Category: Senior Citizens

Tests and Treatments Older Americans Should Question

The American Geriatric Society (AGS) has released an updated list of recommendations that will raise awareness about treatments and tests that may lack efficacy and even cause potential harm. The list is part of the ABIM Foundation’s Choosing Wisely campaign. More than 70 societies have released recommendations of test and treatments that patients and providers should question.

The updated list from AGS reflects new research on conditions affecting older adults, such as agitation, certain types of cancer, delirium, dementia, diabetes, and insomnia. Based on new research and insights, these topics may warrant deeper discussions on the appropriate healthcare choices, according to AGS.

“Providing high-quality care to older adults means recognizing and responding to the specific, evolving challenges and opportunities that we all face as we age,” Wayne C. McCormick, MD, MPH, AGSF, president of the AGS, said in a statement. “Since 2012, the AGS and the ABIM Foundation have worked together through Choosing Wisely to synthesize pressing updates from the geriatrics field in a format that is easy to understand—and apply—in everyday practice.”

AGS has updated 7 specific tests, treatments, or procedures based on emerging expert opinion. For instance, lung cancer screening have been added to the list of oncological screenings that should not be recommended for older adults without first considering life expectancy and the risks associated with testing, overdiagnosis, and overtreatment. In addition, when recommending moderate blood-glucose control for older patients with diabetes, medications other than metformin should be avoided.

AGS continues to recommend avoiding antipsychotics as the first choice treatment for behavioral and psychological symptoms associated with dementia. This guidance has been expanded based on new data. The AGS panel of experts determined that antipsychotics provide “limited and inconsistent benefits” and include the risk of oversedation, worsening memory problems, and increased likelihood of falls, strokes, and mortality.

The Society also added new guidance:

  • Pursuing oral-assisted feeding for patients with advanced dementia instead of a “percutaneous” feeding tube threaded through the skin into the stomach
  • Not using antibiotics to treat patients who have bacteria in their urine (a condition known as bacteriuria) unless certain urinary tract symptoms are present
  • Conducting a treatment regimen review before prescribing medication

“As the older adult population in the US continues to grow, it’s so important that geriatrics care principles reflect the latest science, evidence, and advice supporting quality health and care,” said Paul Mulhausen, MD, MHS, FACP, AGSF, who chaired the AGS Choosing Wisely Workgroup responsible for the list. “We are grateful to the ABIM Foundation for this opportunity to share timely recommendations that will help patients avoid unnecessary tests and procedures and support overall well-being.”

Caring For a Person with Dementia

Dementia PatientCaring for people suffering from dementia, a broad term for a variety of mental health conditions that include loss of memory, impaired reasoning, personality changes and cognitive impairment. Alzheimer’s Disease, the most common form of dementia can be challenging and difficult both for caregivers and patient’s families. The inability of people suffering from any form of dementia to remember things, to communicate effectively with others and to take care of themselves, as well as their mood swings can be disconcerting. However, if such people are not taken care of, they may get injured, harm themselves or become depressed due to the feelings of loneliness.  To help caregivers and families assist senior citizens who suffer from dementia, we have listed down some ways to help them cope.

Ensure effective communication

People suffering from dementia often find it hard to effectively communicate with other people due an array of reasons. This may be due to the inability to find suitable words, speak fluently, to recognize and remember a person, to understand what the other person is saying, and the inability to read and write. They may also repeat sentences or stories several times. Following are some tips to overcome these communication barriers:

  • Get the person’s attention by limiting as many distractions as possible
  • Always introduce yourself first and address the person by his/her name
  • Communicate slowly in simple language using short sentences
  • Be patient if they do not understand you and slowly repeat your message or question
  • Give them time to process and understand your words
  • Do not get agitated and/or raise your voice
  • Listen carefully to them and try to understand what they are saying
  • Try not to argue with them or force them for anything. Instead, try to convince them by using compassionate behavior.   

Take care of their diet

While dementia affects a person’s memory, people who are losing their memory cannot take care of their diet and nutrition needs. Therefore, the family, friends and/or caregivers of such people need to make sure they are taking regular healthy meals, since the lack of nutrition can lead to several other health problems. To ensure this, provide them with multiple small meals throughout the day, opt for finger food if they have difficulty in handling the food, eat with them so that they do not feel alone and can also see and copy you.   

Monitoring their Medicine

Dementia patients many times will forget to take their meds. It is imperative that you make sure that your caretaker or other guardian is aware and prepared to assist the patient in taking their prescription medicine at the appropriate time.

Dealing with aggressiveness and troubling behaviors

The behavioral and personality changes that come with dementia are most difficult to handle. Patients can have sudden outbursts and get really aggressive at times, which makes it really difficult for the family and caregivers to handle them.   To deal with such issues, the foremost step should be to find out their causes and triggers and try to avoid such situations as much as possible. Consult the patient’s doctor in case of fierce behavior or reactions. Also, make sure nothing is within the patient’s access where they can use to harm themselves or others in case of a sudden anger attack.

Following the above-mentioned suggestions may help you be able to take care of dementia patients easier, but it is also highly suggested that you stay in touch with a doctor or other medical professional to confirm what you are doing with this particular person is the correct action to take.