Senior Health

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    The new medicines include 150 for diabetes, which affects 12.2 million Americans age 60 and older; 62 for eye disorders that contribute significantly to late-life disability; and 91 for Alzheimer’s disease, which could afflict 16 million people by 2050 without further advances in treatment. Other medicines target depression, osteoporosis, Parkinson’s disease, prostate disease, bladder and kidney diseases, and other debilitating conditions.

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    A Geriatrics Nursing, answered on behalf of

    If you suspect your elderly loved one may be having problems with memory, it's very important to have them evaluated sooner rather than later. There are many, many things that will mimic symptoms of Alzheimer's that could be treated, so don't let the fear of that diagnosis keep you and your loved one away from the doctor. I suggest either a neurologist or a geriatrician, if there is one near you, for a dementia work-up. You would need to have durable healthcare power of attorney so you can legally speak to the doctor about your parent, and they can relay information to you. If there are memory issues, then it's crucial that the doctor does not speak "over" the elder as if they are not there, or they don't feel the concerns warrant investigation. If the friends and family are seeing troublesome changes, then someone needs to accompany that elder to a physician who will do a proper dementia work-up. 

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    A , Internal Medicine, answered
    The absorption and metabolism of drugs can vary between the sexes and among different age groups. And aside from a drug’s side-effect profile, everyone has their own personal way of processing and responding to drugs. If you have ever had hives from head to toe after taking a new antibiotic you know what I mean. There are other factors to consider, too.

    As we grow older, chronic diseases are more likely to rear their ugly heads, so it’s not unusual for someone to be taking a few different drugs at once. That’s when it can get thorny because drugs interact with other drugs, over-the-counter remedies, and dietary supplements and even with certain foods. If you take six, you have over a 50% chance of a drug interaction.

    So it is always prudent to tell your doc (even your pharmacist) what other pills you are poppin’ so you avoid any dangerous combinations or reactions.
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    A , Neurology, answered
    The use of triptans is controversial in seniors because in rare cases these medications have been linked to ischemic heart disease and heart attacks. This concern is primarily limited to older adults and those with known heart artery blockages or definite coronary artery disease. The effects of triptans on the blood vessels that feed the heart were tested in an interesting study in patients with heart disease who were scheduled for an angioplasty procedure to dilate a constricted blood vessel around the heart. During the procedure, they were injected intravenously (IV) with a solution containing either a triptan medication or a comparison placebo. Overall, the diameter of the heart's blood vessel after IV of the triptan was constricted 4 - 7 percent with the triptan, and 5 percent with the placebo. A few patients had more substantial constrictions, up to 35 percent with the triptan and up to 22 percent with the placebo. This study supports the conclusion that the effects of triptans on heart arteries are relatively small, even in people who already have heart disease. Nevertheless, it is recommended that triptans not be given to anyone who has any significant risk of heart artery blockages or coronary artery disease.
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    A , Geriatric Medicine, answered
    If your loved one doesn't have a primary care doctor or if the current doctor isn't a good fit, you may need to help find a new one. The following tips may be useful:
    • Check with insurance providers first. While Medicare and Medicaid policies usually offer people free rein to choose doctors, some doctors won't take many, or any, new Medicare (or Medicaid) patients. On the other hand, most health maintenance organizations (HMOs) and other types of insurance restrict patients to certain preferred providers.
    • Ask around. Recommendations from friends, neighbors, and co-workers can give you important insights. Is the doctor easy to talk to? Does he or she return phone calls swiftly? How quickly can you get an appointment? Consider how available and open to questions a doctor will be.  If you would like to find a geriatrician, go the American Geriatrics Society Website  (http://www.healthinaging.org/public_education/physician_referral.php) to help find one in your area.
    • Schedule an initial meeting or phone call. Once you gather a few names, see if any of these doctors would be willing to hold an initial meeting or talk to you on the phone. (Some physicians will do meet-the-doctor visits, while others won't.) Preferably both you and the patient should attend. Ask plenty of questions: Does the doctor often see patients of this age or with these ailments? Is he or she comfortable working with other family members? How would any disagreements over medical issues be approached? At which hospitals does the doctor have admitting privileges? If a person is in a hospital or nursing home, will the doctor visit him or her there and help coordinate care? And, of course, any primary care doctor you choose should be board-certified in family or internal medicine.
    • Consider location. A primary care doctor should be able to provide local referrals, but sometimes the best care isn't available nearby. Research the options. Decide whether the promise of cutting-edge treatment is worth the travel required and, possibly, being separated from supportive family and friends at a difficult time. A local medical team may be able to arrange for an experimental treatment.
    • Ask about access to health information. Privacy law amendments to the Health Insurance Portability and Accountability Act (HIPAA) have repercussions for caregivers. Doctors and other health professionals are required by law to have written permission to share health and medical billing information with a third party.
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    A , Internal Medicine, answered
    Dr. Robin Miller - drugs and senior citizens

    People rely more on medications as they age -- but they're also more sensitive to drug side effects. In this video, Dr. Robin Miller flags the most important mistakes to avoid when it comes to drugs and the elderly.


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    Honest and sensitive communication between doctors, patients and families is the key to better health decisions.  As people get older, there are unique issues that may change the communication strategy.  For example, 30% of people over the age of 80 have dementia. In that case, communication must become a family affair. Also, because there is no single health professional whose responsibility it is to see the full picture of health in an older person, this full picture is often not communicated. You and your family need to know how each health issue will impact upon your overall health and quality of life.  Your doctor should describe your health issues in detail and what to expect in the future. Since you are the centre of the communication process amongst a number of health professionals, it is up to you to ensure that you receive a full and comprehensive picture from each one in a manner that creates a “true picture” for decision making.  You are encouraged to bring as many of the health professionals into the same room at the same time with your family to build an integrated foundation of information for decision making that directly represents the elderly person.
     
     
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    A Family Medicine, answered on behalf of

    A family doctor can be an excellent choice for providing your healthcare if you are elderly. Many doctors who specialize in family medicine have patients who range in age from newborn to elderly.

    Some family doctors provide healthcare services to all members of a family regardless of age or gender. Your family doctor can act as the quarterback of your medical team, overseeing your care and referring you to other specialists when necessary.

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    A , Nursing, answered

    Regardless of how old you are, it's a good idea to have someone go with you to a physician appointment.  But, with patients who are elderly, and who often have multiple, chronic healthcare issues going on, it's critical.  Too many mistakes in understanding have caused unnecessary problems down the road for many an older patient!

    Elderly patients may not be able to hear what is being said, they may be too shy to ask the physician to repeat things, and they often just agree with whatever's being offered without asking any questions.  This is not a recipe for a good physician/healthcare interaction.

    Having someone accompany the patient who is willing to speak up, ask questions, slow the physician's pace down so that there is time for the patient to understand and who can answer for the patient if he/she can't, is absolutely necessary.  We often are engaged by children of elderly parents who are concerned that their parents is "not getting the whole story." Our experience is that parents are relieved to have a nurse with them.  With their consent, we can relay important information to their children so that everyone is on the same page!

     

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    A , Geriatric Medicine, answered
    Find out who the owners of nursing care facility are. Is this a for-profit or not for profit organization? Is it family owned or corporate run? Who are the investors? What are their motives? Dig a little and find out. Do these people / corporations have a history in long-term care? How long have they owned the particular facility? How often has the facility changed ownership hands? Is it for sale currently? Has the firm divided into smaller corporations insulating it from liability? That is a big red flag.