Addressing Urinary Retention Or Urinary Obstruction
Conditions such as prostate enlargement in older men and neurological damage due to diabetes, stroke or multiple sclerosis may lead to urinary retention. When this happens, a senior is unable to completely empty their bladder. Urine will accumulate and stagnate within the organ, eventually resulting in bacterial colonization and possibly UTI.
Urinary retention is diagnosed by measuring a seniors post-void residual, which is the amount of urine that remains in the bladder after urination. To obtain a post-void residual measurement, a catheter is inserted through the urethra and into the bladder after urinating to drain any leftover urine. Sometimes an ultrasound machine can be used to take this measurement. A residual of 100 mL or more indicates that the bladder is not emptying properly.
Another cause of incomplete voiding is urinary obstruction caused by a kidney stone stuck in a ureter . This blockage can contribute to recurrent UTIs and even kidney infections. Diagnostic imaging, such as an ultrasound or CT scan, can be used to diagnose a ureteral stone and treatment must usually be provided by a urologist.
The Human Form Of Mad Cow Disease
As a geriatric psychiatrist, I recognized that Marjories symptoms warranted careful evaluation. Even though she was only in her late 50s, very young for the onset of a dementia, her problem seemed unlike a routine case of depression. Her memory difficulty and her trouble carrying out tasks that had been simple a few months earlier suggested a neurocognitive problem such as delirium or dementia. The careful work of a local neurologist to whom I referred Marjorie led to a sad discovery. Marjorie was suffering from Creutzfeldt-Jakob disease, an infection of the brain that produces rapidly progressive dementia. Creutzfeldt-Jakob disease is a transmissible spongiform encephalopathy, sometimes called the human form of mad cow disease, and is caused by microscopic particles called prions, which are simple and potentially devastating proteins that cause certain host proteins to undergo a destructive change in shape. Although no curative treatment is available for this disorder, recognition of the diagnosis allowed Marjories family to prepare for her death and to ease her final weeks of suffering by providing a palliative and loving environment.
Ensuring A Person Is Awake And Upright While Eating
This will majorly prevent aspiration dementia. When a person concentrates on eating and drinking, it will reduce the chances of the food going down the wrong pipe.
At some point changing the texture of food by pureeing or mincing may be necessary. Thickening fluids can also make them easier to safely swallow.
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Dementia And Infections: Understanding The Connection
Chronic illness can affect your life in many ways ranging from annoying to life-threatening. Recognizing illness early on in yourself or a loved one may allow for a better quality of life and even more time to live.
One such illness is Dementia. Not many conditions devastate a family quite like this one.
Arming yourself with information may help you combat the effects of this disease. Dementia and infections interplay with one another, and learning this information can save a loved ones life.
Which Medications Are Anticholinergics
You might be surprised to know that anticholinergic medications include seemingly harmless over-the-counter medications like antihistamines and sleep aids .
To help you understand which prescription and over-the-counter drugs have anticholinergic effects, we found a helpful list from ElderConsult of common medical conditions and the anticholinergic medications typically used to treat them.
Medical conditions include a wide variety of common ailments like overactive bladder, sleep issues, coughs, colds, allergies, behavior issues, mood disorders, chronic obstructive pulmonary disease , and Parkinsons disease.
This list might not include every single condition or medication, but its a good start to finding out if any of your older adults medications are anticholinergics.
Use this list to have an informed conversation with your older adults doctor about the risks and benefits of taking that medication.
- Constipation / urine retention
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How Is It Treated
There are medicines you can take for dementia. They cannot cure it, but they can slow it down for a while and make it easier to live with.
As dementia gets worse, a person may get depressed or angry and upset. An active social life, counseling, and sometimes medicine may help with changing emotions.
If a stroke caused the dementia, there are things you can do to reduce the chance of another stroke. Make healthy lifestyle changes including eating healthy, being active, staying at a healthy weight, and not smoking. Manage other health problems, such as diabetes, high blood pressure, and high cholesterol.
Do Antibiotics In Late
A review of the research on antibiotics suggests that antibiotics may often be overused in advanced dementia. One study tracked nursing home residents with late-stage dementia and found that among those who died, more than 40 percent received antibiotics in the last two weeks of life, many of them intravenously.
Research suggests that decisions about treating pneumonia with antibiotics should depend on the goal of the care. A study comparing nursing home residents with advanced dementia found that antibiotics improved survival rates but decreased comfort rates. Thus, they suggested that for those with a goal of comfort care, antibiotics should either be withheld or only given orally, and for those with a goal of prolonging life, antibiotics should be aggressively administered.
But, do they really work? According to multiple studies, the success of antibiotics in the late stages of dementia for pneumonia is questionable. The Journal of American Medical Directors published a study that found that antibiotics, when used for people with dementia and respiratory infections such as pneumonia, extended life, but on average only by several days. These researchers pointed out the concern that antibiotics in late-stage dementia merely prolonged the dying process, rather than effectively treated the infection.
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Why Medication Fog Happens
For starters, our bodies change over time.
Peoples kidney function often declines with increasing age, so youre less able to excrete the medication so the levels can build up in your body, Steinman said.
Peoples bodies and their brains become more susceptible to being pushed off-kilter as they age.
If you are young and healthy and you are given a medication that can cause cognitive changes, typically you have enough reserve in your brain so that even if the medication has a risk of throwing you through a loop your brain has the ability to sort of fight that and keep you feeling normal, he explained.
Theres been a big push in recent years for deprescribing, Steinman said, which is the process of identifying problematic medications and reducing doses or safely stopping those medications.
Steinman and his colleagues created the U.S. Deprescribing Research Network, funded by the National Institutes of Health, to address this issue and help reduce the number of unnecessary or harmful medications people take that can lead to medication fog or other side effects.
How Are Antibiotics Given To People
Some antibiotics are given as pills by mouth, while others are in the form of an injection . The strongest type of antibiotics is typically administered intravenously . Some of these IV antibiotics require frequent blood tests and hospitalization, although some nursing homes are able to provide IV antibiotics. Some people might even go home with IV antibiotics and have a nurse come regularly to assist in administering them.
Due to confusion in middle or later stage dementia, people with IVs may be more likely to be restrained since they may not understand the reason for the IV and attempt to pull it out.
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Antipsychotic Drugs Called Neuroleptics
Drug-induced parkinsonism is due primarily to drugs that block dopamine receptors, particularly the D2 receptors . These drugs are most often the antipsychotic drugs, called neuroleptics, such as haloperidol, chlorpromazine, and trifluoperazine, but include metoclopramide, a gastrointestinal motility enhancer, and the antiemetics prochlorperazine and droperidol. In addition, medications that block synthesis of dopamine, such as alpha-methyl para-tyrosine and alpha-methyl dopa or deplete dopamine also induce parkinsonism. In these cases the pathophysiology is presumably due to diminished dopamine receptor stimulation, resulting in a pharmacologic state closely resembling Parkinson disease.
However, the atypical antipsychotics also block D2 receptors. Yet there is no apparent correlation between the degree of this blockade and the risk for inducing parkinsonism. The explanation for this is uncertain. One current hypothesis is the fast off theory, postulating that the duration of the D2 blockade, rather than the percentage of receptors blocked, determines the likelihood of parkinsonism . A competing theory is that the ratio of 5 HT-2a receptor blockade versus the dopamine D2 receptor blockade is critical because of the interplay between the serotonin and dopamine systems in the brain. An older theory relating extrapyramidal side effects to anticholinergic activity is considered untenable because the concomitant use of anticholinergics does not eliminate the problem.
Medications That Have Side Effects
Dr. David S. Knopman, a clinical neurologist at the Mayo Clinic in Rochester, Minnesota, as well as a member of the Alzheimers Association Medical and Scientific Advisory Group, told Healthline that the key medications to look at are pain medications, sleep medications, anticholinergic medications, antidepressants, and other psychotropic drugs.
He said the anticholinergic class of medications is often considered the worst offender.
For all of them medication misadventures, somnolence, and increased confusion are the common concern, and the third is worsening gait and balance, he said. People who didnt have a prior diagnosis of impairment who are now acting confused, sleepy, or have more balance problems, that in somebody who doesnt have prior diagnosis should trigger a concern.
Your doctor may suggest alternatives to medications that could potentially cause side effects.
When I suggested to one of my patients that we try an alternative to Xanax like melatonin, she became very anxious, said Knopman. Its a difficult problem. Its one best treated by avoidance for starting it in the first place.
Steinman stressed the importance of investigating the side effects medications could be causing.
Unless were really active in exploring that opportunity sometimes it gets missed, and its just written off as dementia and the person sort of keeps deteriorating, he explained.
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Can You Give Your Dog Human Antibiotics
Many people ask this because it seems like a logical, cheaper alternative. And, its true that humans and pets do share some antibiotics in common. However, its more about the dosage than the drug itself, and dosage is not something to ever play with in medicine both human medicine and veterinary medicine. Also, without your dog being properly diagnosed by an expert, you may be treating them incorrectly for the illness that they have, placing them at even more risk. Always consult a veterinarian for diagnosis and treatment plans.
Pneumonia And Dementia: Causes Symptoms Treatment
There is a close correlation between pneumonia and dementia, which we need to be aware of to take action accordingly.
Persons with dementia are prone to different types of infections one of the most frequent being pneumonia.
This is a serious respiratory infection that is common in seniors with or without dementia.
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How Is Dementia Diagnosed
There is no single test for dementia. To diagnose it, your doctor will:
- Do a physical exam.
- Ask questions about recent and past illnesses and life events. The doctor will want to talk to a close family member to check details.
- Ask you to do some simple things that test your memory and other mental skills. Your doctor may ask you to tell what day and year it is, repeat a series of words, or draw a clock face.
The doctor may do tests to look for a cause that can be treated. For example, you might have blood tests to check your thyroid or to look for an infection. You might also have a test that shows a picture of your brain, like an MRI or a CT scan. These tests can help your doctor find a tumor or brain injury.
Common Medications Can Masquerade As Dementia In Seniors
By Judith GrahamJuly 18, 2019
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Could Medications Contribute To Dementia
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
Alzheimers disease and other illnesses that cause dementia are devastating, not only for those affected but also for their friends and family. For most forms of dementia, there is no highly effective treatment. For example, available treatments for Alzheimers disease may slow the deterioration a bit, but they dont reverse the condition. In fact, for most people taking medications for dementia, it may be difficult to know if the treatment is working at all.
Experts predict that dementia will become much more common in the coming years. We badly need a better understanding of the cause of these conditions, as this could lead to better treatments and even preventive measures.
What Is The Outlook For People With Delirium
Patients can recover completely if the cause of delirium is identified quickly and addressed. Any delay makes it less likely theyll recover quickly and/or fully. Lack of treatment can lead to stupor, coma or even death. Older persons with dementia and those with HIV are less likely to have a complete recovery.
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How Antibiotics Are Administered
If the doctor agrees to antibiotics treatment for pneumonia and dementia the drugs can be administered in two major ways.
1. Pills to swallow2. Injections
The strongest antibiotic types are given by an IV infusion or injection. This sends the medicine to the veins directly through a tube or needle.
Anyone subject to IV antibiotics may require frequent hospitalization and blood tests.
As an alternative, the person taking the drugs can work with a nurse at home who will be administering the antibiotics when necessary.
In some cases, restraining the person taking the medicine may be inevitable.
This is because dementia in the middle and later stages can make an individual confused thus, may not understand why they need the IV and want to get rid of it.
Can I Give My Dog Probiotics
Yes! This is perhaps the best thing that you can do for a dog on antibiotics. Probiotics will help to keep your poochs gut flora balanced by adding in more friendly bacteria while the antibiotic is killing everything in sight. Scientific studies even show that taking probiotics may help to enhance your dogs immunity.12
Talk to your vet about which probiotic supplements are right for your dog. You can find them in powders, capsules, chews, and even in dog food.
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Choose The Proper Care
Due to the increased risk with dementia and infections, you may want to consider help in caring for your loved one with dementia. Many families want to give their loved one the best but simply cannot do it all on their own.
Dementia requires a watchful eye as it progresses, and the risk is great. Look into our dementia care for an approach that centers on your loved ones best interest.
Senior Living And Medication Care Plans
For many seniors, a move to an assisted living community can help get this medication chaos under control. Most assisted living communities require that residents have a doctors visit before admission. Families and physicians often use this visit as an opportunity to press the reset button on prescriptions. A complete reassessment of the seniors medication regime can take place at this time. Under doctors supervision, many seniors are able to go off of medicines that are redundant or have outgrown their usefulness.
Once a senior is admitted to assisted living, a care plan is put in place. Care plans lay out goals and strategies for the residents care, and medicines are a big part of the equation. The community, family, senior and medical professionals discuss what medicines will be given to the resident, why, and often set goals for reducing them. In fact, seniors, particularly those with Alzheimers and dementia, are often able to reduce their medications after moving to assisted living communities with memory care.
In fact, many seniors who have been prescribed anti-anxiety medications find themselves in an undignified stupor thats not only painful for loved ones to witness, but also can lead to falls, head injuries and broken bones. Todays memory care communities attempt to reduce this agitation and anxiety non-chemically, with methods such as:
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Medication Management And Healthy Senior Living
While decreasing the amount of prescribed medications is ideal, its not always possible. In some cases, seniors require every medicine theyre prescribed. But even in these cases, assisted living plays an important role. Even if medicines cant be reduced, its important that that they be taken correctly. Medication management, which is offered at nearly all assisted living communities, assures that seniors get the right medicine, at the right dose, at the right time. For seniors with multiple medicines, or with memory loss, this benefit alone can be a lifesaver.
If your older loved one is on multiple medicines, or is showing changes that you believe may be related to drug interactions, arrange a doctors visit to reevaluate medications. Talk to the doctor about what medicines are essential, and which may be doing more harm than good.
If your older loved one cannot take medication safely, and you cant be there to help, consider memory care or residential home care. Our Senior Living Advisors can help your family find the most appropriate options for loved one.
Have medication side effects or reactions led to you or a loved one being misdiagnosed? Are you a medical professional with your own thoughts? We welcome your thoughts in the comments below.