Managing Final Expenses: Tips for Seniors and Families.

Posted on by Maritza Osorio

An important issue that must be discussed with our families is when a member is in the twilight of life, and we do not know what to do with him or her once they die, and this is what is known as final expenses.

 Final expenses refer to costs associated with the end of a person’s life, such as funeral expenses, burial or cremation costs, and others related to the closure of life process. This may include:

1. Funerals and burials: Funeral services, caskets, cremation services, and cemetery plots.

2. Legal arrangements: Costs associated with the processing of wills, estate administration, and other legal services.

3. Debts and obligations: Pending payments of debts, taxes, and other financial commitments.

4.Memorial services: Costs of memorial services or events, such as publishing obituaries.

 How can we protect our older adults and families affected by the death of the former?:

1. Final expense insurance: This type of insurance helps cover the costs of final expenses, ensuring that family members do not face a significant financial burden. This insurance is typically more affordable and easier to obtain for seniors compared to other types of life insurance.

2. Planning ahead: Having a plan for final expenses can relieve stress and uncertainty for seniors and their families. Knowing that these costs are covered can provide peace of mind.

3. Avoid family debt: Prepaid or insured final expenses prevent costs from falling on surviving family members, who may not have the financial resources to handle them.

4. Facilitate the processing of matters: By planning and documenting final wishes, the emotional and logistical burden can be reduced for family members, who will not have to make difficult decisions in a time of grief.

In short, planning for final expenses and purchasing specific insurance for these expenses can provide a financial and emotional safety net for both seniors and their families.

If you want to delve deeper into the topic. In the links I leave below you will find more information about the costs of final expenses and other items in relation with it.

https://www.lhlic.com/es/seguro-de-gastos-finales/#:~:text=%C2%BFQu%C3%A9%20es%20un%20Seguro%20de,popular%20entre%20las%20personas%20mayores

https://www.dignitymemorial.com/es-es/pre-planning/funeral-costs/types-of-final-expense-insurance

I hope you liked this post, In my next publication I will talk about skin care of elderly people, because it can be the first sign of a health condition, and we must follow closely, to prevent it.

Urinary infections in older adults : Symptoms, Risks and Prevention.

Posted on by Maritza Osorio

One of the issues that concern relatives, caregivers, and healthcare providers of older adults the most is urinary tract infections, as they are very common and can be caused by various pathogens. The most common ones are:

  1. Escherichia coli (E. coli): It is the most common cause of urinary tract infections.
  2. Proteus mirabilis: Common in complicated urinary tract infections.
  3. Klebsiella pneumoniae: Common in hospital-acquired urinary tract infections.
  4. Enterococcus faecalis: Can be a cause in complicated infections.
  5. Pseudomonas aeruginosa: Especially occurs in hospital-acquired infections and in patients with urinary catheters.

Urinary tract infections in older adults can present with both classic and atypical symptoms. The most frequent classic symptoms include:

  1. Classic Symptoms:
    • Dysuria (pain or burning during urination).
    • Polyuria (increased urinary frequency).
    • Urinary urgency.
    • Cloudy or foul-smelling urine.
    • Hematuria (blood in the urine).
    • Pain or pressure in the lower abdomen or pelvis.
    • Fever or chills (less common in older adults).
  2. Atypical Symptoms:
    • Changes in mental status or confusion, which can be the only signs in some cases.
    • Fatigue or general weakness.
    • Urinary incontinence or worsening of existing incontinence.
    • Loss of appetite.
    • Nausea or vomiting.
    • Pain in the lower back or side.

Because older adults may not exhibit the typical symptoms of a urinary tract infection, it is important to be vigilant for any changes in behavior or mental status, as well as less common physical symptoms.

Older adults with urinary incontinence use diapers to relieve this discomfort, and this can influence the incidence of urinary infections due to:

  1. Increased moisture:
    • Diapers can retain moisture near the skin and urethra, creating a favorable environment for bacterial growth. Persistent moisture can facilitate bacterial colonization and eventually lead to a UTI.
  2. Fecal contamination:
    • Diapers can contribute to fecal contamination of the genital area, especially in people with fecal incontinence. Gastrointestinal tract bacteria, such as Escherichia coli, are a common cause of urinary tract infections.
  3. Skin irritation and damage:
    • Prolonged use of diapers can cause skin irritation and small abrasions, which can serve as entry points for bacteria, increasing the risk of infection.
  4. Urinary retention:
    • Some older adults may avoid urinating frequently due to the discomfort of changing diapers, which can lead to urinary retention. Stagnant urine in the bladder can become a breeding ground for bacteria.

To mitigate these risks, it is important to take certain preventive measures:

  • Frequent diaper changes:
    • Ensure diapers are changed regularly to keep the skin dry and reduce exposure to moisture.
  • Proper hygiene:
    • Properly clean the genital and perineal area with suitable, gentle products to avoid bacterial buildup.
  • Use of quality absorbent products:
    • Opt for diapers and pads that keep moisture away from the skin and provide an effective barrier against bacteria.
  • Monitoring and medical attention:
    • Monitor for signs and symptoms such as strong-smelling urine, mental confusion, and seek medical attention promptly if an infection is suspected.

Tips to Prevent Urinary Tract Infections in Older Adults:

  1. Proper hygiene: Maintaining proper genital hygiene is crucial to prevent bacterial colonization.
  2. Hydration: Drinking enough water to maintain frequent urination helps expel bacteria from the bladder.
  3. Regular bladder emptying: Avoid holding urine for prolonged periods.
  4. Avoid irritants: Limit the use of irritating products such as scented soaps, bubble baths, and feminine hygiene products that can disrupt the natural balance of genital flora.
  5. Frequent change of underwear: Use cotton underwear and change it daily.
  6. Care with catheters: If urinary catheters are necessary, they should be handled with aseptic techniques and regularly checked.
  7. Control underlying diseases: Properly manage conditions such as diabetes, which can increase the risk of infections.
  8. Prostate care: In men, conditions such as prostate enlargement can increase the risk of urinary tract infections and should be monitored and treated appropriately.

Implementing these measures can significantly help reduce the risk of urinary tract infections in older adults and improve their quality of life.

I hope this post has been helpful to you. In my next post, I will discuss end-of-life expenses, as this is a topic we do not often talk about but need to prepare for.

References

Detweiler, K., Mayers, D., & Fletcher, S. G. (2015). Bacteruria and urinary tract infections in the elderly. Urologic Clinics, 42(4), 561-568.

Lim, V. H., Whitehurst, T., Usoro, E., & Ng, S. M. (2014). Management of urinary tract infections in elderly patients: Strategies for improvement. BMJ Open Quality, 3(1), u203314-w1503.

Nicolle, L. E. (2009). Urinary tract infections in the elderly. Clinics in geriatric medicine, 25(3), 423-436.

The Continuous Journey of Personal Growth: Strategies and Benefits

Posted on by Maritza Osorio

Personal growth is defined as the desire that an individual experiences to continue growing and developing to the fullest extent of their potentialities and capabilities, being dissatisfied with past achievements and striving to take on new personal challenges that allow them to grow as a person and achieve their full self-realization. It involves an active and intentional commitment to one’s psychological growth, which encompasses both cognitive (e.g., “I know how to change things I want to change in my life”) and behavioral (e.g., “if I want to change something in my life, I start the process of change”) aspects towards intraindividual development.

Personal growth has no age limit and is equally relevant for older adults. Here are some ways a senior can foster personal growth:

1. Continuous Learning: Participate in classes, workshops, or online courses on topics of interest. This not only stimulates the mind, but also provides opportunities to socialize and stay intellectually active.

2. Physical Exercise: Incorporate regular physical activity, adapted to individual abilities. Exercise improves physical and mental health, and can include walking, yoga, swimming or gentle gymnastics.

3. Development of New Skills: Learn something new, such as a language, a musical instrument, or a craft. Developing new skills is rewarding and challenges the brain.

4. Volunteering: Get involved in volunteer activities. Helping others provides a sense of purpose and community, and can be a source of personal satisfaction.

5. Maintain Social Relationships: Foster and maintain social connections. Participate in community groups, clubs, or associations of common interest. Social relationships are crucial for emotional well-being.

6. Mental Health Care: Practice relaxation techniques, such as meditation or deep breathing. Seek professional support if necessary to manage stress, anxiety or depression.

7. Reflection and Spirituality: Dedicate time to personal reflection, meditation or prayer. Exploring spiritual aspects can offer a broader perspective and a sense of peace.

8. Write a Diary or Memoir: Write about life experiences, achievements and learning. This can be therapeutic and also a legacy for future generations.

9. Personal Care: Maintain a balanced diet, get enough sleep and take care of personal hygiene. Feeling good physically contributes to better mental and emotional health.

10. Technology and Connectivity: Learn to use technology to stay connected with family and friends, access information and participate in online activities.

Personal growth in older adulthood is about staying active, both physically and mentally, and continually seeking ways to enrich your own life and the lives of others.Good night. Personal growth is a process of development and improvement in various aspects of life, both emotionally, intellectually, socially, and spiritually. It involves knowing yourself, overcoming limitations, achieving personal and professional goals, and living a fuller and more satisfying life.

Tips to improve personal growth :

1. Self-knowledge: Reflect on your values, beliefs, strengths, weaknesses and objectives. You can keep a journal, practice meditation, or seek feedback from people you trust.

2. Set Goals: Define clear and achievable objectives in different areas of your life. Make sure they are Specific, Measurable, Achievable, Relevant and Temporal (SMART).

3. Continuing Education: Stay constantly learning. Read books, take courses, attend workshops and seek new experiences that enrich your knowledge and skills.

4. Develop Healthy Habits: Incorporate habits that promote physical and mental well-being, such as a balanced diet, regular exercise, and stress management practices.

5. Time Management: Organize your time efficiently. Prioritize your activities and avoid procrastination.

6. Emotional Health: Work on your emotional intelligence, learn to manage your emotions and maintain healthy and constructive relationships with others.

7. Resilience: Learn to face and overcome difficulties. Resilience allows you to adapt to changes and move forward despite obstacles.

8. Support Network: Surround yourself with people who support you and inspire you to grow. Get involved in communities, seek out mentors, and build positive relationships.

9. Reflection and Evaluation: Regularly review your progress and adjust your strategies as necessary. Reflect on what you have learned and how you can continue to improve.

Personal growth is a continuous journey that requires dedication and effort, but the benefits to your well-being and personal satisfaction are immense.

In my next post I will talk about urinary infections in elderly people, because they are very common in this group of population.

Psicología del Adulto Mayor: Desafíos y Estrategias.

Posted on by Maritza Osorio

Uno de los aspectos mas difíciles de manejar en los adultos mayores es su psicología, La cual puede variar dependiendo de factores como la salud física, el entorno social y las experiencias de vida. Sin embargo, algunas tendencias comunes incluyen la búsqueda de significado en la vida, el enfoque en relaciones significativas y el desarrollo de estrategias de afrontamiento para encarar los desafíos del envejecimiento. También pueden experimentar cambios en la memoria y en la cognición, así como enfrentar desafíos emocionales como la soledad o la pérdida.

Los adultos mayores pueden experimentar una serie de aspectos psicológicos distintivos, que incluyen la adaptación a cambios en roles sociales, el enfrentamiento a la pérdida de seres queridos y la reflexión sobre su legado y sentido de vida. También pueden enfrentar desafíos como la soledad, la depresión y la ansiedad debido a cambios físicos y sociales. Es importante brindarles apoyo emocional y oportunidades para mantenerse mentalmente activos y socialmente conectados.

Algunas conductas repetitivas pueden incluir revisar constantemente objetos o hacer preguntas repetidas, por ejemplo si han comido o no, o preguntar sobre eventos recientes, tambien pueden repetir historias o actividades simples como caminar por la casa, estas conductas pueden ser signos de deterioro cognitivo asociados al envejecimiento o trastornos neurodegenerativos como la demencia.

Todos tenemos que pasar por la experiencia de cuidadores a tiempo parcial o a tiempo completo, porque tenemos padres, madres, tios, tias, amigos entrañables o parejas, ademas de que la tendencia global demografica, es la del envejecimiento, y debemos prepararnos para ese momento, que nos demanda comprensión, conocimientos sobre la psicología del adulto mayor, ademas de otras areas de conocimiento como nutrición, farmacologia, cuidado personal, apoyo, legislación, finanzas, seguro social, entre otras tematicas.

Si te ha gustado mi post dame un like y/o comenta. En mi próxima publicación hablare sobre crecimiento personal.

Impacto del estrés en los adultos mayores.

Posted on by Maritza Osorio


Estimados suscriptores, hoy estaré hablando del estrés en los adultos mayores ya que puede tener una influencia significativa en su salud física y mental. A continuación, se detallan algunas formas en las que el estrés afecta a los adultos mayores y algunas estrategias para aliviarlo:


1.  Salud Física:
   – Sistema Inmunológico: El estrés crónico puede debilitar el sistema inmunológico, haciendo a los adultos mayores más susceptibles a infecciones y enfermedades.
   – Problemas Cardiovasculares: Aumenta el riesgo de hipertensión, enfermedades cardíacas y derrames cerebrales.
   – Dolores y Molestias: Puede incrementar dolores musculares, articulares y exacerbar condiciones como la artritis.

2. Salud Mental:
   – Ansiedad y Depresión: El estrés puede agravar los síntomas de ansiedad y depresión.
   – Cognición: Puede afectar la memoria y la capacidad de concentración.
   – Calidad del Sueño: El estrés puede provocar insomnio y trastornos del sueño.

Estrategias para Aliviar el Estrés

1. Actividad Física:
   – Ejercicio Regular: Actividades como caminar, nadar o yoga pueden ayudar a reducir el estrés.
   – Ejercicios de Relajación: Técnicas como la meditación, respiración profunda y el tai chi pueden ser muy beneficiosas.

2. Conexión Social:
   – Apoyo Social: Mantener conexiones con amigos y familiares puede ofrecer apoyo emocional y reducir el sentimiento de soledad.
   – Participación en Grupos: Unirse a clubes, grupos de voluntariado o actividades comunitarias puede mejorar el bienestar emocional.

3. Hábitos Saludables:
   – Dieta Equilibrada: Una nutrición adecuada puede mejorar la salud física y mental.
   – Sueño Adecuado: Mantener una rutina de sueño regular y de calidad es crucial.

4. Manejo del Tiempo y Actividades:
   – Planificación y Organización: Evitar sobrecargarse con demasiadas actividades y aprender a decir no puede reducir el estrés.
   – Actividades Recreativas: Dedicar tiempo a hobbies y actividades placenteras puede proporcionar una distracción positiva.

5. Apoyo Profesional:
   – Terapia: La terapia cognitivo-conductual y otras formas de psicoterapia pueden ayudar a manejar el estrés.
   – Medicación: En algunos casos, bajo la supervisión de un médico, puede ser necesario el uso de medicamentos para controlar la ansiedad o la depresión.

Implementar estas estrategias puede ayudar a los adultos mayores a gestionar mejor el estrés y mejorar su calidad de vida.

Si te ha gustado el post, dame un like y/o comenta.

Understanding and Embracing Sexuality in Old Age

Posted on by Maritza Osorio

 Hello my dear followers, today I will be writing about sexuality in older adults, which is an important and often underestimated topic. 

 I begin by stating that sexuality is an integral part of human well-being throughout all stages of life, including old age. As people age, their sexuality may undergo changes, but it remains a significant source of pleasure, intimacy, and emotional connection.

Physical Aspects

1. Physiological Changes:

   – Men: They may experience erectile dysfunction, decreased testosterone and less firmness in erections.

   – Women: They may experience vaginal dryness, decreased estrogen and changes in vaginal elasticity, which can cause pain during sexual intercourse.

2. General Health:

   – Chronic diseases, such as Diabetes and Heart disease, and the use of certain medications can affect sexual function.

Some of the most common are:

1. Antidepressants:

   – Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline and paroxetine can cause decreased sexual desire, erectile dysfunction and difficulty achieving orgasm.

   – Tricyclic antidepressants such as amitriptyline and imipramine can also reduce sexual desire and cause erection problems.

2. For high blood pressure:

   – Beta blockers (such as metoprolol and propranolol) can cause erectile dysfunction and decreased sexual desire.

   – Diuretics (such as hydrochlorothiazide) can decrease blood flow to the penis, causing erection problems.

3. Cholesterol medications:

   – Statins such as atorvastatin and simvastatin may be associated with decreased sexual desire and erection problems.

4. Medications for the prostate:

   – Alpha blockers (such as tamsulosin) and 5-alpha-reductase inhibitors (such as finasteride and dutasteride) can cause decreased sexual desire and erection problems.

5. Medications for heart conditions:

   – Digoxin can reduce sexual desire and cause erectile dysfunction.

6. Medications for Diabetes Mellitus:

   – Some diabetes medications can have side effects that include sexual problems, although proper control of blood glucose is crucial to avoid sexual problems related to this disease.

7. Pain relief medications:

   – Opioids such as morphine, oxycodone and codeine can cause decreased sexual desire and erection problems.

   – Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, when used long term, can affect sexual function.

8. Antihistamines:

   – Medications such as diphenhydramine and chlorpheniramine can cause erectile dysfunction and decreased sexual desire.

9. Antipsychotics:

   – Medications such as haloperidol, risperidone and olanzapine can reduce sexual desire and cause erection problems and difficulties reaching orgasm.

It is important for older adults to talk to their doctors about any sexual problems they experience, as in many cases there are alternatives or treatments available to mitigate these side effects.

Psychological and Emotional Aspects

1.Self-esteem and Body Image:

   – The perception of one’s own body can change with age, affecting self-esteem and sexual desire.

   – Maintaining a positive body image and accepting the natural changes of aging is crucial.

2. Intimacy and Connection:

   – Sexuality in old age can be an important source of intimacy and emotional connection, not just physical pleasure.

   – Open communication with your partner about wants and needs is essential.

Social factors

1. Stereotypes and Taboos:

   – There are many negative stereotypes about sexuality in old age that can inhibit sexual expression.

   – It is important to challenge these taboos and recognize that sexuality is a natural part of life at any age.

There are several stereotypes and taboos that can negatively affect sexuality in older adults. These myths and misconceptions can limit sexual expression and decrease quality of life in old age. Here are some of the most common:

1. “Sexuality is only for young people”:

   – This stereotype suggests that sexual desire and activity inevitably decline with age and that older adults should have no interest in sex. The reality is that many older people continue to have an active and satisfying sexual life.

2. “Aging eliminates sexual desire”:

   – It is mistakenly believed that the physiological changes associated with aging completely eliminate sexual desire. While there may be changes in sexual response, desire may persist and adapt to new forms of expression.

3. “Older adults are not sexually attractive”:

   – This taboo is based on youthful beauty standards and can affect the self-esteem of older people, making them feel that they are not desirable.

4. “Sex is only for reproduction”:

   – The perception that sexuality has to do exclusively with procreation can lead to the devaluation of sexual life in old age, ignoring that sex is also a source of pleasure and emotional connection.

5. “Older people should not talk about sex”:

   – There is a belief that sexuality is an inappropriate topic for older people, which can make open communication about sexual desires and needs difficult.

6. “Sexual problems in old age are normal and have no solution”:

   – This myth can lead older adults not to seek help for sexual problems, assuming that they are inevitable. However, many problems can be successfully treated with the help of health professionals.

7. “Older people in care institutions should not engage in sexual activity”:

   – In settings such as nursing homes, there may be a lack of privacy or even explicit restrictions on sexual activity, based on the belief that it is inappropriate.

8. “The use of medications to improve sexual function is only for young people”:

   – Older adults may be hesitant to use treatments such as hormone therapy or erectile dysfunction medications due to the belief that they are not right for them.

9. “Older people should not form new romantic relationships”:

   – There is the idea that, after a certain age, it is not appropriate or necessary to seek new romantic relationships, which can limit the opportunity for older adults to find a partner and enjoy intimacy.

It is essential to challenge and dismantle these stereotypes to promote a more inclusive and positive understanding of sexuality in later life, allowing older adults to fully live their sexual lives.

2. Loss of Partner:

   – The loss of a partner can have a significant impact on the sexual and emotional life of older adults.

   – Some may find new relationships, while others may focus on self-exploration and personal pleasure.

Tips for a Healthy Sex Life

1. Communication:

   – Talk openly with your partner about desires, limits and any sexual problems.

2. Education:

   – Find information and resources about sexuality in old age, including therapies and treatments available for sexual problems.

3. Healthy Diet: A diet rich in antioxidants, vitamins and minerals improves sexual function, a Mediterranean diet is perfect, for example.

4 Avoid excess alcohol and tobacco

5 Create a comfortable and safe environment, clean, adequate lighting, soft music, light underwear, comfortable bed and above all privacy invite sex.

6 Explore new forms of intimacy: Penetration is not the only form of sexual intimacy, arms, kisses, caresses, oral sex, massages as well as the use of erotic toys can be equally pleasurable and satisfying.

7 Reduce stress: The practice of relaxation techniques such as meditation, yoga and deep breathing help mitigate stress

8 Medical Care:

   – Consult with health professionals to address any physical or emotional problems related to sexuality.

Sexuality in older adults is as valid and important as at any other stage of life. Promoting a positive and open vision about sexuality in old age contributes to general well-being and a better quality of life. In a future publication I will talk to you about stress.  

References

Kalra, G., Subramanyam, A., & Pinto, C. (2011). Sexuality: Desire, activity and intimacy in the elderly. Indian journal of psychiatry, 53(4), 300-306.

Merghati-Khoei, E., Pirak, A., Yazdkhasti, M., & Rezasoltani, P. (2016). Sexuality and elderly with chronic diseases: A review of the existing literature. Journal of Research in Medical Sciences, 21(1), 136.

Uchôa, Y. D. S., Costa, D. C. A. D., Silva, I. A. P. D., Silva, S. D. T. S. E. D., Freitas, W. M. T. D. M., & Soares, S. C. D. S. (2016). Sexuality through the eyes of the elderly. Revista Brasileira de Geriatria e Gerontologia, 19(06), 939-949.

 

Impact of USA Health policy in elderly people.

Posted on by Maritza Osorio

Health is  esential  for the people, specialy for elders, USA health policy impacts this group of  people in different ways,  particularly through programs and regulations that address their healthcare needs. Here are the most important

1. Medicare: This federal program provides health insurance to people aged 65 and older, as well as some younger individuals with disabilities. It covers hospital care (Part A), medical services (Part B), and prescription drugs (Part D). Medicare is a crucial source of healthcare coverage for the elderly, helping to reduce out-of-pocket expenses and improve access to necessary medical services.

2. Medicaid: This joint federal and state program assists with medical costs for some low-income individuals, including many elderly people. Medicaid can help cover long-term care, which is not typically covered by Medicare, making it essential for elderly individuals requiring nursing home care or home health services.

3. Affordable Care Act (ACA): The ACA has provisions that indirectly benefit elderly people, such as improving prescription drug coverage by closing the “donut hole” in Medicare Part D, and expanding Medicaid in some states. Additionally, the ACA promotes preventive services and chronic disease management, which are vital for elderly health.

4. Long-term Care Policies: Policies surrounding long-term care insurance and support services for aging in place are critical for the elderly. There is ongoing debate and policy development to better address the growing need for long-term care services as the population ages.

5. Social Security:While primarily a financial program, Social Security benefits play a significant role in the health and well-being of elderly individuals by providing them with income support, which can affect their ability to afford healthcare and related services.

6. Regulations and Reforms: Various health policy reforms aim to improve care quality and reduce costs. For example, the implementation of value-based care models seeks to enhance care coordination and outcomes, particularly for elderly patients with multiple chronic conditions.

These policies collectively influence the quality, accessibility, and affordability of healthcare for elderly Americans, shaping their overall health outcomes and quality of life.

If you have involve some how with people with  more than 65 years old, this post may be useful for you. Follow me and learn more about topics who concern elderly people.

Updated Classification of Antidepressants for Older Adults: A Simplified Guide

Posted on by Maritza Osorio

Antidepressants

An important topic for those of us who care for older adults is antidepressants, These are frequently used in the treatment of depression, if you work caring for older adults, this post will be very useful, if you have a family member who is experiencing depression or taking this type of medication, it may also be of interest to you, to search for more information on the subject and/or to find specialized help.

Classification according mechanism of action

Below, I present an updated classification of these drugs according to their mechanism of action.

Class A: Monoaminergic modulators
Class A I: Monoamine oxidase inhibitors (MAOIs)
AIa: Irreversible non-selective Tranylcypromine, Phenelzine, Isocarboxazid
AIb: Irreversible selective MAO-B: Selegiline
AIc: Reversible selective MAO-A: Moclobemide
Class A II: Neuronal reuptake inhibitors
AIIa: Relatively selective
AIIa: Serotonergic: Selective serotonin reuptake inhibitors (SSRIs): Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram), Fluvoxamine
AIIb: Serotonergic and noradrenergic Serotonin-noradrenaline reuptake inhibitors (SNRI): Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran
AIIc: Noradrenergic and dopaminergic Noradrenaline and dopamine reuptake inhibitor (NDRI): Bupropion
Class A III: Alpha-2 (α2) receptor antagonists Noradrenergic and specific serotonergic antidepressant (NaSSA): Mirtazapine
Class A IV: Multimodals
AIVa: Serotonergics: Vortioxetine, Vilazodone, Trazodone(2) AIVb: Noradrenergics: Mianserine, Maprotiline
AIVc: Noradrenergic and serotonergics (with significant muscarinic antagonism): Imipramine, Clomipramine, Amitriptyline, Desipramine, Nortriptyline
Class B: Non-Monoaminergic modulators
Melatonin receptors (MT1 and MT2) agonists: Agomelatine
Class C: Drugs in research and development

source: Alvano & Zieher (2020)

The most commonly used by older adults are selective serotonin reuptake inhibitors, such as sertraline, fluoxetine, and paroxetine. These medications are usually safe and effective in this population, but it is always important to consult with a specialist before starting any treatment. Fasipe (2018)

Long-term use of antidepressants, especially in older adults, may have some side effects, which may include:

  1. Increased risk of falls and fractures due to decreased balance and coordination.
  2. Gastrointestinal problems, such as nausea, diarrhea, or constipation.
  3. Sleep disturbances, such as insomnia or excessive drowsiness.
  4. Decreased appetite or weight gain.
  5. Risk of serotonin syndrome, especially if taken along with other medications that increase serotonin levels in the body.
  6. Sexual problems, such as decreased sexual desire or difficulties achieving orgasm.
  7. Increased risk of bleeding, especially in people taking anticoagulants.

It is important for older adults taking antidepressants to be regularly monitored by a doctor to detect and manage any potential side effects.

Tips:

If you are caring for an older adult or working in an ALF( assisted living facility) take into account the antidepressant medications that the patient(s) are taking, as well as their daily dosage and frequency. Be alert to any changes in behavior or clinical symptoms that may indicate they are experiencing adverse or side effects after taking the medication and report it to their family members or administrators so that they can take action and solve the problem in time.

If you liked the publication, comment and share. Your comments can help improve my posts and suggest topics of interest. I leave the references for you to delve deeper into this topic. In my next post, I will talk about the psychology of the older adult.

References

Alvano, S. A., & Zieher, L. M. (2020). An updated classification of antidepressants: A proposal to simplify treatment. Personalized Medicine in Psychiatry, 19, 100042. Available in 

Understanding Benzodiazepines and Their Impact on Older Adults.

Posted on by Maritza Osorio

Benzodiazepines are a class of medications that act on the central nervous system to produce sedative, anxiolytic, hypnotic, anticonvulsant, and muscle relaxing effects. They are commonly prescribed to treat anxiety disorders, insomnia, seizures, and other nervous system-related issues. However, their prolonged use can lead to dependence and other adverse effects. The most commonly used by older adults are those with a shorter half-life and less tendency to accumulate in the body, such as lorazepam (Ativan), alprazolam (Xanax), and oxazepam (Serax). These are preferred due to their lower potential to cause adverse effects and accumulation in the body. However, their use must be carefully monitored due to the risk of dependence and side effects, particularly in older adults, where they may increase the risk of falls, confusion, excessive drowsiness, and loss of memory and attention, in addition to their prolonged use potentially leading to dependence and tolerance, which complicates withdrawal.

This pharmacological group has interactions due to its metabolism (pharmacokinetics), increasing benzodiazepine concentrations in relation to medications like digoxin, omeprazole, and beta-blockers, which are frequently used by older adults. Additionally, in terms of effect (pharmacodynamics), antidepressants, anticonvulsants, neuroleptics, and antihistamines enhance their depressive effects.

The use of these medications should be evaluated by psychiatrists, and depending on the clinical picture, comorbidities, and the age of the older adult, the prescription of benzodiazepines will proceed or not.

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References

Hirschtritt, M. E., Olfson, M., & Kroenke, K. (2021). Balancing the risks and benefits of benzodiazepines. Jama, 325(4), 347-348.es

Ballokova, A., Peel, N. M., Fialova, D., Scott, I. A., Gray, L. C., & Hubbard, R. E. (2014). Use of benzodiazepines and association with falls in older people admitted to hospital: a prospective cohort study. Drugs & aging, 31, 299-310.

How social determinants of health can affect elderly people?

Posted on by Maritza Osorio

Social determinants of health can significantly impact the well-being of elderly individuals. Factors like access to healthcare, socioeconomic status, social support networks, and living conditions can influence their health outcomes. For instance, limited access to healthcare services, financial constraints, isolation, and inadequate housing can exacerbate health issues among the elderly population. On the other hand, strong social connections, financial stability, and access to quality healthcare can promote better health outcomes and overall well-being in older adults.Here are a some  examples:

1. **Access to Healthcare**: Elderly individuals with limited access to healthcare services may face challenges in receiving timely medical attention, preventive care, and treatments for chronic conditions. This can lead to worsened health outcomes and higher rates of hospitalizations.

2. **Socioeconomic Status**: Low socioeconomic status can restrict access to nutritious food, safe housing, and quality healthcare for elderly individuals. This can contribute to a higher prevalence of chronic conditions such as diabetes, hypertension, and malnutrition.

3. **Social Isolation**: Elderly individuals who lack social connections and support networks are at greater risk of experiencing loneliness and depression. Social isolation can negatively impact mental health and cognitive function, leading to a decline in overall well-being.

4. **Living Conditions**: Living in inadequate or unsafe housing environments, such as homes with structural hazards or limited accessibility, can increase the risk of falls and injuries among the elderly. Poor housing conditions can also contribute to respiratory problems and other health issues.

5. **Transportation**: Limited access to transportation options can make it difficult for elderly individuals to attend medical appointments, social activities, and community events. This can lead to feelings of isolation and prevent them from accessing necessary healthcare services.

Addressing these social determinants of health through policies and programs aimed at improving access to healthcare, promoting economic security, fostering social connections, and ensuring safe living environments can help enhance the health and well-being of elderly individuals.