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Guest Blog: Managing Back Pain as You Age

Like other critical parts of the musculoskeletal system, the spine experiences some wear and tear over the decades. Does this mean back pain is inevitable as you get older? Not necessarily.

What Happens to Your Spine as You Age?
The spine itself is composed of a series of stacked bones called vertebrae. Small joints between each vertebra allow for the spine’s range of movement and little rubbery discs with jelly-like centers inside make sure bones don’t rub against one another (they also serve as the spine’s shock absorbers).

Over time, these disks can dry out, shrink, and wear away, causing the spine to compress. This is known as degenerative disc disease. Sometimes the space surrounding the spinal cord will start to narrow too; this is known as spinal stenosis. Arthritis and osteoporosis may also affect the spine as you age leading to joint degradation and even spinal fractures.

Any of these age-related conditions can contribute to back pain, especially when bones start rubbing against one another and nerves get pinched. The body may even go as far as to grow bone spurs in an effort to stabilize a degenerating spine.

Preventing and Managing Back Pain
So, is there anything older adults can do to prevent it or at least manage the pain and discomfort that comes with those types of conditions? Definitely.

Experts recommend taking actions to relieve some of the burden your spine bears during daily activity. This includes:

Exercising to strengthen your back and core to more properly support the spine
Practicing good posture when sitting, using the computer, texting, etc.
Wearing a back brace for added posture support and lumbar compression
Eating a healthy diet rich with anti-inflammatory foods that help you maintain a healthy weight and combat systemic inflammation in they body – think fresh fruits, vegetables, whole grains, nuts, seeds, legumes, and lean proteins
Reducing stress on the back. This may mean utilizing lumbar cushions when driving, updating your mattress to better support your spine when sleeping, and avoiding activities which exacerbate your back pain

Additional Thoughts
Of course, it is also important to remember that acute back pain can also stem from something as simple as a muscle strain. Lifting something heavy, straining your arms and neck reaching for something in an awkward position, even sitting for a long period of time in an uncomfortable chair – any of these things can cause back pain and inflammation.

By Jim|2022-07-30T11:49:49-05:00September 24th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Healthy Eating Habits for Common Health Conditions

Having a healthy diet is important to your wellness as a whole, but when you have specific health conditions, it may be time to inspect how changes to your diet can impact your well-being. Check out these areas of health that recommend specific diets.

Heart Health

Your cardiovascular health is incredibly important to your overall health. As heart disease is the leading cause of death in the United States, having a diet that promotes heart health is crucial. Eating plenty of fruits, vegetables, and healthy protein will aid in your heart health. Choosing whole-grain options and minimizing processed foods, salt, and alcohol in your diet will also be beneficial to your cardiovascular health.

Creating a diet plan with your doctor can help you understand what foods help or harm you in the long run, as well as help you understand the importance of maintaining a healthy diet. You should monitor your heart health frequently as you age to ensure the swift identification of any changes to your cardiovascular wellness.

Eye Health

As you age, the health of your eyes changes. Between glaucoma, age-related macular degeneration, cataracts, and diabetic retinopathy, it’s incredibly important for you to have your eye health top of mind. Introducing eye-friendly nutrients into your diet can ensure the longevity of your eye health. Lutein, which you’ll find in dark leafy vegetables, along with vitamin c, vitamin e, and omega-3 fatty acids, can all play an important role in the health of your vision.

Aside from your diet, reviewing your corrective lenses on an annual basis is a small task that can yield great results for your overall health. This can include making sure you update your prescription eyeglasses often so you can quickly identify any changes to your vision. Catching these changes early on ensures you take the right steps in adjusting your lifestyle for the sake of your eye health. Prioritizing your vision and making a diet conducive to the optimal health of your eyes can help ward off the onset of many age-related eye problems.

To keep the health of your gut top of mind, creating a gut-conscious diet is imperative. This diet should include probiotics, prebiotics, fiber, and fermented foods. Incorporating foods like this should increase the good bacteria found in your gut which helps ward off illness. If you have any of the above-mentioned autoimmune disorders in your family history, it is important to take care of your gut early on and learn about the ways you can make your health as optimal as possible.

Staying on top of your health will always need to be a top priority. Understanding any conditions you have, or could have in the future based on your family history, helps you create a prevention plan. Diet, exercise, and environmental changes are all things you can alter for the sake of your health. Prioritizing your wellness will always be a necessary step for the longevity of your life.

By Jim|2022-03-16T10:19:39-05:00March 10th, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Guest Blog: Managing Family Dynamics with Geriatric Patients: A Guide for Nurse Practitioners

Gerontology nurse practitioners face a unique set of challenges within their field. It comes with the territory of caring for older adults that issues such as death, dying, terminal illness, and chronic illness are commonly addressed.

Common Challenges

There are many challenges families face when caring for an older relative. For example, the loss of independence a geriatric patient may have. Families may need to step in and care for the aging patient, which, unfortunately, can add stress to their daily lives. This buildup of stress can lead to caregiver burnout, depression, anxiety, tension within the family, and even anger or resentment.

Another possible challenge is the imbalance of perceived “power” within the family. A scenario for this would be if an elderly patient moves in with their adult child and their family. For many years, the patient was the head of household; the one who made decisions and ran the home. Now, the adult child is the head of household, while the aging parent/ family member is an occupant. The family may experience a “power struggle” which can lead to conflict and strife within the home.

Dealing with chronic illness is another prominent challenge – possibly one of the most significant. Dementia, for example, is a condition which does not improve over time. Dementia affects almost half of adults over age 85. The early stages are the most difficult, as patients experience forgetfulness which could lead to safety concerns (i.e., wandering away from home, leaving the stove on, etc.). Family members may become frustrated easy, but as the disease progresses, they may experience a prolonged “mourning” of the patient.

Along with situational components, there are other factors that contribute to a family’s dynamic. Socioeconomic level, education level, cultural differences, and even something as basic as personalities all contribute to how a family interacts with each other and deals with stress.

Tips for Geriatric Nurse Practitioners

When dealing with geriatric patients and their families, it’s important to first acknowledge that each family unit has unique dynamics. From there, utilizing the nursing process is a great way to address the individual needs of the patient and family. Below are some tips, using the nursing process, that can help geriatric NPs manage the sometimes-complicated dynamics within families.

Assess

The first thing geriatric NPs should do is assess the family’s interactions and communication skills. Ideally, meeting with both the family and patient is ideal. Assessing communication skills such as active listening, non-confrontational statements, and body language will help the NP determine how effective communication is within the family, and what needs to be improved. Geriatric NPs can also assess the patient and family’s knowledge base, readiness to learn, and if anyone is experiencing any of the stages of grief.

Diagnosis

After assessing the family dynamics and interactions, geriatric NPs can create a “diagnosis” of what they may need. For example, if the daughter of an elderly patient with dementia can no longer care for the patient, the NP will need to take action in terms of finding a suitable living arrangement. Another example is if the son of an elderly patient with a chronic disease becomes easily frustrated and angry with them. The NP would have to develop a plan to address the issue.

Planning

After assessing the family and patient’s needs and determining what is needed, the geriatric NP must create a plan to meet their individual needs. Because the needs of the patient and family are unique, breaking apart the needs of each family member will help tailor a plan to help create a healthy family dynamic. For example, using the first scenario above, the NP can create a plan to help the family find a care home for the patient, while assisting to help them manage the emotions involved with possible feelings of loss of control and fear. In the other example, the NP can consider arranging appointments for the son to see a counselor to deal with his feelings regarding his parent’s chronic illness, and how to communicate in a positive manner.

Implementation

The implementation phase of the nursing process is putting the plans into process. For the geriatric NP, this means arranging appointments, providing resources, and collaborating with the rest of the care team. Using the examples above, that could mean providing a list of care homes, putting the family in touch with a social worker, and/or recommending a counselor for the significant life change of transitioning to a care home. In the second example, the NP can recommend family counseling as well, and possibly provide tips for stress management for caregivers.

Evaluation

Evaluating a patient and family’s response to the recommended plan is one of the most essential pieces of dealing with altered family dynamics. This phase is a delicate process, as the NP needs to ensure the family has not only followed through with the treatment plan, but that it was effective as well. If not, the planning and implementation phase would need to be re-structured. In the examples used above, that would mean making follow-up calls to see how the elderly patient is doing in the care home, how the family and patient are doing with the transition, and if there are any other needs. In the second example, the NP can follow up with the elderly patient’s son to see how he is dealing with his parent’s chronic illness. It may also mean working to help manage the chronic illness as well.

Conclusion

Working with families is not unique to nurses and nurse practitioners. However, working with aging patients and their families presents a different set of challenges. While it’s impossible to provide tips on every potential challenge geriatric NPs may face, going back to basics using the nursing process will help identify each individual need so that a plan can be developed to address them. One of the most important things to remember is to include the family whenever possible in the decision-making process, and to maintain as much dignity and independence as possible for the geriatric patient.

By Jim|2022-01-30T20:06:14-05:00January 31st, 2022|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Alzheimer’s: Signs & Symptoms

Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.

Risk factors

Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.

Warning Signs

Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.

Diagnosis

Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.

The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.

Treatment

Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.

Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.

Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.

Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.

Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.

For more information on Alzheimer’s disease, visit the Alzheimer’s Association website at: http://www.alz.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.

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By Jim|2021-10-08T11:49:39-05:00November 4th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off

Simple Ways to Find Purpose as you Age

Having a purpose in life impacts its quality regardless of our age. A recently published study on Purpose of Life (PIL) in older adults found that people with purpose experienced fewer disability problems and chronic conditions. PIL is defined as a life with goals, direction, and meaning. People with a high PIL were found to be resilient, healthy and with social support, faith, and good knowledge of health-related matters. Here are some simple ways of keeping these factors in your life as you age.

1. Join an Age-Friendly Gym
Find a gym that has programs for elders. If you don’t know many fitness centers that offer such programs, use an online tool like this facility locator on the International Council of Active Aging website. The map shows the available options in a city by name, number, address, and allowed gender. Next to the name of the center, there are icons to show what type of services they offer. Besides fitness centers, you can use the tool to find other services as well, including recreation centers, retirement living facilities, YMCA, community services, etc. Here are 5 places you can visit to stay in shape and find new friends.

2. Become a Volunteer
Consider becoming one of the many elderly who volunteer. Some popular forms of volunteering include fundraising, teaching, mentoring, and preparing/distributing food. Retired individuals are a good fit for volunteering programs because they come from a variety of businesses and sectors. For instance, your input can be valuable for a fundraiser if you have spent your career in marketing and have a strong connection in the community that takes years to develop. Sites like Volunteer Match list opportunities in a variety of areas and for people of different age groups.

You can also offer your services as a mentor to young people in general or in your field of expertise. For food related jobs, check at your local food banks and at any local food service companies. Volunteering can offer both physical and mental benefits. When choosing a form of volunteering, make sure that it engages you, so you don’t find the work to be tedious and boring.

3. Visit Your Favorite Places
Start signing off the places you have on your travel bucket list. Hit the road, take the plane, rail, or ship. Don’t allow a limited budget to come in your way – look for discounts. A variety of discounts are available, including airfare, dining, clothing, grocery, and entertainment discounts. Here is a list of some of these discounts. Go through them to plan your trip for less. If your travel appliance have gone out of shape, use a home warranty to fix or replace them for free.

4. Learn Something New
Join a class at your library or senior center to stay mentally agile and find people who share the same interests. Check courses at your community college as well. Take a driving course if you feel like your driving skills need a little sharpening. Continue the process of learning.

By Jim|2021-08-27T11:00:17-05:00September 17th, 2021|Dr. Mauk's Boomer Blog, News Posts|Comments Off

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