Glaucoma Awareness for Seniors

 Glaucoma is a group of eye conditions that damage the optic nerve, which is responsible for transmitting visual information from the eye to the brain. It is often associated with increased pressure in the eye, known as intraocular pressure (IOP). Glaucoma can affect people of all ages, but it is more commonly diagnosed in older adults.

In the elderly population, glaucoma becomes more prevalent due to the natural aging process and other age-related factors. Here are some key points to consider regarding glaucoma in the elderly:

1. Increased risk: The risk of developing glaucoma generally rises with age. The most common type of glaucoma, called primary open-angle glaucoma, typically occurs after the age of 40. As people live longer, the likelihood of developing glaucoma increases.

2. Asymptomatic progression: Glaucoma often progresses silently and gradually. In its early stages, individuals may not experience noticeable symptoms or vision loss. Regular eye examinations are crucial for early detection and treatment.

3. Vision impairment: If left untreated or uncontrolled, glaucoma can lead to vision loss and permanent damage to the optic nerve. The peripheral vision is typically affected first, which can make daily activities challenging for older adults, such as driving or recognizing obstacles.

4. Comorbidities: The elderly population often has other age-related health conditions, such as diabetes and cardiovascular diseases. These comorbidities can influence glaucoma management and the choice of      treatment options.

5. Treatment challenges: Treating glaucoma in the elderly can be more complex due to factors like medication adherence, physical limitations, and cognitive impairments. It is important for healthcare providers to consider the overall health status and individual circumstances when determining the most appropriate treatment approach.

6. Regular eye exams: Routine eye examinations are vital for early detection and ongoing monitoring of glaucoma in the elderly. These exams often involve measuring IOP, assessing the optic nerve, evaluating visual fields, and sometimes employing imaging techniques to track disease progression.

7. Treatment options: Treatment for glaucoma in the elderly typically involves lowering IOP to prevent further damage to the optic nerve. This can be achieved through various methods, including eye drops, oral medications, laser therapy, and surgical procedures. The choice of treatment depends on factors such as disease severity, overall health, and patient preferences.

It's important for older adults to maintain good eye health and be aware of the risk factors and signs of glaucoma. Regular communication with healthcare professionals, adherence to treatment plans, and proactive management of eye health can help minimize the impact of glaucoma on the elderly population.

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

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!