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Chronic Health Conditions and Safety Concerns for Seniors

Find additional information and resources at the DHS Public Health Web site:
Living Well with Chronic Conditions  


Overview

All persons, whether active or frail, can benefit from health promoting behavior and aggressive preventive care. Preventive care includes making sure nutrition, exercise, immunizations and routine screening tests are attended to. Caregivers also need to make sure glasses, hearing aids and mobility devices work. This kind of care is critical even if a person has a major illness or is very old.

Successful aging relies on many factors. One of the key factors lies with the individual. Individuals are responsible for adopting behaviors that will keep them healthy. Half of all deaths can be attributed to unhealthy lifestyles or modifiable behaviors. These include excessive alcohol consumption, tobacco use, physical inactivity, poor diet and absence of regular medical screenings. For example, regular walks help maintain strength, endurance, balance and a healthy heart. One is never too old to begin living a healthy life.

In this section, we have listed diseases that occur or become more complex to manage in old age. Our primary goal here is to link you to specialized Web sites and caregiver support groups. If, after searching these sites, you still have questions, please contact us, toll-free, at 866-219-7218.

Arthritis

Wear and tear on joints can produce changes leading to Osteoarthritis. The problem increases with aging. Younger joints move smoothly because there is a moist lining or membrane cushioned by underlying cartilage between the bones that form the joints. With wear and tear this cartilage cushion begins to deteriorate resulting in the development of osteoarthritis. Continued wear causes the underlying bone to change its shape, and this produces the arthritic deformity. Osteoarthritis is slowly progressive. Fingers, toes, knees, spine and hips are particularly susceptible.

The early changes of Osteoarthritis may cause no symptoms. Pain is the most common symptom associated with Osteoarthritis. Joints may be stiff in the morning. With movement, joints are painful, but they can be relieved by rest. As the disease progresses, changes on x-rays become evident.

For more information, see the American Arthritis Foundation.

Cancer

Skin, prostrate, breast and colon-rectal are examples of cancers that can occur in older persons. Symptoms, management and prognosis for each of these conditions vary. Caregivers should make sure that those under their care receive regular preventive screenings for cancer and that early signs of cancer are not dismissed as symptoms of age.

For more information, see the American Cancer Society, and Cancer Care Inc.

Chronic pain

Chronic pain is very common in older adults. Some conditions that are highly associated with pain include: neuropathy, shingles, arthritis, fractures, osteoporosis, trauma injuries, back/joint injuries, gout, cancer, diabetes and post stroke. A person who has pain needs a thorough medical assessment and ongoing pain management. Modern medicine can successfully treat pain. Health, independence and quality of life depend on the absence of pain.

Some common myths about pain and aging
Pain is to be expected as a normal part of the aging process. Not true. The presence of pain in older adults is not normal and is usually associated with a medical condition. It should be treated with the same aggressive approach that is used for younger people.

As people get older, their ability to sense and perceive pain decreases. Not true. Studies show that a person's ability to feel pain does not decrease with age or dementia.

A person who does not complain of pain must not have pain. Not true. People do not report pain for many reasons. They may fear that their pain is a sign of a worsening health or medical condition or they don't want to be a burden to their families or caregivers.

A person in pain will not be able to sleep. Not true. Experiencing pain regularly can be very tiring. People become exhausted from dealing with their pain. This can result in extended periods of sleep.

If you have pain, exercise is not good for you. Not true. Exercise helps to prevent muscle wasting and in some cases can prevent increased pain by conditioning your muscles.

How to recognize pain
Pain can be expressed in many ways. It can be identified by mood changes, facial expressions, physical movements or in non-verbal vocal expressions. It is especially important to watch for these non-verbal, behavioral forms of expression (such as hitting, restlessness, irritability) in persons who have communication losses associated with stroke or dementia. Pain needs to be viewed as the fifth vital sign. Just as we have our temperature, pulse, respiration and blood pressure taken as part of routine checkup, we should expect pain to be addressed as well. As a caregiver, you need to ask regularly to see if the person you care for is experiencing pain.

Pain is a personal experience. It can be measured and described only by the person having it. There are no laboratory tests or technical tools that can measure pain. Never dismiss or minimize an individual's reports of pain.

*Also see our Pain Management Program Web site.

Delirium

Delirium is the medical term for confusion that develops rapidly as a result of an adverse reaction to medications or is a symptom of an underlying illness. It is particularly common in elderly persons. Delirium may:

  • Decrease alertness impair awareness of the person's surroundings
  • Cause confusion or disorientation
  • Impair memory
  • Disturb sleep
Symptoms may be subtle (such as restlessness, lethargy, simple misinterpretations, and inattention) or dramatic (such as combativeness, paranoia, visual or auditory hallucinations).
There can be many causes of delirium. It can occur as a result of:
  • Infections
  • Metabolic disorders
  • Poor heart function
  • Small strokes
  • Temperature imbalance
  • Drug reactions
  • Urinary or fecal retention
Delirium develops quickly, typically within hours to days. Its severity usually fluctuates throughout the day. You may be easily fooled into thinking that the delirium has subsided. Caregivers are often the only persons who can identify mental status changes, the first clue to identifying and treating the underlying cause.

A physician needs to uncover health problems that have caused the delirium. Because delirium can be caused or aggravated by a variety of medications, be sure you provide the physician with a complete list of drugs, both prescription and non-prescription, that the person is taking. With proper management, the delirium usually clears in a few days; but in a few cases, it may persist for several weeks before responding to treatment.


Dementia

Dementia is a disorder of the brain. It involves the loss of memory and other mental functions. It can result from many different causes and can vary in its severity. Alzheimer's disease is one form of dementia.

It is important to have a complete diagnostic evaluation by a geriatrician or neurologist to identify the causes of the dementia. Excellent health care can help caregivers support and extend the quality of life for themselves and the person in their care. Symptoms of dementia may include:

  • Loss of memory, particularly recent memory.
  • Impairment of intellectual functions severe enough to interfere with a person's job, social life or both.
  • Change in personality.
  • Behavioral changes such as delusion, hallucination or depression.
  • Impairment of judgment.
  • Wandering
To learn more about early-stage Alzheimer's Disease see the Alzheimer's Association.


Driving

The process of growing older tests our independence in many ways. Often it seems that a driver's license is an official symbol of independence. Careful studies show that accidents increase for older drivers. The changes that occur with aging and its many associated diseases produce genuine impairment in some older drivers. Family members are often the persons who notice the first signs of unsafe driving habits.


Falls

Falls are a major cause of disability and death of senior citizens. More than one third of persons older than age 65 fall at least once each year. Injuries from a fall may range from bruises to life-threatening trauma. Head injuries and fractures of long bones lead the list of serious injuries. There may be a delay in the onset of the effects of head injury. Medical problems may predispose a person to suffer a fall. These problems can include:

  • Changes that decrease vision, particularly at night and in the dark
  • Neurological problems that cause weakness or affect stability and balance
  • Medications that cause imbalance, light headedness, decreased coordination or sedation
All falls merit some degree of evaluation. If the person has a health risk, a physician should be involved in the evaluation and any needed treatment. Even if no injury occurred, you should be concerned about why the fall happened and how to prevent more falls. A physician can help evaluate health-related causes. As the caregiver, you must evaluate environmental causes in the home. The home environment is responsible for more than one-third of all falls.

After a fall, elderly persons frequently restrict their activity because they fear falling again. This reduction in activity leads to loss of conditioning and further weakness which increases the risk of another fall. The elderly need encouragement and protected ambulation (such as a walker) after a fall to help them return to their normal level of physical fitness. 
 

Health care

The decline in health status that occurs as a result of aging is different for each individual. Disease, lifestyle habits, attitude, economic and social factors influence a person's health status as much as age. Needing help in everyday tasks is a reality of the aging process. It is important to provide health care in a way that maximizes an individual's independence and promotes their wishes.

*Also see: Other health related resources & Food & nutrition