Older adults take more medicines and are more likely to have problems due to using them. Medicines should be avoided if possible. But pain is also more prevalent among seniors and medicines are the most effective way to control pain. This post will be part 1 about medications for chronic pain in older adults. Let’s start with some basic concepts: Acetaminophen: “Pain Relief You Can Count On”, Partly True Acetominophen has been the most common over-the-counter pain reliever since the 1970’s. (Outside the United States it is called paracetamol). The most well-known brand is Tylenol. It […]
Category Archives: Geriatrics with Aloha
It hurts so much I can’t walk
“My 82-year-old Mom has had back pain for decades. She had back surgery, but the pain came back after 5 years. Then she had kyphoplasty but that only helped for about a year. Since then, she’s had injections and taken many pain medications including narcotics. Sometimes I think she’s drugged. Now she also has neck pain. She’s investigating stem cell therapy. What do you think?” Stem cell therapy has been used for degenerative disc disease of the back. The intent is to grow cells that restore the disc and decrease inflammation. Patients with less severe […]
What should I do when I see a pressure sore?
Pressure sores need close attention as soon as they are noticed. This post discusses the management of Stage I and II pressure sores. At these stages, the skin is not broken open or the wound is very shallow. With good care, these wounds should look much better within a week. Follow-up with a healthcare provider is needed if there is no improvement. This is especially true for patients with diabetes or any advanced illness.
Protect the Heels
Thirty percent of serious pressure sores are on the heels. These ulcers occur among people who cannot move their feet. This could be due to a stroke, leg injury or inability to walk.
How to Prevent Pressure Sores
This post is about prevention of pressure sores among people who are at risk. There are four key aspects: 1) Take good care of the skin. 2) Avoid weight loss. 3) Avoid continuous pressure on any part of the body. 4) Use pressure reducing surfaces/cushioning while in bed or sitting.
Yikes, a skin tear!
In my last post, I discussed preventative care for fragile skin. But even with extra care, skin tears happen. Healthy skin stretches when bumped or pulled. Fragile skin rips open. This is especially common on the forearms and calves. We managed many skin tears in our clinic. In fact, we had a ready to go skincare equipment tray. There’s a right way and a wrong way to manage a skin tear. This post will cover both. We saw skin tears managed the wrong way all too often. When a skin tear isn’t managed correctly it […]
I’m always worried about her skin; it gets bruised just like that
Do you know of, or care for, someone who has skin as thin as tissue paper? Even a slight pinch or an accidental bump can result in a skin tear that just bleeds and bleeds. Large brown spots called hemosiderin spots can form on the skin over time (1). That’s when blood gets into the skin but is not completely reabsorbed. Residual iron from the red blood cells results in the brown color. Damage to the skin can also result in irregular white scar tissue that is not elastic and pulls at the skin (2). […]
“Doing Good” What Services Does a Caregiver Need
Melanie became a caregiver “all of a sudden”. It started two years ago when her tech savvy husband couldn’t use the TV remote control. At 77, he was diagnosed with Alzheimer’s Disease. Things have changed dramatically since then. Now, much of what he says doesn’t make any sense. In addition, he fractured his hip and is unsteady on his feet. He can’t be left alone. It has been a huge adjustment for Melanie. She was desperately looking for hired help at home and found a person who was compassionate, skilled, and dedicated. She was thrilled. […]
2023: The Year in Caregiving
1. Home and community-based healthcare are definitely coming to the forefront Most care of frail older adults happens in the home and community. Up to now, the healthcare system has not acknowledged this reality. Healthcare has been based in the clinic, hospital, and nursing facilities. The result has been intense care in those settings and few services in the home. Caregivers receive little support. We are now at a turning point. The importance of home and community-based services is finally being recognized. Providing more healthcare in the home setting is good news for frail older […]
Doing Good: What matters to a frail older person?
Susan has had a fulfilling life. As a woman, she made it in the world of architecture and became quite successful. She raised 3 children and had many friends. She enjoyed golf and swimming. But life took an unexpected turn at the age of 75. Even though she had few risk factors, she started having memory problems. She was eventually diagnosed with Alzheimer’s Disease. In a few short years, Susan has declined quite a bit. She is now frail. Her gait is unsteady, and she has fallen many times. One fall resulted in a hip […]