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Resources2018-05-18T09:03:15-05:00

Guest Blog: A Solid Rehab Approach for the Elderly

Unfortunately, addiction doesn’t just stop in one place and stay there. It can affect many people across all walks of life. It happens to any person, of any age, in any area, in any place of their life. This is why it is important to note those rehabs that specialize in rehab care for the elderly.

With over 40 million seniors aged 65 or older living in the country, it is no wonder that some of them do have an addiction issue. With so many seniors, many of them have taken prescription pills for one health issue or another. As a leading cause of substance abuse in the country, seniors are not exempt from this addiction.

In fact, seniors are more likely to be prescribed these medications and more likely to abuse them than any other age group. This is because they are oftentimes forgetful, may feel like they haven’t taken enough, do not realize they are taking too much, or any number of other reasons.

Rehab for these seniors addicted to these medications will be needed.

Addiction in Seniors
Many find it surprising that so many seniors are addicted to medications. Isolation and loneliness tend to be the most common issues for addiction in older adults, especially those abusing alcohol or other drugs.

This type of addiction needs to be addressed in a specific setting and in a specific way. Not only should the root of the problem, such as the loneliness, be addressed, but the specific person should understand that they have a problem. Even though they are older, it doesn’t mean that they shouldn’t get help.

An addiction rehab with specialists that are trained in senior rehab is required. This is a rehab center that can speak with the senior, understand why they are using or abusing the substance, and then find the best course of action to take regarding their treatment plan.

Seniors, just like the rest of us, are susceptible to addiction. Due to this, it is important to check in on those that are close to you to make sure that they do not feel the need to use. You want to help them when it is needed, visit with them, and let them know you are there. Rehabs for seniors, and others that have drug abuse issues are out there, but it shouldn’t have to get this far.

By |August 14th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Blog: A Solid Rehab Approach for the Elderly

Diabetes Risk Factors and Treatments

Diabetes mellitus type 2

Background

Diabetes mellitus is a common metabolic disorder that affects carbohydrate, lipid, and protein metabolism. It is estimated that about 4.4 to 17.4% percent of adults in the United States have diabetes mellitus (Cory , Ussery-Hall, Griffin-Blake et al., 2010). It is estimated that 11.5 million women and 12.0 million men over the age of 60 have diabetes, but many do not know it. The Indian Health Service reported via the National Diabetes Survey of 2007 that of the 1.4 million Native Americans and Alaska Natives in the United States, 14.2% age 20 years or older have diagnosed diabetes. Rates vary by region, from 6.0% of Alaska Natives to 29.3% of the Native Americans in southern Arizona (CDC, 2007). There are two major types of diabetes, type 1 (T1DM) and type 2 ( T2DM). T1DM is characterized by autoimmune destruction of the insulin-producing beta cells of the pancreas, leading to a deficiency of insulin. New-onset of adult T1DM in older adults rarely happens; however, due to better treatment of T1DM, older adults who have been diagnosed at an earlier age are living longer. About 90% of older adults with diabetes have T2DM, which is often related to obesity. T2DM is characterized by hyperglycemia and insulin resistance; however, impaired insulin secretion may also be present. Diabetes mellitus is a major cause of disability and death in the United States, and is the seventh leading cause of death among older adults.

Risk Factors

The risk of diabetes increases with age (45 years and older). Other risk factors include family history, obesity, race (African Americans, Hispanics, Native Americans, Asian Americans, Pacific Islanders), hypertension, less “good” cholesterol (less than 35 mg/dl), lack of exercise, having a history of delivering large babies (≥9 pounds), personal history of gestational diabetes, and pre-diabetes in men and women (Laberge, Edgren, & Frey, 2011). Type 2 is the most common type in older women (CDC, 2007). The risk of death from DM is significantly higher among older ¬Mexican American, African American, and Native American women when compared to Whites. The Centers for Disease Control CDC (2005) names obesity, weight gain, and physical inactivity as the major risk factors for DM among women.

Diagnosis

The most common presentation for older adults with T1DM is hyperglycemia (high blood sugar). Older adults may not have the classical symptoms such as polydipsia, polyuria, polyphagia, and weight loss. Instead, they may have an atypical presentation (Halter Chang & Halter, et al., 2009). They may first present with falls, urinary incontinence, fatigue, or confusion. Because older adults may have T2DM for years before it is diagnosed, they often have macrovascualar and microvascular complications at the time of diagnosis, so evaluation of these should be considered at that time.

Treatment

Prevention is the best approach to care, which involves identifying those at risk and encouraging lifestyle change. Older adults with diabetes mellitus have a high risk for complications related to macrovascular disease, microvascular disease, and neuropathy. Macrovascular diseases include coronary heart disease, stroke, and peripheral vascular disease, which can lead to amputation. Microvascular diseases are chronic kidney disease, which is the most common cause of end-stage renal disease, and diabetic retinopathy, that which can lead to blindness. Peripheral neuropathy presents as uncomfortable, painful sensations in the legs and feet that are difficult to treat. A lack of sensation may also be present and contribute to the risk of falls. There is no cure for peripheral neuropathy, and it tends to be a complication for which patients experience daily challenges trying to manage the symptoms. A combination of medication to address pain and interventions by a physical therapist seems to be the best current treatment.

Treatment is aimed at helping patients to achieve and maintain glycemic control to decrease risk of complications. The initial treatment approach is to work with the older adult to establish treatment goals aimed at reducing long-term complications. This often requires working within an interprofessional team. Aggressive treatment may be appropriate for most older adults; however the risk of hypoglycemia (low blood sugar) is higher in older adults. Older adults with hypoglycemia may have an atypical presentation with acute onset of confusion, dizziness, and weakness instead of tremors or sweating. The best measure of good blood glucose management and controlled blood sugars is HgbA1c levels (glycosylated hemoglobin). This measure of hemoglobin provides insight into the previous 3 months of blood sugar control. If HgbA1c is elevated, it indicates that the blood sugar has been high over time. For most people, a HgbA1c ≤ 7% indicates optimal glycemic control; however, due to poor health outcomes, for frail older adults or those with a life expectancy ≤ 5 years this may not be the best, and a Hgb A1c of 8% might be more appropriate.

Management is successful when a balance is achieved among exercise, diet, and medications. Medications may be oral hypoglycemics or insulin injection. Insulin injection is used in T1DM and may be prescribed for T2DM because as the person ages, beta-cell function declines. If insulin is needed, it is important to consider if there are visual problems and or hand arthritis that limits the dexterity that is necessary to prepare and inject the medication. For some, a simple regimen, such as premeasured doses and easier injection systems (e.g.,insulin pens with easy-to-set dosages) is the best.

Thorough evaluation of readiness to learn and of the ability of an older person to manage his or her medications must be done. Older adults who need to give themselves insulin injections may experience anxiety about learning this task. Demonstration, repetition, and practice are good techniques for the older age group. Adaptive devices such as magnifiers may help if the syringes are hard to read. A family member should also be taught to give the insulin to provide support and encouragement, although the older adult should be encouraged to remain independent in this skill if possible. Williams and Bond’s (2002) research suggested that programs that promote confidence in self-care abilities are likely to be effective for those with diabetes. A plan for times of sickness and the use of a glucometer to monitor blood sugars will also need to be addressed. Additionally, the dietician may be consulted to provide education for the patient and family on meal planning, calorie counting, carbohydrate counting, and nutrition. Many patients benefit from weight loss, so the nutritionist can assist with dietary planning in this regard also.

Due to the increased risk of infection and slow healing that result from diabetes, foot care is an essential component in teaching older adults to manage DM. Some experts believe that good preventive foot care would significantly reduce the incidence of amputation in the elderly. Older persons with DM should never go barefoot outside. Extremes in temperature should be avoided. Shoes should be well fitting and not rub. Socks should be changed regularly. Elders should be taught to inspect their feet daily, with a mirror if needed. Corns and ingrown toenails should be inspected and treated by a podiatrist, not by the patient. Older persons should see their podiatrist for a foot inspection at least yearly. Patients should be cautioned that even the smallest foot injury, such as a thorn or blister, can go unnoticed and unfelt—and often results in partial amputations that lead to a cascade of lower extremity problems.

For more information on living with Diabetes, visit the American Diabetes Association:
http://www.diabetes.org

 

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.

By |August 13th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Tags: |Comments Off on Diabetes Risk Factors and Treatments

Guest Post: How to Reduce Loneliness for the Elderly in Your Life

Reaching the golden age does not always come only with a great life experience but also with reasons to make you feel lonelier than ever. Years have passed by and many of those people you encountered and loved so much may have passed away over time. This is something that remains in your heart forever.

Feeling lonely is not something to be ashamed of but also not something to control your life. Discover below the best ways in which to reduce loneliness for the elderly in your life. They deserve to live happy during this new stage in their existence. Help them rediscover the joy of living!

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 Develop a Strategy to Defeat Seclusion

If you have elder people you love, you must engage more in their life. It is unavoidable for them to feel lonely from time to time. This is why they need your love and support more than ever. Make them feel loved and an important part of your life. Offer them reasons to smile and continue every day. Do not forget about them or ever leave them feeling like no one has time for them anymore.

Allow Them to Feel Useful

Feeling like there is nothing left for you to do in life is the worst possible feeling. Older people should be treasured because they have a life experience to share. Learn to listen to them more often, spend more time with them and allow these amazing people to teach you what they know. Engage with them in activities that are suitable for their age and help them keep themselves active. Never leave them alone for too much time and always advise them on how to stay clear of sadness and depression.

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 New Bridge for the Generation Gap

The generation gap between young people and older ones is obvious. However, there should always be a bridge built with love, compassion, and respect or understanding to help keep these two generations together. Teach your children to appreciate the elderly. If they have grandparents, guide them towards building close relationships with them. Spending time together and sharing experiences will be a great way in which to reduce loneliness for the elderly in your life. It will also be a great life lesson for your children.

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To ensure a better life experience for them at this stage you can also consider professional help in care homes in Maidstone. The main stages of life are the same for all of us. We may go through them differently and face varied challenges, but we all get to the same place sooner or later. Let’s treasure the amount of experience and life stories these amazing people have to share. We will learn more from them than from any other experience in our life.

 

 

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By |August 11th, 2020|Categories: Dr. Mauk's Boomer Blog, News Posts|Comments Off on Guest Post: How to Reduce Loneliness for the Elderly in Your Life
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