The information in this book is intended for general information. The information does not imply an endorsement of any drugs or medical procedures. This book is not a substitute for medical advice from a doctor. Always consult a physician about all issues relating to your health.
Chapter 1. What Does It Mean to Grow Old?
Why we age has been a question that has confused humankind throughout
history. We simplify many of the complicated concepts regarding the molec-
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Chapter 2. What Happens to Our Bodies as We Age?
Many changes to the different organ systems occur with aging.These age-related
changes increase the risk of many common health issues that seniors face.
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Chapter 3. The Real Truth about Preventative Medicine
What steps can you take to lead a healthier life? We describe the major pre- ventative tests that are currently available. Some tests are simple and may lead to interventions that allow you to live longer and healthier. Other tests may be expensive, involve potential complications, and/or have no proven benefit. We will tell you which ones are appropriate for both the healthy and the frail older adult.
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Chapter 4. The Facts about Anti-aging Therapies
There are many products that claim to reverse aging and improve one’s memory, strength, and sex drive. We will give you the tools you need to ana- lyze these claims for yourself.
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Chapter 5. Do I Need Hormone Replacement Therapy?
We review the latest research regarding the effectiveness and potential side effects of “anti-aging” hormones (growth hormone, testosterone, and DHEA).
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Chapter 6. Which Vitamins and Herbal Supplements
Should Seniors Take? Millions of seniors take vitamins, herbs, and other supplements for the pre- vention of specific diseases and to improve their overall health. We will tell you which of the thousands of products available have been shown to be ben- eficial for seniors. We also discuss the theory that calorie restriction may help you live longer.
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Chapter 7. The Real Truth about Exercise
It is well known that exercise is good for the mind as well as the body. How- ever, knowing which exercises are safe and effective for older adults is not so simple. An exercise routine designed for young adults may lead to injuries for seniors. This chapter will review the precautions that elderly patients need to be aware of before starting an exercise program.
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Chapter 8. Avoiding the Common Dangers of Medications
Seniors account for about 12.5 percent of the population but they consume over 30 percent of all prescription medications. Medication problems are common. This chapter will provide an explanation of:
• why many seniors are prescribed too many drugs
• why seniors are at an increased risk of medication side effects
• which drugs are considered dangerous for seniors to use
• the potential problems with the Medicare Part D prescription benefit
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Chapter 9. Emerging Trends of Healthcare for the Elderly
As people live longer, there will be more people who are unable to take care of themselves. Many seniors will need to be moved to assisted living facilities or to nursing homes. Today’s hospitals and nursing homes are far different from those of yesteryear. These facilities are now taking care of patients who are older, frailer, and sicker than ever. This chapter discusses the major changes in our healthcare system and its impact on the frail elderly. We also discuss other options for long-term care besides nursing homes.
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Chapter 10. Making the Most of Your Doctor’s Visit
Today’s doctors are expected to see more patients in less time. Elderly patients with multiple health problems may be uncomfortable with this fast-paced set- ting. This chapter will provide you with valuable tips to help you maximize the limited time you have to see your doctor.
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Chapter 11. Whom Can I Turn to for Help?
Many different healthcare professionals are involved in the care of the elderly. This chapter defines the level of training and the responsibilities for each of the following professions and how they can help your elderly parent:
• case managers
• dieticians
• home health services
• pharmacists
• physical/occupational/speech therapists
• physicians
• nurse assistants
• nurses
• social workers
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Chapter 12. Why Do Some People Hate Nursing Homes?
Many older adults fear being placed in a nursing home more than they fear death. The perception by many in the public is that nursing homes are dirty places where residents are abused, neglected, and left to die. This chapter explores the reasons why so many negative stereotypes exist. Many resources that discuss how to choose a nursing home provide inaccurate and misleading information. We provide the reader with a realistic list of issues to consider when choosing a nursing home.
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Chapter 13. Dangers Encountered when Seniors Are Transferred to the ER or Hospital
Millions of older adults are hospitalized each year. While hospitals provide lifesaving care for millions of Americans each year, these medical centers are often dangerous places for frail elderly patients. The modern hospital is an unfamiliar environment that can be especially frightening for those with dementia or poor vision. The hospitalized senior is at high risk for becoming delirious, falling, developing bedsores, and acquiring antibiotic-resistant infections. Knowing whom to turn to for help or for answers to your questions can often be difficult to figure out. This chapter will provide the reader with insights into how the modern hospital system works and what to expect.
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Chapter 14. Falls are a Serious Problem
Falls are common and may lead to a variety of injuries, including head injuries and hip fractures. Falls usually do not have one single cause but rather are the result of a complicated process involving a variety of age- related body changes, environmental factors, and medical conditions. This chapter will discuss the things you can do to lower your risk of falling.
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Chapter 15. Osteoporosis and Broken Bones
Osteoporosis weakens your bones. In many cases it can lead to fractures of the bones in the hip, spine, and wrist. This chapter explains how osteoporosis is diagnosed and what you can do to slow down the effects of this disease.
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Chapter 16. Why Is Rehab So Important?
Many seniors are sent to nursing homes for rehabilitation. Others may receive therapy at home or at an outpatient center. Their progress will often deter- mine to what extent they will be able to take care of themselves once they recover. This chapter will discuss:
• the basic structure of a rehab program
• the special issues involved with rehabilitation following hip or knee surgery
• the prevention of contractures
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Chapter 17. Helping Patients Move around Safely
Family and caregivers need to know how to safely help frail older adults with basic activities of daily living. We will also discuss the proper use of mobility aids (walkers, canes, and wheelchairs).
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Chapter 18. Minimizing the Risk of Infectious Diseases
The elderly are not only at higher risk for developing infections, but they are also more likely to die from infection. This chapter will discuss causes and treatments of the four most common infections in the senior population:
• infectious diarrhea
• pneumonia
• skin infections
• urinary tract infections
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Chapter 19. How NOT to Lose Weight!
Malnutrition and starvation are terms that elicit strong emotions and suspicion of abuse or neglect. Such suspicions do not reflect the truth regarding malnutrition in the frail elderly. Malnutrition is often the result of multiple poorly understood agerelated organ changes, medical illnesses, and psychological issues. This chapter will discuss the difficulties in evaluating this problem. It will also provide an overview of current treatments.
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Chapter 20. The Truth about Feeding Tubes
Feeding tubes were initially developed for use in children and in patients with cancer of the throat and esophagus. Today, they are often used to provide nutrition to elderly patients with end-stage dementia. There are many misconceptions on the part of families and even many healthcare professionals regarding the benefit of this “medical intervention.” Feeding tubes can lead to a variety of medical complications.
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Chapter 21. Taking Care of Older Adults Who Are Incontinent
Anywhere from 40 to 60 percent of frail older adults cannot control their urine and have urinary incontinence. Risk factors for urinary incontinence include a variety of age-related body changes, medical illnesses, and medica- tions. It is important to identify which of the several forms of urinary incontinence the patient has since the treatments vary.
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Chapter 22. Depression Can Be a Real Bummer
Depression is often difficult to diagnose in the elderly. Older adult patients may only exhibit signs of anxiety or physical symptoms, such as weakness, fatigue, or pains in the abdomen, chest, or back. Patients with dementia may not have any complaints but manifest their depression in the form of a variety of abnormal behaviors. This chapter will discuss the difficulties in diagnosing depression in this population, as well as the importance of treating this disease. An explanation of the common medications used to treat depression will be reviewed. Misconceptions regarding electroconvulsive therapy will also be discussed.
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Chapter 23. Can Dementia Be Prevented or Treated?
By the age of eighty-five, 40 percent of people will have a diagnosis of dementia. While Alzheimer’s disease is the most common cause of dementia, other forms do exist. In this chapter we discuss the major categories of dementia. We also discuss current therapies for the prevention and treatment of dementia.
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Chapter 24. Treating the Behavioral Problems Associated with Dementia
Most patients with dementia will eventually exhibit one or more abnormal behaviors. In fact, for many families it is the behavioral problems rather than the loss of memory that is most troublesome. This chapter will give you the insights you need to address the following behavioral problems:
• agitation
• anxiety
• depression
• hallucinations/delusions
• sleep disturbances
• wandering
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Chapter 25. Difficulty Sleeping
This chapter will explain why so many seniors have trouble sleeping. A variety of age-related body changes, medical illnesses, and medications play a role in this common problem. Sleep problems can often be addressed without the use of medications. If you do need medication, be careful! Many sleep medications have harmful side effects.
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Chapter 26. Why Do People Get Bedsores?
Bedsores, also known as decubitus ulcers or pressure ulcers, frequently occur in the nursing home or hospital setting.Many people are appalled when they hear that these bedsores were “allowed to happen.” Many books will tell you that bedsores are usually the result of poor care. This chapter will explain the real reasons why some frail elderly develop bedsores. We will explain why they are not only difficult to prevent but also difficult to treat.
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Chapter 27. What Can Be Done to Control Pain?
Pain is a serious problem that affects the majority of frail older adults. Too often, pain is not addressed because it’s thought to be a normal part of the aging process. The failure to address pain can have serious psychological and health consequences. This chapter will discuss:
• what you need to know about the benefits and potential side effects of commonly used pain medications
• other available treatment options
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Chapter 28. Growing Old Is Expensive
The longer you live, the more money you will need for your retirement. Increasing healthcare costs and inflation make financial planning difficult. Most people are not ready. This chapter will tell you what to expect and how to prepare for this financial challenge.
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Chapter 29. When Is It Time to Give Up Driving?
We discuss the factors that place some older drivers at risk for auto accidents. Many of these factors are quite subtle and may be difficult to recognize. Wewill provide tips for recognizing if there is a problem. We will also give advice on what to do once a problem is recognized.
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Chapter 30. What You Need to Know before You Travel!
Following retirement, many older adults have more free time to visit family and to travel. Whether they will be spending several months in another city with family or vacationing in exotic locations, they need to consider impor- tant health issues.
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Chapter 31. Are You Prepared for a Hurricane or Other Disaster?
With millions of seniors living in Florida, the Carolinas, and the Gulf Coast, the threat of hurricanes is something that we can no longer ignore. The affected regions usually have several days to prepare. Other disasters, such as earthquakes and terrorism, occur without any warning. Having a disaster plan may mean the difference between life and death. This chapter will give the information that seniors need to survive.
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Chapter 32. The Time to Discuss End-of-Life Issues Is Now!
Advanced directives allow patients an opportunity to express their healthcare wishes before they are no longer able to make those decisions for themselves. Advanced directives can take many forms, such as a living will or a health- care surrogate. This chapter will review the important issues regarding the different types of advanced directives. We will also discuss how patients are assessed for their decision-making capabilities.
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Chapter 33. The Dying Process Death is a reality we all must eventually face.
The last days can be quite frightening for family members to watch. For many, this can be a difficult time that is full of fear and guilt. This chapter will discuss how hospice can help both the patient and the family. We will review what to expect and what can be done to try to make the patient more comfortable.We will also discuss many of the misconceptions surrounding the dying process with regard to issues, such as withdrawal of care, dehydration, difficulty breathing, and the use of narcotic medication.
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