, senior citizens have also reaped the benefits of health tracking devices. Here are seven health tracking devices perfect for seniors:
Fitness Trackers
Best for Seniors explain that fitness trackers show health related metrics like sleep quality, heart rate, and steps taken. In some cases, they even help the user reach a specific health goal.
Personal Emergency Response
This wearable gives the wearer an easy, quick, and convenient way to call for help in case something is amiss with their health. If they feel a shortness of breath all they need to do is press a button to call for attention.
Senior Safety Systems
These wearables track the activities of seniors to establish their activity patterns. They can then identify any abnormalities that will alert the doctor to irregularities.
Home Fall Detection System
Falls are a big concern for people in their old age, and this is where detection systems come in. These small wearable sensors detect falls and will instantly send out an alert that will bring help.
Medication Alerts
Medicines are a big part of life for those already in their golden years. These devices send out notices that make sure that the medicine is not forgotten and taken at the right time.
GPS Trackers
Seniors suffering from degenerative conditions need to be constantly monitored as they might wander aimlessly and get lost. GPS trackers help in this regard as they can let family members or carers keep track of them all the time.
Virtual Reality
Virtual reality is helping many different industries break new ground.Coral’s article on technology’s impact on sports details how VR is now changing how professional teams train. For instance, NFL quarterbacks are now using the technology to practice additional repetitions. This very same tech is also being used to improve and track the health of seniors. VR Fitness Insider reports that virtual reality helps seniors be more active without the need to leave their home. All they need to do is put on a headset and enjoy! They will also get a digital record of the exercise session.
Sure, the aforementioned health trackers may be perfect for seniors, but nothing will ever beat the attention and love that you, as a relative, can provide.
Guest Post: Why dieting isn’t sustainable
A diet is simply a way of eating. Some people diet with too much food, some people with too little food. But for most people, it’s just the wrong foods. However, one thing is for sure, diets don’t work. They never had and they never will. Just ask anyone who has been on any of the well-known, celebrity-endorsed diet plans for any length of time.
Note: Check out this guide to flexible dieting on how to escape the dieting life!
Dieters are often excited about the quick weight loss, but invariably, the diet doesn’t last forever and they quickly find that not only did they gain back all they lost, but they have taken on extra pounds too.
Dieting in the typical sense actually sets you up to fail in your attempt to lose those extra pounds. Immediately on any diet plan, your caloric intake is limited. That in itself isn’t a bad thing. Most meal portions have become unnecessarily large these days and actually need to be kept in check.
When you limit the number of calories consumed to get quick weight loss results on your diet plan, your body has to compensate for this loss. That’s when it begins to break down muscle tissue so as to maintain energy levels. The body also adjusts its requirements for energy and slows down its rate of metabolism.
But what happens when you go back to eating the way you did before? Well, your body is still functioning in diet mode. Your metabolism has slowed, so all that extra food is stored as fat. So you end up heavier than you were before you started dieting.
It’s also important to stress that activity can play a vital role in this too. If you can maintain your normal activity while dieting then you’re one of the few. Take a look at athletes for example. They follow a nutrition plan that that’s heavy in calories as activity like rugby training needs to be fueled. Dieting wouldn’t be an option for athletes and they do not put on unnecessary weight. The point here is that you need to also try and be active to help with your new lifestyle, dieting makes it even harder.
Aside from calorie restriction, here are other reasons why dieting isn’t sustainable for most people;
Too Restrictive – frankly speaking, diets are depressing. They take away all the fun foods and all of a sudden you can’t have chocolate anymore. Oh, now all you see is chocolate, it’s everywhere and everyone is having a bite… except you. Then, you cheat and go right back to square one.
Your Body Rejects It – your body likes eating and wants to eat. Denying your body means your body fights you to get more food. It forces you to cheat and go right back to square one.
The ‘fad diet of the week‘ is not right for your metabolism – your body needs certain nutrients. Your cravings match those nutrients. When you force your body to eat a way it doesn’t like, it slows downs, becomes clogged, and sick. You don’t even need to cheat and you’re worse now then you were at square one.
So how do you really lose fat and keep it off for good?
Getting down to your ideal weight and maintaining it means eating a balanced diet and getting plenty of exercise. It doesn’t mean a severe restriction in calories and spending hours at the gym. Simply pay more attention to the foods you eat and move around more.
Easy exercises like walking, cycling and swimming can go a long way to shaping a leaner, healthier you. Even walking 5 minutes per day is enough to get started. Then, work up to better and better exercises until you are exercising every day, alternating between strength training, cardio, and stretching.
Attaining and maintaining a healthy weight is as much about adjusting your self-concept and attitude as it is your lifestyle.
When you change the way you see yourself, it’s easy to make those necessary changes. In fact they often happen subconsciously. Your weight is governed by your self-concept. When you change the assumptions about yourself and your body, you change the results. That’s how you master weight loss forever.