Urinary Tract Infection
Background
Urinary tract infections (UTIs), also called cystitis (inflammation of the bladder), are common among older adults and are more frequent in women. They are a primary cause of urinary incontinence and delirium. Catheter-associated urinary tract infections (CAUTIs) are more common among older adults (Fakih et al., 2012) and is mainly attributed to the use of indwelling urinary catheters. Many indwelling catheters are thought to be unnecessary (Cochran, 2007) and one study noted that physicians were often not aware of the purpose for which their patients had a catheter inserted (Saint, Meddings, Calfee, Kowlaski, & Krein, 2009). UTIs have been show to increase morbidity and mortality, length of hospital stay, and cost of hospitalization (Kleinpell, Munro, & Giuliano, 2008). CAUTI is considered preventable and is not reimbursed by Medicare. Therefore, hospitals will largely assume the financial costs for preventable infections of this type.
Risk factors/Signs and symptoms
Several risk factors are associated with UTIs in general. These include being female, having an indwelling urinary catheter, the presence of urological diseases, and hormonal changes associated with menopause in women. Signs and symptoms of UTIs include urinary frequency and burning or stinging felt during voiding. Pain may be felt above the pubic bone, and a strong urge to void but with small amounts of urine expelled. The most significant risk factor for CAUTI is prolonged use of an indwelling catheter. In hospital-acquired UTIs, 75% are associated with the use of an indwelling catheter (CDC, 2012). In women, signs and symptoms of CAUTI may be more severe than those reported by women by patients in the community who do not have an indwelling catheter. Lethargy, malaise, onset or worsened fever, flank pain, and altered mental status have been associated with CAUTI (Hooton et al., 2010).
Diagnosis
A thorough assessment should be done of the patient’s urinary output, including amounts, color, odor, appearance, frequency of voiding, urgency, and episodes of incontinence. A urine specimen should be obtained if UTI is suspected. Laboratory results will show the type of organism causing the infection, and the sensitivity will tell what medication the organism is susceptible to. These results should be reported promptly to the physician or nurse practitioner caring for the patient and so that a diagnosis and treatment plan can be made.
Treatments
Prevention of UTIs is considered a primary nursing strategy. Elderly female patients can be instructed to make lifestyle modifications such as: increasing their fluid intake; emptying the bladder after sexual intercourse; practicing good perineal hygiene, including wiping front to back after toileting; getting enough sleep; and avoiding stress (PubMed Health, 2011). Although many of these common sense strategies are recommended by primary care providers, there is a lack of scientific evidence to support some of them. Many UTIs will clear up on their own, particularly if the person increases oral fluid intake during early symptoms. However, with many older adults, antibiotic treatment may be needed. In general, a course of three 3 days for healthy adults is thought to be sufficient, but for more resistant bacteria, a longer course more than five 5 days may be needed (PubMed Health, 2011). For those with repeated or chronic UTIs, a low dose of antibiotics taken for 6– 12 months may be indicated (Hooton et al., 2010). If the underlying cause is CAUTI, treatment will be more aggressive. Monitor the patient’s temperature at least every 24 hours (Carpenito, 2013). Encourage fluids. Evaluate the necessity of continuing an indwelling catheter if one is in place.
Alternatives to indwelling catheters should be considered for appropriate patients. Intermittent catheterization, if appropriate, is preferred over indwelling catheter use, especially for long- term maintenance of bladder management (CDC, 2009; Hooton et al., 2010). Condom catheters may be an appropriate choice for some males. If an indwelling urinary catheter is necessary, the catheter should be removed as soon as possible, per the physician or nurse practitioner’s orders, to reduce the risk of CAUTI.
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.
How to Communicate With Your Elderly Loved One About Their Health
It’s a sad fact that as we age, our bodies change. It is true for your elderly loved one as well. As their health begins to fade, they are unable to do things they have easily done before. And they feel this change deeply. And because they are worried that their family members may think of them as a burden, they would act as if nothing is wrong, which is very tricky since it can lead to more problems along the way.
As someone who looks after the welfare of your senior loved ones, it is important to take the initiative to communicate with them. However, doing that is never easy, knowing that seniors will often be argumentative or defensive when it comes to their health. Therefore, it is important to understand your seniors’ health before you discuss anything with them.
You may want to discuss some things with your older family member like a regular check-up, treatment options that the doctor suggests, and diet changes. Also, you need to discuss home modifications to improve their safety at home or whether it’s time to consider personal care, home care, or companionship support. You should approach this topic either in a calm manner or by showing concern for their well-being. But how are you going to do it?
This article will discover the best ways to communicate with your senior loved ones about their health.
8 Ways to Communicate With Your Elderly Loved One About Their Health
- Listen to Your Senior Loved One’s Concerns
When you listen and understand what your loved one is saying, you create a more fertile ground for conversation. Your senior loved one is more open to considering what you have to tell if you let your loved one speak his concerns freely without judgment. In addition, it could well be that your loved one is ambivalent and needs his time to think things thoroughly. Don’t rush to put words in their mouth. You might need to paraphrase what your loved one said to show that you understood them.
- Pick the Right Environment
There are several things to consider when picking the right environment. If your loved one is agitated, choose a quiet place for communication. It could be the dining table, living room, or bedroom. Another option is to choose a comfortable chair at the hospital or in their nursing homeroom. You could also schedule a visit for later in the afternoon when your loved one may be more likely to have some energy and interest in talking about their health with you.
- Ask a Thoughtful Question Instead of Just Giving an Advice
When you are trying to communicate with your elderly loved one about their health, the best thing you can do is ask a thoughtful and well-researched question. It will help you understand your loved ones and concerns much better. Ask them what makes them feel that way and why they feel that way. If you think your aging loved ones need to hear a hard truth like telling him, it might be time to give up the car. It could go a lot better to have a third party begin the discussion, like a physician and a family.
- Speak Clearly to Make Sure That You are Well Understood
You must speak clearly during the health discussion. You can either repeat what your loved ones said or paraphrase their concerns. Since they are not looking at you, they may not understand you properly. So, repeating what your loved one said would ensure that your loved ones are well understood. One thing to remember is to stick with speaking using more of an informal tone of voice.
- Include Other Family Members in the Discussion
Include other family members, like your siblings, in the discussion. But before you include your aging loved ones into that discussion, bring all the issues and concerns to the table and ask them what they think should be done. It will help you have a more fruitful discussion with your elderly family member. A unified consensus among family members regarding these transitions for aging loved ones is a more supportive environment than a divided family.
- Accept Differences of Opinions
Not all families are going to agree on what you think should be done. It means that the discussion is going to be difficult. It is okay if other family members have other ideas on how to proceed. But what you should try to do is find a middle ground agreement among the family members. If there are disagreements, don’t push your loved ones to make a decision they are uncomfortable with.
- Let Your Loved One be Part of the Decision-Making Process
If you want your loved one’s cooperation and keep them as active as possible, it is important that they feel like they are a part of the decision-making process. You should allow your family members to weigh in by asking their opinion and giving them all the information they need to make the right decisions. If your loved one agrees with what you plan to do, give them all the reasons for why you think it is necessary. It could be very helpful for you both if you can involve your loved ones in planning their future.
- Keep Notes from Your Important Discussions
You may want to take some notes and record your discussions during your discussions with your aging loved one. It will help you pick up on any key concerns you need to address later on. Also, there might be memories were shared that you may want to use later.
When situations come up in future episodes of your elderly loved one’s health, bring them up again and ask them if they remember it or if it happened before. It could help if you keep records of important conversations and events in the past regarding their health.
- Offer Your Loved One Choices Whenever Possible
Whether it be house cleaning, grocery shopping, or taking a walk at the park, it would be a good idea to let your loved one choose what to do. If they feel like going out to take a short walk or have a bite to eat, allow them. Be sure that the things you want them to do are things they can still safely do. If you have a senior loved one who is confined to their home and cannot leave, consider creating an environment for them that is as comfortable as possible.
- Pick Your Battles
Discussing every single issue at once can be embarrassing for an aging parent or loved one. Pick the issues that are the most important, let him know you are aware of the other issues, and then ask if he wants to talk about them later. For example, if your aging relative feels that he is not getting any exercise by walking to the store, ask how his doctor has suggested he should do more exercise. Perhaps there is a way for you to be his walking buddy during the next week or two.
There are a variety of effective ways you can communicate with your aging loved one. It is important that you first understand how their confusion and unclear thinking may affect their health. There are steps you can take to make the interaction more productive and beneficial for both of you. These tips will help you have a more fulfilling conversation with your loved ones regarding their health and help them feel that they have been heard.
Author Bio
I’m Andrea Gibbs, Born, raised, and still living in New York. I’m a work-at-home mom with a background in business development, strategy, and social media marketing. I’m a blog contributor at Serenity Senior care to motivate other parents about how they can enhance their elderly loved ones quality of life.
Guest Blog: Exploring active wear for boomer generation
Introduction:
Whether you’re trying to get in shape after years of being sedentary or have always been active, it’s important that you make sure that your clothes are functional.
It’s also important to wear clothes that are comfortable and appropriate for your activity level. Not only will this make exercising more enjoyable but it will also help prevent injuries while working out.
Active wear is available in a wide variety of styles and colors, making it easy to find something that suits your own personal tastes. Here are some tips on how you can choose the right fitness gear:
The benefits of wearing active wear:
In addition to being comfortable and functional, active wear is also versatile. You can wear your activewear for any type of workout, whether you’re hitting the gym or working out at home. Activewear is stylish, yet functional–and it can help you feel confident and look great!
The options for active wear are endless:
When it comes to active wear, the options are endless. There are so many different styles and colors that you can choose from that you may find yourself overwhelmed by all of your choices. That’s okay though! You don’t have to pick just one kind of sportswear–you can mix and match different pieces with each other depending on what activity you’re doing or where you’re going. For example, if I’m going hiking in the mountains I’ll probably wear jeans with some hiking boots (or sneakers if it’s not too muddy), and you can order best boots for men or women online too, but if I’m going mountain biking then I would wear shorts and knee pads instead because they’re more comfortable when riding bikes!
Boomers are wearing more color and patterns than ever before:
As you age, it’s important to maintain your sense of style. While you may have worn all black in your younger years, now that your part of the boomer generation, it’s time to express yourself through color and patterns!
Color is a great way to express your personality–and if you don’t like how something looks on someone else? The answer is simple: wear it yourself along with stylish MK bags! Patterns can also be used as an expression of individualism–and boomers aren’t afraid to stand out from the crowd.
There are many choices when it comes to active wear in every size:
When it comes to active wear, there are plenty of choices for every boomer generation. There are many brands and styles, as well as sizes available. You can find active wear in any color or pattern, style and size–even if you’re looking for something special. You can buy bodybuilding stringer tank tops or gym trousers or shorts online too!
Plus-size options are becoming more readily available in the market:
Plus-size options are becoming more readily available in the market. This is a positive development for the boomer generation, who are no longer limited to one or two active wear brands. There are many options for boomers to choose from, including brands like Athleta and Lululemon that cater to older women with their unique designs and styles. The good news is that there’s an abundance of choices out there now so you don’t have to settle on just one brand or style!
Active wear is available with a variety of styles for all body types:
Active wear is available in a variety of styles, sizes and colors. It’s important to remember that active wear isn’t just for people who are physically active. If you’re looking for something more casual or want to wear your favorite pair of jeans, there are plenty of options out there that won’t make you feel like an old fuddy-duddy.
Active wear helps you feel comfortable and confident:
Active wear is the perfect combination of fashion and function, making it a great choice for older adults. Active wear can be used to make a bold fashion statement while also being functional during workouts. Activewear is designed to fit the body, providing comfort and functionality during athletic activity. Activewear comes in a variety of styles suited for all body types or ages.
Want to start moving your body, this is the article for you.
If you’re a boomer and want to start moving your body, this is the article for you.
You’ve probably heard about how important it is for people to keep moving as they age–and it’s true: regular physical activity can help improve your health, reduce stress and increase happiness. But if it feels like there are so many things in life that need your attention that finding time for exercise seems impossible? That feeling isn’t unusual! The key is starting small with simple activities like walking or gardening that fit into your daily routine.
Here are some tips for getting started on this journey:
- Wear clothes that feel comfortable when exercising–the right gear will help motivate you throughout the day!
- Don’t forget sunscreen! Age spots aren’t just something we see in photos anymore; they’re real and they will occur if unprotected skin gets too much sun exposure over time.
- If possible, try scheduling workouts around other activities such as taking care of kids/grandkids or volunteering at church/school events – these kinds of things provide extra motivation because they remind us why getting active matters so much (and give us something else fun/productive).
Add some new gear when comfortable with your exercise routine:
When you’ve gotten comfortable with your exercise routine, it’s time to start thinking about how to make the experience more enjoyable. In addition to finding new exercises that are right for your body and fitness level, there are also some other things you can do:
Gear: If you want a little extra help with your workout, consider buying some gear. For example, if running is difficult for you because of knee pain or back problems (or any other reason), then an elliptical machine may be better suited for these areas than running would be. Or maybe an adjustable weight bench will give those biceps a boost! On the other hand, don’t waste money on something like a yoga mat unless it’s going to make things easier or more fun–and even then only get one if there’s room in the budget!
Active wear can be a bold fashion statement and also functional during workouts:
When you think of active wear, what comes to mind? Do you see the same old gym clothes that have been around since you started working out in high school? Or maybe it’s those yoga pants that have become your uniform for all things work out-related. While there’s nothing wrong with these staples, active wear can be used to make a bold fashion statement while also being functional during workouts.
The options for active wear are endless and include everything from colorful leggings or sports bras to printed tops and jackets! Boomers are wearing more color and patterns than ever before because they want their clothes to be fun without sacrificing function. There are many choices when it comes to active wear in every size so everyone can participate in this trend whether they’re into running marathons or just trying something new at their neighborhood gym class (and yes–there is such thing as “gym class”).
Conclusion
Active wear is a great way to stay active and look good. It’s also important for you to remember that you don’t need to spend a lot of money on new clothes or equipment; there are plenty of options out there that won’t break the bank!
How Sleeping Incorrectly Can Affect Your Pain
When you think about your sleep, you typically think about a period of restoration and rejuvenation. Your sleep is supposed to be the time your mind and body have an opportunity to rest and repair for the next day.
What most people don’t know is that you could be sleeping incorrectly and making your pain worse instead of better.
How you could be sleeping incorrectly
You may not realize there’s a specific technique to the way you sleep. Besides, you’ve been sleeping all of your life. How could you possibly be doing it wrong?
One of the most important factors to your sleep, especially when you’re dealing with aches and pains, is your sleeping posture. Most sleepers sleep on their sides, and this can cause a lot of complications. For one thing, half of your body is crushed under the weight of the other half of your body. This can specifically target your pain points, so you’ll wake up with soreness in your shoulders, hips, and knees.
It’s not only sleeping on your side that can amplify your pain. Stomach sleepers are in an even worse position, putting undue stress on their lower backs all throughout the night, especially with thicker pillows that raise your neck up even higher.
You probably knew your sitting posture was important for your neck and back pain, but keeping proper posture while unconscious is a little more challenging to account for. Here’s how you can work on it.
What you can do to correct your sleep
If you’re a stomach sleeper, you should probably work on trying to get comfortable in other positions. It takes some time to adjust to sleeping in a new position, but it is possible to make a change. If possible, try to adjust to becoming a back sleeper. This is the best position for maintaining spinal alignment and decreasing your chances of waking up in pain.
If you’re absolutely committed to stomach or side sleeping, there are ways you can fix your technique. As a stomach sleeper, sleep with less, or no, pillows to eliminate the arching up that causes lower back pain. As a side sleeper, try to keep your body elongated rather than curled into the fetal position. This can help reduce morning pains (and snoring, too).
Author’s bio: Laurie Larson is a writer based in NC who writes on health topics.
Total Knee Replacement
Background
Similar to hip replacement, knee replacement is done when a person is experiencing decreased range of motion, trouble walking or climbing stairs, and increased degeneration of the joint so as to impair quality of life. This most often occurs as a result of arthritis.
Treatment
Total knee replacement (TKR) surgery involves resurfacing or removing the distal portion of the femur that articulates with the end of the shin bone. The prosthesis consists of metal and plastic or similar materials that are cemented onto the newly resurfaced areas of the articulating bones. Although often done under general anesthetic, this surgery can also be performed under spinal anesthesia. Sometimes blood loss is significant, so patients may be asked to donate their own blood ahead of time to be given back to them in the event it is needed. In addition, a growing trend is toward bilateral knee replacement in those persons requiring both knees to be surgically repaired. The benefits of this are the one-time operative anesthetic and room costs, and many physicians feel recovery from bilateral replacement is similar to single replacement. However, the pain and lack of mobility, as well as the significant increase in the assistance needed after surgery when a bilateral replacement is done, may make this less than ideal for older patients. Surgical procedures for TKR have not evolved quite as rapidly as total hip arthroplasty.
Discomfort after knee surgery is generally severe in the first few days. Complications after surgery may occur, including pain, infection, and blood clots. Patients may use cold packs on the operative area and take pain and sleeping medications as ordered. In addition, alternative therapies such as guided imagery have been shown to help with pain management (Posadzi & Ernst, 2011). Many joint replacement patients feel a loss of control and independence.
Therapy will begin immediately in the acute care hospital. Although weight bearing does not usually occur until 24 hours after surgery, sitting in a chair and using a continuous passive motion machine (CPM) (if ordered), will ease recovery. The use of a CPM is generally based on the surgeon’s preference. There is research to support it, as well as studies indicating that walking soon after surgery has an equal effect and makes the CPM unnecessary. However, in cases of an older person who may not have the mobility skills initially after surgery that a younger person would, a CPM may be beneficial to keep the joint flexible and decrease pain.
Dr. Zann (2005) indicated that “patients undergoing total knee replacement do not achieve their maximum improvement until 2–4 years” (p. 1). This is attributed to the lack of muscular structures that surround and protect the knee and the need for the ligaments and tendons to adapt to the indwelling prosthesis. Recovery times vary and depend upon a number of variables, including the patient’s overall health, age, other preexisting health issues, and motivation. Patients report that the new knee joint never feels normal even years after the surgery, but that they experience an increase in function and generally much less pain than before.
Patients should be educated about signs and symptoms of infection, care of the surgical site (if staples are still present), pain management, and expectations for recovery. A range of motion from 0–90 degrees is the very minimum needed for normal functioning. Normal knee flexion is 140 degrees, but few older persons would get this amount of flexion after surgery, and may not have had full flexion even prior to the operation. After discharge, a walker is usually used in the first few weeks, followed by light activities 6 weeks after surgery. In addition, the patient’s spouse may experience feelings of being overwhelmed due to role transitions that occur after surgery and during the recovery period (Walker, 2012 ). Newer knee prosthetics are still going strong for the majority of patients 15 years after surgery.