Health tips for the older adult

Urinary Tract Infections

     

Urinary   Tract Infections in the Elderly

Urinary tract infections (UTI) aren't just a nuisance – they can cause serious health problems. A urinary tract infection happens when bacteria in the bladder or kidney multiplies in the urine. Left untreated, a urinary tract infection can become something more serious than merely a set of uncomfortable symptoms. UTIs can lead to acute or chronic kidney infections, which could permanently damage the kidneys and even lead to kidney failure. UTIs are also a leading cause of sepsis, a potentially life-threatening infection of the bloodstream.

Urinary Tract Infections in the Elderly

The population most likely to experience UTIs is the elderly. Elderly people are more vulnerable to UTIs for many reasons, not the least of which is their overall susceptibility to all infections due to the suppressed immune system that comes with age and certain age-related conditions According to the National Institutes of Health (NIH).

Younger people tend to empty the bladder completely upon urination, which helps to keep bacteria from accumulating within the bladder. But elderly men and women experience a weakening of the muscles of the bladder, which leads to more urine being retained in the bladder, poor bladder emptying and incontinence, which can lead to UTIs.

Symptoms of UTIs

The typical signs and symptoms of a UTI include:

· Urine that appears cloudy

· Bloody urine

· Strong or foul-smelling urine odor

· Frequent or urgent need to urinate

· Pain or burning with urination

· Pressure in the lower pelvis

· Low-grade fever

· Night sweats, shaking, or chills

·  

Elderly people with serious urinary tract infection don't exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. In fact, elders often don't exhibit any of the common symptoms – or don't express them to their caregivers.

Elderly people with serious urinary tract infection don't exhibit the hallmark sign of fever because their immune system is unable to mount a response to infection due to the effects of aging. In fact, elders often don't exhibit any of the common symptoms – or don't express them to their caregivers.

UTIs in the elderly are often mistaken as the early stages of dementia or Alzheimer's, according to NIH, because symptoms include:

· Confusion, or delirium-like state

· Agitation

· Hallucinations

· Other behavioral changes

· Poor motor skills or dizziness

· Falling

Sometimes, these are the only symptoms of a UTI that show up in the elderly—no pain, no fever, no other typical symptoms of a UTI.

Why Do the Elderly Develop UTIs?

According to NIH, the following conditions make the elderly more susceptible to UTIs:

· Diabetes

· Urinary retention (unable to empty the bladder, even if your loved one has just used the bathroom)

· Use of a urinary catheter

· Bowel incontinence

· Enlarged prostate

· Immobility (for example, those who must lie in bed for extended periods of time)

· Surgery of any area around the bladder

· Kidney stones

How to Reduce Risk of UTIs

People with incontinence are more at risk for UTIs because of the close contact that adult briefs have with their skin, which can reintroduce bacteria into the bladder. Some recommendations to help reduce this risk include the following:

· Change the briefs frequently

· Encourage front-to-back cleansing

· Keep the genital area clean

· Set reminders/timers for those who are memory-impaired to try to use the bathroom instead of the adult brief

Other ways to reduce the chance of UTIs:

· Drink plenty of fluids (2 to 4 quarts each day).

· Drink cranberry juice or use cranberry tablets, but NOT if your elder has personal or family history of kidney stones.

· Avoid caffeine and alcohol, because these irritate the bladder

· Do not douches or use other feminine hygiene products

· Always wipe from front to back (for women)

· Wear cotton-cloth underwear, and change them least once a day

Chair Exercises

  

Chair Exercises to Strengthen Legs:
These are suggestions. It is ALWAYS best to consult a Physical Therapist first.

Chair exercises to strengthen legs can be done by all age groups. The exercises are versatile enough to be done either standing up or sitting down. They can be used during rehabilitation programs or in everyday exercise routine. The exercises improve, maintain and strengthen muscle tone while increasing your sense of balance. According to Sit and Be Fit, your overall vitality will improve.

Strengthening your buttocks will help you increase your overall leg muscle strength. A basic standing chair exercise involves you holding onto the chair for balance. Breathe out and gently lift one leg straight back behind you. Do not bend your knee or point your toes. Slightly bend the leg you are standing on. Avoid leaning forward. Hold. As you breathe in, slowly lower your leg. Repeat 10 times, then repeat with other leg.

Quadriceps (thigh muscles)

o A basic exercise to strengthen your quadriceps is to sit up straight in a firm chair. Your feet should be firmly planted on the floor. Roll up a towel and place it underneath your thigh for support. While breathing out slowly, gently extend your leg in front of you. Straighten as much as possible, but do not lock your knee. Flex your foot to point your toes toward the ceiling. Hold. Breathe in and slowly lower your leg back to original position. Repeat 10 times with same leg. Alternate legs and repeat.

Knee

o A sitting chair exercise to strengthen the muscles surrounding your knee can be done by using isometrics. Cross your legs above the ankles. Keep your feet on the floor. Push forward with your back leg and press backward with your front leg at the same time. Pressure should be evenly distributed so your legs do not move. Hold for 10 seconds. Rest. Repeat.

Lower Leg Muscles

o A basic toe lift will strengthen your calf muscles. Sit in a firm chair. Place feet firmly onto floor. While keeping your heels on the floor, lift your toes up. Hold for 3 seconds. Lower back to original position. Be sure to keep your hips straight during this exercise.

Another beginning chair exercise for strengthening the calves and ankles consists of standing up while holding onto the back of a firm chair. Place your feet shoulder-width apart. Use the chair for balance. As you breath out, slowly stand up onto your tiptoes. Hold. Breathe out as you lower yourself to original position. Repeat 10 times. Rest. Repeat.

Hamstrings

o A basic chair exercise for hamstring strengthening involves sitting in an office chair with wheels. On a flat surface, such as linoleum, pull yourself around the room. Start out with three minutes. Rest. Repeat.

A standing knee curl is another chair exercise to strengthen your hamstrings. Hold onto the chair for balance. Lift one leg straight back. Gently bend your knee while bringing your heel up towards you buttocks. Hold. Return to original position. Repeat.


 https://www.sitandbefit.org/category/exercises/  

Balanced Diet

  

Maintaining a Healthy Weight

Keeping a healthy weight is a worthwhile goal at any age. As you get older, it can get trickier.

Keep a food journal: Write down what you eat every day for at least 2 weeks. Discuss your journal with a Nutritionist or Registered Dietician.

You might not be burning calories like you did when you were younger, but you can still take off extra pounds.

The golden rules of weight loss still apply:

  • Burn more calories than you eat or drink.
  • Eat more veggies, fruits, whole      grains, fish,      beans, and low-fat or fat-free dairy; and keep meat and poultry lean.
  • Limit empty calories, like sugars and foods with      little or no nutritional value.
  • Avoid fad diets because      the results don't last.

There are some other things you need to do if you're over 60 and want to lose weight.

1. Stay Strong

You lose muscle mass as you age. Offset that by doing strength training. You can use weight machines at a gym, lighter weights you hold in your hands, or your own body weight for resistance like in yoga or Pilates. Keeping your muscle mass is key to burning more calories.

2. Eat More Protein

Because you're at risk for losing muscle mass, make sure your diet includes about one gram of protein to every kilogram (2.2 pounds) of body weight. "Protein also keeps you full for longer, so that helps with weight loss efforts." She recommends salmon, whole eggs, organic whey protein powder, and chicken.

3. Hydrate, Hydrate, Hydrate (Unless you have cardiac issues such as Heart Failure, or Renal failure, check with your Physician).

Drink plenty of water. Sometimes, thirst masks itself as hunger. As you get older, you may not be as quick to notice when you're thirsty, Li says. She says you should get 64 ounces of water a day. You can drink it or get part of it from foods that are naturally rich in water, such as cucumbers and tomatoes. If you're not sure if you're getting enough water, check your urine: It should be pale yellow.

4. Outsmart Your Metabolism

Eat more small meals and snacks, and don't go much longer than 3 hours without eating. "Because your metabolism is already slow, if you're starving yourself, it just gets slower." You may need fewer calories than you did when you were younger. Ask your doctor or a registered dietitian about that. "If you're eating the same way you did when you were 25, you're definitely going to be gaining." 

Published by 

Joanna Li, RD, nutritionist, Foodtrainers, New York.

Cleveland Clinic: 

© 2014 WebMD, LLC. 

Safety in the home

  

BEING PREPARED FOR EMERGENCY SITUATIONS

If you wait until an emergency situation rears its head, it will already be too late. It is important to prepare in advance and not only take preventative measures but also have a plan in place if you need to exit your house quickly or get help.

FIRE SAFETY

Fire safety should be a part of any home safety checklist for seniors. Seniors are at higher risk than others when it comes to residential fires. The elderly are three times more likely to pass away in a residential fire than those who are younger.

Having your home assessed is necessary to determine what your smoke alarm needs are. Once you’ve had an assessment, you will know where you need smoke alarms and which rooms they need to be installed. Being educated when it comes to fire safety could wind up saving your life.

ARE THE ROOMS IN YOUR HOME SAFE?

A common misconception is that injuries occurring to seniors within their homes are usually related to falls on stairs or in bathrooms. Injuries and dangers within the home are not limited to falling, however, and can happen in many different ways. Home safety could potentially be at risk in almost any room in a given house. Any home safety checklist for seniors should include each part of the home.

BATHROOM SAFETY

The bathroom is one of the most common locations for injuries to occur within the homes of the elderly. Not only can injury happen in the shower, but the shower can also cause the floor to get wet which can create an unsafe/dangerous environment outside of it. These are a few of the things that should be tended to in the bathroom:

§ Tub or shower should be equipped with a non-slip surface

§ If the shower has doors, they should be made of safety glass or plastic

§ Grab bars should be installed both by the toilet and the bathtub

§ Towel bars should be sturdy and installed correctly

§ Flooring should consist of textured tile, a matte finish or should be covered with low pile commercial carpet

§ The lighting should be even, sufficient, and glare-free. The light switch should be near the door

§ Door should open outward

§ A ventilation system and safe, supplemental heat source

§ Outlets should protect from electric shock

§ A bath or shower seat should be accessible

STAIRCASE SAFETY

Climbing or descending a staircase can prove to be extremely dangerous even for healthy, middle-aged adults. It’s not hard to understand why so many seniors suffer injuries as a result of an unsafe, shoddy staircase. The stairs should be a part of any home safety checklist for the elderly. Here are some precautions that can be taken to make sure your staircase is as safe as possible:

§ Stair construction: Stairs should always be evenly built. If they are not dimensionally uniform, it exponentially increases the odds of tripping and falling

§ Stairs should be clear: This sounds obvious, but people leave things on staircases all of the time including books, papers, or shoes

§ Staircase lighting: Every staircase in your house should have sufficient lighting throughout so that you can clearly see each step

§ Maintenance: If carpet or tread is worn, it can be very dangerous and cause a fall. Replace any worn tread or carpet on your staircase immediately

§ Placement: Sometimes people are unaware of the presence of a stair in poorly lit areas or in parts of the home where the patterns and colors run into each other

§ Handrails: Every staircase should have a functional, sturdy handrail. Circular rails are best as they are easier to grip completely compared to rectangular rails

KITCHEN SAFETY

When it comes to a household safety checklist, the kitchen may be one of the last rooms in your house that you think to address. However, many accidents can occur in the kitchen, so it is imperative to check this list to make sure you are taking the proper precautions:

§ Your kitchen should be equipped with a fire extinguisher that is less than ten years old and is verified to work

§ The area around the stove should be clean and free of clutter. Grease, towels, potholders, and curtains are all examples of things that could easily catch fire

§ Ventilation and exhaust in the kitchen are paramount. Without proper ventilation, carbon monoxide or indoor air pollutants may accumulate and make the air unsafe

§ Never leave cooking food unattended. Anything on a stove top should be supervised at all times

§ All electrical appliances and cords should be kept away from the sink or anywhere there is water. Cords should also be kept away from hot surfaces

§ All countertop appliances such as toasters, coffeemakers, etc., should be protected by ground-fault circuit interrupters

§ A sturdy step-stool with a handrail should be on hand for reaching up onto shelves or high cabinets to retrieve items

BEDROOM SAFETY

Yes, even bedroom safety precautions are important to take and need to be a part of any home safety checklist for seniors. Injuries and accidents can happen in any room of the house, and the bedroom is no different than any other. There are steps you can take to ensure that your bedroom is as safe as possible:

§ Make sure there is an easy to reach light that you can get to from your bed

§ The path from your bedroom to the nearest bathroom should have enough lighting so that you can see if you need to get up in the middle of the night

§ Cords are a tripping hazard; if there’s a phone in your bedroom that is not within reach from your bed, you should consider moving it closer

§ If you wear eyeglasses, make sure they are also well within reach in case you need to get up in the middle of the night for any reason

§ A lamp or flashlight should be kept within range of your bed so that if you lose power for any reason, you have access to light

§ Have a sturdy chair with arms in your bedroom so that you can sit to dress if need be

§ Candles, ash trays, hot plates, or any other potential fire sources should be kept far away from curtains, furniture, beds, and bedding

LIVING ROOM/LIVING AREA SAFETY

Living rooms typically have televisions with cords, telephones, tables, chairs, and many other things in them that could potentially cause a resident to get hurt. You may also have a fireplace in your living room area which has safety concerns of its own. Here are a few of the things that should be a part of any elderly home safety checklist when it comes to the living room:

§ If you have a chimney and a fireplace, make sure it is evident before use. A clogged chimney can result in poisonous fumes and smoke entering the home

§ Check all rugs/carpet to make sure it is level with the ground. If either of these surfaces bunches up, they could cause you to trip and fall

§ Remove low coffee tables, foot rests or any other object that is low to the ground and blocking a clear path through the room

§ Do not run cords under a rug and keep all pathways clear of wires that could cause you to trip

Discard any furniture that feels loose or wobbly as it could create a safety hazard 

 https://www.shieldmysenior.com/home-safety-checklist-for-senior/ 

Dementia

 Dementia is not a single disease; it’s an overall term — like heart disease — that covers a wide range of
specific medical conditions, including Alzheimer’s disease. Disorders grouped under the general term “dementia” are caused by abnormal brain changes. These changes trigger a decline in thinking skills, also known as cognitive abilities, severe enough to impair daily life and independent function. They also affect behavior, feelings and relationships.

Alzheimer's disease accounts for 60 to 80 percent of cases. Vascular dementia, which occurs because of microscopic bleeding and blood vessel blockage in the brain, is the second most common cause of dementia. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Dementia is often incorrectly referred to as "senility" or "senile dementia," which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging. 

 https://www.alz.org/alzheimers-dementia/what-is-dementia 

Staying Healthy

Elder health starts as a young adult.

Establishing good habits earlier in life will hope to lead to a healthier you as an older adult.   Tips:

  • Eat healthy
  • Exercise
  • Maintain a normal body weight for you age and height.
  • Take medications as prescribed by your Physician or Nurse Practitioner
  • Visit your Physician, Nurse Practioner or Specialists regularly.
  • Maintain a healthy home. Clean and purge what you don't need!
  • Be active
  • Maintain he friendships and family relationships.