Care For Your Elder

It appears that I have gotten over my recent illness and I am glad that that is over.  Gosh, I really hate being on drugs that I don’t normally take. Anyway, enough about me lets talk about Reactive Airway Disease (RAD).

As I stated in last week’s blog RAD describes an asthma-like syndrome which develops after an exposure to high levels of an irritant.  The irritant can be smoke, gases, perfumes, pets, dust or vapors.  The gases can be from cleaning chemicals such as bleach or ammonia or just plain old cigarette smoke.  The irritants cause the respiratory tract to swell and become inflamed.

The body’s response to the irritant or allergen causes increased mucus production, shortness of breath, tightness in the chest, and wheezing. Some other signs of RAD include dry cough, coughing non-stop, decreased appetite, nausea, and feeling tired.

If you find yourself or your elder in a situation where you think there may be a irritant in the air that may cause breathing problems you should:

• Get away from the irritant
• Stay calm - rest and relax
• Drink warm liquids as this helps thin the mucus.  Remember that milk and milk products actually thicken mucus so these need to be avoided.
• Take the medications the doctor has prescribed
• Seek medical treatment if any signs that the breathing is impaired.

RAD may be a disease that your or your elder may have off and on for the rest of your lives, however; if medical treatment is sought people often have excellent recovery from RAD. Some people may experience ongoing night-time symptoms, and may occasionally have acute symptoms for some time.

I think that my Dad had RAD, but back in the 70’s it was diagnosed as just plain old asthma. In my “real” job I am a Safety Specialist and I deal with employee safety in a hospital.

Looking back when I was a teenager, I remember that my Dad was transferred at work. He was a parachute packer and worked on an Air Force Base. One year they moved his “shop” from one building to another one that also worked on propellers.   As Dad called it “The Prop Shop.”  Dad would come home every day from work and he couldn’t breathe. He would get on the floor on his knees and lean over the edge of the couch and just gasp for his breath. He would get a bit better by morning, as he found an over the counter medication that helped some, but then he would return to work and he would be gasping for air.  Oh, and over the weekend, he was a new man back to normal.   I really do believe that he had RAD and also asthma. He was able to get a medical retirement from his job and he retired in his 50’s.

For the recent RAD that I had, I believe that I had a combination of exposure to cigarette smoke and tree pollen. My stepson, got married that weekend and they smoked a lot. I tried to stay clear of the smoke but sometimes there is no escape. Also in Houston, that same weekend, the tree pollen was in the “extremely heavy” levels according to the news reports. That’s what I believed triggered my RAD, asthma and bronchitis.

As we grow older, it is virtually inevitable that the amount of medication we are required to take is going to increase. In our youth, most of us only have to worry about taking our Flintstone vitamins. When we reach our senior years, however, there is medication for blood pressure, heart conditions and other various ailments.

I know that personally, when my wife and I started seeing our number of prescription medications rising, we often were confused as to what to take on which day. It may seem like a simple enough task, but with over 20 medications between the two of us, it was somewhat daunting. Now that we have gotten into the routine, it is a bit easier, and we now use a medication calendar schedule to help us keep everything organized.

Mary Davis - Yep That's Me

Last week I felt really, really bad.  I live in Houston, Texas and here on the Gulf Coast there are many allergens in the air, from dust, pollen, and many chemicals from the petrochemical plants.  On Monday evening I noticed that I seem to have a lot of nasal drainage going down my throat.  On Tuesday evening, I had a really hard time sleeping due to coughing because of the post nasal drip.  On Wednesday, it got worse so I took a Mucinex® DM to help thin out the drainage and I also took some Delsym® cough syrup.  I slept better that night but woke up Thursday having trouble breathing.  It felt like I couldn’t get enough air in my lungs.  I went into work and made a doctor’s appointment for later in the day.

I felt worse and worse as the day progressed.  My throat became sore, my throat swelled and I had a very hard time swallowing and I began running a low grade fever.  I thought that 1 pm would never come so I could go to the doctor.

I made it to the doctor’s office and he told me that I had Reactive Airway Disease, Asthma, and Bronchitis.  I was stunned that I had 3 things going on in my body and I never had Asthma (that I knew of) even as a child.  The doctor loaded me up prescriptions for an asthma inhaler, antibiotics and tussalon pearls (cough pills – these are great little pills that keep you from coughing for 8 hours).

I felt immediately better as soon as I stated taking the medications, but 5 days later I still am not 100%.

I am sure you are wondering why the heck Mary is whining on her elder care blog about her illness.  Well, I know these 3 illnesses do affect more people than me and I know they affect the elderly, so I figured they would make great a blog topic especially as they can affect someone all at the same time and make for a more complicated illness.  For today I will start with just a definition of the 3 conditions and in later blogs I will discuss how each of these may affect your elder.

Reactive Airway Disease (RAD) describes an asthma-like syndrome which develops after an exposure to high levels of an irritant.  The irritant can be smoke, gases, fumes, dust or vapors.  The gases can be from cleaning chemicals such as bleach or ammonia or just plain old cigarette smoke.  The irritants cause the respiratory tract to swell and become inflamed.

Asthma is a chronic disease that causes inflammation and narrowing of the airways. The airways become swollen and very sensitive to certain substances that are inhaled.  The airway reacts by narrowing and not letting enough airflow into the lungs.  The airways also respond by making more mucus because of the inhaled substance again making it harder to breath.  All these triggers make a person cough, wheeze and/or have chest tightness.

Bronchitis is an acute inflammation of the mucus membranes in the bronchial tubes or air passages within the lungs. This inflammation is typically caused by a virus such as the flu or the common cold.  However; many bacteria also can trigger bronchitis.  Bronchitis causes a person to cough, to have shortness of breath, and to have tightness in the chest.

PS.  The picture of me is a few years old but sorta looks like the way I felt on Friday.

Here are some interesting facts about vision that you may find interesting.

Vision and poor eye health affects more than 120 million people in the United States.

Approximately 61% of United States Citizens require some form of vision correction (glasses, contacts etc)

A Georgetown University Medical Center Study showed that there are approximately 1,000,000 new cases of blindness each year that are either curable or preventable through proper eye care and early detection.

Cataracts are the primary reason that elderly people seek an eye exam due to the loss of vision.  Cataracts are the third leading cause of blindness, which is preventable, in the United States.

As of 2007 approximately23.7 million Americans have diabetes (that’s 7.6%) and 12.2 million of those diabetics are age 60 and older.   Diabetes is the leading cause of newly diagnosed blindness and diabetic retinopathy causes 12-14 thousand new cases of blindness each year.

A doctor commonly looks at the back of the eye with a scope to look for signs of uncontrolled diabetes. This can appear as little hemorrhages or fat deposits on the retina surface.
Age-related macular degeneration is the leading cause of vision loss and blindness among elderly Americans who are age 65 and older.

Your eyes are also affected if you have high blood pressure.  High blood pressure can cause blood vessels in the eye to burst or bleed and can cause your vision to be blurred or impaired due to damage to the retina.  This condition is called hypertensive retinopathy.

A cigarette when smoked contains 4000 chemicals and they get into your bloodstream when you smoke.  These 4000 chemicals travel throughout your body causing damage to the macula, an area in the center of the retina that provides the clearest most distinct vision.  The small blood vessels can burst which leads to irreversible damage.

Smoking has also been linked to the development of cataracts. Researchers RG Cumming, P Mitchell, RE Klein, and KE Lee have concluded that smoking is associated with a higher risk of cataracts.

It used to be that when a person reached the brink of death, they were put to bed and often died within a few days. This phenomenon—as well as the mental anguish of the patient—is well documented in literature, particularly in Tolstoy’s “The Death of Ivan Ilyich.” Now that people can have a feeding tube inserted and be on life support for years without any sign of consciousness, there are severe ethical and logistical complications to the question of when the natural processes of death should be allowed to take place.

For all of the ways that advancements in modern medicine have bettered our lives, there are many ways that innovations have also made matters more unclear. The recent discovery that a man who was thought to be unconscious for decades was really having cognitive processes only muddies the waters. While modern medicine may have solved some of the problems of prolonging life, there is still much debate to be had over the humane and ethical issues involved.

Here are some tips to help keep your elder’s eyes healthy:

1. Anyone over the age of 40 needs to have an annual visit an eye specialist and get a complete eye examination.

2. Glaucoma is called the silent killer of vision. It can be detected only by a eye care specialist. When you take your elder for their annual eye exam be sure the doctor performs the test for glaucoma. It is painless and an easy test to do.

3. If your elder is a diabetics they really do need to have a their eyes dilated to ensure a through eye examination.

4. If your elder sees cobwebs or large floating stings in their vision they really need to go to the eye doctor as soon as they can for an eye exam.

5. Ensure that your elder has a healthy diet and gets plenty of exercise. Many vegetable are a great source of vitamins such as broccoli, carrots, red bell peppers, sweet potatoes, and tomatoes to name a few. Fruits that are good for the eyes include blueberries, cantaloupe, guavas, kiwi, dried apricots and purple grapes.

6. Help control your elder’s diabetes and blood pressure to help maintain healthy eyes.

7. Stop smoking.

As you age your vision may change due to the normal aging process.  There are many “normal” conditions of the eye where you or your elder may notice vision changes. 

The elderly may notice a reduced sensitivity to light.  Is a larger wattage light bulb needed as they read?  Are they putting the menu in a restaurant near the candle or under the light to be able to read the menu?  If so, they are showing signs of normal changes in the eye due to aging.

The elderly may tell you items they see seem less sharp or look dull.  Does your elder tell you that there is a glare from the headlights from other cars while they are in the car or driving?  This is another normal change in their eyes.

Your elder may not be able to read small print in a book or magazine.  Do you notice that they have to move the reading material far away?  Do they ask you for a magnifying glass to read the newspaper or book?  This condition is called presbyopia where the eye becomes less elastic and looses the ability to focus.  This condition tends to occur to people between the ages of 40 and 50.  It is more noticeable in artificial light (indoor lighting) than outdoors in the sun.  The reason is when the eyes are out in the sunlight the iris closes due to the bright light making the opening a smaller diameter. 

Another age-related vision change is due to the reduced production of tears and the eyes are dry.  This condition can be very painful and can begin as early age 30.

So how do you “treat” these age-related vision changes?

Some older people notice that if they use a red light on in darkened rooms (hallway or bathroom) makes it easier for them to see than using a “regular” night light. The red light tends to produce less glare than a regular light bulb. 

Eye drops or saline (salty water) can really help keep the eye moist if your elder is complaining of dry eyes.  If your elder’s condition is very painful and the over the counter eye drops or saline doesn’t work well for them, you will need to take them to doctor for prescription eye drops specifically made for tear production.

For presyopia a trip to the drug store may be all your elder needs to pick up a pair of “reader” glasses.  Some people call these “cheaters” or my favorite “MeMaw or PawPaw” glasses.  I have gotten to the stage of needing “MeMaw” glasses and I have probably 10 pairs scattered around the house, in the cars, at work, in my purse and any where else I think I need a pair.  They can be found at the local dollar store for literally a buck, or you can go to an optical store and get a better pair.  I love to get ones that are crazy colors and wild patterns.  Hey, I have to wear them, so why not make a fashion statement.

The economy as we are seeing at the turn of a new millennium is not a reliable one.  The stability that we experienced in the late 90s is now being replaced with uncertainty and incredulity at how it all went wrong.  There are considerations that we all have to make when we are moving into a different phase of our lives.

One thing I looked into was my family medical history and the elderly health care that I may need, so that I could protect myself in the future when my savings is really put to the test. When it comes to that time, I really don’t want to rely on my own kids to be there to run my life. I want to have the security to do it all myself and be independent of anyone else’s help, like I was most of my life.

February is Vision Awareness month, so here are a few ideas that may help your elder if they are having some vision problems associated with normal vision loss. 

1.      Get your elder a large numbered clock.  Their eyes are not working as well as yours and they may not be able to see a regular sized clock.  They make digital large number clocks as well as large numbed regular wall clocks.  Some clocks with Roman numerals have the 4 written IIII. or IV.   I don’t like the clocks with the IIII, but it is a valid way to express a 4, your elder may have a preference too.

2.      Be sure to provide ample lighting for your elder.  You may only need 60 watt bulb in your rooms, but an elder needs a brighter lighting.  Try using 100 watt bulbs especially in lights where they may be sitting down to read.

3.      If your elder plays cards get them large numbered cards.  They are much easier to use if they are not seeing items clearly.

4.      Large button telephones are great for those elderly who like to talk on the phone.  No need to reach for the glasses.

5.      Large print books are a must of those people who love to read, but still have a hard time reading with their glasses.  Also, some magazines such as Reader’s Digest have large print issues.

6.      For the elderly who really have a hard time seeing items and are nearing blindness there are many “talking” items that can help them.  Some that I have found are talking alarm clocks, talking thermometers, talking bathroom scale, talking color detector (tells you what color an item is), and a countdown/count up timer.  Wow, I never knew there were so many talking items available.

7.      Audio books are great for those elderly who love to read and are really having a very hard time reading with glasses and/or the large print books. 

 I hope these hints come in handy to you and your elder.  Feel free to submit a comment if you have more ideas and I will put them on my blog.

A condition where the thyroid gland is over producing hormones which controls the body’s metabolism is called hyperactive. When your thyroid is over productive the hormones speed up every function in the body, causing unexplained weight loss, hair loss, irregular heart beats, tremors in the hand, feeling tired all the time, increased urination, anxiety, goiter, trouble swallowing and heat intolerance to name a few. Because of the other disease processes in the elderly, often times an overactive thyroid is often overlooked.

Hyperthyroidism usually begins slowly. At first, the symptoms may be mistaken for simple nervousness due to stress. Hyperthyroidism also runs in families. If your elder’s aunt, mother, father, or great-uncle had thyroid problems, it’s a good idea to ask your elder’s doctor to monitor their thyroid hormone levels regularly.

The most common disease from having a hyperactive thyroid is Grave’s Disease, a condition in which the body produces abnormal cells that result in the over production of the thyroid hormones. You may see that the eyes look enlarged or may bulge. Some people have swelling of the front of the neck from an enlarged thyroid gland also known as a goiter. In the elderly, it is not uncommon that they only show one symptom of hyperthyroidism and needs to be treated promptly as with many diseases, this can be life-treating.

Treatment options for a hyperactive thyroid are medications – anti-thyroid, surgery and radioactive iodine treatment.

Another disease of the thyroid is where not enough hormones are produced. This is called hypothyroidism . Hypothyroidism is most prevalent in elderly populations, with 2% -20% of older age groups having some form of hypothyroidism. In a study by NHANES it was reported that the odds of having hypothyroidism were 5 times greater in persons aged 80 years and older than in individuals aged 12-49.

The symptoms of hypothyroidism are impaired mental activity, including problems with concentration and memory, depression, muscle weakness, numbness, pain, muscle cramps, unsteady gait due to muscle cramps, numbness in the fingers, hearing loss, weight gain, brittle finger nails, course dry hair, and snoring. As with many diseases in the elderly, these symptoms can mimic other diseases so care needs to be taken to assure that the elderly have their thyroids tested on a regular basis.

Treatment for a hypoactive thyroid is medications that supplement the hormones.