Dehydration is common and a very serious condition in older adults (64 years and older). Maintaining the body’s fluid balance is critical to healthy aging. Dehydration when not adequately treated can be fatal; it’s associated with serious effects like poor mental functioning, blood clots, infectious diseases, kidney stones, and severe constipation. Dehydration should be prevented whenever possible; properly diagnosed and treated when present.
As we age, there is a decrease in overall body hydration (the absolute amount of water in the body). In addition, kidney function and the sensation of thirst decline in older adults. Taken together, these account for the prevalence of dehydration. (Note: if you are thirsty you are already dehydrated).
With increasing age, a substantial number of older adults drinks less than 1 quart of fluid per day. The lower our body weight and overall body hydration, the sooner the loss of even a small amount of body water will cause dehydration. Environmental and disease-related risk factors play a substantial role among older adults. For instance, even a viral infection with its high fevers, vomiting and diarrhea can dehydrate.
The most important risk factors for dehydration were identified in a large study on a nursing home population: Being over 85 years old, female, having five or more chronic diseases, taking five or more kinds of medication, and being bedridden. Being dependent on others for care, and therefore water intake, can increase the risk of dehydration. Since much fluid is taken with meals, eating “like a bird” may lead to lesser intakes of water than is desirable.
Diagnosing dehydration in the older population isn’t straightforward. Classical signs such as the time it takes skin to rebound when pinched (recoil), increased thirst, and drops in blood pressure upon standing up are not reliable in older adults. At the same time, dehydration often causes symptoms associated with several other conditions in the elderly; symptoms like confusion, constipation, fever or falls. This all muddies the diagnostic waters.
However, good news, we can self-manage. When older adults know that they should not trust to thirst to signal dehydration (if you’re thirsty you’re already dehydrated), but drink water because it is healthy, their intake increases above the absolute minimum intake of 57 ½ fluid ounces of water per day.
For calculating the minimum amount of fluid per day, an easy method is to drink half your body weight in ounces of water daily. Remember, that’s merely a minimum. Be sure to increase intake by many ounces in pregnancy/breastfeeding, hot weather, dry or humid climates, high altitudes and physical activity.
Caffeine leeches water from your body, so avoid it in sodas, coffee and even teas. (Black and green teas both contain caffeine.) Alcoholic drinks as well as fluids with high protein intake also leech body water.
Reminders to yourself, friends, loved ones to drink water plus keeping water visibly handy during the day can help. Don’t underestimate dehydration!
In seeking to keep older Americans healthy and well, the AARP regularly posts information and suggestions for each of us to consider. Here is a recent article about Thyroid Cancer.
Originally posted by Cheryl Bond-Nelms, on AARP, July 5, 2017.
As with all articles expressing facts and/or opinions about health and wellness: nothing in the sharing of this article is meant to be medical advice. Please consult your own healthcare provider as you monitor and/or research your own health needs.
Nearly three out of four cases of thyroid cancer are found in women.
Although the death rate from cancer in America is down 25 percent since 1991, there is one type of cancer rapidly increasing in the U.S. According to the American Cancer Society, the chance of being diagnosed with thyroid cancer has tripled over the last three decades, making it the fastest-growing cancer.The thyroid is a gland located in the front of the neck, shaped like a butterfly. It produces hormones that enter the bloodstream and affect the metabolism, heart, brain, muscles and liver, and keep the body functioning properly and effectively.The estimates for cases of thyroid cancer in America for 2017 have increased, and rates are higher in women than men, according to these figures published on cancer.org.
In 2017, there will be an estimated 56,870 new cases of thyroid cancer — 42,470 in women and 14,400 in men.
An estimated 2,010 deaths will result from thyroid cancer — 1,090 in women and 920 in men.
Women account for nearly three-quarters of thyroid cancer cases. The exact cause of most thyroid cancers is unknown. Research has concluded that better imaging technology has increased the number of thyroid cancer cases diagnosed. “Much of this rise appears to be the result of the increased use of thyroid ultrasound, which can detect small thyroid nodules that might not otherwise have been found in the past,” the American Cancer Society says.What are the signs or symptoms related to thyroid cancer? The American Cancer Society lists the following on cancer.org:
Pain in the front of the neck, sometimes going up to the ears
Hoarseness or other voice changes that do not go away
A constant cough that is not due to a cold
Talk with your doctor immediately if you have any of the signs or symptoms associated with thyroid cancer. Noncancerous conditions or even other cancers can also cause many of the symptoms.How can you protect yourself?Experts say most people found to have thyroid cancer have no known risk factors, and so emphasize that most cases can not be prevented. Professionals suggest regular self-exams to catch thyroid changes in the earliest stages as one of the best means of protection.Here are five steps to performing a self-exam from thyroidawareness.com:
Hold a mirror in your hand, focusing on the lower front area of your neck, above the collarbones and below the voice box (larynx).
While focusing on this area in the mirror, tip your head back.
Take a drink of water and swallow.
As you swallow, look at your neck. Check for any bulges or protrusions in this area when you swallow. Reminder: Don’t confuse the Adam’s apple with the thyroid gland. The thyroid gland is located farther down the neck, closer to the collarbone. You may want to repeat this process several times.
If you see any bulges or protrusions in this area, see your physician. You may have an enlarged thyroid gland or a thyroid nodule that should be checked to determine whether further evaluation is needed.
Health professionals estimate that 15 million Americans have undiagnosed thyroid problems. The good news is that the survival rate of thyroid cancer patients is higher than for most other cancers. Early detection of thyroid cancer can open up more treatment options. You can also ask your doctor to check your thyroid health with a thyroid-stimulating hormone (TSH) test, a blood test that can determine whether the gland is functioning normally.
When you don’t have a tissue handy to cover your mouth and nose, your best bet is to cough or sneeze into the crook of your elbow, or upper arm, according to the Centers for Disease Control and Prevention.
The point is to avoid using your hands, which may not be that clean, and can also easily spread germs around. Covering up also prevents germ-laden droplets from getting launched into the air, where they can land on frequently touched surfaces and infect others.
This simple technique is not only good advice for adults and kids to remember during cold and flu season, but it’s also a smart health move any time — when allergies strike, or a bug is going around.
Politicians and policymakers are discussing what parts of the Affordable Care Act to change and what to keep. While most of us have little control over those discussions, there is one health care topic that we can control: what we talk about with our doctor.
The Institute of Medicine (IOM) released the landmark publication Crossing the Quality Chasm 15 years ago. The report proposed six aims for improvement in the U.S. health system, identifying that health care should be patient-centered, safe, effective, timely, efficient and equitable.
The idea that health care should be patient-centered sounds obvious, but what does that mean? The IOM defines it as care that is “respectful of and responsive to individual patient preferences, needs, and values” and that ensures “patient values guide all clinical decisions.”
For this to truly happen, doctors’ appointments need to cover more topics than how one is feeling and what can be done. Does your doctor know your values?
If you answered no, you’re not alone. Fewer than half of people report that their physician or other health care provider asks about their goals and concerns for their health and health care.
Your doctor can discuss medical tests and treatments without knowing your life goals, but sharing your values and needs with your doctor makes discussions and decisions more personalized – and may lead to better health.
How does patient-centered care happen?
In order for your health care to center around you, your doctor needs to know your values, preferences and needs. Everyone is different. Your values and needs may also vary from one appointment to the next.
As a neurologist, when I’m working with a 76-year-old widow whose main goal is to remain independent in her home, we frame her care in that context. We weigh benefits of medications versus the complexity of adding one more drug to her crowded pill box. We discuss how a walker helps her be more independent rather than less, as she can move around her home more safely.
When a stressed college student comes to my office for a bothersome tremor, his preference is to avoid medications that he might forget to take or that might harm his school performance. This guides our discussion of the pros and cons of different options, including using medications but also doing nothing, an option that almost half of patients feel strongly should always be discussed. A year from now after graduation, we’ll revisit the conversation, as his goals and needs may be different.
In sharing their values and goals with me, these individuals enabled a health care approach that respected their needs and also responded to their life circumstances.
Shared decision-making is not just relevant when deciding whether or not to start a treatment, but also when deciding whether to undergo screening (e.g., mammography) or get testing to tease out a diagnosis. The key element of shared decision-making is incorporating your values and preferences alongside the best available evidence.
To do this, your physician should explain the medical information associated with each of the different options – the research, the anticipated benefits and how likely they are, the risks and how often complications or side effects happen, the costs, etc.
Your physician should also discuss your values and preferences as they relate to these options. For example, when partnering with a person with chronic daily headache and a high-stress job, I’ll help him or her reflect on the potential benefits of fewer headaches on work productivity but also the potential impact of the side effect of morning grogginess.
With so many options and so much uncertainty in medicine, individualized care is critical. That happens most effectively if you and your doctor are on the same page about your goals and needs.
Tools for navigating shared decision-making
There are three-step and five-step outlines for shared decision-making, which are primarily aimed at helping physicians be intentional about this process.
These models frame the steps of medical discussions slightly differently, but both emphasize that patients and health care professionals need to be engaged – it’s a partnership. Alternatives are compared, values discussed and a decision made. Reassessment is also an important part of shared decision-making, as alternatives and values can change over time.
For common decisions, different health care organizations have created decision aids to help physicians and patients talk through the scientific evidence, pros and cons, and values that are likely to impact the specific decisions to be made.
Decision aids are not designed for patients to make decisions on their own. They are created to enhance your partnership with your doctor, providing a structured way for you to talk through a decision by reviewing the evidence and your preferences.
What you can do
While busy lives can hinder introspection, it is helpful for you to know your own goals and needs. Are you focused on working two more years until retirement? Do you want to explore physical therapy or diet changes before considering medications? Are you walking your daughter down the wedding aisle in two months and want something to hide the tremor that never really bothered you before?
If you know your values and your goals for the coming months or years, it’s easier to share them with your doctor.
Shared decision-making also requires you to be an active participant. Listen to the options, the pros and cons. Ask questions. Think through how each option relates to your personal values and preferences. Take time if you need it. And then with your doctor, decide what’s best for you.
Just 20 minutes of exercise may help fight inflammation in the body, a new study suggests.
In the study, 47 people walked on a treadmill at a brisk pace for 20 minutes, and had blood samples taken before and after this exercise session.
The researchers found that this amount of exercise reduced markers of inflammation in the body. Specifically, the 20-minute exercise session resulted in a 5 percent decrease in the number of immune cells that produced a protein called TNF, which is involved in the body’s inflammatory response, the researchers said.
I live with a significant hearing loss. I am grateful that with the help of hearing aids I am able to enjoy the sounds of the mountain and forest and hear the people around me. I read this article with interest. ~Fr. Dan
I was intrigued by this part of the longer post:
Hearing loss is being recognized as a national health issue
In June, a series of recommendations on hearing loss announced by the National Academies of Sciences, Engineering, and Medicine seemed to be proof that hearing is loss is finally getting its due as a national health issue.
If followed, these 12 recommendations — combined with those made the previous autumn by a presidential commission on science and technology — could result in a revolution in hearing health care. They would provide changes that would open the market to a wider range of hearing technology and devices, making it easier for consumers to “find and fully use the appropriate, affordable, and high-quality services, technologies, and support they need.”