Friday, October 21, 2011

Caregiving’s Hidden Benefits

Caregiving's Hidden Benefits

By PAULA SPAN
Could there be measurable benefits to your health, and to your brain in particular, from being a caregiver?
It's practically become an article of faith that the reverse is true, that caring for an elderly relative is so stressful, relentless and draining that it takes a toll on your well-being. Some studies have shown that it can increase your risk of depression and heart disease, impair your immune system, even contribute to death.
That caregiving could actually provide some health advantage is so counterintuitive that when Lisa Fredman, a Boston University epidemiologist, first saw such results emerging from her study of elderly women, "I thought, what on earth is going on here?" she recalled. "I blamed myself. I thought something was wrong with my data."
But over several years of studying the differences between caregivers and non-caregivers in four locations (Baltimore, Pittsburgh, Minneapolis and Portland, Ore.), Dr. Fredman and her colleagues found that while caregivers were indeed more stressed, they still had lower mortality rates than non-caregiversover eight years of follow-up.
In another study of about 900 women drawn from the same four-site sample, even those classified as high-intensity caregivers — because they performed more functions for their dependent relatives — maintained stronger physical performance than non-caregivers. On tests like walking pace, grip strength and the speed with which they could rise from a chair, the high-intensity group declined less than lower-intensity caregivers or non-caregivers over two years.
"That was a shocker," Dr. Fredman said.
Now Dr. Fredman and her co-author Rosanna Bertrand, a health policy associate at Abt Associates in Cambridge, Mass., have gone back to this pool of women to look at their cognitive functioning. Here, again, caregivers did significantly better on memory tests than did non-caregivers followed over two years. Though the groups were about the same average age, in their early to mid-80s, caregivers scored at the level of people who were 10 years younger.
Along with what's called "caregiver burden," gerontologists and psychologists use the phrase "caregiver gain" to reflect the fact that this role, which often exacts such high costs, can bring rewards. But they've typically described those rewards in psychological, emotional and even spiritual terms: growing confidence in one's abilities, feelings of personal satisfaction, increased family closeness. That caregivers can walk faster or recall more words on a memory test — that's news.
Dr. Fredman has begun referring to this notion that caregivers are not invariably beaten down by their responsibilities as the "healthy caregiver hypothesis." Taken together, her studies provide some evidence that caregivers, however stressed, may be stronger and stay stronger than women of the same ages who don't undertake those tasks. The interesting question is why.
You can't randomize studies like this, assigning some old women to serve as caregivers but not others. So it's likely that a big part of the differences, Dr. Fredman said, stemmed from self-selection: Women become caregivers because they are healthy enough to shoulder that responsibility. "If you're not healthy," she said, "it goes to your daughter or daughter-in-law." It's not surprising, therefore, that even high-intensity caregivers have and maintain more physical strength.
It's also true that Dr. Fredman's definition of a caregiver sets a fairly low bar, including anyone who performs even one "instrumental activity of daily living," such as helping someone with bill-paying or phone use. Hands-on help with bathing or toilet use is clearly more stressful, physically and emotionally; caring for someone with dementia can be particularly arduous.
But caregiving itself may provide real benefits. "Most caregiving activities require you to move around a lot," Dr. Fredman pointed out. "It keeps people on their feet, up and going." And exercise is known to improve physical health and cognition.
Moreover, Dr. Bertrand added: "Caregiving often requires complex thought. Caregivers monitor medications, they juggle schedules, they may take over financial responsibilities." That, too, can ward off cognitive decline.
Plus there's the whole matter of people benefiting from having a purpose. It's hard to quantify, but it's real.
So it's fair to say that the question of how caregiving impacts the caregiver is more complicated and individual than we think. Both could be true, the burdens and the benefits, depending on how demanding the job is and a host of other factors.
That caregiving is a very tough job is beyond debate. "We don't want to overstate this and say it's good for caregivers and have governors across the country rush to cut support programs that help families," said Steven Zarit, a Penn State gerontologist who has studied caregiving. (Of course, governors seem all too eager to do that anyway.)
Still, "it may not be as predictive of their demise as previously thought," Dr. Bertrand said of elder care and caregivers. "There are potentially some positive aspects."
http://newoldage.blogs.nytimes.com/2011/10/12/caregivings-hidden-benefits/?ref=elderly

"Learn About Senior In Home Health Care in Austin, Texas Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "

Friday, October 7, 2011

Are You Taking Drugs You Don’t Need?

Are You Taking Drugs You Don't Need?
by Elizabeth Smoots, MD

In your medicine cabinet you may have a mix of prescription drugs and over-the-counter drugs to treat various conditions. Some of these medications are truly necessary, as people tend to have more health problems with age. But the more medicines you take, the greater your risk of suffering adverse reactions from the drugs.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. Older people are especially susceptible to becoming confused, dizzy, or falling and breaking a hip. Previous studies have found unnecessary drugs common in nursing homes, hospitals, doctors' offices, and the home. Although medical providers have tried to address this issue, misuse of drugs remains a major problem for seniors.
List of Inappropriate Drugs
In the journal, Archives of Internal Medicine, researchers identified drugs that may be inappropriate for persons aged 65 years and older.
This is not a complete list, though. There may be other medications that can be harmful to you. Talk to your doctor.
Drug Name Severity Rating
Indomethacin (Indocin, Indocin SR) High
Pentazocine (Talwin) High
Trimethobenzamide (Tigan) High
Methocarbamol (Robaxin) High
Carisoprodol (Soma) High
Chlorzoxazone (Paraflex) High
Metaxalone (Skelaxin) High
Cyclobenzaprine (Flexeril) High
Oxybutynin (Ditropan) High
Rurazepam (Dalmane) High
Amitriptyline (Elavil) High
Chlordiazepoxide-amitriptyline (Limbitrol) High
Perphenazine-amitriptyline (Triavil) High
Doxepin (Sinequan) High
Meprobarnate (Miltown, Equanil) High
Lorazepam (>3 mg) (Ativan) High
Oxazepam (>60 mg) (Serax) High
Alprazolam (> 2 mg) (Xanax) High
Ternazepam (>15 mg) (Restoril) High
Triazolam (>0.25 mg) (Halcion) High
Chlordiazepoxide (Librium) High
Chlordiazepoxide-arnitriptyline (Limbitrol) High
Clidinium-chlordiazepoxide (Librax) High
Diazepam (Valium) High
Quazepam (Doral) High
Halazepam (Paxipam) High
Chlorazepate (Tranxene) High
Disopyramide (Norpace, Norpace CR) High
Digoxin ( >0.125 mg/d, except if treating atrial arrythmias) (Lanoxin) Low
Short-acting dipyridamole (Persantine) Low
Methyldopa (Aldomet) High
Methyldopa-hydrochlorothiazide (Aldoril) High
Reserpine (>0.25 mg) Low
Chlorpropamide (Diabinese) High
Dicyclomine (Bentyl) High
Hyoscyamine (Levsin, Levsinex) High
Propantheline (Pro-Banthine) High
Belladonna alkaloids (Donnatal and others) High
Clidinium-chlordiazepoxide (Librax) High
Chlorpheniramine (Chlor-Trimeton) High
Diphenhydramine (Benadryl) High
Hydroxyzine (Vistaril, Atarax) High
Cyproheptadine (Periactin) High
Promethazine (Phenergan) High
Tripelennamine High
Dexchlorpheniramine (Polaramine) High
Diphenhydramine (Benadryl) High
Ergot mesyloids (Hydergine) Low
Cyclandelate (Cyclospasmol) Low
Ferrous sulfate (>325 mg/d) Low
All barbituates (except phenobarbital) except to control seizures High
Meperidine (Demerol) High
Ticlopidine (Ticlid) High
Ketorolac (Toradol) High
Amphetamines and anorexic agents High
Naproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve) High
Oxaprozin (long-term use of full dosage) (Daypro) High
Piroxicam (long-term use of full dosage) (Feldene) High
Daily fluoxetine (Prozac) High
Bisacodyl (long-term use) (Dulcolax) High
Casacara sagrada (long-term use) High
Neoloid except in presence of opiate analgesic use (long-term use) High
Amiodarone (Cordarone) High
Orphenadrine (Norflex) High
Guanethidine (Ismelin) High
Guanadrel (Hylorel) High
Cyclandelate (Cyclospasmol) Low
Isoxsurpine (Vasodilan) Low
Nitrofurantoin (Macrodantin) High
Doxazosin (Cardura) Low
Methyltestosterone (Android, Virilon, Testrad) High
Thioridazine (Mellaril) High
Mesoridazine (Serentil) High
Short-acting nifedipine (Procardia, Adalat) High
Clonidine (Catapres) Low
Mineral oil High
Cimetidine (Tagamet) Low
Ethacrynic acid (Edecrin) Low
Desiccated thyroid High
Amphetamines (excluding methylphenidate hydrochloride and anorexics) High
Estrogens only (oral) Low

Note: For your own health and safety, do not stop taking any medication unless you have consulted with your doctor and have her approval.
Risks for Inappropriate Drug Use    
When you are on a lot of medicine, how can you tell if you are taking more than you need? First of all, you need the help of your doctor to determine this. You and your doctor should be on a heightened state of alert for unnecessary medications if any of the following risk factors apply to you:
  • Taking multiple drugs, especially if filling over 14 prescriptions a year
  • Using over-the-counter drugs and supplements
  • Visiting a number of different doctors
  • Having trouble understanding instructions
  • Saving medications for later use
  • Borrowing or sharing medication
  • Being age 65 years or older
  • Being female
  • Having poor health status
    Talk to Your Doctor    

The best way to fine-tune your medications is to work with your doctor. After all, most doctors are experts in the drug treatment of disease. But your doctor can only help if you tell him or her about all the medicines you are taking, including prescription and over-the-counter drugs and supplements.
Thoroughly review your medications with your doctor at least once a year. Write down a complete list, or better yet, bring all your medications into the office in a brown bag. And don't forget to include those in your medicine chest or kitchen cupboard that you only take once in awhile.
Another key is to ask questions. Keep inquiring until you understand the dose, frequency, and purpose of the medicines you are taking. Finally, don't be afraid to ask about nondrug options that can help you minimize your use of medications.

"Learn About Senior In Home Health Care in Austin, Texas Senior Helpers Provides Many services in the Austin, Texas area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Austin, Bartlett, Bertram, Briggs, Burnet, Cedar Park, Florence, Georgetown, Granger, Holland, Hutto, Jarrell, Johnson City, Killeen, Leander, Liberty Hill, Manor, Marble Falls, Pflugerville, Round Mountain, Round Rock, Salado, Spicewood, Taylor and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Austin Home Health Care Company. "