Over 13% of the population of the United States is 65 years of age or older. Caring for ourselves as we grow older is challenging. Oftentimes, care of the older adult involves children or relatives. They often assist in day-to-day activities such as house cleaning and shopping, driving their loved-ones to appointments, offering financial support, and providing companionship.
Health concerns can change as we age, too. For instance, it is uncommon for a young person to have osteoporosis, but it is a common diagnosis in women over age 70. Eye diseases, often painless, can rob senior citizens of their vision. Falls and injuries can result in significant injury, including fractures and bleeding in the brain (hemorrhages). Therefore, it is wise to be aware of the most common conditions affecting senior citizens, and the steps that can be taken to protect us and our loved-ones.
Nutrition. Nutritional concerns in the elderly include lack of money for purchasing groceries, lack of motivation for cooking a meal when living alone, and loss of taste leading to a poor appetite. Try sharing a meal with a friend, going to social gatherings in the community or at your church, or eat with family.
Physical activity. As we grow older, it is very important to continue physical activity. Even a daily walk of 15-20 minutes can be very helpful. Many health clubs have a low-cost plan for senior citizens. Oftentimes, clubs will have a warm-water pool, which can be an ideal way for a senior citizen to get exercise, while limiting the stress on joints.
Falls and injuries. This is one of the greatest concerns for senior citizens. Falls can result in broken hips, hospital stays, and a reduced quality of life. Oftentimes after a fall, the person never returns to his or her prior functioning. Therefore, fall prevention is essential. Remove all loose rugs from your home, and have grab bars installed in your bathrooms. Every stairway should have a handrail, even if it has only a few steps. Every stairway should be well-lighted.
Sleeping pills. Many senior citizens have difficulty sleeping. Some of them use sleeping pills to help with sleep. However, there is a risk with sleeping pills, in that they can make a person so drowsy that they are unable to travel safely to the bathroom in the middle of the night. Whenever possible, avoid the use of sleeping pills.
Vision. As we grow older, the risk for eye diseases increases, including macular degeneration, cataracts, and glaucoma. These diseases are painless. Therefore, it is wise to have a dilated eye examination each year. If you need a referral for an examination, talk with your doctor. Keep your prescription for eyeglasses current. Poor vision can lead to falls and injuries.
Hearing. Loss of hearing is common in the senior citizen. The greatest concerns are the inability to hear fire alarms in your home or sirens on the road. It is also important to hear other things as well, such as instructions from your doctor regarding how to take your medications.
Arthritis. Pain in the joints from arthritis can make it difficult for the senior citizen to move about freely. Sometimes stiffness and pain in the joints leads to the need for pain medications. Such medications can cause drowsiness and falls. This is especially true when a person takes the pain medication prior to going to sleep, and then awakens in the middle of the night and has to use the bathroom. Discuss your arthritis pain and pain medications with your doctor.
Cancer. Senior citizens with cancer can feel sick from chemotherapy treatments, have nausea or vomiting, or generally feel weak. Any of these symptoms can lead to falls and injuries. If you are in the midst of chemotherapy, consider having a friend or family member with you in your home or available at a moment’s notice the day or two following treatment.
Parkinson Disease. Parkinson’s disease is a movement disorder. Symptoms can include a tremor in the hands, difficulty when starting to walk, and a jerking motion with footsteps. Individuals with Parkinson’s need to be aware that they have a high risk for falling. It can be tremendously helpful to wear a safety device that automatically calls for help when a person falls, or to use a device that allows a person to push a button when they need help.
Incontinence. Incontinence can lead to several concerns. A person with incontinence might find that they do not want to leave the house. This can lead to depression, and loneliness. The body fluids that leak can also lead to rashes of the skin, and sores. Discuss incontinence with your doctor. There may be treatments that will improve your symptoms.
Dizziness. The greatest concern with dizziness is that a person is more likely to fall. If you suffer from dizziness on a regular basis, talk with your doctor. It may also be wise to have a bed that is lower (closer to the ground), and to have a cushioning mat on the floor. The mat will provide some protection if you do fall out of bed.
Hypertension (high blood pressure). Many, many senior citizens have high blood pressure. Uncontrolled blood pressure can lead to kidney failure, strokes and heart attacks. Blood pressure that is too low can result in dizziness. Therefore, it is vital for you to see your doctor regularly if you have high blood pressure. Your doctor will work with you to control your blood pressure and limit side effects, such as dizziness.
Diabetes. Many senior citizens have diabetes. Diabetes can lead to vision loss, numbness of the feet and loss of sensation in walking, heart disease, and episodes of dizziness from low blood sugar. Any of these symptoms can result in falls and injuries. See your doctor regularly if you have diabetes. It is beneficial to keep your diabetes in control, but as we grow older, sometimes it is wiser to have a slightly higher goal for your hemoglobin A1c than when you were younger.
Medications. The average number of prescriptions taken by a person age 65-69 is fourteen, and for a person 80-84 it is 18! Juggling medications—and supplements—can be complicated and lead to further health problems. Use a pill-minder that will accommodate all of the medications you take in one week. Place your pills in your pill-minder once per week. Do not allow yourself to be interrupted when you are filling your pill-minder. If you need assistance in taking your medication properly, ask a friend or relative to help, or tell your doctor. Many assisted-living facilities provide this support to their residents, but people living alone may also need help. Also, ask your doctor if any medications can be safely eliminated.
Medicare health insurance. Every person with Medicare is entitled to have an Annual Wellness Visit (AWV) with his or her physician each year. For many Medicare supplemental plans, the patient is also allowed to have an annual preventive exam each year. Talk with your insurance company to determine what you are entitled to have. See your doctor at least once per year.
Advance Directives. Although every adult should have an Advance Directives document, it is especially valuable as we grow older. “Advance Directives” is a document that identifies what you would want done when you cannot make decisions for yourself. For example, if a person has a stroke, an Advance Directives document will help doctors and family members know what should be done for the person. The document will also identify the person who should make decisions for you, in the event you are unable to do so. Talk with your doctor about completing an Advance Directives document—it is indispensable for everyone, especially you!
Do Not Resuscitate (DNR) Directive. If you do NOT want aggressive measures taken to keep you alive, then it is essential that you have a DNR directive in place. Most states have a ‘community DNR’ bracelet that can be worn. It informs physicians, paramedics and health professionals that you do not want resuscitation measures taken on your behalf in the event of a life-threatening event such as a heart attack or severe stroke. A DNR directive can be revoked at any time.
If you do not have a primary physician or a medical home, you are encouraged to find one.
© Trinity Integrative Family Medicine, Inc., glkocourek Sep-2013; latest revision 09-May-2021