Senior citizens face unique health challenges as they enter their twilight years. As caregivers, we want to ensure the highest quality of life for our loved ones so it’s important to learn about and understand the common conditions they may face, illnesses they are susceptible to, and treatments available.
- ALS Disease in Older Adults
- Cerebral Palsy in Older Adults
- Diabetes in Older Adults
- Dysphagia in the Elderly
- Heart Disease in the Elderly
- Higher Cholesterol in the Elderly
- Dehydration in the Elderly
- Flu Complications in the Elderly
- High Blood Pressure in Seniors
- Hip Replacements for Seniors
- Parkinson’s Disease in the Elderly
- Pneumonia Risks for Seniors
- Rheumatoid Arthritis in Old Age
- Sleep Deprivation in the Elderly
- Strokes in Older Adults
- UTIs in Older Adults
- Treatment Options for Older Adults with Chronic Conditions
- Pain Management in Seniors
- Physical Therapy for Seniors
- In Conclusion
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ALS Disease in Older Adults
ALS, also known as amyotrophic lateral sclerosis or Lou Gehrig’s disease, is a progressive neurodegenerative disease affecting the spinal cord and brain. This disease interferes with the brain’s ability to send messages to the muscle fibers, causing motor neuron deterioration and muscle weakness. ALS has four stages: beginning stage, middle stage, late stage, and end stage. Learn more about each stage here.
If you are caring for an elderly individual with ALS, it is important to know what is affected in order to provide quality support.
- Eating and swallowing
- Psychological impact
By gaining a good understanding of the disease, patients, caregivers, and loved ones can prepare to deal with each stage in the best way possible.
Cerebral Palsy in Older Adults
Cerebral palsy is a non-degenerative group of disorders that affect the brain and nervous system. While cerebral palsy (CP) usually shows up within the first two years of life, medical advances are helping to increase life expectancy into old age. [i] Research on older adults with CP is in the beginning stages, so there is much to be learned, but older adults with cerebral palsy do suffer from certain symptoms:
- An increase in pain levels
- More frequent falls
- Problems with dental health
- Difficulty walking
- Difficulty swallowing
- Health problems due to side effects of long-term medications
Treatments like medication and therapy are used to treat the symptoms of CP. Assistive technology is often used to help with speech and mobility when appropriate.
Diabetes in Older Adults
Treating diabetes in elderly individuals is different than for younger diabetics because as the body ages, a diabetic person will process glucose and insulin differently.
Diabetes Complications in the Elderly
When it comes to diabetes in the elderly, complications are numerous, including [ii]
- Cognitive impairment
- Functional impairment
- Cardiovascular and macrovascular disease
- Nerve damage
- Kidney damage
- Foot damage
- Visual and hearing impairments
- Skin problems
- Alzheimer’s disease
Managing Diabetes in Older Adults
In the past, managing diabetes in the elderly was focused on strict glycemic control through glucose-lowering therapy. Today, however, there is increasing evidence that a one-size-fits-all approach is an oversimplification, and physicians are moving towards a more individualized approach for better results. [iii]
It is important for the caregiver, in partnership with the patient and healthcare partners, to follow an established care plan to treat diabetes and provides the senior with the best possible management of their diabetes.
Dysphagia in the Elderly
Dysphagia, characterized by difficulty swallowing, is a growing concern among our elderly population. Chronic dysphagia can indicate a serious medical issue, so it is important to look out for warning signs.
Common signs of dysphagia in the elderly include: [iv]
- Pain while swallowing or inability to swallow
- Sounding hoarse
- The sensation of having food stuck in your throat or chest
- Regurgitating food
- Frequent heartburn or food/stomach acid backing up in the throat
- Unexpected weight loss
- Gagging or coughing when swallowing
- Avoidance of certain foods due to trouble swallowing
Complications from dysphagia can include aspiration pneumonia, choking, malnutrition, dehydration, and weight loss. There are ways to manage this condition. Caregivers should contact the primary care physician if they notice signs of dysphagia in an elderly patient.
Heart Disease in the Elderly
Coronary heart disease, a common heart disease in the elderly, results in half of all cardiovascular disease-related deaths. [v] With age comes a higher risk of developing heart disease due to the typical rise in cholesterol, blood pressure, and other heart-related numbers in senior citizens.
While there is no way to completely prevent heart disease, there are actions you can take to help prevent a coronary event. Here are some heart disease prevention tips for the elders among us:
Attend regular checkups. Meet with the primary care physician to watch heart-related numbers. The American Heart Association also recommends having an ankle-brachial index test done to test for a related disease called peripheral artery disease.
- Maintain a healthy weight.
- Exercise regularly.
- Eat a healthy diet.
- Learn the signs of a heart attack or stroke.
As a person ages, they require fewer calories. Excess weight puts undo stress on the heart and cardiovascular system.
With input from the healthcare team, put together an exercise plan catered to the senior’s abilities.
A balanced diet full of fiber, vitamins, and minerals goes a long way in the prevention of diseases and boosts immunity.
[vi] Fast response to symptoms can minimize the damage done.
As a caregiver, you can encourage the tips above to help the senior in your life be as healthy as possible.
Higher Cholesterol in the Elderly
Good heart health and normal cholesterol go hand in hand, having cholesterol levels that are too high increases the risk of stroke or heart attack.
But recent findings from a study done by a South Florida professor, along with an international team of experts, show that cholesterol levels for senior citizens may require special consideration before statin drugs are used. [vii]
When looking at individuals with high levels of cholesterol over 70 years old, recent research indicates that high cholesterol contributed to lowered incidences of some life-threatening diseases like cancer as well as certain neurological disorders, namely Alzheimer’s disease and Parkinson’s disease.
The takeaway? Discuss all options with the primary care physician to determine the best treatment plan.
Dehydration in the Elderly
It is understood that proper nutrition and hydration are important factors for good health in people of all ages, but this becomes even more important as we get older. Dehydration in senior citizens is not uncommon, especially following a lengthy illness, and can result in hospitalization and hospital-associated mortality as dehydration is associated with other problems like pneumonia and urinary tract infections. [viii]
Recovery from dehydration in the elderly should be focused on identifying factors causing dehydration and prevention strategies. If you are caring for an elderly family member or client, here are some tips to prevent dehydration [ix]:
- Identify preferred beverages.
- Keep healthy drinks close by throughout the day.
- Avoid caffeine and alcoholic beverages.
- Promote hydration with foods.
- Breathing difficulties
- High fever that does not come down with medication
- Blue or gray skin color
- Chest/Abdominal pressure or pain
- Frequent, severe vomiting
- Confusion or sudden dizziness
- Symptoms improve, but then symptoms of a more serious condition become evident
- Slowed movement
- Impaired balance or posture
- Muscle rigidity
- Speech difficulties
- Fine motor problems
- Loss of unconscious movements like smiling or blinking
- Lack of appetite
- Shortness of breath
- Lack of energy / tiredness
- Bluish-looking nailbeds or lips
- Increase in pulse
- Rapid breathing
- Profuse sweating
- Cough with yellow, green, or bloody mucus
- Stabbing chest pains when coughing or breathing deeply
- Worsening of a cough
- Muscle aches
- Increased breathlessness
- Regular exercise program
- Physical therapy
- Aquatic therapy
- xercises for balance
- Set up a comfortable, quiet, sleep-friendly environment
- Establish a regular sleep and wake time schedule
- Develop a relaxing bedtime routine
- Avoid caffeine, alcohol, and nicotine close to bedtime
- Allow 2-3 hours between the last meal/snack and bedtime
- Encourage the patient to follow the care plan, including therapies that they might be participating in
- Offer encouragement and emotional support to create a positive environment
- Look for signs of depression, especially if recovery has been slow, and consult with the team if this occurs
- Ensure proper nutrition and hydration to aid in recovery
- Encourage the patient to share their feelings, whether positive or negative
- Catheter use
- Bladder and bowel incontinence
- Prolapsed bladder
- History of UTI
- Certain conditions, including Diabetes, Alzheimer’s, and Parkinson’s, requiring the use of incontinence briefs
- Stay hydrated and avoid alcohol or caffeine consumption, which can irritate the bladder
- Encourage urination whenever the urge strikes
- Frequently change incontinence briefs to avoid bacteria exposure
- Practice good hygiene when cleaning the perineal area, including front-to-back wiping
- Find out what the patient enjoys most. Whether it is a favorite TV show, listening to music, going out for breakfast, or something else, encourage those activities whenever possible
- Consider a companion animal for entertainment and companionship
- Stay active whenever possible
- Explore traditional and alternative treatment options to find out what works best
- Keep the lines of communication open with the senior and their team
- Pain reduction
- Increased muscle strength
- Better endurance
- Wider Range of motion
- Increased flexibility
- Improved balance and coordination
- Retraining for everyday tasks following a medical event or injury
Drinking water all day is not the most appealing option for many. Instead, offer healthy beverage options like low-sugar fruit juices, milk, non-caffeinated teas, or all-natural water flavoring to make staying hydrated easier.
Encourage sipping rather than drinking large amounts at once. Avoid too many drinks near bedtime to head off any incontinence fears.
When consumed frequently, alcohol and caffeine can have a diuretic effect, leading to dehydration.
Serve foods with a high water content like soups, fruits, and yogurts.
Flu Complications in the Elderly
This year’s flu has been especially rough, causing flu-related complications and deaths in both the young and old. For adults ages 65 and over who are at high risk for the flu, elderly complications like pneumonia and the worsening of chronic conditions can become very serious very quickly.
Important Flu Symptoms to Watch For
Common flu symptoms include cough, fever, body aches and pains, fatigue, sore throat, or headache. These are important symptoms to note, but if you notice any of the signs below in your elderly loved one, contact the primary care provider immediately. [x]
While there is no fail-safe method of preventing the flu, the Centers for Disease Control and Prevention recommends getting the yearly flu vaccination.
High Blood Pressure in Seniors
What is considered high blood pressure in seniors? For the average person, normal blood pressure is under 120 systolic and under 80 diastolic pressure. But new studies find that this may not be a good gauge for the elderly.
Based on data collected by the U.S. National Health and Nutrition Examination survey, researchers have found that among elderly adults who are more frail, a higher systolic pressure may be beneficial. Why? As blood vessels stiffen with age, more pressure may be necessary to keep blood pumping to central organs. [xi]
Furthermore, it was determined that some blood pressure medications used with senior patients may have associated side effects that cause more harm than good.
In light of this new research, it is important to talk with your healthcare provider to determine the best medications and plan of care for the elderly patient.
Hip Replacements for Seniors
Having a total hip replacement can go a long way to improve quality of life by relieving pain and improving mobility for senior citizens. Hip replacements are commonly done to replace damage to the hip joint from conditions like osteoarthritis, rheumatoid arthritis, bone tumors, and avascular necrosis. [xii]
As with any surgery, there are risks involved. Hip replacement elderly mortality rates are slightly elevated during the initial post-operative period, mainly due to cardiac complications and thromboembolic complications within 90 days of the surgery. [xiii]
For best results, it is important to discuss the risk factors with the patient’s medical team and conduct a thorough pre-operative assessment prior to having the procedure done.
Parkinson’s Disease in the Elderly
Parkinson’s disease is a progressive neurodegenerative disease characterized by a breakdown of certain neurons that produce dopamine. It typically develops gradually and affects movement. While there is no cure, there are medications that can greatly reduce symptoms. [xiv]
Symptoms of Parkinson’s can include:
Seniors with Parkinson’s disease old-age onset differ from middle age onset PD because they typically have greater motor impairment and more rapid progression. If you are a family member or caregiver, it is important to understand the disease and its progression to provide the best care and highest quality of life possible.
Pneumonia Risks for Seniors
Pneumonia occurs more frequently among seniors than any other age group, and it can lead to hospitalization and even death. There are over thirty causes of pneumonia with bacterial, viral, and mycoplasma being most common causes.
As the name indicates, bacterial pneumonia is caused by bacteria. Common symptoms for this type of pneumonia are:
Caused by a virus, viral pneumonia has symptoms that look a lot like the flu. Early symptoms are similar to those for bacterial pneumonia, but may be followed by these symptoms:
Over the course of twelve to thirty-six hours, there may be an increase in coughing and mucus production.
Caused by a bacterium, this type of pneumonia is milder with symptoms including a severe cough and possible mucus production.
With pneumonia, old age survival depends on accurate diagnosis and treatment relative to the germ causing the infection and the severity of the illness.
Preventative measures, like getting the pneumococcal pneumonia vaccine, the flu vaccination, or other related vaccines, is recommended. Implementing good health practices, like washing hands frequently and not smoking, can lower the risk of developing pneumonia. [xv]
Caregivers and family members should be diligent in observing and communicating possible symptoms to the elderly patient’s medical team.
Rheumatoid Arthritis in Old Age
Elderly-onset RA starts between ages 60-65 and is known to progress far more quickly than early-onset RA. This disease typically affects shoulders and other large joints and tends to be less severe than RA that develops in younger people. [xvi] Common symptoms of elderly onset rheumatoid arthritis can include joint pain, muscle pain, anemia, weight loss, and fever. Late-onset RA can be tough to diagnose since it has many other symptoms that appear to overlap other conditions.
Treatments are focused on remission to prevent joint damage and often include:
Caregivers and loved ones should work as a team to help the elderly patient with treatments and pain management options under the consultation of a primary care provider.
Sleep Deprivation in the Elderly
According to the National Sleep Foundation, 24% of seniors are diagnosed with at least four medical conditions, with many of those conditions leading to problems sleeping.
In addition to affecting the overall quality of life, consequences of lack of sleep in elderly can include increased pain sensitivity, a decrease in endurance and muscle strength, increased stress on vital organs, an increase in the risk of diabetes, and a weakened immune system.
As a caregiver, it is important to identify possible sleep problems and work with the elderly patient’s team to diagnose and treat sleep disorders. Additionally, here are some sleep tips to help encourage a good night’s sleep [xvii]:
Strokes in Older Adults
Strokes are caused when a hemorrhage or blood clot blocks the flow of oxygen and blood to the brain. According to the National Stroke Association, strokes are the 4th highest cause of death. [xviii] For individuals who survive a stroke, the effects can be devastating and can require long-term rehabilitation for the individual to regain functions affected by the stroke. Depending on the part of the brain damaged by the stroke, patients can lose the ability to speak, control motor movements, or even think clearly.
Stroke recovery for elderly people can last anywhere from a couple of weeks to years, depending on the individual. As caregivers, you can play an active role in recovery with the following tips:
UTIs in Older Adults
Urinary tract infections (UTIs) are frequent in older adults and can be hard to identify because seniors don’t always experience classic symptoms like frequent urination, pelvic pain, burning pain, and foul-smelling urination. Instead, caregivers may notice symptoms like lethargy, incontinence, agitation, or confusion in the case of patients with dementia.
When undetected for a period of time, UTI in older adults can become more serious, leading to kidney or bladder infections and even life-threatening blood infections. [xix]
Common risk factors for UTIs in seniors include:
While there is no way to prevent UTIs completely, here are some steps you can take to decrease the risk:
If you suspect that an elderly patient has a UTI, contact the care provider. Most UTIs respond well to antibiotics, especially if caught early.
Treatment Options for Older Adults with Chronic Conditions
Pain Management in Seniors
Regardless of age, pain can negatively affect every part of a person’s life. Chronic pain is especially common in seniors. According to an American Geriatrics Association report, around 50% of older adults living at home and between 45-80% of seniors living in nursing homes suffer from persistent pain. [xx]
When chronic pain, pain lasting 3-6 months or longer, is not addressed, it can become debilitating and cause anxiety, depression, loss of appetite, sleep problems, and social withdrawal.
As a caregiver, it’s hard to watch your loved one or patient experience ongoing pain. It is important to work with the patient’s care team to diagnose and treat chronic pain with appropriate medications.
In addition, here are some tips to help improve quality of life:
If you notice a sudden change in the patient’s mobility or ability to function due to pain, or if a new pain is severe or is causing distress or talk of not wanting to live anymore, contact the medical provider immediately and discuss it with the patient’s team.
Physical Therapy for Seniors
Physical therapy can be a great treatment to build strength and endurance, relieve pain, and help with chronic issues like incontinence, arthritis, and Parkinson’s. Often considered effective treatment for those recovering from an injury or long illness, PT is frequently overlooked in its ability to help with conditions affecting elderly adults. Yet countless studies have been done validating the effectiveness of physical therapy for everything from incontinence and strokes to osteoporosis, arthritis, and Alzheimer’s disease. [xxi]
Here are some of the benefits of physical therapy:
Family and caregivers can help by encouraging the elderly individual, staying positive, and not putting too much pressure on him/her to reach a certain level of progress.
Becoming familiar with the topics above can help you provide the best support and care for the important senior in your life.