Elder Care Issues

Advice on tackling common health care issues affecting the senior population and resources to turn to for help.

5 Myths About End-of-Life Issues

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Some people don't fill out important paperwork like a living will because they think they are signing their lives away. Not the case. Instead, this important paperwork ensures health care wishes are being met.

Some people don’t fill out important paperwork like a living will because they think they are signing their lives away. Not the case. Instead, this important paperwork ensures health care wishes are being met.

Some people don’t have a health care power of attorney or living will because they don’t realize how important these documents are. Others worry that such documents mean they are signing their lives away. Not so, according to Harvard Medical School’s HEALTHbeat.

These powerful documents make sure that you get the treatment you would want for yourself if you couldn’t communicate your wishes. Here are a few myths that shouldn’t get in the way of creating a health care power of attorney or living will:

Myth #1: More care is always better.

Truth: Not necessarily. Sometimes more care prolongs the dying process without respect for quality of life or comfort. It’s important to know what interventions are truly important. It’s often impossible to know that in advance. That’s where the advice of a health care team is invaluable.

Myth #2: Refusing life support invalidates your life insurance, because you are committing suicide.

Truth: Refusing life support does not mean that you are committing suicide. Instead, the underlying medical problem is considered to be the cause of death.

Myth #3: If medical treatment is started, it cannot be stopped.

Truth: Not starting a medical treatment and stopping a treatment are the same in the eyes of the law. So you or your health care agent can approve a treatment for a trial period that you think may be helpful, without any fear that you can’t change your mind later. However, be aware that stopping treatment can be more emotionally difficult than not starting it in the first place.

Myth #4: If you refuse life-extending treatments, you’re refusing all treatments.

Truth: No matter what treatments you refuse, you should still expect to receive any other care you need or want — especially the pain and symptom management sometimes called intensive comfort care.

Myth #5: Stopping or refusing artificial nutrition and hydration causes pain for someone who is dying.

Truth: Unlike keeping food or water from a healthy person, for someone who is dying, declining artificial nutrition or intravenous hydration does not cause pain.

For more on setting goals for end-of-life care and avoiding common pitfalls, access Living Wills, a Special Health Report from Harvard Medical School.

 

 


Are Statins Overprescribed to the Elderly?

heidi Elder Care Issues, Resources for Physicians Comments Off on Are Statins Overprescribed to the Elderly?
Seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get statin drugs than they were in 1999.

Seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get statin drugs than they were in 1999.

Inexpensive statin drugs are given to millions of people to reduce cholesterol, even many who do not show signs of heart disease. But a recent study has found that seniors with no history of heart trouble are now nearly four times more likely – from 9 percent to 34 percent – to get those drugs than they were in 1999, according to Kaiser Health News.

Here’s the catch: For patients of that age, there is little research showing statins’ preventive heart benefits outweigh possible risks, which can include muscle pain and the onset of diabetes.  There have only been a handful of studies that included the over-79 population, according to a review in the American Journal of Cardiology in 2012, Kaiser reports.

The rate of statin use among octogenarians and beyond who don’t  have a history of heart attack, stroke, coronary heart disease or vascular heart disease increased four times from 1999 through 2012, according to two researchers from Ohio State University and the University of Alberta in Edmonton, Canada.  Their research letter was published in the Journal of the American Medical Association Internal Medicine in August.

Despite the lack of evidence to guide the use of statins in this population, “the very elderly have the highest rate of statin use in the United States,” they said, citing past studies.

Concerns about statins’ effects in those older than 79 are being raised as some cardiologists question whether statins are overprescribed even among some younger people.

Read entire article here.


Older Adults Not Getting Recommended Vaccines

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Skipping necessary vaccines leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

Skipping necessary vaccines leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

Three out of four Americans older than 60 don’t get a shingles vaccine to protect themselves from the virus’ miseries: rashes over the face and body, stinging pain that can last for weeks or months and the threat of blindness, reports Kaiser Health News.

Many older adults are not getting their recommended vaccines. The rates for older adults getting flu, pneumonia, tetanus or shingles shots – the four most used vaccines among the elderly – have stayed flat and trail national goals, according to latest federal data. That leaves millions of older adults at risk of dying, being hospitalized, or suffering debilitating effects that last for years.

— One in three seniors each year skips the flu vaccine, recommended annually for everyone over 6-months-old. Between 3,000 and 49,000 Americans, primarily older adults, died of flu or related illnesses each flu season for 30 years through 2007, according to the Centers for Disease Control and Prevention’s latest estimates. Immunization rates for seniors have been around 65 percent for more than 15 years. The federal government’s goal is 90 percent by 2020.

— Four in 10 seniors are not vaccinated for pneumonia. It’s recommended once for people 65 and older who did not have it previously. Pneumonia affects about 900,000 seniors a year. Immunization rates are up only slightly in the past decade.

— Nearly half of seniors are not immunized for tetanus. A shot is recommended once every 10 years to prevent a rare but often deadly bacterial condition known as “lockjaw.” Vaccination rates have changed little since 2008.

— The shingles vaccine has the lowest adoption rates by older adults regarding those leading preventives — 76 percent of them had not received it as of 2013, the latest year that data is available. There are an estimated 1 million cases each year in the United States, half among people older than 60. Shingles is caused by a reactivation in the body of the same virus that causes chickenpox. The vaccine, approved in 2006, is recommended once for everyone age 60 and over, regardless whether they had chickenpox. Nearly one out of three people in the United States will develop shingles in their lifetime.

Read entire story here from Kaiser Health News.