Newsletter

THE RISKS OF FALLING:

Falls are the leading cause of injury-related visits to hospital emergency rooms, and falls are a major factor in accidental deaths of people over the age of 65. According to a report in The American Family Physician journal, 70 percent of accidental deaths of those over age 75 are related to falls. More than 90 percent of hip fractures are caused by falls.

Common risk factors for falling include the use of sedatives, postural hypotension, the use of four or more prescription medications, and balance impairment.

A study published in the New England Journal of Medicine, found that risk of falling was reduced substantially either a combination of adjustment in their medications, behavioral instructions, and exercise programs aimed at modifying their risk factors.

Medications that increase the risk of falling include sedatives, hypnotic and anxiolytic drugs (especially long-acting benzodiazepines), tricyclic antidepressants, major tranquilizers (including phenothiazines and butyrophenones), antihypertensive drugs, cardiac medications, corticosteroids, and nonsteroidal anti-inflammatory drugs.

Best prevention tips:
Ensure regular medical assessment of prescription drugs, and make special note of the medications that tend to increase the risk of falling. Regular exercise and strength-building programs can reduce the risk. Watch out for other risk factors including medical problems with feet and legs, nutrition problems, or hearing and vision problems. Use a Home Safety Checklist to eliminate living-area risks such as throw rugs, poor lighting, and electrical cords on the floor.

I HATE FALLING:

(mnemonic for those who fall)
I     Inflammation of joints
H   Hypotension
A   Auditory/visual abnormalities
T    Tremor
E    Equilibrium problem
F    Foot problem
A   Arrhythmia or heart disease
L    Leg-length discrepancy
L    Lack of conditioning
I     Illness
N   Nutrition problem
G   Gait disturbance

Reduce the risk of falls:
Remove throw rugs. Secure carpet edges. Reduce clutter. Remove cords/objects from floors. Ensure adequate lighting. Install handrails on stairs. Eliminate chairs that are too low. Avoid floor wax.
Bathrooms:
Install grab bars. Use rubber mats in bathtub or shower. Install a raised toilet seat.
Outdoors:
Repair cracked sidewalks. Install handrails on stairs and steps. Trim shrubbery along walkways. Install extra lighting near doors.

DEHYDRATION: What you need to know

According to the Mayo Clinic, adults grow more susceptible to dehydration as they age. The sense of thirst is less acute, the ability to conserve water in the body is reduced, and the body is less able to respond efficiently to temperature changes.

Older adults do not eat as much as younger people do, and it's not uncommon to forget about drinking fluids — or even forget to eat. Chronic illnesses and the use of some medications can also increase risk factors for dehydration. Diabetes, especially if it's untreated or uncontrolled, greatly increases risks of dehydration. Other illnesses such as cystic fibrosis, kidney disease, and adrenal gland disorders also increase risks. Even a cold or a mild fever risks dehydration.

Symptoms of dehydration include:

Severe dehydration can cause a rapid heartbeat and low blood pressure, confusion and irritability, very dry skin and mucous membranes, lack of perspiration, and even unconsciousness or delirium.

According to Registered Dietitian Melinda Hemmelgarn at the University of Missouri-Columbia, dehydration is one of the most frequent causes of hospitalization for people over 65, and about half of those hospitalized for dehydration die within a year. A report published by the Oxford University Press noted a statistical association between serious dehydration and poor mental function.

What to watch for:
Remember that thirst is NOT a good gauge for dehydration. Check urine color for a better assessment:  light-colored urine indicates good hydration, but an amber or dark yellow color often means dehydration.

Prevention:
The old myth of needing 8 glasses of water each day is just that — a myth. Drinking too much water, in fact, can cause not only bloating but also hyponatremia, a condition of dangerously low blood sodium. Your best bet for preventing dehydration is to ensure the intake of plenty of fluids, along with foods high in water content — fruits and vegetables. "Letting thirst be your guide" will work for most healthy people, but seniors and people with illnesses or other risk factors should be carefully monitored for adequate intake.

Read our DEHYDRATION TIPS for a quick guide to prevention.

DEHYDRATION TIPS:

Adequate fluid intake comes from not just water but also other liquids and foods. Consider extra water or oral rehydration solution at the first sign of illness. Avoid ginger ale or other sodas — these contain excess sugar and too little sodium. Drink an extra cup or two of water before and after exercise. Don't drink too much water; this can cause bloating and can cause hyponatremia, a condition of dangerously low blood sodium. Drink extra fluids in hot or humid weather. Heated indoor air may also result in extra water needs.

Respite care for family caregivers

Millions of caregivers in the U.S. help family members, friends, and neighbors remain in their own homes when faced with illness, injury, disability, or just age. But caregivers themselves need care — even if it's just a break for some time to relax or catch up on other responsibilities in life. And, too often, caregivers don't get a chance for this time, or don't make the time, or can't figure out how to manage it.

One solution is respite care. Caregivers can find the help they need, while offering the reassurance that their loved one still receives the care and attention needed in the absence of the caregiver. According to the U.S. Department of Health and Human Services, adult day care programs provide both care and companionship to elderly or disabled persons who need help during the day. The program helps caregivers go to work, take care of personal business, or just find some time off to relax.

Caregivers can't adequately care for someone else when they become too tired or stressed out to provide good care. Accepting help from friends or other family members, or neighbors or church volunteers is important — and critical to the well-being of the person who needs care.

But what if no one offers to help? Many other options are available. In-home respite care offers four types of services:

1. Companion services to help a caregiver with supervision, entertainment, or just companionship.
2. Homemaker services to help with housekeeping, meal prep, and shopping.
3. Personal care services to help with bathing, dressing, exercise, and other personal care.
4. Skilled care services to help the caregiver with medical needs and services.

The Older Americans Act Amendments of 2000 (Public Law 106-501) established the National Family Caregiver Support Program (NFCSP), and funding is allocated to states and Area Agencies on Aging — along with other community service providers — to provide support for caregivers. Respite care can include services provided in a private home, in an adult day-care program, or over a weekend in a nursing home or assisted living facility.