Nurses Know! - Complimentary and Alternative Treatments

By: Rosalind Anderson RN
Complementary and alternative medicine (CAM) is the use of practices and products that are not considered part of conventional medicine in the United States. Biological therapies include herbs, vitamins, foods including dietary supplements and other natural substances (Pepa). With the increase of infomercials which boasts the benefits of these products, use of alternative medicine is on the rise.

This is especially important when assessing the medication history of elder patients. Although many herbal supplements are safe when used as recommended, the concern is that many elder patients may not tell their nurse, practitioners or physicians they are taking these medications (Pepa). Often times the reason for this is that elders feel that the supplements are not medications because they are “natural”. However the astute nurse should realize that these “all natural” supplements may have deleterious effects when combined with prescribed medications and address natural supplements or home remedies in the medication history assessment of their patient. Common prescription drugs taken by elders such as blood thinners, blood pressure medication, cyclosporins, digoxin, hypoglycemic agents, and antidepressants should not be taken with herbal supplements (Pepa).

The increased use of CAM by the elderly mandates that nurses maintain thorough communication and be knowledgeable about these supplements in order to provide proper care for the patient.


Reference:
Pepa, C. (2006). Alternative health modalities. In Mauk, K. (Eds.), Gerontological nursing: Competencies for care (pp 683-700). Sudbury, MA: Jones and Bartlett Publishers.

Nurses Know! - Recognizing Depression in Older Adults

By: Lisa Whitney RN
Loss is painful whether it is a loss of independence, mobility, health, career, or someone you love. Grieving over these losses is normal, even if the feelings of sadness last for weeks or months. Losing all hope and joy, however, is not normal. It’s depression.
Untreated depression poses serious risks for older adults, including illness, alcohol and prescription drug abuse, a higher mortality rate, and even suicide.
Recognizing depression in the elderly can be difficult, since many people believe it is a normal part of the aging process. As we age, it is normal to experience sadness when facing changes in capabilities, or sorrow at the loss of loved ones, however, we also continue to feel happiness, joy, contentment, and other positive emotions.
It’s important to watch for the warning signs of depression and seek professional help when you recognize it.
Signs and symptoms of depression:

• Unexplained or aggravated aches and pains
• Hopelessness
• Helplessness Anxiety and worries
• Loss of feeling of pleasure
• Slowed movement Irritability
• Memory problems
• Lack of interest in personal care (skipping meals, forgetting medications, neglecting personal hygiene)

Depression in the elderly has underlying causes and treatment is complex in that it involves consideration of the role of current disease, memory changes, various medications, and the status of the patient's support systems. Optimum results are achieved with a management approach that incorporates a system of collaborative care.

References

Ashok, R., & Md. (2004, June 1). Depression in the elderly. In Symposium on geriatric psychiatry (Postgraduate Medicine). Retrieved February 9, 2008, from The Practical Peer Reviewed for Primary Care Physicans: www.postgradmed.com.

Notes: This blog post reflects the work of Lisa Whitney RN with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Hearing Loss

By: Debbie Minniefield RN

CAN YOU HEAR ME NOW?

Many elderly people have hearing problems and it only gets worse as they get older. Hearing loss affects some 2 million older adults over 70, by estimate. That statistic makes it one of the most chronic health conditions affecting older adults today. In one study, more than 90% of adults were found to have some degree of hearing loss. Despite this, more than 36% of them reportedly never even had their hearing tested. (Archives of Otolaryngology Head and Neck Surgery)Four out of five who could benefit from wearing hearing aids, do not use them.

Many avoid going to their doctor with their hearing problems, are unaware of their deteriorating hearing, or see it as a sign of growing old and feel embarrassed.

Hearing Loss is seldom Assessed

Untreated hearing loss in the elderly is common and often results in depression and social isolation. Effective treatment could dramatically improve their hearing. Yet, according to a major study published by the Journal of the American Medical Association, in 2003, fewer than 10% of primary care physicians screen elderly patients for hearing loss. So, ask to have a hearing test whenever you see your doctor. JAMA strongly recommends that hearing screenings become as consistent a focus of health examinations taking blood pressures or vision screenings. At the same time, it is imperative that the elderly themselves ,their relatives, colleagues and friends be aware of the need to look for signs of hearing loss and ask that it be properly diagnosed and treated.

References

Journal of the American Medical Association, April 2003.

http://www.webmd.com/

http://www.righthealth.com/

http://www.hear-it.org.com/

Notes: This blog post reflects the work of Debbie Minniefield RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Smoking and the Older Adult

Smoking Cessation in Older Adults

By: Keturah Mayhorn



Most elderly people, who use tobacco, didn’t start recently. In fact, many have been smoking for years, sometimes even decades, making cessation a hard battle to win. Despite it’s documented relationship with cardiovascular diseases and illnesses, such as cancer, so many older Americans have yet to kick the habit. There isn’t a particular number of cigarettes that causes illness and disease, for some people it could one and for others thousands.

Financial Considerations

It is not uncommon for elderly patients to be on fixed income forcing them to perform a balancing act between food, medication, and other necessities of life. With tobacco’s recent tax increase, uncomfortable adjustments will have to made to some already impossibly tight budgets. Unfortunately, many smoking adults will always make room in their bugets for tobacco.

Why Quitting is recommended no matter what your age

“There is good data to support that smoking cessation lowers the risk for heart disease, stroke, and lung disease” (Mauk, 2006). According to the American Lung Association, benefits begin within only 20 minutes of quitting and continue for by the hour. They include: decreased heart rate and blood pressure, normal blood levels of oxygen, enhanced smell and taste, improved circulation, easier walking, and improved lung function (all within 3 months).

Effective interventions

“The USPSTF found evidence that screening, brief behavioral counseling, and pharmacotherapy are effective in helping clients to quit smoking and remain smoke-free after one year” (Mauk, 2006). It’s never to late to quit paying for tobacco and all of its bad effects, and start living healthier lives.



References

American Lung Association (2007). Smoking Cessation Support.Retrieved February 7, 2008, from web site:http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33568



Mauk, K. (2006). Gerontological Nursing Competencies for Care. Massachusetts: Jones and Bartlett




Notes: This blog post reflects the work of Keturah Mayhorn RN (pictured above) with editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Preventing Heart Disease

by: Charissa Hurt RN

According to the American Heart Association (AHA), cardiovascular diseases rank as America’s No. 1 killer. Heart Disease claims the lives of 41.4 percent of the more than 2.3 million Americans who die each year. Over 83% of people who die from the disease tend to be over 65 years (Mauk, 2006).

Coronary Artery Disease (CAD) is the end result of narrowing and hardening of the arteries associated with fatty plaque buildup and fibrin formation within the heart.

Risk factors include:

• heredity
• race
• increased age
• obesity
• high sodium and cholesterol intake
• sedentary lifestyle. (Mauk, 2006).

CAD can cause angina (chest pain), heart attack, heart failure, high blood pressure and arrhythmias (irregular heart beat).

What can be done to prevent CAD?

Genetics, race and increased age are unavoidable risk factor to developing CAD; however we can make lifestyle modifications to prevent the disease from progressing.

1. Eat a low fat, low sodium, fiber rich diet.
2. Maintain a healthy lifestyle by stop smoking
3. Regular exercise at least every day of the week, such as walking
4. If overweight, try losing a few pounds can make a significant difference
5. Get routine blood pressure screenings
6. If diabetic, controlling blood sugar reduces cardiac risk (Wikipedia, 2008).

CAD is becoming a growing problem in America. Making lifestyle changes can drastically reduce our risk.


References

American Heart Association. 2008.

retrieved Feb. 8 2008

Coronary Artery Disease. Wikipedia the Free Encyclopedia. Feb. 7 2008

retrieved Feb. 8 2008

Mauk, K. L. (2006). Gerontology Nursing: Competencies for care. Sudbury, Massachusetts: Jones and Bartlett

Notes: This blog post reflects the work of Carla Hurt RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Recognizing Elder Abuse

By: Carla Jenkins RN

What is Elder Abuse?

Have you or someone you know been a victim of elder abuse? Do you know what elder abuse is? Do you know where to report suspicions of elder abuse?

Elder abuse is often defined as a single or repeated act, or as a lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.

How big of a problem is Elder Abuse?

It is estimated that only 1 in 10 cases of elder abuse are actually reported. Every year an estimated 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect.

Where should Elder Abuse be Reported?

In almost all states, reporting of elder abuse is mandatory. It should be reported to the Adult Protective Service Agency, Department of Aging or other state mandated agencies. Abuse occurring in nursing homes and assisted living facilities should be reported to the Ombudsman program.

Types of Elder Abuse

There are several types of abuse of older people that are universally recognized as being elder abuse and include:

• Physical

• Psychological

• Financial

• Sexual

• Neglect

Once the report is made, ascertain if the person is in immediate danger, law enforcement may be needed. Ensure that there is a safety plan. Elderly persons referred for suspected abuse are at increased risk of injury due to retaliation.

References

http://www.dmoz.org/Society/Issues/Violence_and_Abuse/Elder/

http://www.en.wikipedia.org/wiki/Elder_abuse

http://www.karisable.com/elderabuse.htm

Mauk, K.L. Gerontological Nursing Competencies for Care.(2006). Salisbury,Mass. Jones and Bartlett.

Notes: This blog post reflects the work of Carla Jenkins RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Nurses Know! - Should I get a flu vaccine?

By: Lisa Dempsey RN

Many people are aware of the importance of young children receiving vaccines to prevent common childhood illnesses, but what about the older population? As well as very young children, the elderly more susceptible to illness. Annual vaccination against influenza is recommended for all adults 65 years of age or older (Mauk, 2006).

More than 90% of deaths from influenza occur in persons over 65 years of age (Mauk, 2006). In an average year, influenza causes 36,000 deaths and more than 200,000 hospitalizations in the United States.(mostly among those aged 65 years and older)(CDC). Influenza vaccines are available beginning every September until the end of December. The Centers for Disease Control recommend receiving the vaccine in October or November because influenza activity in the United States generally peaks between late December and early March(CDC).

There are a few "cons" to receiving the Influenza vaccine. There may be some mild side effects such as soreness to the injection site and a low grade fever for a few days after the injection(CDC). Influenza viruses change year after year, so it is necessary to get a "flu shot" every year. It is also possible that even after receiving the vaccine that a person may still get Influenza. That is because illness may be caused by a strain not protected by the vaccine.

There are certain people who should NOT get the Influenza vaccine. Those persons who are allergic to eggs or chicken, and those who have ever had Guillian Barre Disease. In such cases, the Influenza vaccine is CONTRAINDICATED(CDC).

Although there are "cons" to receiving the Influenza vaccine, the benefits greatly outweigh the risks. Get the Influenza vaccine every year and protect your health.

References

Mauk, K.L. Gerontological Nursing Competencies for Care.(2006). Salisbury,Mass. Jones and Bartlett.

Notes: This blog post reflects the work of Lisa Dempsey RN (pictured above) with minor editing by Shirley Comer RN and was completed as a class assignment. The information in this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.