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Archive for July, 2019

Is antibiotic use in older adults always the best choice?

Monday , July 29 , 2019

Is antibiotic use in older adults always the best choice?

When an older adult becomes ill, even a simple infection can quickly turn into something much larger. UTIs, in particular, are notorious for leading to sepsis when left untreated. But is immediately throwing a senior citizen on an antibiotic always the best option?

Not exactly.

When a younger adult goes to the doctor with an infection, treatment with antibiotics is a no-brainer. In fact, it’s standard protocol. But in the elderly, “standard protocol” can have some very serious repercussions.

New research lends credence to the fact that healthcare professionals should be treating individuals, not symptoms. Even when lab results come back with an astounding “positive”, factors like age and functionality need to be taken into consideration before prescribing a drug.

Antibiotics and urinary tract infections

An antibiotic (such as penicillin) is a medicine that inhibits the growth of or destroys bacteria. They are used in people of all ages to treat everything from minor illnesses to life-threatening infections, with much success.

Often, drugs such as Cipro or Bactrim are prescribed to help fight urinary tract infections. For most people, these are highly effective treatments. For older adults, however, they may do more harm than good.

Why? Because even though a senior citizen has bacteria in their urine, it DOES NOT mean they actually have a UTI.

It is not uncommon for trace bacteria to show up on a urinalysis, but unless symptoms (such as painful urination or increased frequency) are present, a UTI is unlikely.

What happens when antibiotics are unnecessarily prescribed?

When an antibiotic is prescribed despite the lack of infection, it doesn’t do much good at all. In fact, it may do some pretty serious damage.

For younger people, treatment with an antibiotic usually puts them ‘back where they were before’: Healthy and able, like nothing ever happened. But for older adults, it doesn’t necessarily work that way.

Instead, treatment with antibiotics (necessary or not) can lead to increased confusion, worsening dementia, a weaker immune system, nerve damage, and a whole slew of physical ailments such as diarrhea and vomiting.

Even more alarming: Excessive use of antibiotics can help drug resistant bacteria to grow. These bacteria are more difficult to kill, as they’ve developed immunity to most of the more commonly prescribed drugs. According to the Centers for Disease Control and Prevention, every year, more than 2 million people in the United States acquire antibiotic-resistant infections, with at least 23,000 people dying as a result.

When are antibiotics appropriate?

If an older adult tests positive for bacteria in the urine AND has symptoms of a UTI, antibiotics may help.

Classic UTI symptoms include burning, pelvic pain, frequent urination, an increased urgency to urinate, fever, and urine with an abnormal odor. For the elderly, however, symptoms may not be so obvious. Some of the less-typical symptoms which present in older adults include:

  • Incontinence
  • Agitation
  • Confusion
  • Lethargy
  • Decreased mobility and appetite

Final thoughts

Deciding whether or not to use antibiotics can be a scary prospect. On the one hand, you want to trust what the doctor says and, of course, avert more serious infection. On the other hand, you want to avoid any unnecessary complications and ailments down the road. Ultimately, you just have to make the best decision possible given the information you have (but it never hurts to get a second opinion!)

Posted in: Health

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Deaths caused by falls are rising among older adults: Here’s what you need to know

Monday , July 22 , 2019

Deaths caused by falls are rising among older adults: Here’s what you need to know

As adults age, the constant, terrifying threat of falls looms over them: Everyone knows that once you reach old age, a broken hip or head injury can spell certain disaster.

Now, there is even more reason to worry. Surprising new research from the CDC shows that among Americans aged 65 plus, fall-related deaths have tripled in the last ten years. That adds up to more than 25,000 deaths a year.

The rise in fall-related deaths

The research, recently published in the Journal of the American Medical Association, shows that almost 25,000 people aged 75 and older died as a result of falls in 2016 – 31% more than in 2000. The study tracked both men and women and found that the increase in fall related deaths was about the same for each group. In addition, both groups were more likely to experience death as a result of falls as the median age increased.

For example, the death rate due to falls among 75- to 79-year olds was 42 per 100,000 people. Among those aged 95 and old, the rate was 591 per 100,000.

Lead researcher Elizabeth Burns said, “If deaths from falls continue to increase at the same rate, the U.S. can expect 59,000 older adults will die because of a fall in 2030.”

Risk factors for falling

Exactly why the rates of fall-related deaths is increasing isn’t entirely clear, researchers said. One obvious explanation is that people today are living longer than ever before – and many of them live on their own without help or experience chronic conditions which leave them predisposed to falling.

According to Dr. Burns, “The chance of falling increases with age, and risk is higher with certain chronic diseases, such as a history of stroke, arthritis, diabetes, dementia and Parkinson’s disease.”

In addition, many medications common to older adults (such as blood pressure meds), make them prone to fall. Other risk factors include a sedentary lifestyle, chronic diseases, neurologic issues, and incontinence.

Fall-related injury

One in three adults over 65 takes a serious tumble every year – and even though most of those falls don’t result in death, the risk is always there. More often, however, a fall will result in a serious injury or permanent disability. According to Aging.com:

  •  When an elderly person falls, their hospital stays are almost two times longer than those of elderly patients who are admitted for any other reason
  • Every 11 seconds, an older adult is treated in the emergency room for fall-related injuries
  • Two-thirds of those who fall will do so again within six months
  • One in ten falls resulting in serious injuries such as hip fracture, other fractures, subdural hematoma, or traumatic brain injury
  • The most profound effect of falling is the loss of functioning associated with independent living

How to reduce the risk of falls

The important thing to remember is that falls can be avoided.

Another study in the Journal of the American Medical Association tested a home-based exercise program aimed at helping seniors prevent falls. Researchers found that a home-based strength and balance exercise program reduced falls in older adults by 36% in just 12 months.

A few of the exercises that can help reduce risk include:

  • Walking (both forward and backward!)
  • Balance exercises such as Tai Chi or squats
  • Resistance exercises with light weights or bands

Those who need extra help should consider home visits by a physical therapist, or asking a care giver or family member for assistance if that’s not an option. In addition, it’s also important to take steps to prevent and treat osteoporosis to help avoid future complications.

For those whose fear of falling affects their daily life, the State of New Jersey, Department of Human Services, Division of Aging Services run a fabulous program called A Matter of Balance: Managing Concerns About Falls.

The program is designed to reduce the fear of falling and increase the activity levels of older adults who have this concern. The class utilizes a variety of activities to address physical, social, and cognitive factors affecting fear of falling and to learn fall prevention strategies. For more information: http://bit.ly/2W3lTEB

Posted in: Aging, Health, Home Care

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Summer Travel: Helpful Tips for Vacationing with Older Adults

Tuesday , July 9 , 2019

Summer Travel: Helpful Tips for Vacationing with Older Adults

It may be mid-July already, but it’s not too late to take a summer vacation! Whether you’re a beach person or mountain person, there is still plenty of fun to be had.

Many families find that the summer months are an ideal time to bond and catch-up with older loved ones. The kids are home from school and the entire family can spend some much-needed (and uninterrupted) time together.

But if you’re like the countless other families that want to include grandparents in vacation plans, there are some things you should keep in mind. Travel can be stressful for many people, but especially older adults. From hours spent in a car or plane, to climate changes, to simply walking around town – there are dozens of issues that can make vacationing difficult for elderly travelers.

Fortunately, a little forethought can make the trip easier for everyone. Before you begin planning that end-of-summer vacation, take a look at these tips for traveling with your older loved ones:

Travel at the right time of day

Whether you’re taking a plane or a car, the act of traveling from one place to another can be stressful and uncomfortable for senior citizens. One thing to keep in mind is that most older adults don’t have the same energy as younger people – and traveling very early in the morning or late at night can be exhausting for them. Try to plan your departure for mid-morning or early afternoon to make things a bit easier.

Plan frequent stops when traveling by car

Road trips can be tiring under the best of circumstances (even for young people). Hours on the road can leave you cramped up, worn-out, and longing for a restroom. For older adults, it’s even worse! Make sure you take frequent breaks for stretching, grabbing a snack, or using the loo. Bonus points if you can plan them around points of interest (just remember to keep canes, walkers, or other assistive devices easily accessible!)

Taking a plane? Book a non-stop flight.

Travel by plane may be faster than automobile, but that doesn’t mean it’s easier. Navigating the airport alone is a process – especially for older adults who may have limited mobility. To avoid an unnecessarily long layover or (worse) running through the airport to catch a connecting flight, book non-stop whenever possible. Other airport tips to keep in mind include:

  • Check with the airline to see if early boarding options are available
  • Take advantage of assistance offered at the airport, such as a courtesy wheelchair
  • Anticipate frequent restroom visits and request an aisle seat
  • Get up and stretch frequently to help avoid deep-vein thrombosis
  • Try to avoid regional airlines – many smaller airports don’t offer a jet-bridge and passengers must climb a flight of stairs

Plan a realistic itinerary

Even if your older loved one is in excellent health, it’s likely they’ve slowed down a bit since their younger years. Most seniors need a little more time to get around, especially if they have mobility issues or other health problems. Be sure to plan accordingly! Try to book activities for earlier in the day, so the afternoon can be spent resting before dinner.

It is worth noting that cruises seem to be one option that work well for both the old and young. With everything offered all in one place, there’s less effort required for older adults to take part in activities, and many cruise lines offer shore excursions for those with limited mobility.

Consult with your loved one’s doctor before booking a trip

Before a vacation, especially one that’s far from home, it’s important for seniors to check in with their doctors. A physician is the only person that can say for sure if your elderly loved one is able to manage the stress of travelling and the change in routine. In addition, it’s an opportunity to get a print-out of all current medications and pre-existing conditions in case they need to visit another doctor or hospital while away.

Ensure that you can maintain care during travel

If your senior loved one requires daily care, it is important to make sure it can be provided while travelling. This may mean taking special measures to ensure all medications, medical equipment, and medical devices can be transported. Note that if you’re travelling by plane, the TSA may need to be notified of certain equipment in advance.

If your loved one receives home care, you may want to find out if their caregiver can travel with you. Having the same person care for them that they see on a regular basis at home can help alleviate any stress. In addition, the caregiver is intimately familiar with the services required and can help make sure your older loved one enjoys their summer travel in a safe and healthy manner.

Final thoughts

No matter how you travel or where you go, enjoy your time with your senior loved one! It’s a chance to make amazing memories and maybe even learn more about someone you care about deeply. Now go have fun on your summer vacation – and be safe!

Posted in: Aging

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