Senior Dental Problems & Underlying Health Issues

There's an old saying about the eyes being windows to the soul. But the latest medical and dental research shows that the mouth truly is a window into one's overall health. Looking out for a loved one's health means not only keeping an eye on their nutritional intake and physical capabilities, but also on their teeth and gums. Senior dental problems can be common, from dry mouth to periodontal disease, and since oral health directly impacts the health of the rest of the body, these issues need to be taken seriously. Taking care of elderly teeth and gums is just as important as heart or digestive health.

COMMON DISEASES WITH ORAL SYMPTOMS

Researchers have found that many diseases in the rest of the body have oral symptoms. With careful examination of the teeth, gums, and tongue, dentists have found evidence of heart or liver disease, eating disorders, diet deficiencies, anemia, diabetes, arthritis, HIV, osteoporosis, and even some autoimmune diseases. "We're now realizing how they're interrelated," explains Dr. Cynthia M. Carlsson, assistant professor of geriatrics and gerontology at the University of Wisconsin School of Medicine and Public Health.

Not only does the mouth tattle on the rest of the body, oral health can actually affect overall health.

For example, recent studies show a correlation between gum disease and heart disease. In fact, risk factors for periodontal disease and cardiovascular disease are similar: smoking, stress, poor diet, excessive weight gain, and low exercise levels. One study suggests that people with severe periodontal disease face double the risk of fatal heart disease, and severe periodontal disease also is associated with higher rates of stroke in some studies. And in certain circumstances, a tooth infection has the potential to cause bacterial endocarditis, which is an infection of the heart's inner lining or the heart valves. Bacteria in the bloodstream can lodge on the valves or damaged heart tissue, and it could be serious enough to damage, or even destroy, the heart valves.

Periodontitis also appears to share risk factors with chronic degenerative diseases such as ulcerative colitis, and lupus. If a patient has severe gum disease, they may be advised to take antibiotics before undergoing invasive dental procedures such as gum surgery or tooth extraction.

Conversely, other diseases can affect the mouth. For example, diabetes affects healing, so if a diabetic senior has gum disease, it may take quite a bit longer to treat that gum disease.

Researchers now urge both doctors and dentists to be alert to overall health problems when taking care of elderly patients and encourage behaviors that will promote a healthy body from head to toes.

MAKING ORAL HEALTH A PRIORITY

It's easy for someone to let oral health slide a bit when they're distracted by other ailments. Perhaps arthritis makes tooth brushing painful, or they can't stand at the bathroom sink very long. "They're maybe not quite as vigilant because of their frailty, which leads to a quick decline in oral health, and this could be a detriment to systemic health," explains Dr. Marsha A. Pyle, director of the Training Center for Geriatric Oral Health and associate dean of Education at the Case School of Dental Medicine in Cleveland, Ohio. "You can't just treat dental disease in isolation."

It's best to brush after every meal, says Pyle, not just in the morning and at night. If a patient is at risk of periodontal disease, a dentist can prescribe special toothpastes or gels that help combat dental disease, as well as a daily treatment of high-fluoride gel or anti-bacterial rinse.

Carlsson advises encouraging your loved one to visit their dentist on a regular basis either to have their teeth cleaned or to have their dentures refit. Missing teeth or dentures that don't fit well can lead to potentially serious senior dental problems. "They may aspirate the food, where food goes down into the lungs and causes pneumonia," Carlsson says. Besides encouraging good nutrition and regular dental visits, watch him eat to see if he's avoiding something, and try to notice if any of his teeth look loose or broken.

Ill-fitting dentures can be a culprit in poor nutrition among seniors. When a person loses his natural teeth, his jaw bones begin to shrink away, leading to the jaw continually "remodeling" itself. Dentures that once fit well start slipping. So, a senior may start limiting the kinds of food he eats because it's too hard to eat, or because he's embarrassed that others may see him having trouble chewing.

"And it happens during a really important stage of a person's life. These really frail seniors really need their nutrition," Pyle says.

If a senior does lose her natural teeth, instead of traditional dentures, she could have implant-supported dentures. These implants are attached to the jaw bone, and a special denture snaps onto the implants. These implant-supported dentures fit more snugly than traditional dentures, so eating different foods shouldn't be a problem.

A less drastic measure places a softer material on the gum side of traditional dentures so they're more comfortable.

Just a few decades ago, 50% of all seniors had no natural teeth remaining, according to Pyle. That number has now dropped to 27% of those over age 65. "It's not a natural part of aging, I'm happy to say," says Pyle. "People now are aging with a full set of teeth."

Whether or not your loved one has his natural teeth or dentures, a little help from you can go a long way toward ensuring that he maintains good dental hygiene. A healthy smile may affect a person's confidence and self-image, but, more importantly, it will pay off not only in her oral health, but in her overall health as well.  

DRY MOUTH: A COMMON ISSUE FOR SENIORS

According to Pyle, one of the major senior dental problems is dry mouth. "If they have a chronic disease managed by medications, one of the side effects is dry mouth. There are 400 medications known to cause dry mouth," Pyle says, including medications for common problems such as high blood pressure and depression.

While a small amount of gum recession is normal as seniors age, dry mouth increases that recession dramatically, leaving the mouth more susceptible to root area cavities. And those root surface cavities advance more quickly on the soft surface of a tooth.

There are many ways to treat dry mouth including:

• Increase liquid intake
• Rinse mouth frequently with water
• Use a commercially available saliva substitute
• Use specially-formulated toothpastes, chewing gum, or non-alcohol-based mouthwashes
• Apply lip moisturizer frequently
• Suck on tart, sugarless hard candies
• Avoid dry, salty foods

Source: http://www.aplaceformom.com/senior-care-resources/articles/senior-dental-problems

Senior Flu Prevention and Taking Care of the Elderly

Getting the flu can be a nasty experience, no matter what your age or general health, and each year flu shots are a major public health initiative. But, because of the risks to the elderly, senior flu prevention is especially important.

According to the Centers for Disease Control (CDC), each year more than 200,000 people will be hospitalized because of the flu, and 36,000 of them will die.

"Disproportionately it's the elderly," explains Debra Beauchaine, MN, ARNP, and geriatric services director at Virginia Mason Medical Center in Seattle. Seniors in their seventies and eighties are at higher risk from the flu than seniors in their sixties, because of declining immunity to illnesses as they age.

HOW FLU SPREADS

Seasonal (or common) flu is one of the most highly contagious illnesses. It is spread by "respiratory drops"-coughing and sneezing. Someone may touch something with the flu virus on it-such as door knobs, telephones or shopping cart handles-then unwittingly touch their mouth or nose.

And it's not enough to simply stay away from other people who feel sick. "People may be contagious one day before they develop any symptoms, and for up to five days after becoming sick," Beauchaine says. "That's part of the problem; people don't realize they have the virus before they actually feel sick."

Flu symptoms include fever, chills, runny or stuffy nose, headache, sore throat, cough, extreme fatigue, and muscle aches. Nausea, vomiting and diarrhea are sometimes present, but rarely prominent.

FLU ANTIDOTES

Flu season typically runs from October through the end of February, but some years it runs into March and April as well. It is estimated that 10 to 20 percent of the U.S. population contracts influenza each year. Once someone gets the flu, the only real "cure" is to rest and drink plenty of fluids, although a doctor may prescribe Tamiflu® or Relenza®, both anti-viral medications which can keep the influenza virus from spreading inside the body and shorten the duration of symptoms. Both must be taken within 48 hours of the onset of flu symptoms, and neither is a substitute for a flu vaccination.

FLU & SENIOR HEALTH

While otherwise healthy adults can be laid low by the flu for a full week, senior citizens are at risk for becoming much sicker. "They are more vulnerable, once they get the flu, to develop complications," Beauchaine says. "Because the flu is really a pretty severe illness, they may not have as much of what we call 'physiological reserve' as a younger adult. So, seniors will feel very sick from a case of the flu and that puts them at greater risk for complications."

Dr. W. Paul McKinney, associate dean of the School of Public Health at the University of Louisville, explains that one of the more serious complications is primary viral pneumonia or a secondary bacterial pneumonia. Most hospitalizations and deaths from the flu are a consequence of pneumonia and other respiratory disorders. Also, if a senior has any chronic health conditions, such as congestive heart failure, chronic lung disease, even diabetes or renal failure, those could be exacerbated by the flu. And another common complication of the flu is dehydration, so drinking plenty of fluids is especially vital for the elderly.

SENIOR FLU PREVENTION

Staying away from work or crowded places while sick is important to prevent spreading the flu to others. But that's not an option for seniors living in nursing homes or assisted living facilities, making senior flu prevention that much harder at these communities. "When you congregate large numbers of people in close quarters, transmission is a lot easier," McKinney says.

However, Beauchaine points out that nursing homes usually require all employees to be vaccinated, which is the single most effective way to guard against getting the flu. And, it's important to get a flu shot every year, because the virus changes slightly from year to year. Getting a flu shot one year and not the next, will not protect someone from that year's particular strain.

"They should make every reasonable effort to get vaccinated early in flu season," McKinney says, but don't do it too early in the season, because occasionally the immunity will wear off before flu season ends, especially if the season lasts into March or April.

According to the U.S. Department of Health and Human Services, seniors covered by Medicare Part B pay no coinsurance or deductible for their flu shot, as long as they receive the shot from a Medicare provider.

What if a senior is otherwise healthy and doesn't feel they are "at risk?"

"There is no reason a healthy senior should defer a vaccine," McKinney says.

A University of Michigan study found that boosting elderly flu vaccinations could save as many as 6,500 lives over ten years. In fact, research from Johns Hopkins University shows that annual flu shots reduce the number of deaths among hospital patients by one half.

While vaccination is the most important senior flu prevention, it's only 70 to 90 percent effective, so some people who receive the vaccination will still get the flu.

So, for at-risk populations, it's especially important that everyone around them also gets vaccinated. That includes everyone involved in taking care of the elderly. And like nursing homes, some hospitals, such as Seattle's Virginia Mason, require all employees to be vaccinated.

The CDC's target groups for vaccination keep expanding, recently adding children aged 2-5, and lowering the seniors' age range from age 65+ to 50+. The CDC estimates 218 million Americans fall into the at-risk groups that should be vaccinated. "That's over two-thirds of this country," McKinney says. "This year we'll have 100 million doses of the vaccine, so we won't even be able to vaccinate 50 percent."

According to McKinney, the U.S. should not face a vaccine shortage this year. "Unless someone is in a very remote, isolated area, there shouldn't be a problem getting the vaccine," he says.

While it's not possible to get the flu from the standard injectable flu vaccine, which is made from a killed virus, some people will experience a sore arm for one to two days, and possibly a fever. (The newer nasal spray vaccine is made from a live attenuated virus and recommended only for healthy, non-pregnant people between the ages of five to forty-nine.)

Although some people believe certain foods or vitamins can ward off illness, Beauchaine says that while they may make you healthier in general, they aren't effective for senior flu prevention.

During flu season, practicing good hygiene can help people avoid catching or spreading the flu. Wash hands frequently, especially after touching door knobs and stair rails in public places. Always cover nose and mouth when coughing or sneezing, and immediately wash hands afterward. And, of course, stay away from people who are sick. People taking care of the elderly especially need to follow this type of common sense senior flu prevention.

Finally, don't confuse influenza with avian flu. While bird flu gets a lot of press these days, it is extremely rare, occurring when a human has direct contact with infected poultry or surfaces contaminated by secretions or excretions from infected birds. Vaccines to protect against bird flu are being developed, but are not yet available.

Source: http://www.aplaceformom.com/senior-care-resources/articles/senior-flu-prevention

5 Tricks for Getting Enough Fruit and Veggies

Seniors are better than younger people at getting their servings of fruit and vegetables, but that's still not saying much. Only 30 percent of people 65 and older eat five or more daily servings of fruit and vegetables, which is the minimum amount recommended for good nutrition.

Eating plenty of fruit and vegetables is especially important as you get older, because the nutrients and fiber in these foods can help reduce high blood pressure, lower your risk of heart disease, stroke, and certain cancers, stave off eye and digestive problems — and simply satisfy your hunger.

How Big Is One Serving of Fruit or Vegetables?

Before you try to eat an entire bunch of bananas or a bushel of apples, know this: One serving of fruit or vegetables equals half a cup, or about the amount you could hold in a cupped hand. Nutrition experts used to recommend five servings of fruit and vegetables per day, but that’s probably no longer enough, according to the U.S. Centers for Disease Control and Prevention (CDC). Individual needs are different, and depending on age, gender, and level of physical activity, you’ll require between 5 and 13 servings of fruit and vegetables each day. 

To help determine your specific needs, visit the CDC’s fruit and vegetable calculator.

Meeting Your Healthy Eating Goal for Fruit and Vegetables

Follow these simple tips for increasing the amount of fruit and vegetables you eat each day:

1. Add fruit and vegetables to your favorite dishes. Find ways to incorporate fruit and vegetables into foods you already eat. For example, stir fruit into your cereal or yogurt, add strawberries or blueberries to your pancakes, pack your sandwich with extra veggies,add vegetable toppings to your pizza, stir greens into your favorite casserole or pasta dish, or stuff your omelet with extra vegetables.
2. Display your produce. Put your fruit and vegetables out on the counter or in a prominent position in the refrigerator, so that you'll be more likely to eat them.
3. Try new things. Next time you go to the grocery store, pick out a new fruit or vegetable to try.
4. Cook vegetarian. At least once every week, skip the meat (you could join in on Meatless Monday) and try a new vegetarian recipe for dinner.
5. Snack away. Try snacking on fresh or dried fruit, carrot and bell pepper strips with a low-fat dip, or baked chips with fresh salsa.

Why We Eat Less as We Age

As you get older, certain age-related changes can make it more difficult to get the fruit and vegetables you need, such as:

• Difficulty chewing. Some people have dental problems that make it harder to chew, resulting in a reduced interest in eating.
• Changes in taste. Your sense of taste can change as you get older, so you may avoid some of the foods you used to enjoy.
• Mobility problems. For older people who are no longer able to drive, it may be difficult to get out and shop for fresh produce.
• Lack of motivation to cook. If you live alone, you may not feel like cooking just for one.
• Changes in appetite. For many people, getting older means that you just aren't as hungry as you used to be. 

To get the most out of the fruit and vegetables you eat, aim for variety. Eat many different types of fruit and vegetables in a rainbow of colors. This will help ensure that you get the variety of nutrients your body needs for healthy aging.

By 

Krisha McCoy

 Reviewed by 

Lindsey Marcellin, MD, MPH

Source: http://www.everydayhealth.com/senior-health/health-benefits-of-fruits-and-vegetables.aspx

Falls in the Elderly

GEORGE F. FULLER, COL, MC, USA, White House Medical Clinic, Washington, D.C.

Am Fam Physician. 2000 Apr 1;61(7):2159-2168.

See related patient information handout on the causes of falls and tips for prevention, written by the author of this article.

Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.

Elderly patients who have fallen should undergo a thorough evaluation. Determining and treating the underlying cause of a fall can return patients to baseline function and reduce the risk of recurrent falls. These measures can have a substantial impact on the morbidity and mortality of falls. The resultant gains in quality of life for patients and their caregivers are significant.

Epidemiology of Falls in the Elderly

From 1992 through 1995, 147 million injury-related visits were made to emergency departments in the United States.1 Falls were the leading cause of external injury, accounting for 24 percent of these visits.1 Emergency department visits related to falls are more common in children less than five years of age and adults 65 years of age and older. Compared with children, elderly persons who fall are 10 times more likely to be hospitalized and eight times more likely to die as the result of a fall.2

Trauma is the fifth leading cause of death in persons more than 65 years of age,3 and falls are responsible for 70 percent of accidental deaths in persons 75 years of age and older. The elderly, who represent 12 percent of the population, account for 75 percent of deaths from falls.4 The number of falls increases progressively with age in both sexes and all racial and ethnic groups.5 The injury rate for falls is highest among persons 85 years of age and older (e.g., 171 deaths per 100,000 white men in this age group).6

Annually, 1,800 falls directly result in death.7 Approximately 9,500 deaths in older Americans are associated with falls each year.8

Elderly persons who survive a fall experience significant morbidity. Hospital stays are almost twice as long in elderly patients who are hospitalized after a fall than in elderly patients who are admitted for another reason.9 Compared with elderly persons who do not fall, those who fall experience greater functional decline in activities of daily living (ADLs) and in physical and social activities,10 and they are at greater risk for subsequent institutionalization.11

Falls and concomitant instability can be markers of poor health and declining function.12 In older patients, a fall may be a non-specific presenting sign of many acute illnesses, such as pneumonia, urinary tract infection or myocardial infarction, or it may be the sign of acute exacerbation of a chronic disease.13 About one third (range: 15 to 44.9 percent) of community-dwelling elderly persons and up to 60 percent of nursing home residents fall each year; one half of these “fallers” have multiple episodes.14 Major injuries, including head trauma, soft tissue injuries, fractures and dislocations, occur in 5 to 15 percent of falls in any given year.15 Fractures account for 75 percent of serious injuries, with hip fractures occurring in 1 to 2 percent of falls.15

In 1996, more than 250,000 older Americans suffered fractured hips, at a cost in excess of $10 billion. More than 90 percent of hip fractures are associated with falls, and most of these fractures occur in persons more than 70 years of age.8 Hip fracture is the leading fall-related injury that results in hospitalization, with these hospital stays being significantly prolonged and costly.16 It is projected that more than 340,000 hip fractures will occur in the year 2000, and this incidence is expected to double by the middle of the 21st century.17

One fourth of elderly persons who sustain a hip fracture die within six months of the injury. More than 50 percent of older patients who survive hip fractures are discharged to a nursing home, and nearly one half of these patients are still in a nursing home one year later.18 Hip fracture survivors experience a 10 to 15 percent decrease in life expectancy and a meaningful decline in overall quality of life.

Most falls do not end in death or result in significant physical injury. However, the psychologic impact of a fall or near fall often results in a fear of falling and increasing self-restriction of activities. The fear of future falls and subsequent institutionalization often leads to dependence and increasing immobility, followed by functional deficits and a greater risk of falling

Older Adults and Exercise

We are all probably aware that exercise is good for us.  It improves our overall functioning, both physically and mentally.  It not only helps us live longer, healthier lives, but it also goes a long way in keeping us more independent as we age and allowing us to continue to participate in many of the activities that we enjoy.  It improves our mood, and it feels good for our body.  Exercise has found to be an effective treatment for many health concerns such as depression, diabetes, arthritis, and high blood pressure.  It can prevent or delay the onset of other health conditions as well.  And on the opposite end of the spectrum, those who are inactive are twice as likely to suffer from heart disease. They also have a higher risk of hospitalization and are dependent upon more medications than those who remain active throughout their lives. 

It is easy for anyone to make excuses about exercising.  We are too busy, too tired, unmotivated at times.  As we age we have even more excuses at our fingertips.  Aches and pains, lack of stamina, feeling the need to “take it easy”. These things add up and over time a lot of older adults become more inactive as they age, when it is actually a time in our lives that it is more important than ever to stay fit.  There are many moderate endurance activities that are recommended for older adults such as walking, swimming, dancing, tennis, golf, and bicycling. Make your exercise program a priority, and to help with this try to keep it interesting and fun.  Make it a social activity if possible. 

If you have not been active in a long time, start slowly and build up your endurance over time. Talk to your doctor before beginning any new exercise program and ask what is safe for you given any medical conditions, or to learn how to modify certain activities to avoid any problems.  If you smoke, are obese, or diagnosed with any chronic health problems such as heart disease or diabetes, your doctor can give you the best advice on which activities will be the most beneficial to you. Time is precious and we only get one chance at life, make yours the best that it can be! 

4 Ways to Prevent Elderly Dehydration + Must-Try Summer Mocktail Recipes

by Dana Larsen

Our elderly loved ones need a little extra TLC during the hot summer months. Find out why dehydration increases with age and get valuable tips on keeping your favorite senior hydrated.

Senior dehydration is a common health issue that can lead to bigger problems if proper hydration is not made a priority, such as urinary tract infections and low blood pressure. Proper hydration helps to keep the body and vitals regulated. The University of Chicago Medical Center found that 40% of heat-related fatalities in the U.S. were among people over 65.

What Can Cause Dehydration?

There are a number of reasons the elderly are so prone to dehydration:

1. The ability to notice changes in body temperature typically decreases with age.

2. As people get older, body water content decreases.

3. Many medications the elderly take make them more susceptible to dehydration.

4. The elderly often experience diminished thirst; which leads to a reduced fluid consumption.

5. With aging, the kidneys have a reduced ability to concentrate urine and retain water during water deprivation.

6. Specific conditions, such as reduced swallowing capacity, decreased mobility, comprehension and communication disorders, as well as, decreased mobility and/orincontinence can contribute to dehydration.

7. Many seniors have underlying health conditions that make them less able to adapt to heat.

What Health Issues Can Dehydration Create?

There are some staggering statistics, compiled from The Department of Health, The Hydration for Health Initiative, The Adult & Geriatric Institute, European Review of Aging and Physical Activity, and the  Department on Aging, about dehydration in seniors.

Things you should know about dehydration:

• Dehydration has been associated with increased mortality rates among older adults

• Dehydration can accelerate or bring about emergency hospitalization and/or increase the risk of hospital stays

• Dehydration is a frequent cause of hospitalization of older adults and one of the ten most frequent diagnoses responsible for hospitalization in the U.S.

• Dehydration has been associated with many elderly health issues, including elderly confusion, impaired cognition, falling and constipation

• It is estimated that avoidable costs of hospitalizations resulting from dehydration is $1.14 billion, annually

What Steps Can Be Taken To Prevent Dehydration?

Fluid intake is key. Families and caregivers need to be cognizant about risks and plan ahead to make sure aging loved ones are properly hydrated. Here are some tips to help encourage fluid consumption and reduce the risk of elderly dehydration:

1. Offer fluids on a regular basis throughout the day.

2. Encourage 8 oz. of fluid intake every time the senior takes medication.

3. Keep water bottles and/or a water cooler available throughout the day wherever the senior is (for example, in bed, on the patio, throughout the house or at the senior living community).

4. Provide favorite “mocktail” concoctions (see below for some great recipes) or your senior’s favorite beverages (make sure they’re not caffeinated or alcoholic).

Tasty Recipes To Keep Your Elderly Loved Ones Hydrated

Strawberries and Coconut Water

Ingredients

To make 2 Strawberry Mocktails combine:

• 1 cup (250ml) of fresh coconut water

• 1 cup (250 ml) strawberries hulled and sliced

• 3 T of sugar syrup or agave nectar

Directions

1. To make the sugar syrup, boil sugar and water together in a ratio of 1:3 sugar to water until it thickens to a runny syrup consistency. Store in a jar for all future cocktail making.

2. Measure 1 cup of coconut water, either directly from a cut-open coconut or from a store-bought container (if you are lucky enough to live in an area that sells fresh coconut water in a bottle).

3. Combine the strawberries and sugar syrup and blend with a blender to desired consistency.

4. Serve with ice.

Get more information on making this delicious 

strawberries and coconut drink

.

Cucumber Lemonade with Basil

Ingredients

To make 3 to 4 Cucumber Lemonade treats combine:

• 1 English cucumber

• 3 C water

• 3 lemons

• 2 T sugar

• 1 small bunch basil

• 1 C soda water

Directions

1. Start by cutting your cucumber in half. Peel one half and cut it lengthwise (you can cut it in half again first if need be).

2. Scoop the seeds out and chop it into pieces.

3. Put the cucumber pieces in a food processor and puree until smooth.

4. Put puree in a fine mesh sieve over a container and push with a wooden spoon or spatula, extracting as much liquid as you can from the cucumber puree.

5. Fill a separate bowl or container with 3 cups water. Squeeze 2 lemons into the water and mix in the sugar.

6. Pour lemonade and cucumber juice into a pitcher or serving container. Slice remaining cucumber half (unpeeled) and remaining lemon and add to pitcher. Add basil, too. Refrigerate until chilled.

7. Serve with ice.