Archive for January, 2012
Posted on January 31, 2012 - by Nurse Virginia
STRESS RELATED CONDITIONS IN THE ELDERLY – ALOPECIA/SHINGLES
(PART III)
Louise could just as easily have developed Shingles after her emotional stress. (See part I) All of the potential was there. Louise had had Chickenpox as a child. Only people who have had Chickenpox get shingles, as it is the same virus. After having Chickenpox the virus lies dormant in your nervous system, near your nerve endings. It can be many years later that something triggers the virus to come back down the nerve, to the skin, and erupt again into a painful pustule or a “shingle.”
Louise is also well over 60 years old, most people who develop shingles are over sixty. All the possible triggers that bring on a case of shingles are not known. However, being exposed to a child with chickenpox is certainly one. And having a severe emotionally stressful event can bring about an attack of shingles as well.
Shingles may start out with an elder just feeling under the weather, or it might begin with intense pain. A few days later the red rash will appear. This rash develops fluid filled pustules, just as with chickenpox. You do not want to break these pustules. They will open and drain on their own. Opening any encapsulated blister or pustule provides an opportunity for infection to begin.
Using an antibiotic ointment as the pustules open and drain prevents against the possibility of infection. This fluid that drains is extremely itchy and very problematic for the confused elder who forgets not to scratch.
An elder who is confused and unable to express their feelings of pain, should be medicated as well as monitored for signs of pain. Keeping in mind that the pain of shingles can be present long after the last pustule has drained and healed. Pain management may be indicated for up to a year after the shingles event, especially if it was a severe case and involved the eyes.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on January 24, 2012 - by Nurse Virginia
STRESS RELATED CONDITIONS IN THE ELDERLY – ALOPECIA/SHINGLES
(PART II)
Frank also had significant hair loss; however it happened over so many years that he really didn’t notice until the hair started coming back. Because of his high blood pressure (he was on 5 medications) and his weight gain his physician advised Frank to stop eating wheat products. After going gluten free for several months, Frank noticed that at the age of 68 he was now growing a remarkable amount of hair on his arms and legs.
Frank did lose 55 pounds going gluten free and the edema in his legs was totally gone as well. But what he hadn’t expected was to see the re-growth of all that hair on his extremities. He had had Alopecia and hadn’t even realized it.
A person usually has only 80 – 90% of their hair shafts growing at a time. The rest are somewhat dormant for periods of about two months at a time. When the individual is impacted by one of the previously mentioned conditions, (see Part I) more hair shafts go dormant than normal and that is Alopecia.
Hair loss may be only noticed in one location or in patches. But in many extreme cases of Alopecia it may include all the hair on the body including pubic, eyebrows, eye lashes and so forth.
While stress may be the cause of this disorder, having Alopecia can also be a large source of stress. Usually time is the great healer here. As previously noted a dormant area of hair will start re-growth after two months. Many people with a spontaneous case of Alopecia will regain their hair in a year.
While the resulting baldness on your head will be stressful it will not be painful, susceptible to infection or potentially life threatening as Shingles may be. (See Part III Shingles)
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on January 23, 2012 - by Nurse Virginia
STRESS RELATED CONDITIONS IN THE ELDERLY – ALOPEIA/SHINGLES
(PART I)
The elderly couple was shopping at the mall, “their mall,” they had been there many times. Louise was getting tired, her knees hurt as they often did walking those hard floors. Charles told her to sit down for awhile and he would bring the car to the door. “Take your time,” he told her, “I’ll just wait.”
Which door? The problem came when they went to different doors. No one would ever know who was right, they just didn’t communicate before he left for the car. Louise went to the exit she thought Charles would be at, stood and waited on those sore tired knees till she was crying and still he didn’t come.
Charles was waiting at another door and because of the frustration of waiting, he became angry. Finally Charles started circling the mall checking all the doors and found Louise. Seeing Louise standing there crying, Charles became even angrier and began yelling at her. The situation had scared him and he reacted poorly.
Louise was in severe pain by this time and being yelled at in an enclosed car, where she couldn’t even walk away, didn’t help. When she got home she was beyond crying.
Soon her hair started falling out in large clumps. That episode at the mall was still so painful to remember, Louise being the mild mannered, meek person she was, she never said anything, she just kept going over it in her mind.
The loss of hair or Alopecia can occur because of medications, cancer treatments, fungal infections, hypothyroidism, hormonal changes – as after giving birth and many other environmental causes. Hair loss may be temporary or permanent. However this kind of hair loss was probably due to stress. The stress might be a significant illness, a crash diet, physical trauma as in an accident, or a shock to the system.
This episode probably would not have cause the hair loss in a younger person, but because of Louise’s age, close to 80 at this time, she suffered major hair loss for the next six months and had to wear a wig.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on January 16, 2012 - by Nurse Virginia
EARLY STAGE DEMENTIA – LOSS OF JUDGEMENT AND REASONING
Part I
“It’s an American Eskimo,” Ray said with a big smile as he showed his daughter the new puppy he had just bought. “I know Dad, that’s what Sugar was, the dog I had growing up, I know all about that dog.” Ray’s expression turned blank, as his daughter realized that Ray no longer remembered the family dog.
Ray had been giving signals to his wife that he was thinking of getting a dog. Beth had tried to have a conversation with Ray about the kind of dog he might want Ray had been retired now for 11 years, since he was fifty-seven. Beth thought a dog would be a good idea for Ray and over the last months she had suggested several options.
Beth still worked full-time and thought a dog would be good company for Ray and give him a reason to get out of bed and take a walk every day. Beth looked into adopting a “war Dog.” She thought a mature dog who had served the country would be just perfect for the very patriotic Ray, who had never had the chance to serve himself. No, Ray said that’s not what he wanted. Ray started getting dog magazines and spent considerable time poring over these magazines.
Whenever Beth asked what kind of dog Ray was thinking of, Ray would shut her down with his usual, “It’s none of your business, and I’ll do what I want.” Now here he was with his impulse purchase because he went to a pet store and saw this dog that looked “just like a wolf.” He thought it would be great to have a dog that looked like a wolf, and even named it “wolf.” Completely forgetting that family dog, that also had “looked just like a wolf.”
Ray’s daughter reminded him that this was a very energetic dog. This was a dog for a young family with a lot of energy to match the dog’s needs. That this was the breed of dog that had been so hard to train that she became a junior dog trainer when she was just thirteen because of all the time she spent, working with this breed of dog. She told Ray that November was a bad time to buy a puppy in the Midwest, that this puppy would need regular trips outside during the winter months to housebreak.
Ray was no longer able to use reason or logic in this life changing purchase. All he could say was, how this dog looked just like a wolf, and that seemed to be enough for him.
Ray missed going to his daughter’s out of state for Thanksgiving a week later, because he had forgotten all about the trip, and how that daughter’s family had allergies and could not have pets. He also missed going there several weeks later for the Christmas holiday
Ray is no longer able or interested in learning about his new pet. He is just in the moment, while he is trying to understand why the dog seems nervous and unable to sit still, always wanting to go somewhere, and now dragging Ray behind.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on January 4, 2012 - by Nurse Virginia
MALNUTRITION IN THE ELDERLY – ESPECIALLY IN THOSE WITH ALZHEIMER’S DISEASE
“I never lived so well,” said Grace as dinner was served in her assisted living facility. Fortunately, there are some elderly who feel this way. But they seem to be the in the minority, the vast majority of the elderly have signs of malnutrition for a variety or reasons. As people age, the risk of malnutrition increases. Signs of malnutrition are: weight loss, nausea, illness, muscle wasting which results in frequent falls, dizziness and fatigue.
The causes of malnutrition can involve a large range of challenges for the elder especially the confused elder.
- They may have a loss of appetite sometimes due to medication or lack of exercise.
- Food may no longer taste good to them because of a loss in the ability to taste or smell.
- Their metabolism has slowed down and they just aren’t hungry.
- They may no longer have the equipment to make the food they like.
- They may not have the money to buy the food they like.
- They may not have the strength or transportation to go get the food they like.
- They start to develop poor eating habits related to these issues.
Encouraging an elder to eat can be at times a challenge. The best approach is to address these issues in the reverse. Make sure the elder does get some exercise everyday, so they can build up an appetite. Provide a balanced diet with foods that are familiar and that are favorites of the elder. Make sure the foods are easy to chew and that the elder chews food well to aid in digestion.
Provide a pleasant dining experience. Even the simplest meal can seem a treat when served on the “good” dishes with relaxing music. Assist the elder in the purchase of food, remembering that the confused elder may be having difficulty using money, transportation and equipment.
Bon Appétit!
Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
- Help support this site by buying my book! Click the link below for details. Thanks!
www.pleasegettoknowme.com
