12 Medications that may increase fall risk in older adults

12 Medications That May Increase Fall Risk in Older Adults

Of the 20 medications that are most frequently prescribed to older adults, over half may increase fall injury risk, say researchers from the Karolinska Institutet in Stockholm, Sweden.

One-third of Americans over 65 take a tumble each year, and falling represents the largest source of fatal and nonfatal injury among older adults. Preventing falls in this population remains a top priority for health care providers and caregivers alike.

Jette Moller, study author and lecturer with the Department of Public Health Sciences at Karolinska, points out that a person’s age, sex and health condition(s) can all compound fall risk, though these factors are largely uncontrollable. On the other hand, proper medication management could be a simple way to improve an older adult’s chances of staying safely on their feet.

Fall-inducing pharmaceuticals

Polypharmacy—taking too many medications—is a common problem for older adults. Over 76 percent of Americans age 60 and older take two or more prescription drugs on a regular basis, according to the Centers for Disease Control and Prevention (CDC), and thirty-seven percent take five or more.

“Polypharmacy been suggested to increase the risk for fall in several ways; increased risk for inappropriate medications (i.e. fall risk inducing drugs), increased risk of side-effects and interactions between medications, and also that compliance to prescription might decrease with increased number of prescribed medications,” says Moller.

Drugs that affect the central nervous system—antidepressants, hypnotics and opioids—have long topped the list of pharmaceuticals that may increase fall risk, along with diuretics, constipation medications and NSAIDs. The Karolinska study, which tracked the medical records of more than 64,000 Swedes who’d been hospitalized because of a fall, uncovered surprising new links between fall injuries and vitamin B12, calcium, antithrombotics, and GERD and peptic ulcer drugs.

The list of commonly prescribed drugs that may enhance fall injury risk, according to Moller’s research, is as follows:

  1. Antithrombotic agents
  2. Drugs for peptic ulcer and GERD
  3. High ceiling diuretics
  4. NSAIDs (women only)
  5. Vitamin B12 and folic acid
  6. Constipation drugs
  7. Calcium
  8. Hypnotics and sedatives:
  9. Analgesics and antipyretics
  10. Opioids
  11. Antidepressants
  12. Thyroid hormones (men only)

Of course, any medication that causes drowsiness, dizziness, vision problems, gait disturbance (ataxia), hypotension, or one that increases bleeding risk or exacerbates osteoporosis could potentially up the chances of experiencing a harmful fall.

Which causes the fall, disease or drug?

Eliminating these drugs from the prescription repertoire of an aging adult may not be a realistic option. For instance, warfarin, a popular antithrombotic, is highly-effective in inhibiting the formation of dangerous blood clots in people with heart conditions and those who’ve had a stroke.

Doctors must constantly weigh the benefits and drawbacks of every medication they prescribe, and, in many cases, there are no alternative drugs for them to consider. “Although we can assume that the risk for individual patients to sustain injurious falls would be minimized by not prescribing these medications, they may still remain essential in other critical aspects of health and well-being,” Moller explains.

Then there’s the chicken-and-egg problem of trying to determine what’s to blame for a fall: a particular drug, or the condition that the drug was prescribed to treat. “To develop effective preventive programs it is important to know if it is the medication that increases the risk or the health impairment the medication is prescribed for,” says Moller.

Brown bag it

For people taking multiple medications, the importance of discussing prescriptions with your doctor(s) and doing a periodic “brown bag checkup” with your pharmacist cannot be overstated.

AgingCare.com Expert, Dr. Vik Rajan offers the following list of questions to ask your physician to avoid polypharmacy:

  • Which medications am I taking and why?
  • How necessary is each medication? Can any be removed?
  • Could any of these medications be interacting with each other in a negative way?
  • Could any of my symptoms or conditions potentially be caused by the medications I’m taking?

Making an appointment with your local pharmacist to bring all of your medications (over-the-counter and prescription) for a “brown bag checkup” is another way to identify possible medication problems.

For more information check out agingcare.com.

 

September is Falls Prevention Month

Preventing Falls in an Elderly Person’s Home

Caregivers can do several things to make the home safer for their senior mom or dad.

  • Install safety bars, grab bars or handrails in the shower or bath.
  • Put no-stick tape on the floor in the tub.
  • Use a stool riser seat to make getting on and off the toilet easier.
  • Install at least one stairway handrail that extends beyond the first and last steps.
  • Make sure stairs are sturdy with strong hand railings.
  • Be sure that stairwells are well-lit. Consider making the lighting in your home brighter to aid vision.
  • Make sure rugs, including those on stairs, are tacked to the floor.
  • Remove loose throw rugs.
  • Avoid clutter. Remove any furniture that is not needed. All remaining furniture should be stable and without sharp corners, to minimize the effects of a fall.
  • Change the location of furniture, so that your elderly parent can hold on to something as they move around the house.
  • Do not have electrical cords trailing across the floor. Have additional base plugs installed so long cords are not necessary.
  • Have your parent wear non-slip shoes or slippers, rather than walking around in stocking feet.
  • Make sure all rooms have adequate lighting. Consider motion-sensitive lights that come on when a person enters a room. Use night lights in every room.
  • Keep frequently used items in easy-to-reach cabinets.
  • Use a grasping tool to get at out-of-reach items, rather than a chair or stepladder.
  • Keep the water heater thermostat set at 120 degrees F, or lower, to avoid scalding and burns.
  • Wipe up spills and remove broken glass immediately.

For more information check out agingcare.com.

IRS Identifies Five Easy Ways to Spot Suspicious Calls

 

Scam Phone Calls Continue; IRS Identifies Five Easy Ways to Spot Suspicious Calls

IR-2014-84, Aug. 28, 2014

WASHINGTON — The Internal Revenue Service issued a consumer alert today providing taxpayers with additional tips to protect themselves from telephone scam artists calling and pretending to be with the IRS.

These callers may demand money or may say you have a refund due and try to trick you into sharing private information. These con artists can sound convincing when they call. They may know a lot about you, and they usually alter the caller ID to make it look like the IRS is calling. They use fake names and bogus IRS identification badge numbers. If you don’t answer, they often leave an “urgent” callback request.

“These telephone scams are being seen in every part of the country, and we urge people not to be deceived by these threatening phone calls,” IRS Commissioner John Koskinen said. “We have formal processes in place for people with tax issues. The IRS respects taxpayer rights, and these angry, shake-down calls are not how we do business.”

The IRS reminds people that they can know pretty easily when a supposed IRS caller is a fake. Here are five things the scammers often do but the IRS will not do. Any one of these five things is a tell-tale sign of a scam. The IRS will never:

  1. Call you about taxes you owe without first mailing you an official notice.
  2. Demand that you pay taxes without giving you the opportunity to question or appeal the amount they say you owe.
  3. Require you to use a specific payment method for your taxes, such as a prepaid debit card.
  4. Ask for credit or debit card numbers over the phone.
  5. Threaten to bring in local police or other law-enforcement groups to have you arrested for not paying.

If you get a phone call from someone claiming to be from the IRS and asking for money, here’s what you should do:

  • If you know you owe taxes or think you might owe, call the IRS at 1.800.829.1040. The IRS workers can help you with a payment issue.
  • If you know you don’t owe taxes or have no reason to believe that you do, report the incident to the Treasury Inspector General for Tax Administration (TIGTA) at 1.800.366.4484 or at www.tigta.gov.
  • If you’ve been targeted by this scam, also contact the Federal Trade Commission and use their “FTC Complaint Assistant” at FTC.gov. Please add “IRS Telephone Scam” to the comments of your complaint.

Remember, too, the IRS does not use unsolicited email, text messages or any social media to discuss your personal tax issue. For more information on reporting tax scams, go to www.irs.gov and type “scam” in the search box.

Additional information about tax scams are available on IRS social media sites, including YouTube and Tumblr where people can search “scam” to find all the scam-related posts.

 

IRS warns about scams

WASHINGTON, DC — Taxpayers are being warned about a new widespread phone scam.  The Internal Revenue Service says people are calling claiming to be IRS agents and demanding payment for fake tax liens.

The callers are using a number with a Washington DC area code.   The number 202-609-7070 has been frequent in complaints in the month of August. The phony agent usually has a heavy accent and tells the victim they owe money to the IRS.   They say that if they don’t pay immediately then they will be arrested.

There have been 90,000 complaints to date about this scam.  So far 1,000 people have lost an estimated $5 million dollars.

If you get a call that you believe to be a part of this scam, the IRS urges you call 1-800-366-4484 to report the incident.  Visit the IRS’ website for much more information on this scam.

The IRS says that there a some typical signs of this scam.  They include:

  • Scammers use fake names and IRS badge numbers. They generally use common names and surnames to identify themselves.
  • Scammers may be able to recite the last four digits of a victim’s Social Security number.
  • Scammers spoof the IRS toll-free number on caller ID to make it appear that it’s the IRS calling.
  • Scammers sometimes send bogus IRS emails to some victims to support their bogus calls.
  • Victims hear background noise of other calls being conducted to mimic a call site.
  • After threatening victims with jail time or driver’s license revocation, scammers hang up and others soon call back pretending to be from the local police or DMV, and the caller ID supports their claim.

 

How to prevent dehydration

What Steps Can Be Taken To Prevent Dehydration?

Fluid intake is key. Families and caregivers need to be cognizant about risks and plan ahead to make sure aging loved ones are properly hydrated. Here are some tips to help encourage fluid consumption and reduce the risk of elderly dehydration:

  1. Offer fluids on a regular basis throughout the day.
  2. Encourage 8 oz. of fluid intake every time the senior takes medication.
  3. Keep water bottles and/or a water cooler available throughout the day wherever the senior is (for example, in bed, on the patio, throughout the house or at the senior living community).
  4. Provide favorite “mocktail” concoctions (see below for some great recipes) or your senior’s favorite beverages (make sure they’re not caffeinated or alcoholic).

Tasty Recipes To Keep Your Elderly Loved Ones Hydrated

Strawberries and Coconut Water

Elderly Hydration: Strawberries and Coconut Water

Ingredients

To make 2 Strawberry Mocktails combine:

  • 1 cup (250ml) of fresh coconut water
  • 1 cup (250 ml) strawberries hulled and sliced
  • 3 T of sugar syrup or agave nectar

Directions

  1. To make the sugar syrup, boil sugar and water together in a ratio of 1:3 sugar to water until it thickens to a runny syrup consistency. Store in a jar for all future cocktail making.
  2. Measure 1 cup of coconut water, either directly from a cut-open coconut or from a store-bought container (if you are lucky enough to live in an area that sells fresh coconut water in a bottle).
  3. Combine the strawberries and sugar syrup  and blend with a blender to desired consistency.
  4. Serve with ice.
Get more information on making this delicious strawberries and coconut drink.

Cucumber Lemonade with Basil

Combating Elderly Dehydration: Cucumber Lemonade With BasilIngredients

To make 3 to 4 Cucumber Lemonade treats combine:

  • 1 English cucumber
  • 3 C water
  • 3 lemons
  • 2 T sugar
  • 1 small bunch basil
  • 1 C soda water

Directions

  1. Start by cutting your cucumber in half. Peel one half and cut it lengthwise (you can cut it in half again first if need be).
  2. Scoop the seeds out and chop it into pieces.
  3. Put the cucumber pieces in a food processor and puree until smooth.
  4. Put puree in a fine mesh sieve over a container and push with a wooden spoon or spatula, extracting as much liquid as you can from the cucumber puree.
  5. Fill a separate bowl or container with 3 cups water. Squeeze 2 lemons into the water and mix in the sugar.
  6. Pour lemonade and cucumber juice into a pitcher or serving container.  Slice remaining cucumber half (unpeeled) and remaining lemon and add to pitcher. Add basil, too. Refrigerate until chilled.
  7. Serve with ice.

For more great tips, check out A Place for Mom.

Dehydration and the Elderly

Elderly Dehydration

Watching for signs of illness in a loved one can be challenging. Some illnesses show up quite clearly, while others have a more subtle effect on daily living. Dehydration, depending on the severity, sometimes creates only small telltale signs while having a big effect on the body, especially in the elderly.

Dehydration occurs when a person loses more water than they take in. It takes an adequate amount of fluid for the body to function properly; for example, to regulate body temperature through sweating, maintain blood pressure, and eliminate bodily waste. If severe enough, dehydration can lead to confusion, weakness, urinary tract infections, pneumonia, bedsores in bed-ridden patients, or even death. In general, a human can survive for only about four days without any fluids.

Elderly dehydration is especially common for a number of reasons: some medications, such as for high blood pressure or anti-depressants, are diuretic; some medications may cause patients to sweat more; a person’s sense of thirst becomes less acute as they age; frail seniors have a harder time getting up to get a drink when they’re thirsty, or they rely on caregivers who can’t sense that they need fluids; and as we age our bodies lose kidney function and are less able to conserve fluid (this is progressive from around the age of 50, but becomes more acute and noticeable over the age of 70). Illness, especially one that causes vomiting and/or diarrhea, also can cause elderly dehydration.

“Everybody has a normal state of body water that relates to their weight. Anything below that (normal state) is dehydration; everything above it is hyperhydration,” Dr. Larry Kenney, professor of physiology and kinesiology at Penn State University, explains.

That normal level of hydration varies widely from person to person. Contrary to the mantra that everyone should drink eight glasses of water every day, Kenney says there is nothing scientific to back that up. “People misinterpreted that to be, it had to be liquid and it had to be water,” he says.

A person’s diet can greatly affect hydration levels: fruits (especially watermelon), vegetables, and soups are mostly water-based. “Day in, day out, a lot of people get their water from foods, as well as behavioral attitudes towards food,” Kenney explains. “For instance, when we walk by a water fountain, we tend to take a drink, and we tend to drink when we eat.”

Kenney also takes issue with the idea of not drinking caffeinated beverages because they’re dehydrating. He says the amount of caffeine in a cup of coffee or tea is relatively small, and it’s made of mostly water anyway, so it will hydrate you to some degree. The same holds true for beer, he says, but there is a point at which the diuretic effect of caffeine and alcohol kicks in, so moderation is always the key.

In general, larger people need to drink more water, as do athletes and those who perspire heavily, but that may mean more or less than eight glasses a day. “There is no one-size-fits-all remedy,” he says.

Instead, he recommends monitoring body weight to keep track of hydration levels. To monitor body weight, one should be weighed every morning. If they’ve lost two pounds or more from the day before, and especially if they feel thirsty or have a headache, they’re probably dehydrated.

Mild dehydration is defined as losing 2 percent of your body weight. Severe dehydration occurs with 4 percent or greater body weight loss. Even mild dehydration can affect a person’s health, especially if he already has cardiac or renal problems. “We have measured in the lab cognitive impairment,” he says. “With severe dehydration, it puts a greater strain on the heart. Think of a pump trying to pump with less fluid. That would be one of the primary problems.”

Kenney says an active 65-year-old who exercises probably doesn’t need to weigh herself every day, but a 75-year-old in a nursing home who has had issues with dehydration in the past or has had cardiac issues, should be weighed every day.

But, don’t rely on scales that also claim to measure hydration levels and body mass index. “Their accuracy is very poor; we can’t use them even for research purposes,” Kenney says.

Complicating matters is that signs of dehydration in younger people don’t always show up in the elderly. For example, if a young person was extremely dehydrated, his skin may be wrinkled or sagging. But, that certainly wouldn’t be noticed in most cases of elderly dehydration.

Perhaps because of that delay in diagnosis, elderly dehydration is a frequent cause of hospitalization (one of the ten most frequent admitting diagnoses for Medicare hospitalizations, according to the Health Care Financing Administration), and it can be life-threatening if severe enough.

Other signs of dehydration to look for: confusion, problems with walking or falling, dizziness or headaches, dry or sticky mouth and tongue, sunken eyes, inability to sweat or produce tears, rapid heart rate, low blood pressure or blood pressure drops when changing from lying to standing, and constipation or decrease in urine output. Also check for a decrease in skin turgor-pull up the skin on the back of the hand for a few seconds; if it does not return to normal within a few seconds, the person is dehydrated.

To help make sure your loved one doesn’t suffer from elderly dehydration, make sure he or she consumes an adequate amount of fluids during the day; eats healthy, water-content foods such as fruit, vegetables and soups; checks that urine color is light and output adequate (dark urine or infrequency of urination is a classic sign of dehydration).

Seniors also need to be educated to drink even when they’re not thirsty. Keeping a water bottle next to the bed or their favorite chair could help, especially if they have mobility issues.

If your loved one is in a nursing home or other care facility, make sure that the staff has a hydration program in place, including assisting residents with drinking, offering a variety of beverages (remember, taste buds change with age, so a beverage they used to enjoy may no longer taste right), and providing drinks not only at mealtimes but in between meals. Also make sure that they monitor residents’ weight and assess them if their physical condition or mental state changes. If dehydration is an issue and your loved one takes laxatives or diuretics, speak to his or her doctor about changing medication.

As with most illnesses, prevention is the key. Making sure your loved one stays hydrated now is much easier than treating him or her for dehydration later.

Fingernails: 5 signs that point to bigger health issues

Changes in the fingernails can indicate everything from heart disease to thyroid problems and malnutrition. Here are some nail conditions that might require medical attention.

Nail Separates from Nail Bed

What it looks like: Fingernails become loose and can separate from the nail bed.

Possible causes:

  • Injury or infection
  • Thyroid disease
  • Drug reactions
  • Psoriasis
  • Reactions to nail hardeners

Yellow Nails

What it looks like: Yellow discoloration in the fingernails. Nails thicken and new growth slows. Nails may lack a cuticle and may detach from the nail bed.

Possible causes:

Spoon Nails

What it looks like: Soft nails that look scooped out. In spoon nails (koilonychia), the depression usually is large enough to hold a drop of liquid.

Possible causes:

  • Iron deficiency
  • Anemia

Nail Clubbing

What it looks like: The tips of the fingers become enlarged and the nails curve around the fingertips.

Possible causes:

  • Low oxygen levels in the blood, which could point to heart disease
  • Inflammatory bowel disease
  • Cardiovascular disease
  • Liver disease

Opaque Nails

What it looks like: Nails look mostly opaque but have a dark band at the tips (a condition known as Terry’s Nails)

Possible causes:

If your senior parent has one of these nail problems, and it doesn’t go away, make an appointment with your doctor to get it diagnosed.

Information compiled from Mayo Clinic

Brain Health: Keeping Your Brain Healthy and Sharp

Maintaining the health of your brain as you age is just as important as staying physically fit. In fact, many studies show that brain fitness can play an important role in warding off dementia. According to the Center for the Longevity of the Brain, more than 24 million people are living with this disease, so the stakes are high. The good news is that there are easy and fun ways to keep your brain sharp. Some simple lifestyle adjustments and engaging activities can make a world of difference in brain health!

Eating a healthy balanced diet is always important, but for brain health, it is essential. A diet rich in fruits, vegetables and lean proteins is an excellent place to start. Eating a healthy diet can also reduce the risk of high blood pressure, diabetes and other health conditions that contribute to cognitive decline.

brain health is importantMartha Clare Morris, ScD, an associate professor of internal medicine at Rush University Medical Center in Chicago, has found that a diet that incorporates one meal a week high in omega-3 fatty acids can slow cognitive decline by 10% each year. Omega-3 fatty acids are unsaturated fats that are also called “good fats.” Our bodies need this type of fat in order to lower cholesterol and reduce the risk of heart disease. Some of the best natural sources of omega-3 fatty acids are fish, nuts and flax seed.

In addition to diet, physical exercise is important for a healthy body and a healthy mind. Two studies presented at the 2011 Alzheimer’s Association International Conference in Paris suggest that that exercise can protect one’s brain against mental decline and promote brain health. Exercising four to five times a week for at least 30 minutes is preferable. Simply going for a brisk walk or even exercising from a seated position will yield measurable benefits. Remember that it is important to check with your doctor before starting any new physical exercise program.

Brain Health Can Be Fun!

Exercising your brain is just as important as exercising the rest of your body. Effective brain exercise includes reading a book (preferably aloud), engaging in a favorite hobby, doing simple arithmetic or learning a new skill. Hosting a game night, doing a crossword puzzle, playing card games, learning to dance or play an instrument are just a few other suggestions. The brain is like a muscle and the more it is used, the stronger it will be! Promoting brain health can be fun.

Interestingly, another important way to support the brain health is through social interaction. Research supports the notion that social interaction plays a positive role in one’s cognitive abilities and overall health. According to the National Institute on Aging, “Several research studies have shown a strong correlation between social interaction and health and well-being among older adults, [while] social isolation may have significant adverse effects for older adults.” In other words, stay in touch. Online social networking has its benefits, but nothing beats the lasting impact of in-person socializing.

Another good way to stay in touch is to volunteer. Meeting new people and starting new friendships can be exciting and may give you a renewed sense of purpose. See how your skills may be a perfect match for local volunteer opportunities at www.createthegood.com.

The trick is to be open-minded and willing to make an effort to stay engaged with your body and your brain. Getting started is often the hardest part of making even minor changes to your daily routine. Stimulating your brain activity to help keep your mind sharp can be as simple as engaging in something that incorporates one or more of your senses such as gardening or attending a concert.

For more information on brain health research, go to the DANA Foundation website www.dana.org  or the National Institute of Neurological Disorders and Stroke . You can also find out more about AARP’s Staying Sharp initiatives at www.aarp.org.

Brain health can be fun. Keeping your brain fit, engaged and active now can help you maintain mental alertness throughout your life.

Reprinted with permission from  Maine Senior Guide.

Seniors Eyecare Program

The Seniors Eyecare Program ensures that every senior has access to medical eye care and promotes annual, dilated eye exams.  It raises awareness about age-related eye disease, including cataracts, provides free eye care educational materials and facilitates access to eye care.

The Seniors EyeCare Program is designed for people who:

  • Are US citizens or legal residents
  • Are age 65 and older
  • Have not seen an ophthalmologist in 3 or more years

People may call the toll-free help line at 800-222-EYES ( 3937) anytime, for themselves and/or family members and friends to see if they qualify for a referral to a volunteer ophthalmologist or to request free eye care information.

To see if you qualify or for more information you can go www.eyecareamerica.org