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World Alzheimer’s Day: Stand Up and be Counted

September hosts a month-long celebration to boost Alzheimer’s awareness, with September 21 marking the 20th anniversary of World Alzheimer’s Day. Currently, over 5 million Americans are living with Alzheimer’s dementia. Even more daunting is the fact that one American is diagnosed with this deadly disease every 67 seconds. If scientists could successfully develop an Alzheimer’s antidote, over 500 million lives would be spared around the world each year.

For caregivers who are unfamiliar with Alzheimer’s and its subsequent disease process, it’s best to turn to the Alzheimer’s Association for help. According to this authority, Alzheimer’s is “a type of dementia that causes problems with memory, thinking and behavior.” The association goes on to say that Alzheimer’s is the most common form of dementia and makes up four of every five dementia cases. As if that weren’t enough, it is estimated that as many as 16 million Americans will have the disease in 2050.

Good Things Come from World Alzheimer’s Day
Every year on September 21, people around the world take part in Alzheimer’s Day activities. Some events collect money for research; others lobby for Medicare reform. In celebration of World Alzheimer’s Day 2010, a group of researchers bicycled cross-country in the Alzheimer’s Breakthrough Ride. Their mission was to collect petition signatures that would essentially force elected officials to make Alzheimer’s disease a national priority. Riders crossed the finish line on World Alzheimer’s day and promptly delivered the list of signatures to Congress’ front door. Talk about sending a message!

What’s Your Alzheimer’s IQ?
Alzheimer’s dementia is an overwhelming and all-too-common problem among seniors. For a bulk of independent older adults, in-home care duties often fall to a family member. More and more adult children are being charged with the duty of caring for an ailing parent, making them more susceptible to stress and isolation.

Though we don’t yet know how to prevent Alzheimer’s or have a cure looming in the near future, seniors and their caregivers can participate in a number of pro-active techniques that are thought to ward off the disease.

Let’s take a look at some activity suggestions that are known to help seniors remain physically and mentally healthy:
  • Eat berries: Thanks to the anthocyanosides contained within berries, seniors can help to safeguard their memory recall skills. Anthocyanosides are famous for their ability to mend or fight off memory impairment.
  • Make time for brain exercise: When seniors participate in activities that are mentally stimulating or challenging, it’s the equivalent of a brain workout. The focus and concentration required to complete tasks like jig saw puzzles serve as a way to preserve – and perhaps even improve – mental acuity.


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With a New App, You Can Always Have Your Wishes Known

If you’re one of my patients, or the family of one of my patients, I’ve already nagged you about this: Make out an advance healthcare directive: Figure out whom you would want to make your health and legal decisions if you become unable to do so. Think about what you want to have done if you are critically ill: Do you want everything done to prolong life? Or, are there certain procedures you’d like to avoid, such as a tube to help you breathe with a respirator?

The answers to these questions are different for everyone. There are lots of resources on-line to help you through the process: here, here, here, here, and here.

As a culture, we are not very good at talking about endings. So only a small percentage of people actually prepare these forms, but they’re essential if you want to avoid treatments that are more aggressive than you would want, or if you want to keep an unscrupulous nephew, or whoever, from taking over your affairs and your medical decision-making power. Please, please, please, make your wishes known before it’s too late. Or make sure that your loved ones do.

But here’s the other thing you need to know: If you go to all the trouble to prepare advance directives, they won’t be followed if loved ones don’t know where they are, or if they’re locked in a safe deposit box or some other secret spot. If the EMTs show up at your doorstep, and you’re unconscious or unable to communicate, they can’t follow a “Do Not Resuscitate” (DNR) order, if they don’t actually see a signed, witnessed copy of that document.

So what to do? Luckily, we live in the digital age. The American Bar Association has developed a free, smartphone app called “My Health Care Wishes.” The app will store all your advance directives on your phone. And most of us have a phone around pretty much all that time, so mischief managed. If your elder doesn’t have a smartphone, the documents can be stored on a family member or caregiver’s phone. The app works on both Apple and Android phones.

You can also store healthcare directives digitally in other ways: For $45 a year, Docubank will make your directives available with a phone call. MyDirectives makes available a Universal Advance Digital Directive (uADD)™ for free, from a web-based database. It makes money by charging healthcare providers to access the database.

At the very least, you can post on the refrigerator along with emergency contact information, current medications and illnesses to help the EMT’s if they are called in an emergency. Emergency personnel are trained to look at the refrigerator for such information in homes.

Be sure to have a conversation with your family, friends and especially your ‘agent’ -the person who will be making decisions for you. Be sure they know not only what your wishes are, but where you keep your important papers, as well as have access to your computer and phone passwords.

So the directive templates are out there. There are ways to make them easily available when a problem comes up. You don’t have any more excuses to avoid completing a directive.

Just do it. Please. You and your family will not be sorry.

Elizabeth Landsverk, MD Specialist in Geriatrics

- See more at: http://elderconsult.com/with-a-new-app-you-can-always-have-your-wishes-known/ To comment on this blog post, please do so on our Facebook page ElderConsultGeriatricMedicine or on our webpage www.ElderConsult.com

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Spreading Ovarian Cancer Awareness Among Seniors

The whole month of September is dedicated to recognizing a specific type of cancer: ovarian cancer. Recognized as Ovarian Cancer Awareness Month in the U.S., females of all ages can benefit from a healthy dose of education and ovarian mindfulness.

Ovarian cancer is one of the most deadly of all women’s cancers. According to official statistics, an estimated 22,880 women will be diagnosed with ovarian cancer this year. In 2012 alone, almost 15,550 women died from this form of female cancer. Tragically, a bulk of these women could have been saved. If detected in the earliest stages of the disease, the five-year survival rate for ovarian cancer is well over 93 percent.

The Value of Medical Intervention
Signs and symptoms of ovarian cancer are often blown off or downplayed, as many of them can also indicate the presence of similar diseases or conditions. For this reason, thousands of women don’t visit a doctor or specialist until the cancer has begun to spread throughout the body. Symptoms of ovarian cancer include:
  • Bloating
  • Pelvic or abdominal pain
  • Difficulty eating
  • Feeling full quickly
  • Urinary urgency or frequency


Giving Seniors a Helping Hand
Knowledge is power and this is certainly true of ovarian cancer. The National Ovarian Cancer Coalition has been providing education and support for women with ovarian cancer and their families since 1995. Senior caregivers should support and encourage their older loved ones to have regular check-ups with their primary doctor, along with ensuring she receives any other recommended tests for the disease.

Myths about Ovarian Cancer
As with most medical conditions, ovarian cancer has developed its own set of myths and tall-tales. Here’s a look at three debunked ovarian cancer myths that can help to keep female seniors healthy for years to come.

The Pap Screen Tests for Ovarian Cancer
On the contrary, Pap screens are used to detect the presence of cervical cancer. There is not yet a screening test for early detection of ovarian cancer.

Oral Contraceptives Cause Ovarian Cancer
This myth is dead wrong; oral contraceptives create a 40 to 50 percent decrease in the risk of ovarian cancer.

It’s All Genetics
Genetic or hereditary causes of ovarian cancer only make up a mere 5 to 10 percent of the cases diagnosed each year.

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Prostate Cancer Screenings: Helpful or Harmful?

Older males tend to shy away from the topic of prostate cancer, but – as one of the most important and prominent modern health topics among male community – the discussion is necessary. Screening for prostate cancer is a highly contested procedure. That’s because screening for the disease using the PSA (Prostate-Specific Antigen) test may or may not be a good idea. So, what should seniors and their caregivers understand about the PSA screening process and, and more importantly, should seniors get screened for prostate cancer?

The Debate
Common sense would tell you that early screening for a disease raises the patient’s chances of stopping it before it grows to an untreatable scale. Unfortunately prostate cancer screenings just aren’t that simple and many medical experts offer polar opposite opinions as to whether or not prostate cancer screening is appropriate for all men.

Pro-Screeners
Among the medical experts who promote PSA screenings, previously conducted research indicates that locating and treating prostate cancer in its earliest stages saves lives. By tackling the disease early and aggressively, men theoretically enjoy a longer and healthier lifestyle. Pro-screeners suggest men with a life expectancy of 10 years and over are screened.

Anti-Screeners
Some people believe the PSA test does more harm than good, citing the lack of evidence to support the procedure’s life-saving capabilities. Most prostate cancers are extremely slow-growing, never affecting a man’s health. In fact, many men die with prostate cancer that has never affected them. Because the test can’t differentiate between harmful cancers and those that will never affect the person, many men who get the test are treated for cancer unnecessarily. Another concern is that the treatment may have very serious side effects, such as impotence and incontinence.

The United States Preventive Services Task Force (USPSTF), an organization that makes recommendations for doctors based on reviews of all the available evidence, and the Centers for Disease Control (CDC) do not recommend that men of all ages get a PSA screening test for prostate cancer.

The Decision
Deciding whether or not a senior should be screened for prostate cancer is a choice that should be made under the guidance of a medical professional. Though the PSA test is a point of contention, medical experts do agree that men currently experiencing symptoms of prostate cancer – such as difficulty urinating or blood in the urine – should be tested for prostate cancer as soon as possible.

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Healthy Aging Month: 5 Tips for Living a Longer and Healthier Life

Healthy Aging Month is a month-long time of recognition, ultimately designed to focus attention on the positive aspects of growing older. The mission is to encourage the development of local Healthy Aging events, promoting the concept that – no matter your age – it’s important to take personal responsibility for one’s overall health. That “health” includes physically, socially, mentally or financially.

As of 2014, Healthy Aging Month has been recognized for a period of twenty years. Developers work to provide practical tips and present alternative therapies for improving physical, mental, social and financial well-being. With the upcoming boom of older adults ages 65 and up, soaking up all the knowledge available will likely lead to longer and healthier lives.

Expert Tips on Healthy Aging



Get Serious About Health
For seniors managing chronic conditions or medical issues, don’t be afraid to ask questions. That’s what medical professionals are there for. Ask the doctor for tips on healthy aging and then create a plan to see those ideas come to fruition.

Don’t Take a Seat
When people exercise, blood flow increases across the lining of your blood vessels. New research shows that, when blood flows faster over the blood vessel lining, it releases naturally-occurring chemicals in the brain. Often called the “feel good” chemical, endorphins are released during exercise, giving seniors a welcome burst of energy.

Think About It
To ward off an urge to overeat, just imagine eating that sweet treat. Research shows the “mental dessert” will satisfy seniors and lead to a smaller food intake.

Know Your Own Meds
Seniors are often diagnosed with chronic conditions that require daily medication administration. With so many pill bottles lying around, making time to clean out the medicine cabinet is necessary. Toss out any medication that is out of date, made from potentially hazardous ingredients or used for a condition that’s long healed.

Get into Oils
Known as the “young oils,” eating more fish oil, flax oil, olive oil and nut oil have been linked to living a longer and healthier life. On the flip side, seniors should avoid eating “old” oils. Those include partially hydrogenated, corn, cottonseed, palm kernel, safflower, sunflower and soybean oils.

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Celebrate the Fall Season with Fall-Free Prevention Tips

That’s right CELEBRATE…..because the good news about falls is that they are preventable! We all face challenges in life that we may not have much control over; however, falling doesn’t have to be one of them. We now know that falls are not an inevitable part of aging if we take some simple preventative measures.

As we welcome the fall season on September 23rd, join the San Mateo County Fall Prevention Task Force in celebrating National Fall Prevention Awareness Week.

Here are some ideas for getting the celebration (and a fall-free life) started:


  1. Find a good balance and exercise program. Having good balance and strength can be the difference between a near fall and a fall.
  2. Talk to your health care provider about any falls, near falls or a fear of falling. Consider a home safety pro-active fall prevention plan assessment and getting some help in making a of your own.
  3. Regularly review your medications, and anything you take over-the- counter, with your doctor or pharmacist for fall risk side effects.
  4. Get your vision and hearing checked yearly. Good vision and hearing are key to keeping you on your feet.
  5. Make safety modifications to age in your own home as safely and independently as possible.
  6. Talk to your family members, ask for help and seek the supports you may need.


What will you do to celebrate this Fall Prevention Awareness Week?

The San Mateo County Fall Prevention Task Force is a good local resource for you if you need more ideas. We can provide you with written materials and information on fall prevention workshops, balance and exercise programs and home safety tips and services.

Check our website www.SMCFallPrevention.org or call toll free 844-NoFalls (663-2557)

Friend us on Facebook and tell us your story……. What did you do to CELEBRATE Fall Prevention Awareness Week?

Submitted by Sarah Eggen-Thornhill, OTR/L Health Educator for the San Mateo County Fall Prevention Task Force

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World Suicide Prevention Day

Unfortunately, we live in a world that places a stigma on mental health disorders and suicidal behaviors. This stigma commonly prevents seniors from seeking professional help, never knowing that treatment has saved lives time and again. With the number of suicides rising each year, education is key. Enter World Suicide Prevention Day, co-sponsored by the International Association for Suicide Prevention (IASP) and the World Health Organization (WHO).

History of Suicide Prevention
Suicide claims more lives than war and homicide combined. Suicide rates have risen in the United States over the past decade, after declining over the previous 10 years. A new study from the Centers for Disease Control and Prevention showed a sharp increase in suicide among middle-age Americans, with the rate rising by almost 30 percent for people ages 35 to 64 between 1999 and 2010. These numbers encouraged the creation of World Suicide Prevention Day

For the last 11 years, September has served as Suicide Prevention month. This event calls attention to treatable mental health issues that are directly related to suicidal attempts. Events are scheduled in at least 60 countries and range from public awareness to seminars and walks for survivors. Hundreds of organizations are taking part this year, opting to be pro-active in spreading the word about suicide.

2014 Specifics
Many events will work within this year’s theme, “Stigma: A Major Barrier to Suicide Prevention.” Ridding the world of mental illness stigma can help people currently contemplating suicide, while also offering support to their loved ones.

The core worldwide event has been labeled “Cycle Around the Globe,” and it invites participants to raise suicide awareness while collectively biking the 24,900-mile. Why the odd distance requirement? Organizers set it up that way because 24,900 miles are equivalent to the circumference of Earth.

Why are Seniors at Risk?
Suicide is quite common among seniors, as they can become bombarded with suicidal triggers. Once experiencing a trigger, most seniors are unequipped to navigate the issues. Some common catalysts among seniors include:
  • Depression
  • Isolation
  • Chronic Illness
  • Physical Inadequacies
  • Substance Abuse or Addiction


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Understanding Dementia-Related Behavioral Changes in Seniors

Alzheimer’s dementia is brought on by significant changes taking place in select few areas of the brain. Specifically affected are parts of the brain that control mood, memory and behavior. When a senior develops Alzheimer’s, dramatic behavioral patterns are usually a side effect. These behaviors can place an enormous amount of stress on family members and senior caregivers, especially if the senior was previously gentle, kind and loving.

Coping with these Changes
When dementia-related behaviors grow to become cruel or dangerous, it is important for everyone to understand that the senior is not deliberately changing his or her behavior. Two classic behaviors associated with Alzheimer’s dementia are anger and aggression. Unfortunately, these uncontrollable behaviors are usually directed toward loved ones and caregivers. It’s nothing personal; they’re just the ones who happen to be in constant contact with the senior.

Even though the anger and aggression can take friends and family members aback, the senior is not in control of his or her own actions. In fact, according to the latest research studies, the senior is likely suffering a great amount of fear brought on by his behaviors. Experts suggest that Alzheimer’s patients also need consistent reassurance by loved ones.

Reaching Out for Help
When friends or family members begin to notice behavioral changes in a senior loved one diagnosed with dementia, discussing the changes with a medical professional is essential. And, since time is of the essence, seeking help in a timely manner is of the utmost importance.

Physicians will be able to assess the senior’s situation, working to rule out other possible causes for the personality change. For example, a number of behavioral changes are brought on by physical illness or pain.

Physicians will also talk to the senior and his family members, answering the questions or concerns related to Alzheimer’s. It’s always a good idea write down a list of questions in the days leading up to the medical evaluation. This helps to ensure a clear understanding of the treatment plan going forward.

For those who deal with the personality changes on a daily basis, the following coping tips offer some much-needed relief:

  • Follow a strict daily routine with as little deviation as possible
  • Don’t make changes to the senior’s environment
  • Control the number of unfamiliar people going in and out of the home


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Traumatic Brain Injury 101: What Senior Caregivers Should Know

According to the Brain Injury Association of America, a yearly total of 1.7 million children and adults in America sustain a traumatic brain injury (TBI). Considering the fact that seniors face an ever-increasing risk of suffering a TBI, it’s important for family members and close friends to understand the basics of this particularly dangerous injury.

What is a traumatic brain injury?
TBI is defined as “a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain.” However, not all TBIs are caused by blows or jolts to the head. As with many chronic disorders, TBIs vary in severity on several different levels. For that reason, each individual brain injury is evaluated and staged by qualified medical experts.

Common Causes
Most TBIs are the results of motor vehicle accidents, acts of violence, falls, recreational injuries or blows to the head.  These injuries can also occur without visible physical evidence of injury or trauma. Examples include, whiplash, and shaken babies.

Classifying the Severity of TBIs
Though they’re not always visible and can seemingly appear minor, brain injuries are actually extremely complex. After sustaining a TBI, seniors should immediately seek professional medical help. After a thorough physical exam, experts will evaluate the specific types of damage left behind.

TBIs can result in short or long-term problems for independently functioning seniors. For example, mild TBIs normally present with brief changes in mental status or consciousness, while severe TBIs usually cause long periods of unconsciousness or amnesia.

Recovering from a TBI
These unique brain injuries can cause physical, cognitive, social and vocational changes among older adults. The changes can affect individuals for short periods of time, or alter a senior’s life permanently. In fact, many seniors find that true – and effective – recovery is a lifelong process of vigilance and compromise. In many cases, a senior’s family members and close friends suffer along with their loved one. The entire process can feel overwhelming for everyone involved.

Lasting Effects
Seniors suffering from TBIs often complain of impairments or difficulties with memory, mood and concentration. Other significant deficits are seen in organization, reasoning, learning, cognitive and other various functions. However, TBIs can also result in an increased risk for Alzheimer’s disease, Parkinson’s disease and other brain disorders directly linked to aging in place.

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Do I Need to Drink Water?

PT Sue LogoApproximately 60% of your body weight is water. All of your cells, organs, and tissues use water in order to perform all the bodily functions and to regulate your body temperature. Water keeps all of your tissues, including your bones, blood, and brain, moist; lubricates your joints; and protects your spinal cord by providing a buffer. The kidneys, liver, and intestines need water to flush out waste material.

You lose water naturally by breathing, sweating, and digestion. Dehydration is the condition of severe water loss with loss of essential salts and minerals. In simple words, your body has lost more fluid than you are taking in and your body does not have enough water and fluids to function properly.

All people are susceptible to dehydration but especially older people. You need to monitor your fluid intake to balance fluid loss during hot weather, illness, exercise, and/or excessive sweating. Many older people avoid drinking fluids for a variety of reasons. If repeated urination during the night is a problem, stop drinking water by 5 PM but increase your water intake during the earlier part of the day. Avoiding water intake really becomes a problem when you get sick. As the body ages, its ability to conserve water is reduced, thirst becomes less acute, and responsiveness to temperature changes lessen. Some chronic illnesses may put you at a higher risk to dehydrate, such as diabetes, kidney disease, alcoholism, and adrenal gland disorders. Some of the serious complications of dehydration include: heat injury, cerebral edema, seizures, low blood volume shock, kidney failure, and in severe cases, coma and death.

Some of the symptoms of dehydration include: dry, sticky mouth; sleepiness or tiredness; thirst; decreased urine output (no urination in 8 hours for an older person); dry skin; headaches; constipation; and dizziness or lightheadedness. In severe dehydration the symptoms worsen and can include: rapid heartbeat; rapid breathing; lack of sweating; and extreme fussiness, irritability, confusion and/or sleepiness in the older adult. Dehydration can occur in 24 hours and can become serious in 48 to 72 hours if enough fluid is lost. Severe diarrhea, as in viral gastroenteritis, can especially lead to dehydration even if there is no vomiting or fever present. If the dehydration becomes advanced, conservative measures may not work and you may need to go to the hospital for IV fluids. The loss of the salts and minerals in the loss fluids is very important since the body needs those salts and minerals to function.

The best treatment is to prevent dehydration by drinking plenty of fluids (water and other beverages) and eating foods that are high in water, such as fruits and vegetables. The amount of water that you need depends upon the climate where you live, your level of physical activity, and your medical health. The official recommendation for adequate hydration is 8 8oz. glasses of water a day. Please check with your doctor for his recommendation specific for your body needs.

If you are ill, start pushing fluids as soon as diarrhea, vomiting and/or fever are detected. Use water or a rehydration solution such as Gatorade or PowerAde. Chicken broth, even diluted with water 50%, is excellent. Avoid fruit juices, carbonated drinks and coffee which can make the diarrhea worse. Carbonated sodas have too much sugar and too little sodium to replenish lost electrolytes. If the symptoms continue for 8 to 12 hours and especially if you are unable to keep anything down (even water produces vomiting), you or a love one should contact your physician, his nurse or nurse practitioner for advice. Be sure and give your physician all the pertinent, concise details so that he can accurately treat you before you get into trouble with dehydration.

Please feel free to contact me if you have any questions at my web site, ptsue.com, my office (951)369-6507, or my email address, askptsue@gmail.com. My goal is to help seniors keep healthy and moving. I welcome all questions or comments. This article is dedicated to a senior friend, Martha, who lives in assisted care and was recently hospitalized due to dehydration.

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