Guest Blog: Ways to prevent and treat depression in older adults
Older adults are at high risk of developing depression. As we age, the brain becomes less active and we often begin to experience mild memory losses. Even though many seniors choose to get treatment as soon as they realize their mental health begins to decline, they don’t want to become pariahs to their families. As a consequence, they refuse to get further help and end up in depression. How can we help our older parents overcome depression when they refuse to accept our assistance?
Depression – a real health concern we shouldn’t leave unattended
Depression is a proven health concern that manifests differently from individual to individual. The symptoms are real, and if they’re not treat in advance, the condition may lead to even greater health issues, including sleep deprivation, lack of interest in performing daily activities, isolation, lack of appetite, and more.
Sadly, too many seniors can’t or won’t want to admit that they feel depressed. They refuse to get help because they don’t want to be a burden to their loved ones. As their parent, you have to be more aware of the signs, so that you can help them get back on their feet. Depression shouldn’t be seen as a sign of weakness. Everyone can become depressed at any age, and regardless of any accomplishments of background.
Have a chat with your parents and talk about their feelings
Stress or bereavement are not the sole cause of depression in older adults. If you’ve noticed that your loved ones are not eating anymore or that they’ve lost interest in performing daily activities that once made them feel good, then they might be depressed. It’s very important to talk to your parents about their feelings.
Have a friendly conversation and ask them if they’re doing ok. Older adults become depressed when their health is in jeopardy; or when they begin losing their friends due to old age. If you can’t afford to hire a specialized caregiver, you can be their caregiver. All you have to do is listen to what they have to say. Be there to comfort them and find a way to lift their spirit by doing activities together.
The link between sadness and depression
There’s a very tight connection between sadness and depression. However many older adults claims they’re not sad, making you believe they’re not depressed. But deep down something’s off. Their depression might kick in and develop in a totally different way. Pay close attention to the signs, and if you notice that mom doesn’t talk as much or doesn’t want to do anything, then she might be depressed.
In older adults, depression can be observed physically. Your parent may suffer from insomnia, acute arthritis, lack of appetite, or lack of energy. Migraines and headaches can also be a predominant symptom. As we age, we begin losing some of the people we care most about. Loss is excruciating, and older seniors don’t know how to cope with it. Many grieve differently, and even though it’s normal, some adults end up depressed.
It’s tough to make the difference between depression and grief because oftentimes the symptoms are very similar. Nonetheless, there are ways to tell them apart. Grief involves a wealth of emotions; some are good, others are not so good. Sometimes, the person grieving a loved one may experience feelings of joy and happiness. When you’re depressed, positive feelings are completely eradicated, and you feel totally empty.
Helping a loved one cope with depression
Beating depression is hard, but not impossible. It demands a lot of hard work and determination. Support matters the most, they key often being to be there for your aging parent and engage in activities that make them feel positive and upbeat. Note that digital communication doesn’t help; talking to your mom every week over the phone is not enough to raise her spirit. You have to do it in person.
Make time to visit every week. Bring the kids over, go out for coffee, and find a way to have a good time and remember the good times. Residential care may not be the first thing that comes to mind when aiming to overcome depression. But it might be a good idea because it allows older adults to make new friendships and build relationships.
How Important are Bedside Manners?
Physicians are medical experts, for sure, but there’s more to being an excellent doctor than making the correct diagnosis time after time. How physicians treat and interact with the patients they serve is just as important as the medical treatment they provide.
In fact, you can argue that having an excellent bedside manner plays a pivotal role in ensuring that patients get the best medical care possible. Take a look at how bedside manners can cement the physician-patient relationship and improve the overall experience.
Establish Trust
Bedside manner describes how a physician or medical care provider interacts with and approaches a patient. Some doctors are notorious for not having a good bedside manner. They might wave off patient’s concerns or act like they are in a rush whenever they see patients.
Doctors with good bedside manners take the time to get to know their patients. The doctors might ask patients about their lives and show a genuine interest in the patients’ wellbeing. Taking that extra time to connect with patients allows doctors with a good bedside manner to build trust.
Patients are more likely to open up to doctors when they feel that the doctor will listen to their concerns or take them seriously. Trusting patients are also more likely to follow the medical advice they get from doctors.
Build Compassion for Your Patients
Having a good bedside manner helps you see what life is like for your patients. When you take the time to really listen to their problems and hear what they’re telling you, you’ll be better able to empathize with them.
When a doctor has empathy or compassion for their patients, they’re better able to see their patients as living, breathing humans. That’s why compassion matters for doctors. It humanizes the medical experience. It lets doctors share in some of the patient’s suffering, for sure. But it also gives doctors a chance to genuinely rejoice and feel relieved when patients do well.
Improve Patient Outcomes
Better bedside manners often leads to better patient outcomes, for several reasons. When doctors demonstrate compassion to patients, patients are more likely to share their concerns. A doctor who has a clearer picture of what’s going on with a patient can make a more accurate diagnosis.
Patients who trust their doctors are more likely to follow through on any treatment plans created. They’re more likely to take prescribed medications and to return for follow-up care.
Boost Your Career
Developing an excellent bedside manner can do wonders for a doctor’s career. When a physician treats their patients with compassion and shows genuine care and interest in their patients, they become the in-demand doctor.
Being in-demand leads to more patients and can also help you move up the career ladder, advancing to more challenging and fulfilling roles.
How to Improve Your Bedside Manner
More and more medical schools are focusing on training students to develop their bedside manner, along with medical skills. That’s a great thing. But if your school didn’t focus on bedside manner or your patients have noted that yours is lacking, all isn’t lost.
Taking a few simple steps can help you get a better bedside manner and improve your patient rapport.
- Always introduce yourself. At the start of every encounter, take a few minutes to introduce yourself by telling the patient your name and what your role is in their care. Also, ask their name or how they like to be called. If other members of the care team will work with the patient, too, inform the patient of that, so that they know what’s going on.
- Pay attention to body language. Look at the patient and how they’re sitting or lying down. Do they have their arms crossed or are they refusing to look at you? Do they seem nervous or scared? Take a few minutes to check in with them based on what you observe.
- Keep things simple. Whenever possible, use the simplest terms to describe things to your patients or when asking questions. Ask them if pain moves, rather than radiates, for example. If you have to use a jargon-y term, take the time to explain what it means. Check in with your patient throughout the encounter to make sure they understand you.
- Listen and repeat. Try repeating what your patients tell you. Doing so verifies that you have the details correct and shows the patient you’re listening. It also gives them the chance to correct any mistakes.
Your success as a physician, and your patients’ success, depends on the strength of your bedside manner. Practicing being compassionate and really seeing and listening to your patients can take you far in your medical career.
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!