Older Adults and Substance Abuse Awareness

Palmer MH high(8) res

Alice Pomidor, MD, MPH, AGSF
Professor
Florida State University School of Medicine

Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing

It’s been called the “invisible epidemic.” In recent years, for the first time, the number of older adults receiving treatment for substance abuse is outpacing that of younger adults.

There are many reasons why the number of older adults who are receiving treatment for substance abuse is on the rise. With aging come very real challenges that can make some older adults more likely to abuse alcohol or drugs.

Job loss, either through retirement or downsizing, caretaking for (or losing) a spouse, children moving away, illness, and financial worries are among the challenges older adults can face. What’s more, some older adults have had had lifelong problems with alcohol or drugs that can become more serious as they age.

What is Substance Abuse?

Substance abuse is an umbrella term that means misusing legal or illegal medications and drugs, as well as misusing alcohol and tobacco. Officially, substance abuse is the use of chemicals that lead to an increased risk of problems and an inability to control your use of the substance.

Addiction, dependence, or “getting hooked” on a drug or alcohol can have especially dangerous consequences for older adults. These substances can cause mental problems, kidney and liver disease, and can cause falls resulting in injuries. Even if you’ve never had a problem with alcohol or drugs, you can become dependent on them in your later years.

Because many older adults manage more than one chronic illness, they may take one or more medications that can interact harmfully. The drugs you take may also react badly with alcohol. The symptoms you may experience as a result may seem to you like typical signs of aging, such as confusion, forgetfulness, dizziness, or sleepiness. In fact, symptoms like these may be reactions due to substance abuse. Continue reading

Why Is My Food Tasteless?

Syed picQuratulain Syed, MD
Assistant Professor of Medicine
Division of General Medicine and Geriatrics
Emory University School of Medicine

Have you recently been struggling with keeping up your nutritional intake? Are you losing weight unintentionally? Does your food seem tasteless? It may not be a fault of yours or the person who does the cooking at home.  You may be one of the many older adults who experience problems with sensation of taste.

Taste disorders can be a result of normal aging and are frequently experienced by older adults living in long term care facilities or admitted to hospitals. Numerous medical conditions can affect taste sensations, such as liver, heart, kidney and thyroid problems, diabetes, upper respiratory infections, among others.

Additionally, numerous medications can affect taste, including cholesterol lowering medicines (commonly called statins), blood pressure medicines, anti-allergic medicines, heartburn medicines, antibiotics, and medicines for cancers.

Cigarette smoking, poor dental hygiene, and dental infections can affect taste as well.

Here are some tips if you think you are experiencing taste impairment:

  • If you have not seen a dentist recently, schedule an appointment to have your teeth and gums examined, to make sure they are healthy.
  • Take all your medications (including prescription, over the counter, and herbal medicines) to your appointment with your provider, so they can be reviewed for any possible side effects.
  • Schedule an appointment with your primary care provider to discuss your problem.
  • Discuss your medications with your provider to understand why you are taking them. Ask if any medications can be stopped or reduced in dosage.
  • There are numerous reasons for quitting smoking, regardless of your age. A taste disorder is one of them!

Bon Appetit!

Mental Health Awareness for Older Adults

Palmer MH high(8) res

Alice Pomidor, MD, MPH, AGSF
Professor
Florida State University School of Medicine

Mary Palmer, PhD, RN, FAAN, AGSF
Helen W. and Thomas L. Umphlet Distinguished Professor in Aging
UNC School of Nursing

Many of today’s older adults grew up during a time when mental health problems were not as well understood as they are today. People didn’t discuss problems like depression, for example, and many people considered mental health issues as “weaknesses” that could be cured by simply improving one’s attitude.

Now, of course, we understand that good mental health and good physical health are equally important to our well-being. Experts understand that mental health challenges are treatable. You can improve the quality of your life, or that of an older adult you care for, by making sure healthcare professionals address any potential mental health issues.

Mental Health Problems: Common Among Older Adults

Among adults aged 65 and older, about one in five have a mental disorder, including dementia.   Over 50% of people living in long-term care facilities have some form of cognitive impairment.

Other common mental health problems that affect older adults include anxiety and mood disorders, such as depression and bipolar disorder.

Even though older adults commonly have mental health issues, they are less likely than younger adults to receive treatment for them. When they do receive treatment, it’s also less likely for them to see a mental health specialist. More often, older adults seek mental health treatment from their primary care providers. Continue reading

Polypharmacy and Deprescribing

WebDoes the number of medications you’re taking sometimes seem too high? Maybe it’s time for you and your healthcare provider to give your medication list a check-up by taking a closer look at the prescription and over-the-counter (OTC) treatments you take.

As you grow older, you’re more likely to develop health conditions that require taking multiple medications—some of which you may take for a long time. Many older people also take OTC medications, vitamins, or supplements as part of their routine care. As a result, older adults have a higher risk of overmedication, also known as “polypharmacy”—the medical term for taking four or more medications at the same time. Polypharmacy can increase your chances of unwanted reactions (also called “adverse drug reactions”) due to medications taken on their own or together.

To address this increasingly common problem, healthcare providers are focusing on how to reduce the number of medicines older adults are using through a practice called “deprescribing.” Dr. Michael Steinman, a member of the American Geriatrics Society (AGS) and a geriatrician at the University of California, San Francisco, recently appeared on WPUR—Boston’s NPR News Station—to discuss deprescribing with Dr. Barb Farrell, a pharmacist from Bruyère Geriatric Day Hospital in Ottawa, and Laura Landro, assistant managing editor at the Wall Street Journal. Hear what they had to say.

Want access to more tips and tools to help you manage multiple chronic conditions or multiple medications? We’ve got you covered.

 

Have you scheduled your Medicare wellness visit yet?

Syed picQuratulain Syed, MD
Assistant Professor of Medicine
Division of General Medicine and Geriatrics
Emory University School of Medicine

Now that we are almost through 2016, I hope you haven’t all lost track of your healthy lifestyle New Year resolutions.  The Medicare annual wellness visit can help you achieve those goals.

If you enrolled in Medicare plan B within the past 12 months, you are eligible for a Welcome to Medicare preventive visit. If you have had Medicare for more than a year, you are eligible for an annual wellness visit every year (at least 11 months after the previous wellness visit).  These visits include a review of your medical history, social history related to your health and education, and counseling about preventive services, including certain screenings, shots, and referrals for services, if needed.

Here is how to prepare for the visit:

  • These visits are free of cost. However, you may have to pay Medicare a deductible or co-insurance if your healthcare provider performs additional tests or services during the same visit and those services aren’t covered under these preventive benefits.
  • Even if you are seeing your current primary care provider, remember to bring any prior medical information, including immunization records, to make sure nothing is overlooked.
  • Gather information about your family’s health history before your appointment. This will help guide discussion on the screenings you should get and the pros and cons of these tests.
  • Bring an updated list of all prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take.
  • Do you have advance directives? If you don’t have any, or if you wish to update them, write down your preferences and goals in life in order to discuss them with your healthcare provider.
  • Write down your current level of physical activity and your activity goals. Physical activity can prevent/reduce falls and improve physical strength. Having notes will allow you to have a conversation with your provider about available resources that can help you achieve these goals.
  • Be prepared to discuss any home safety concerns. If your home is in need of rails or grab bars or other modifications to meet your physical needs, you can discuss them at this visit.

Call your healthcare provider today to schedule your annual wellness visit!