Articles

  • What’s the ‘homebound status’ requirement for home health?

    First, it’s important to note that “homebound status” doesn’t mean a person never leaves the house. It simply means leaving the home requires “a considerable and taxing effort.” This includes the need for assistive devices (canes, walkers, wheelchairs, etc.) and/or help from another person.

    Also, “homebound status” can occur when leaving the home is against good medical advice because of the patient’s condition. A recent example would be the COVID-19 pandemic. During that time, it was against good medical advice for older persons or those with compromised immune systems to leave their homes. This can still be the case with people taking immunosuppressants or are undergoing treatments that lower a patient’s immune system defenses, especially during times of year where there are upticks in cold, flu, and Covid infection rates.

    “Homebound” patients can still go to church, the grocery store, doctor’s appointments, and family events, as they are only intermittent.

  • Hearing aids reduce deadly fall risk
    Photo by Mark Paton on Unsplash

    November 13, 2023
    Heard on NPR Morning Edition
    Allison Aubrey

    If your hearing begins to decline, your risk of falling may rise.

    Research shows older adults with mild hearing loss are at a greater risk—more than double—of falling. Though it’s not exactly clear how hearing loss increases the risk, it’s known that falls are the top cause of death from injury among people 65 and older.

    Now, new evidence shows that restoring hearing through the use of hearing aids may be protective, especially when people wear them consistently. That’s according to a study published this summer in the Journal of the American Geriatrics Society.

    “We found, quite significantly, that individuals that wore hearing aids compared to those that didn’t, did show a significantly lower prevalence,” explains Laura Campos, an audiologist and researcher at UC Health in Colorado and the study’s lead author. “They reported fewer falls,” she explains, and their scores on a falls risk questionnaire showed they were at lower risk.

    There are other strategies to prevent falls, including exercises to improve strength and balance, which are key risk factors.

    As part of the study, Campos and her collaborators surveyed about 300 people with hearing loss about their use of hearing aids and asked about their previous falls. The researchers also accounted for factors that could affect fall risk, such as the use of medication that can cause dizziness.

    Overall, people who wore hearing aids had about a 50% reduced odds of experiencing a fall, compared to non-users. And, the reduction was even greater among those who wore hearing aids at least four hours per day. “The effect size is pretty significant,” she says. These consistent hearing aid users had even lower odds – up to 65% – of falling.

    Prior research on whether hearing aids can help prevent falls has led to mixed findings. One challenge is that many people who get hearing aids don’t use them every day or stop using them altogether. “A lot of people don’t like them,” says Catherine Jewett, 67, who started wearing a hearing aid on one ear about four years ago. She has hearing loss caused by Meniere disease.

    For some people the sound amplification can be hard to adjust to, Jewett says, and others are self-conscious of how they will look with hearing aids. “Most people see it as a mark of age,” she says. Vanity can be a barrier, but Jewett says hers is barely visible and blends in with her hair.

    As part of the research, Campos saw an opportunity to tease out the effects of consistent use of hearing aids, since much of the prior research hadn’t differentiated between people who wore them a lot, compared to those who wore them less. What the study found is that there’s likely a dose-response relationship, meaning the more consistently people wear them, the more benefit they may experience.

    One theory to explain the connection between hearing loss and falls, is that we use our hearing to sense what is around us. “Humans can echolocate,” Campos explains.

    If we close our eyes, we can sense whether we’re in a big auditorium compared to a small closet, based on the sound echoing off walls and objects around us. “We have to be able to hear high frequencies to do that well,” she explains. So, it makes sense that restoring hearing can be helpful.

    Also, people with hearing loss must work harder to piece together conversation. They often rely on linguistic knowledge and contextual clues to fill in words they didn’t hear. “That uses a lot more resources,” and can be taxing, Campos explains. As a result, she says people are left with “less cognitive resources,” to navigate their surroundings. So, perhaps they don’t notice a step or a fall hazard until it’s too late.

    It’s also possible that a fall risk is linked to a decline of the vestibular system of the inner ear, which is very important for balance. “One hypothesis for connecting hearing loss and falls is that perhaps hearing loss is serving almost as a proxy for reduced vestibular function,” explains Erin Piker, an audiologist and director of the Vestibular Sciences Laboratory at James Madison University. So when it’s not working well, falls can be more likely.

    Multiple factors may help explain the relationship between the risk of falling and hearing loss.

    “We still have more work to do to understand this underlying mechanism,” Campos says. But she’s pleased when she sees patients benefiting from hearing aids.

    Jewett says she feels safer when she wears her hearing aid since she can hear the sounds of a car, for instance, if she’s crossing a street. “A hearing aid has just made a massive amount of difference in my life,” she says.

    And she’s more stable on her feet. “It improves my balance,” she says. “It’s a huge benefit.”

  • Lung cancer prevention, screening and treatment in older adults

    Lung cancer is a significant public health concern, particularly in older adults. As people age, their risk of developing it increases due to a combination of factors such as cumulative exposure to risk factors and a natural decline in immune function. However, with appropriate prevention strategies, regular screenings, and advancements in treatment options, older individuals can lead healthier lives and reduce the impact of lung cancer on their overall well-being. This article explores the crucial aspects of lung cancer prevention, screening, and treatment in older people.

    Prevention

    Prevention is the most effective way to combat lung cancer in older adults. While some risk factors like age and genetics cannot be altered, there are several lifestyle modifications that can significantly reduce the risk of developing it:

    • Smoking cessation: Aside from causing COPD, smoking is the leading cause of lung cancer, and quitting smoking is the single most important step in prevention. Regardless of age, quitting smoking offers immediate and long-term benefits, reducing the risk of lung cancer and other tobacco-related diseases. In Kansas, the KanQuit program provides great smoking cessation resources (online + phone, online only, or phone only) for free, including:
      • Up to two or more (2+) weeks of smoking cessation medications, such as nicotine gum and/or nicotine patches.
      • Free one-on-one telephone sessions with a “quit coach.”
      • Educational materials.
      • Planning materials to devise a “quit plan.”
      • Progress tracking.
      • Coaching support through chat, email and text.
    • Avoid secondhand smoke: Minimize exposure to secondhand smoke, which can also contribute to lung cancer risk. Ensure that living spaces are smoke-free and avoid public areas where smoking is allowed.
    • Environmental exposure: Older adults should be mindful of their environment, especially if they have worked in industries with potential carcinogens. Proper protective measures and awareness can reduce exposure risks.
    • Healthy diet and exercise: A well-balanced diet rich in fruits and vegetables, along with regular physical activity, can help support a healthy immune system and reduce the risk of cancer.

    Screening

    Screening for lung cancer is essential for early detection, particularly in older adults who may be at higher risk due to age and prolonged exposure to risk factors. The primary screening method for lung cancer is low-dose computed tomography (LDCT) scans. It allows doctors to detect lung nodules or abnormalities at an early stage, increasing the chances of successful treatment. However, the decision to undergo screening should be discussed with a healthcare provider, taking into account an individual’s overall health, age, and smoking history.

    Lung cancer treatment

    Treatment options for lung cancer in older adults depend on various factors, including the stage of cancer, overall health, and the patient’s preferences. Common treatment approaches include:

    • Surgery: Surgical removal of the tumor is often considered for early-stage lung cancer when the patient is fit for the procedure.
    • Radiation therapy: Radiation therapy is employed to target and shrink tumors, either as a standalone treatment or in combination with surgery or chemotherapy.
    • Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells or inhibit their growth. It can be administered orally or intravenously.
    • Targeted therapy: This treatment targets specific genetic mutations in cancer cells, sparing healthy cells and minimizing side effects.
    • Immunotherapy: Immunotherapy boosts the body’s immune system to fight cancer cells effectively, with fewer side effects compared to traditional treatments.

    Lung cancer prevention, screening, and treatment in older people are critical aspects of maintaining their health and well-being. By adopting healthy lifestyle habits, older adults can reduce their risk of developing lung cancer. Regular screenings can lead to early detection, improving the chances of successful treatment and positive outcomes. Modern treatment options provide hope and better quality of life for older individuals diagnosed with lung cancer. Early discussions with healthcare providers about risk factors, screening, and potential treatment plans are essential for promoting lung health and ensuring the best possible care for older adults.

    Call KanQuit! at 800-QUIT-NOW (800-784-8669)

  • The benefits of mixed-breed dogs for older people

    As we age, the importance of companionship and a healthy lifestyle becomes increasingly vital to our overall well-being. One of the most fulfilling ways for older individuals to enhance their lives is by adopting a furry friend. The benefits mixed-breed dogs offer are often the perfect choice for older people. These delightful canine companions not only bring joy and unconditional love but also offer numerous benefits that cater specifically to the needs and lifestyle of older people. In this article, we explore the advantages of mixed-breed dogs for seniors, highlighting why these beloved pets can be a source of profound happiness and wellness.

    How a mixed-breed dog benefits older people

    1. Adaptability and Size Variability: Mixed-breed dogs, often referred to as “mutts” or “mongrels,” are the result of two or more different breeds coming together. This mix of genetic diversity makes them generally healthier and more adaptable to various living situations, including those of older individuals. With a wide range of sizes and temperaments, mixed-breed dogs can easily fit into different living spaces, from apartments to larger homes. Older people have the flexibility to choose a dog that suits their physical abilities and daily routines.
    2. Lower Maintenance and Health Costs: Mixed-breed dogs often benefit from what’s known as “hybrid vigor.” This means they may have a lower risk of inheriting breed-specific health issues common in purebred dogs. Consequently, older people can enjoy reduced veterinary expenses and have fewer concerns about costly health problems that can arise as their pets age. Additionally, mixed-breeds typically require less grooming and are more adaptable to various weather conditions, making them an ideal choice for older people who may prefer low-maintenance pets.
    3. Increased Physical Activity: Owning a mixed-breed dog can motivate older individuals to engage in regular physical activity, a crucial aspect of maintaining a healthy lifestyle in one’s golden years. Taking daily walks with their furry companions not only benefits the dog’s well-being but also promotes cardiovascular health and joint flexibility for the senior owner. These leisurely strolls or energetic play sessions create a wonderful bonding experience that encourages seniors to stay active and enjoy the great outdoors.
    4. Social Interaction and Emotional Well-Being: Older individuals may face challenges when it comes to socializing and staying connected with others, leading to feelings of loneliness or isolation. A mixed-breed dog can act as a social catalyst, sparking conversations with other dog owners during walks or visits to the park. The companionship and unconditional love offered by these four-legged friends can help alleviate feelings of depression and anxiety, promoting a sense of purpose and emotional well-being.
    5. Cognitive Stimulation: Interacting with a mixed-breed dog can provide older individuals with cognitive stimulation and mental engagement. From teaching basic commands to learning new tricks together, older people can enjoy the mental challenge and joy of training their furry companions. Furthermore, the responsibility of caring for a dog can help seniors maintain a routine and sharpens their cognitive abilities.

    The benefits of mixed-breed dogs for older people are far-reaching, encompassing physical, emotional, and social aspects of their lives. These lovable canines offer unwavering companionship, promoting a healthy lifestyle and overall well-being. From their adaptability and lower maintenance requirements to their ability to increase physical activity and cognitive stimulation, mixed-breed dogs make exceptional companions for seniors seeking a fulfilling and joyous life. By opening their hearts and homes to these beloved furry friends, older individuals can experience the immense rewards of sharing life’s journey with a mixed-breed dog.


    July 31 is National Mutt Day. If you are looking to provide a fur-ever home to a mixed-breed dog, please check out your local humane society. If you are not looking to adopt, perhaps consider making a donation.

    The Kansas Humane Society—Wichita, KS

    The Humane Society of the Flint Hills—Emporia, KS

  • The impact of hepatitis on older adults

    Introduction

    Hepatitis is a silent epidemic that has a tremendous impact on older adults. World Hepatitis Day, observed annually on July 28th, serves as a crucial reminder of the global burden of viral hepatitis and how it affects public health. As the world’s population ages, understanding and addressing the specific challenges faced by older individuals in relation to hepatitis becomes increasingly important. This article sheds light on the impact of hepatitis on older people and emphasizes the significance of raising awareness and implementing targeted interventions.

    The prevalence of hepatitis among older adults

    Hepatitis, particularly caused by the hepatitis B (HBV) and hepatitis C (HCV) viruses, remains a major health concern worldwide. The World Health Organization (WHO) estimates that approximately 290 million people are living with chronic hepatitis B, and about 71 million individuals are living with chronic hepatitis C. Older adults are disproportionately affected, with a higher prevalence of chronic viral hepatitis in this age group.

    Contributing factors

    Several factors contribute to the impact of hepatitis on seniors. Firstly, older individuals may have been exposed to the viruses in their younger years, as HBV and HCV were more prevalent before widespread vaccination and improved healthcare practices. Additionally, aging immune systems can be less effective in combating infections, leading to a higher likelihood of chronicity once infected.

    Furthermore, medical procedures and blood transfusions carried out in the past, before the implementation of stringent screening measures, put many older adults at risk of contracting hepatitis. Moreover, lifestyle factors such as intravenous drug use, unprotected sexual activity, and unsafe tattooing or piercing practices could also contribute to infection rates among the older population.

    How hepatitis affects seniors

    Hepatitis can have severe consequences on the health of older adults. Chronic hepatitis B and C are leading causes of liver cirrhosis and hepatocellular carcinoma (liver cancer). Liver-related complications can significantly reduce the quality of life for older individuals, leading to increased healthcare costs and dependence on caregivers.

    Older adults may also experience comorbidities such as diabetes, heart disease, and other chronic conditions that can worsen when combined with hepatitis. This adds complexity to their overall health management and necessitates a more comprehensive approach to healthcare.

    Challenges in diagnosing and treating hepatitis in seniors

    Fully recognizing the impact of hepatitis in older adults can be challenging due to overlapping symptoms with other age-related conditions. Fatigue, loss of appetite, and general weakness are common complaints among older individuals and can be attributed to various health issues, making early detection of hepatitis difficult.

    Moreover, the elderly may face barriers to accessing healthcare services, including limited mobility, financial constraints, and lack of awareness about the disease. Additionally, some older adults may be hesitant to undergo testing or treatment due to the fear of potential side effects or the misconception that hepatitis is untreatable.

    Awareness and prevention of hepatitis

    World Hepatitis Day offers an opportune moment to raise awareness about the impact of hepatitis on older adults. Public health campaigns should emphasize the importance of vaccination, especially for those who have not been previously vaccinated against hepatitis B. Additionally, encouraging regular screenings for hepatitis and advocating for safe medical practices can help prevent new infections among older individuals.

    Healthcare professionals should be educated on the unique challenges faced by older patients with hepatitis to improve early detection and appropriate management. Collaboration between healthcare providers, caregivers, and community organizations is essential to create a supportive environment for older adults living with hepatitis.

    Conclusion

    World Hepatitis Day serves as a reminder that hepatitis continues to be a significant health challenge, particularly for older adults. By understanding the specific impact of the disease on this vulnerable population and implementing targeted prevention and treatment strategies, we can work towards reducing the burden of hepatitis and improving the quality of life for older individuals living with this condition. Together, we can take significant steps in the fight against hepatitis and its devastating consequences on public health.

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