The following information relates to Chronic Pain only. Acute Pain generally last for a short time and occurs following surgery or trauma or another condition. It is a warning sigh to the body to seek help and usually improves and the body is treated and heals.
Chronic Pain Australia state that Pain should never be thought of as a normal feature of ageing. Chronic pain (unlike Acute pain) is not a symptom but a condition in its own right. Chronic Pain is complex and thus it must be managed using a combination of approaches to ensure you get the best results. Some approaches may work better some days than others but relying on medication alone or avoiding using prescribed medication completely will not help you to manage.
A Note on Medications
- Examples of Opioids include Morphine, Codeine, Endone etc
- Opioids are associated with side effects in around 20-30% of people; such as constipation, nausea, dizziness, sleepiness and sleep apnoea
- Long-term opioid therapy is also associated with a greatly increased risk of fractures in older people
- There is no clear evidence to show that long-term opioid therapy can greatly improve chronic pain and restore physical function
- Increasing doses of opioids in chronic pain has been repeatedly linked to harm, including death from overdose
Note: According to Pain Australia: The human brain boasts a remarkable ability to change and effectively ‘rewire’ itself, a concept known as ‘neuroplasticity’. This is particularly important when it comes to pain.
‘Acute pain’ that is left untreated or under-treated can lead to neuroplastic changes within the nervous system at peripheral, spinal cord and brain levels. The resulting pain ‘memory’ leads to ‘pain sensitisation’, where pain signals are transmitted unnecessarily – long after the original source of pain (surgery, trauma or other condition) has healed – and pain is now chronic.
Therefore: it is very important that you comply and take what your GP or specialist has prescribed to manage your Acute pain. Opioids are not harmful in the short term and can be very beneficial in relieving strong acute pain, especially after surgery. As outlined above, avoiding taking pain medications as prescribed during this time can lead to ongoing Chronic Pain.
- Non-opioid pain medicines can be effective at relieving pain, but should generally be used only for a short period and only for as long as they are helping to manage your pain
- It is unlikely that any pain relievers will be able to completely stop chronic pain. A multidisciplinary approach to management has been shown to be more effective for chronic pain than relying on pain relievers alone
- Medication is best used alongside other non-drug approaches as part of multimodal management of pain
- Pain medicines for Chronic pain do not work for all patients, and often don’t remove pain completely when they do work
- All medicines have side effects and before prescribing a medicine for chronic pain, your doctor should discuss its potential benefits and harms to help you decide whether the medicine will be suitable for you
Research shows that people who actively engage in pain self-management techniques report lower levels of pain-related disability, improvements in mood, better general health and reduced use of medicines.
PAIN MANAGEMENT PLANS
Developing a pain management plan – what to consider:
- Activity management (eg, pacing of tasks and reducing impact on pain areas while participating in tasks)
- Behavioural management (eg, relaxation techniques, mindfulness, flow)
- Cognitive therapy to help you think more positively about your ability to manage your pain
- Exercise & movement
- Good sleep hygiene (Did you know that lack of sleep can make your pain worse the next day?)
- Limiting alcohol and following a nutritious diet. (did you know that some foods and alcohols increase your sense of pain and can trigger inflammation?)
- Medicine management, as needed
A Final Note:
If not managed, pain can impact negatively on all that you do as well as your general outlook on life (wellbeing). Basically being in pain, especially chronic and ongoing pain, is a PAIN. But with a little work, including some trial and error from you, it doesn’t have to be.
Chronic pain is complex and many factors can contribute to it, including state of mind, diet, sleep etc.
Try to make time to find out what factors may be exacerbating your pain and work out ways you can reduce your pain or at least become less aware of it. Giving pain your full attention only strengthens it. Succumbing to your pain is not the same as accepting it but not letting it rule you.
Remember when you first wore a watch – how you were very aware of how it felt – sometimes it may have been irritating but after some time, you didn’t notice you were wearing it. To some extent we can all train our brains to become less aware of our pain by giving it something else to think about.
Take a look at the following video – it may help you really understand your chronic pain a lot better. Chronic Pain Management Video Resource – Brainman – ABC.net.au
Also, take a look through the resources below, get some support and discover what will work for you so that you can get back to enjoying life.
Information, Resources and References
- Hunter New England Local Health Directory – Pain
- Chronic Pain Services in NSW -. Find out how Chronic Pain Services can help you. Our local Chronic Pain Service is at Hunter Integrated Pain Service, John Hunter Hospital, Newcastle Tel: (02) 4922 3435 Fax: (02) 4985 5045 www.hnehealth.nsw.gov.au/pain. You will need a referral from your GP.
- Build Your Pain Management Health Care Team:
- Questions your doctor may ask to help understand the pain
- The Pain Management Network provide 7 short, very informative education videos on acute and chronic pain. If you prefer you can read the transcripts.
- Australian Pain Management Association
- Chronic Pain Australia Health Report
- Chronic Pain Australia
- Health Direct
Depression & Anxiety
The majority of the following information comes from Beyond Blue and specifically addresses Depression and Anxiety in the senior years. Don’t forget that you can click on any words highlighted in blue for more information.
Whether you, or someone you know, is experiencing anxiety, depression or a combination of both, you have nothing to feel ashamed of. Anxiety and depression are serious medical conditions, just as diabetes is, and is usually triggered by some kind of life experience or event. Although sometimes the cause may not be obvious.
Experiencing either or both of these conditions is definitely not a sign of weakness. Please don’t think you have to hide your symptoms.
WHAT IS DEPRESSION?:
Depression is feeling intensely sad, low or apathetic for long periods of time (from weeks to years). Unlike the occasional low mood, Depression is a serious condition that can affect all aspects of your wellbeing.
Triggers for Depression
Its beneficial to recognise some of the Triggers which may onset depression, such as:
- Increases in physical health problems/conditions
- Chronic pain, side effects from medications
- Loss/bereavement, social isolation, hospital admission, decreased independence.
Identifying the potential triggers for depression will enable you to put the necessary supports/prevention strategies in place if and when they occur.
For example; talking to your GP about possible effects of medications before you take them or organising someone to be home with you when you return from hospital or a medical procedure may make all the difference.
Symptoms of Depression
You may be at risk of getting or may already have depression if you experience any of the following symptoms:
- Withdrawing from family/friends
- Decreased sense of pleasure
- Negative self thoughts
- Out of character moodiness
- Irritability/anger, sense of hopelessness
- Fatigue, sleeping more
- Memory problems
- Loss of appetite
If you feel you, or someone you know demonstrating symptoms of depression, speak to your doctor straight way and seek the support and medical assistance you need to manage these symptoms. Help at the time of symptom onset will better hasten your recovery.
WHAT IS ANXIETY?
Anxiety is more than just feeling stressed or worried. Feeling stressed or anxious when you experience stressful situation is a normal reaction.
Anxiety is when these anxious feelings don’t go away or when feelings of anxiety occur with no defining cause. Just like depression, anxiety is a serious medical condition that if left untreated will affect your wellbeing and ability to copy with daily life.
Symptoms of Anxiety
Beyondblue state that anxiety symptoms are not always recognised for those in their senior years. Symptoms can develop gradually and often you may experience a range of symptoms. For example:
- Urges to perform certain rituals in a bid to relieve anxiety
- Difficulty making decisions
- Being startled easily
- Feeling overwhelmed or fearful
- Dread (such as fearing that something bad is going to happen)
- Constantly tense or nervous
- Uncontrollable or overwhelming panic
- Increased heart rate/ racing heart, nausea, stomach pain
- Vomiting, nausea or pain in the stomach
- Difficulties sleeping
Tips For Improving Mental Health & Wellbeing:
Some simple things you can do include:
- Eating well
- Getting enough sleep
- Exercising regularly
- Spending time with your friends and family
- Sharing your feelings with others
- Doing activities you enjoy
- Taking time to relax
If despite your best efforts you find you are still struggling with your mental health, it might be time to get some professional help.
Are you a carer or a friend of someone who may be experiencing signs of mental health issues?
If you’re concerned about an older person experiencing who shows to not be coping and may be experiencing symptoms of anxiety and/or depression; it is important to show you care by having a conversation with them about it.
Unfortunately, many people over 65 still seem to feel there is a stigma attached to depression and anxiety, viewing them as weaknesses or character flaws rather than a genuine health condition.
Older people are also more hesitant to share their experiences of anxiety and depression with others, often ignoring symptoms over long periods of time and only seeking professional help when things reach a crisis point. Go to Beyond Blue for more information on broaching the subject, including videos of older women and men telling their story on the difficulties of asking for help.
Information, Resources and References
Firstly, talk to someone, it doesn’t matter if it is a friend, family member or your GP. Once you have spoken to someone and feel supported, speak to your GP about treatment and health support services such as the Mental Health Care Plan which will enable you to have professional help subsided by a Medicare rebate.
If you feel you can’t speak to someone directly contact the Beyondblue support service on 1300 22 4636 The important thing to speak to someone and ask for help.
- MindSpot Clinic – Contact Number 1800 61 44 34
An online and telephone clinic providing free assessment and treatment services for Australian adults with anxiety or depression. You will also find helpful information on all mental health issues including PTSD and OCD.
- Specialist Mental Health Service for Older people in the Hunter New England Areas:
- Lifeline: 13 11 14 or Suicide Call Back Service 1300 659 467.
- Beyond Blue also provide extensive information on the types of help available and who may best provide it.
- Need an interpreter or have hearing difficulties: Click Here
- The Black dog Institute have many Fact Sheets that you can read, save or print out regarding Depression and Anxiety
- This Way Up Provide a range of self help courses.
- Jean Hales for Women’s Health
- Tips to Improve Mental Health: Head to Health both for yourself and the person you care for.
- MindSpot Clinic – Contact Number 1800 61 44 34
- An online and telephone clinic providing free assessment and treatment services for Australian adults with anxiety or depression.
- National Aboriginal Community Controlled Health Organisation (NACCHO)
- Aboriginal Community Controlled Health Services and Aboriginal Medical Services in each state and territory.
Grief and Mental Health in Older Age
Being a senior citizen can bring with it some amazing experiences such as travel, grand parenting and exploring new hobbies. But getting older can also bring with it some life challenges that can affect your wellbeing.
Retirement, down-sizing, relocating, health problems, chronic pain, loss of independence, bereavement, distance from family and loss of previous existing social groups, can all contribute to feelings of grief, depression and anxiety.
If you or your loved is experiencing bereavement or symptoms of grief and depression such as:
- Low mood
- Increased occurrences of illness
- Unexplained weight loss
It is important to get some support. You should also seek medical help and advice from your GP if symptoms persist.
COPING WITH LOSS AND GRIEF
No matter what your age, the most important thing to remember is that there is no right or wrong way to cope and deal with your loss/grief. So be kind to yourself. But if you feel you are not managing please speak to someone and ask for help. Suggestions which may help from Beyond Blue include:
- Not being afraid to ask for help.
- Talk to friends and family about how you are feeling, or consider joining a support group.
- Take care of your physical health. Grieving can be exhausting, so it’s important to eat a healthy diet, exercise and sleep.
- Manage stress – lighten your load by asking friends, family members or work colleagues to help you with some chores or commitments. Relaxation and gentle exercise can be helpful.
- Do things you enjoy, even if you don’t really feel like doing them.
If you don’t like being in an empty house, visit family or friends, or invite someone you feel close to, to stay with you. If you have just lost a spouse, try not to make any major changes right away. Instead wait a while in case you feel differently when thing settle a bit for you.
And please, if you are having trouble taking care of your daily activities, such as personal care or making your meals, speak to your GP. There is help out there. Go to our ‘Help at Home” section to see what options may be available to you.
Lastly, grief and loss if not managed can lead to depression. Could you be depressed? Click here to self-assess using the Beyond Blue’s anxiety and depression check list as a guide. If your results indicate that you may be experiencing depression or anxiety – speak to your GP immediately.
Information, Resources and References
- The Newcastle Bereavement & Trauma Counselling Service is a free service located at 17 Bolton Street, Newcastle. Phone: 024929 1350
- Grief & Crisis Support is a 24 hour grief support service – (02) 9489 6644.
- Seniors Online – Dealing with loss and grief
- GriefLine is an Australia-wide grief helpline that offers free telephone, online and face-to-face grief counselling services. Call 1300 845 745 to access anonymous and confidential telephone support.
- Life Line- Hunter and Central Coast phone: 131 14
- Mindhealth Connect is a useful website to learn more about symptoms of grief mental health issues, support websites and coping strategies.
- NALAG Grief Support Telephone Service – Sydney – Phone: 0439 922 201. NALAG is a telephone Support Service that provides grief support on a referral system. A Grief Support Telephone Volunteer will ring back to make regular times for you to be contacted for grief support.
- Caresearch Palliative Care Knowledge Network: Useful link for information about grief & loss for individuals from different cultures & special group
- Full list of Bereavement Services
- For the Carers – An unrecognised Grief – loss and grief issues for carers – A Carer’s Guide
Hearing and Vision Loss - Prevention & Management
You will not be shocked to learn that as you age your hearing and sight changes and the older you get; the higher the risk of you developing an eye problem or condition and the more profound your hearing loss may be.
The inability to hear or see clearly can have an effect on your daily tasks, social enjoyment and how people perceive you.
Having regular hearing and visual tests is something that you can do to for yourself to enable early detection of any deficits. Sometimes the loss of vision and hearing is so gradual you may not be aware of how just how much they have deteriorated over time.
Experiencing some gradual hearing and vision loss is a normal part of ageing and usually can be corrected with glasses or hearing aids. At other times the loss may be caused by an underlying condition or disease.
Early detection is always the key to treatment and/or management of any condition. Often there are no symptoms in the early stages of eye diseases and loss of hearing can be gradual and subtle. It is always better to be safe than sorry. Correct early diagnosis, treatment and support can reduce any secondary risks to your health such as falls. In regard to your vision, if you wait until symptoms do occur before your ‘check-up” the loss of vision may be irreversible
The message here is, once your over 50 it is in your best interest to get annual eye tests and if you notice any changes in your hearing, arrange for a hearing test. If you have any conditions that can affect the eyes, such as diabetes, dry eye, or a stroke you should advise your eye specialist and discuss how often appointments should be made.
If you have been prescribed glasses or hearing aids it is important that you wear them, as the better your vision and hearing the better the information your brain receives about its environment. This is especially important at times that you may need to fill out paper work, remember information later on, problem solve and make optimal decisions. If you have forgotten your glasses or refuse to wear hearing aids, please let the people you interact with know. You wouldn’t want them to misinterpret your sensory difficulties as cognitive ones!
VISION AS WE AGE – A SUMMARY:
Better Health Victoria report the main causes of age related vision loss is due to the following:
- Half of all vision impairment in Australia is due to under-corrected refractive error such as long-sightedness, short-sightedness, astigmatism and presbyopia. Refractive error can be improved by wearing glasses
- Age-related macular degeneration – causes distortion or loss of central vision in older people, resulting in difficulties with activities such as reading and recognising faces
- Diabetic retinopathy – symptoms include blurring and patchiness in vision. The underlying cause is diabetes
- Glaucoma – causes tunnel vision and affects safe mobility and driving
- Cataracts – cause blurring of vision and increased sensitivity to glare, but can be corrected by surgery
- Neurological conditions such as stroke
Vision Loss & the effects on Health.
Vision loss, if not addressed and managed, can affect your health and well-being in many ways, such as;
- Increased headaches & fatigue
- Increased difficulty with daily tasks
- Increased risk of falling and incidences of fractures and hospital admittance.
- Increased risk of medication mismanagement – inability to read doses/labels clearly
- Increased risk of depression
- Increased loss of independence and quality of life
- Misperception from community that decreased cognition is the cause of increased errors following written or verbal instructions
- Have regular eye examinations
- Wear UV protective sunglasses
- Wear your glasses as prescribed
- Avoid smoke – give up smoking
- Remain a stable weight – avoid onset of type 2 diabetes
- Eat a balanced and nutrient rich diet including foods high in Omega 3 Fatty acids and Vitamin (A)
- Exercise frequently to ensure good circulation and oxygen necessary for eye health
- Use good lighting – don’t strain your eyes
- Sleep well – sleeping lubricates your eyes and clears irritants such as dust or smoke
- Identify any changes in your vision, such as double vision, hazy vision, difficulties seeing in low light, red eyes, dry eyes, eye floaters, eye pain, sudden and frequent headaches and eye swelling
- Don’t put off cataract surgery once recommended by your ophthalmologist. Your glasses will not help efficiently with the effects of cataracts
Vision Loss: Staying Independent
There are many things you can do to increase your independence and task achievement when experiencing vision loss. Such as;
- Take time to get used to a new prescription slowly. Avoid going out or doing anything that involves sloped pathways or steps until you get used to your script, especially if prescribed bifocal or multifocal glasses
- If wearing multi or bifocals, use your head to look down when going up/down steps so that you use the part of your glasses used for distance and not for reading; which may distort your vision and cause you to trip
- Wear prescription sunglasses or transition lenses post cataracts surgery to manage the glare
- Get help from the professionals
Depending on the type of condition and vision loss experienced you may want to seek specialist help to assist with mobility and daily tasks. Examples of people/organisations that can assess you for your individual vision needs include:
- Guide Dogs Australia – Which is a free services that provides assistance to anyone no matter age or level of vision (they are much more than a guide dog service)
- Vision Australia
- Occupational Therapy – An occupational therapist who has experience with vision loss can assess you at home or in the community and provide personalised strategies/recommendations to help you continue to do your daily tasks. If you would like to discuss your issues with a community based occupational therapist. Contact: Shelly at [email protected]
Information, Resources and References
- Vision Australia Newcastle – 7-9 Beaumont Street, Hamilton Phone (02) 4927 3300 or freecall 1300 84 74 66 and ask for Newcastle.
- Guide Dogs Australia – Newcastle – Suite 15, 2nd floor, 133 King Street, Newcastle Phone: (02) 4925 3066 email: [email protected]
- For a free home assessment, please contact Guide Dogs on 1800 484 333 or fill out an enquiry form. Whether you have low vision, cataract, glaucoma, Macular Degeneration, Diabetic Retinopathy, Retinitis Pigmentosa, or any other eye condition, Guide dogs can work with you to identify your needs and develop an individual support plan to help you meet your goals.
- Vision Loss Australia – Handy Tips for Living with Vision Loss
- Vision Loss Resources for Vision Impairment
- A Clear View – Identifying Australians who live with deaf blindness and dual sensory loss
- Better Health Channel – Vision Loss – Provides a list of practical solutions to assist every-day tasks
- Guide Dogs Mobility & Independence
- Guide Dogs Homonymus Hemianopia
- Optometry Australia
- National Seniors: The facts of vision impairment and loss
HEARING AS WE AGE – A SUMMARY
Causes of Hearing Loss in adults include:
- Age – gradual hearing loss is a part of natural aging (called Presbycusis) with more than 50% of the population aged between 60 and 70 years and 70% of the Australian population over 70 + years experiencing hearing loss. (Listen Hear! The economic impact and cost of hearing loss in Australia – 2005, page 31)
- Build-up of ear wax
- Intake of certain drugs and medications
Other illnesses, including;
- Otosclerosis (a disease which affects the movement of the bones in the middle ear; causing a conductive hearing loss, usually treated with surgery)
- Meniere’s disease (a condition that can cause fluctuating hearing loss, vertigo and tinnitus)
- Diabetes (can cause sensorineural hearing loss caused from damage of the inner ear)
- Stroke (usually associated with strokes occurring in the region of the temporal lobe)
- Noise-induced – caused by excessive noise is one of the most significant causes of hear loss. Exposure to loud noise can damage the delicate structures of the inner. Often causing Tinnitus. NB: some medications can cause or worsen the side affects of Tinnitus
Direct impact of hearing loss:
- Decreases ability to learn
- Impairs communication
- Causes social withdrawal & access to services
- Can decrease confidence and self esteem
- Decrease independence for daily tasks
- Recently linked to increasing risk of dementia
Hearing Loss – Staying Independent:
Make sure you get your hearing assessed regularly, wear your hearing aids and any other prescribed aids regularly.
Do you know about the Government Hearing Services Program which helps holders of Pensioner Health Care Card, Gold or White Repatriation Health Card and other eligible Australian citizens and residents to obtain a comprehensive range of hearing services free of charge. In addition, eligible people can obtain maintenance of their hearing aids and devices and a regular supply of batteries on payment of a small annual maintenance fee (no fee for eligible veterans). Click Here to find out more about the program and how to apply.
Click Here to book a free Australian Hearing Test online or contact the provider in your area by calling 131 797
Areas within the Newcastle region that provide the free Australian hearing tests include:
- Boolaroo, C/- Macquarie Family Health Centre, Room 58 Main Road
- Cardiff, Dr Hayes Surgery, 3/50 Harrison Street
- Charlestown – Charlestown Podiatry Clinic, 48 Smith Street
- Hamilton – Unit 4/34 Beaumont Street
- Lambton, Elder Street Practice, 92 Elder Street
- Mayfield, Blooms Chemist, 179 Maitland Road
- Kotara – Suite 9-10/OTP House, 10 Bradford Close
- Wallsend, Shop 40, Stockland Shoppng Centre, 24 Kokera Street
Information, Resources and References
- Guide Dogs: Guide Dogs Hearing Services Guide Dogs Hearing Services provides assistance and support to any adult who has a hearing impairment or who has both a vision and hearing loss. We provide a range of individual services, group training programs, products and advice. Appointments are necessary. To contact us, email [email protected] or telephone (08) 8203 8394.
- Guide Dogs: Choosing a Hearing Service Provider
- Australian Hearing: Need Help and Advice – call 1300 412 512
- Australian Hearing – Solutions
- Enable Communication Assisting Technology
- Seniors Information Service Australia – Hearing Loss
- Self Help for Hard of Hearing People
- Telstra Disability Services help customers to find the most suitable equipment. A disability catalogue is available. Amplified telephones and extension ringers may be obtained at no extra charge. Contact Telstra Disability Enquiry Hotline, tel. 1800 068 424, TTY 1800 808 981
- Telephone Typewriters (TTYs) are text phones for individuals who cannot hear conversations on the telephone. Contact Telstra Disability Enquiry Hotline.
- The National Relay Service helps people who are deaf or have difficulty hearing, to make phone calls through a relay officer. You can speak normally and read the responses on your TTY. Calls are relayed by a relay officer. You can speak normally and read the responses on your TTY. Calls are relayed by a relay officer. Helpdesk: 1800 555 660 (voice); 1800 555 630 (TTY); 0416 001 350 (SMS).
More than 70 per cent of people who experience incontinence are women, with many experiencing problems after childbirth and menopause.
Menopause is a time of change in a woman’s life. One of the changes many women notice is increased difficulty with bladder and bowel control. These difficulties may be due to:
- Weak pelvic floor muscles
- A less elastic bladder
- Vaginal dryness
- Weight Gain
- Chronic Health problems such as diabetes
- Anal trauma/surgery
There are various causes of poor bladder control and many treatments. For men, once they reach the age of 40, they are more prone to having poor bladder control, often due to prostate issues. For women, if they have had a baby are three times more likely to have poor bladder control and leak than other women. Other causes include:
Having to go to the toilet at night is called nocturia. It can happen to both men and women, especially as we get older. By the time we reach 80 years of age, more than 50 per cent of us will wake to go to the toilet at least twice a night. There are three main types of nocturia and you can have more than one at a time. They are:
- Nocturnal Polyuria– occurs when you produce excessive amounts of urine overnight (up to a third of your daily load)
- Reduced Bladder Capacity– occurs when your bladder shrinks and cannot hold all your urine
- Diurnal Polyuria– is more frequent visits to the toilet during both day and night
The Medicines that can Effect your Bladder or Bowel:
Medicines that can cause problems for the bladder:
- Fluid tablets
- Blood pressure tablets
- Strong pain killers
- Parkinson’s tablets
- Sleeping tablets
- Constipation medicine
Medicines that can cause problems for the bowel
- Sleeping tablets
- Parkinson’s tablets
- Anti-inflammatory tablets
- Strong pain killers
- Fluid tablets
- Medicines used for bladder control
Managing poor bladder and bowel control
There are five things you can do to regain control of your bladder or bowel.
- Eat well
- Drink well
- Exercise regularly
- Tone up your pelvic floor muscles, and
- Practice good toilet habits.
The Pelvic Floor: Pelvic floor muscles become weaker by many issues such as history of constipation, being overweight, inactivity, ongoing cough (such as smokers cough) and of cause growing older.
Go to Pelvic Floor First to learn all about your pelvic floor and how to maintain it.
Common symptoms of bladder and bowel Incontinence.
Passing urine frequently and rushing to the toilet (urgency) to pass urine are the most common symptoms.
Other symptoms include:
- Leakage of urine with coughs, sneezes, or exercise
- Leakage of urine on the way to the toilet
- Getting up twice or more overnight to pass urine
- Frequent urinary tract infections
- Rushing to the toilet to open bowels
- Being unable to control wind, and
A note on Constipation:
Constipation is caused when food moves through the digestive system too slowly which can result in too much water absorption and a dry hard poo.
There are many things that can cause or worsen constipation, especially as we age such as:
- Poor diet and fluid intake
- Side effects of some medicines
- Over use of laxatives
- Being overweight
- Poor mobility – (not being able to go when you need to)
- Anxiety, depression and grief
- Sometimes older women become sensitive to scented and dyed toilet papers which can cause symptoms common with UTI’s
Constipation can cause both bladder and bowel incontinence by:
- An over-full bowel (due to constipation) can press on the bladder, reducing the amount of urine it can hold or making you feel like to need to pass urine urgently
- Constipation can weaken your pelvic floor muscles with straining due to constipation, pregnancy and childbirth, or perhaps heavy lifting
- Severe constipation is the most common cause of faecal incontinence (or bowel leakage), especially in older people. When bowel motions are difficult to pass they may cause a partial blockage high up your bowel, resulting in watery bowel motions flowing around the constipated stool without warning. This is sometimes mistaken for diarrhoea
You can use the Bristol Stool Chart to check what your bowel motions should look like.
Healthy Bladder and Bowel Habits Fact Sheets: Do you know the RIGHT way to sit on the toilet?
Caring for someone with incontinence
It can be difficult caring for someone who is incontinent, especially if you are trying to do it alone. Incontinence is often unpredictable, labour intensive and costly. Although rarely easy, the right advice and support from a health professional may make it more manageable for you. The Caring for Someone with Bladder and Bowel problems may give you some practical information.
If you suffer from poor bladder and bowel control (incontinence), or care for someone who does, you’ll be pleased to know that there is a wide range of products to help you manage bladder or bowel leaks and accidents.
Some products are re-usable while others can be thrown away easily. It may be worthwhile sampling a product first to check if it will meet your needs. Often you can obtain free samples by contacting the product company and asking for a sample to be mailed to you.
Types of products currently available include:
- Absorbent pads and pants
- Absorbent bed sheets and chair covers
- Condom drainage and catheters
- Products to assist toileting
Continence Aids Payment Scheme (CAPS) – Department of Health
Continence Products Brochure – Department of Health
Call the National Continence Helpline on 1800 33 00 66
Information, Resources and References
- Mercy Services provide home delivery linen for people who experience incontinence either through a CHSP or HCP – you will need to be referred via My Aged Care you are not on an existing HCP. Costs start from $17.50 for two deliveries per week. Contact 1800 202 422 for new referrals. For existing clients in the Newcastle LGA contact 02 4961 2616
- New referrals (aged over 65 years of age) Contact My Age Care: 1800 200 422
- Existing Newcastle LGA clients: (02) 4961 2686
- Existing Lake Macquarie, Cessnock, Maitland LGA clients: (02) 4944 1944
- The service provides the following linen to clients who are incontinent.
- Pillow Cases
- Draw Sheets
- Face Washers
- Kylie Sheets
- Absorbent bed pads (available in two different types and sizes)
- Newcastle Continence clinic, 670 Hunter Street, Newcastle West – (02) 4924 2590
- Newcastle integrated Physiotherapy – Women’s Health – (02) 4957 2961
- The National Continence Helpline (1800 33 00 66) can advise about funding schemes for continence products that are provided by the Australian, state and territory governments. To find out more and assess your eligibility, contact the Carer Advisory Service on 1800 242 636.
- The continence foundation of Australia – Carers Support Section
- Continence Foundation Australia – Complete list of resources
- Caring for someone with incontinence Fact Sheet
- Public toilet Map – Helps to build confidence when out and about
If you have Arthritis then you would know that it is generally caused by inflammation of the joints. But did you know that there are over 120 different types of arthritis and other musculoskeletal conditions? (Arthritis Australia). We will focus on the two most common types of arthritis in Australia but you can find out more about the other types of arthritis by clicking here
Osteoarthritis is the most common form of arthritis. It occurs when the cartilage (the spongy, protective tissues in your joints) becomes thin and loses its ability to stretch and bend which leads to the bones in your joints rubbing against each other.
Risk factors that increase the chance of developing osteoarthritis may include:
- Age – due to weaker muscles or joints that may have become worn out
- Gender – women are at a higher risk than men
- Previous Joint injury – especially if not treated properly
- Obesity- being obese places excess strain on your joints, particularly those that bear most of your weight, such as your knees and hips
- Other conditions (causing secondary osteoarthritis) such as rheumatoid arthritis or gout
- Family history – in some cases, osteoarthritis may run in families
The most common signs of osteoarthritis are:
- Joint pain and tenderness
- Stiffness of the joints
- Symptoms that worsen after overactivity. E.g. walking/gardening for long periods of time
- Symptoms that worsen after inactivity such. E.g. getting out of bed in the morning or after sitting for long periods
You may also experience;
- Swollen joints
- A grinding sensation or clicking noises in the joints
- Muscle weakness (unstable joints)
- A feeling that the joint might lock or collapse
- Loss of mobility
Continue to the end of Rheumatoid Arthritis for information on arthritis management.
Rheumatoid arthritis (RA) is the second most common form of arthritis and is an autoimmune disease that causes pain and swelling of the joints. In RA, the immune system attacks itself by targeting the lining of the joints, causing inflammation and joint damage. RA usually affects smaller joints, such as the joints in the hands and feet. However larger joints such as the hips and knees can also be affected
Risk Factors for RA:
Experts do not understand exactly why some people get rheumatoid arthritis, but research suggests that you can be more susceptible to RA if:
- You have a genetic predisposition to RA
- Have been exposed to a harmful environmental factor (e.g. smoking)
- Are a women – and/or have experienced significant disruptions in hormonal balance
- Have an imbalance of intestinal microbes as the result of an infection or other event
- You have a diet low in antioxidants and high in red meat
Symptoms of RA may include:
- Joint pain, tenderness, swelling or stiffness for six weeks or longer
- Morning stiffness for 30 minutes or longer
- More than one affected joint at a time
- Symptoms occurring at the same joints on both sides of the body
- Along with pain, fatigue, loss of appetite and a low-grade fever may be experienced
Symptoms may be intermittent (come and go) in the early stages of RA
If you experience any of the symptoms common with RA it is important to see your doctor from the onset. Early diagnoses and a proper treatment plan will decrease the risk of high levels of inflammation or flare ups. A flare can last for days or months and can cause serious secondary problems to other areas in the body systems, such as the;
- Dryness, pain, redness, sensitivity to light and impaired vision
- Dryness and gum irritation or infection
- Rheumatoid nodules – small lumps under the skin over bony areas
- Inflammation and scarring that can lead to shortness of breath
- Blood Vessels. Inflammation of blood vessels that can lead to damage in the nerves, skin and other organs
- Anaemia, a lower than normal number of red blood cells
There is no cure for arthritis but you can manage the symptoms and pain to decrease any further damage to the cartilage.
The key is to move, move, move with adequate rest breaks. Exercise/movement stimulates the body to produce synovial fluid and keeps it moving around the entire joint. Synovial fluid is not only natures joint lubricant but is also provides the cartilage with essential nutrients.
The best arthritis management plan includes:
- Seeing your doctor as soon as you experience symptoms – early diagnosis and treatment can limit joint damage caused by inflammation
- Educating yourself on your specific arthritis condition
- Learn pain management techniques that best suit your lifestyle
- Be physically active (but don’t over do it)
- Learn techniques to protect your joints and pace yourself
- Stop smoking – smokers are twice as likely to get RA as non-smokers
- Take medications recommended by your GP
- Seek support
For more specific ways to manage your specific diagnosis of arthritis please see the following resources. You may also find our section on “Chronic Pain” useful.
Information, Resources and References
- Arthritis Infoline: 1800 011 041
- Newcastle Arthritis Support Group, Mayfield Seniors Centre, Contact Judy: (02) 4088 3146
- Hunter Hand and Upper Limb Therapy
- Arthritis and Osteoporosis NSW
- Arthritis Australia Home page
- Arthritis Foundation: Rheumatoid Arthritis Self-care
- Arthritis Australia: Taking Control of your Rheumatoid Arthritis (booklet)
- Arthritis Australia: At Home with Arthritis – Simple steps for manage in the home (booklet)
- Osteoarthritis Booklet
- Joint Replacement Booklet
- Back Pain Booklet
- Arthritis NSW – Managing Your Arthritis
- Arthritis NSW – 10 steps to living well with arthritis
- Rheumatoid Arthritis Fact Sheets
- Gout Fact Sheets
- Osteoarthritis Fact Sheets
- Arthritis Foundation
Osteoporosis is a condition in which the bones become fragile and brittle, leading to a higher risk of fractures than in normal bone. Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone mass or density).
As a result, bones become thinner and less dense, so that even a minor bump or fall can cause serious fractures. These are known as ‘fragility’ or ‘minimal trauma’ fractures.
Osteoporosis is often called a silent disease, because it usually has no signs or symptoms until a fracture occurs.
Osteoporosis affects women and men.
- Osteoporosis affects a greater percentage of women because of the rapid decline in oestrogen levels during menopause
- Older age places men at a higher risk of developing Osteoporosis when testosterone levels decline
- Over 1 million people in Australia have osteoporosis
Early detection is the key, so next time you visit your doctor ask about having a Bone Density Test or call Arthritis & Osteoporosis NSW on (02) 9857 3300.
Risk Factors for osteoporosis include:
- Family History
- Low Calcium and Vitamin D levels
- Certain medical conditions such as Hyperthyroidism, coeliac disease, inflammatory bowel disease, condition and medications, rheumatoid arthritis, chronic liver or kidney disease
- Some medicines for breast cancer, prostate cancer, epilepsy and depression and intake of corticosteroids which are used to treat asthma, rheumatoid arthritis and other inflammatory conditions
- Low levels of physical activity
- Excessive alcohol intake
- Weight – thin body build or excessive weight (recent studies suggest that hormones associated with obesity may impact bones)
It is important that if you experience any of the risk factors that may place you at higher risk of developing osteoporosis you speak to your doctor as soon as possible and consider getting a bone density test. Osteoporosis can be treated and there are a number of effective and well tolerated therapist available. Early detection and treatment may reduce your risk of preventable fractures. You may also like to read ‘The Consequences of Falls’ section of our website.
You can also go to Know your Bones for a bond health self-assessment.
Information, Resources and References
- Osteoporosis Fracture Prevention Services – The Hunter. Closest Centre is located at the Royal Newcastle Centre, John Hunter Hospital. Call (02) 4922 3426 for more details.
- www.osteoprosis.org.au What you need to know about Osteoporosis booklet provides information on all aspects of Osteoporosis and how to manage it.
- Preventing Falls
- Arthritis & Osteoporosis NSW
- Osteoporosis Australia
- Osteoporosis Australia: Facts Sheets on Calcium, Vit D, Exercise and Medicines
- Know our Bones Self-Assessment Tool
- Preventing Falls – My Aged Care
Palliative Care Australia defines palliative care as ‘care that helps people live their life as fully and as comfortably as possible when living with a life-limiting or terminal illness”.
Palliative care is a family-centred model of care, meaning that family and carers also receive practical and emotional support. Palliative care can be provided in many locations such as the hospital, residential care and their home.
it takes a Village was created because we believe that communities are not just the geographic places we live. They also reflect how we live, how long we have lived, what we’ve achieved, who we work with and how and who we spend our time with.
So it is understandable that when people are seriously ill, they often prefer to be with those who are familiar and comforting, often choosing to spend their last days at home.
Palliative care does not always mean ‘end of life care’. Many terminal illnesses, such as some types of dementia, cancers and heart disease may be slow to progress from time of diagnosis. A best palliative care approach is one that commences at the time the chronic (not treatable) condition is diagnosed. This approach ensures that you have time to prepare for what is to come and have optimal input when it comes to making end of life decisions based on your needs and wants.
Palliative care doesn’t have to be morbid for you or those that care about you. A palliative care approach in the early stages of a chronic illness can:
- Give you more time and confidence to enable you to get your affairs in order
- Provide comfort by enabling you to have input into your ‘end of life” care plan
- Assist you to manage any subsequent pain and enable you to live a ‘normalised” life but with access to support as you need it
- Enable you to have a say in how much palliative assistance you receive and when you receive it
- Give you more choice. For example, you may want palliative support from diagnosis or wait until your condition progresses to a certain stage or, you may prefer an on-off palliative care approach throughout the various stages of your illness
The important thing is that you have an understanding of what Palliative Care means for you personally and can access the supports available as you need them.
Examples of what palliative care can provide:
- Comfort in the knowledge you are supported and not alone
- Relief of pain and other symptoms e.g. vomiting, shortness of breath
- Resources such as equipment needed to aid care at home
- Assistance for families to come together to talk about sensitive issues
- Links to other services such as home help and financial support
- Support for people to meet cultural obligations
- Support for emotional, social and spiritual concerns
- Counselling and grief support
- Referrals to respite care services
Who is involved with Palliative Care?
Palliative care involves all those who you wish to participate such as friends and family. Palliative care also involves many health professionals who all bring a range of skills to help you manage your illness as you need it. These professions include, but are not limited to:
- Social workers
- Occupational and speech therapists
- Trained volunteers
Whether you’re the person experiencing a chronic/terminal condition, the spouse of the person or a family member, please take some time to read through some of the resources below. You might also like to read through Shelly, our Community Aged Care Occupational Therapist, Blogs in the ‘For the Carers‘ section our website.
Information, Resources and References
- Calvary Mater Newcastle – Specialist Palliative Care Provider
Level 3, Edith Street, Waratah 2298, Phone: (02) 4921 195
Type of Service(s) offered:
Community support to patients in the home, consultative service provided to the hospital, day hospice, equipment hire, education and training, social support.
- Cancer Council NSW – Hunter Central Coast Region Office
30 Regent St, Maitland 2320, Phone: (02) 4932 2741 fax: (02) 4932 2747 or email [email protected]
- Palliative Care After Hours Helpline 1800 548 225
- Lifecircle – support for carers supporting people at end of life.
- Palliative Care and Dementia Position Statement
- Palliative Care Australia
- Palliative Care NSW: Ph: 9206 2094/0403 699 491
- Palliative Care and Planning for End of Life – Health NSW
- Palliative Care Expectations
- NSW Health – Palliative Care in NSW which includes links to:
Please also go to the ‘Your Life – Your Rights” section of our website for more information on making a will, end of life planning, advance care directives and much more…
According to Brain Foundation Australia, Parkinson’s disease (PD) is a progressive, degenerative neurological condition that affects the control of body movements.
The main symptoms of Parkinson’s disease are:
- Tremor or shaking, which usually begins in one arm or hand
- Muscle rigidity or stiffness
- Slowing of movement
- Stooped posture
- Balance problems
Parkinson’s disease can also cause pain, depression and problems with memory and sleep.
Symptoms can be broken down into Motor and Non Motor Symptoms:
Motor Symptoms of Parkinson’s
- Slowed movement (bradykinesia) – Over time, Parkinson’s disease may reduce your ability to move and slow your movement
- Rigid muscles – stiff muscles can limit your range of motion and cause you pain
- Resting tremor – A tremor, or shaking, usually begins in a limb, often your hand or fingers
- Posture and balance – Your posture may become stooped, or you may have balance problems
- Gait Problems – Gait issues such as freezing, shuffling, drooped shoulders and lack of arm swing
- Facial Expressions – People with Parkinson’s often have reduced facial expression referred to as masking
Non-Motor Symptoms of Parkinson’s
- Cognitive impairment – This can range from mild memory difficulties such as thinking quickly, manage multiple tasks to dementia
- Anxiety & Depression – This is not simply a reaction to the diagnosis of Parkinson’s, but is instead a part of the disease itself, caused by changes in the chemistry of the brain
- Sleep difficulties, such as REM Sleep Disorder
- Smell – Loss of sense of smell generally presents prior to any other symptoms appear
- Constipation – Could experience reduced movements or difficulty in passing
- Speech – Most commonly, the voice becomes quieter. It can also develop a breathy or hoarse quality
- Swallowing problems – the slowness of movement that often comes with PD may affect chewing, biting, the ability to work the tongue and the ability to get food or liquid down in one bite
- Speech Problems – You may speak softly, quickly, slur or hesitate before talking
- Writing problems – your writing may appear small
- Vision – Some vision difficulties are related to changes in the movement of the eyeball caused by loss of dopamine neurons
According to ‘Shake-it-Up‘ Parkinson’s disease symptoms effect everyone differently. Many people will experience some symptoms and not others. The progression of the disease also varies between people.
What Causes Parkinson’s Disease (PD):
Parkinson’s NSW states that: ‘Currently there is no known cause for the development of Parkinson’s, however it is thought that a combination of the following may play a role’:
- Genetics (heredity)
- Environmental factors
- Pesticides & Toxins
As with all other medical conditions and diseases, it is important to see your doctor as soon as your experience any symptoms for thorough investigation and early diagnosis.
Early intervention via a multidisciplinary team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses. Members of the team assess the person with Parkinson’s disease and identify any potential difficulties, focusing on improved movement, independence and quality of life.
There is no cure for Parkinson’s disease but there are a variety of treatments available to help you manage the symptoms. Go to Parkinson’s Australia
To find out more about:
- Drug Treatments
- Multidisciplinary Support
- Complementary Therapy
- Surgical Intervention
- Symptom Management
Myths about Parkinson’s Disease:
According to Parkinson’s Australia
“The greatest factor at present which contributes to the social isolation of people with Parkinson’s is their preconceived ideas or myths about the condition. Many people worry that Parkinson’s will either kill them, be inherited to their children, make them totally physically incapacitated, or directly result in dementia. These of course are all untrue.”
As with all other diseases, it is important to see your GP as soon as you experience any changes to your health or onset of any of the Parkinson’s symptoms mentioned above. With a thorough and timely assessment and possible early diagnosis of Parkinson’s Disease, you will have access to the supports available to you to help you manage your symptoms so that you can continue to live a quality and fulfilling life.
Information, Resources and References
- Newcastle’s Parkinson’s Support Group –
Charlestown Multipurpose Centre, 17 James Street, Charlestown, 2290
Contact: Karen Begley, Phone (02) 4955 9822, mobile: 0418 237 535, email: [email protected]
Times: First Saturday of month from 2.00pm – 4.00pm, excluding January
Provides a supportive group for people with Parkinson’s and supports the family and friends who care for them.
- Dancing for Parkinson’s-Newcastle
Socialise 30 minutes before and after a 60-minute dance class
Charlestown Multi-Purpose Centre, 17-21 James St., Charlestown, 2290
Day: Thursdays, following school terms throughout the year
Time: 11:30am – 12:30pm
Cost: $10 per class, registration is required
Contact: Jess Conneely, Phone: 0419 449 578 Email: [email protected]
- Newcastle Parkinson’s Choir
Charlestown Multipurpose Centre, 17 James Street, Charlestown, 2290
Contact Sandra Elms: 0405 441 150 or Keryl Kavanagh 0436 466 481
Building 21, Macquarie Hospital, 120 Coxs Road (Cnr North Rd), North Ryde, 2133
Freecall 1800 644 189
The choir consists of approx. 20 people, half of who have Parkinson’s, the rest are carers. It is mixed male and female. Everyone is welcome, being able to sing is not a requirement.
- Parkinson’s Australia
- Parkinson’s NSW: Information Sheets provide a wide range of information sheets on all aspects on living with and managing Parkinson’s disease.
- Newcastle’s ‘Movers and Shakers” Charity Fund
- Shake it up for Parkinson’s Research
- Healthdirect: Trusted health information and advice online and over the phone (1800 022 222), available 24 hours a day, 7 days a week. Funded by the governments of Australia.
Michael J Fox Foundation – USA
Worldwide Education & Awareness for Movement Disorders (WE MOVE)
Pressure injuries or pressure sores are caused by constant pressure and/or friction applied to the skin over a period of time.
Older people are more susceptible to pressure injuries. This is because as we age our skin becomes thinner and more delicate and the muscles surrounding our bony areas become atrophied and lax.
A pressure injury may look minor such as redness of the skin, but underneath that redness tissue damage can occur under the skin surface. A pressure injury can develop quickly, cause significant pain, become infected, leave scars and may delay your recovery by weeks or months. For people with a chronic illness such as diabetes or compromised immune systems a pressure injury can be even more slow to heal and damaging.
The most susceptible areas for pressure injuries are on areas of the skin over bony prominences such as the heels, elbows, the back of the head and the tailbone. Lack of adequate blood flow can cause the affected tissue to die if left untreated. That is why it is very important to move and reposition regularly when seated or lying.
Risk Factors for Pressure Injuries
- Immobility and paralysis, eg post stroke or head injury
- Dependent on others to assist with repositioning or transfers when seated or lying down
- Shearing when transferring from bed/chair – e.g. not lifting your bottom/sliding forwards or backwards on your bottom or heels
- Impaired sensation or impaired ability to respond to pain or discomfort – e.g. persons with diabetes or later stage dementia
- People who experience urinary and faecal incontinence – skin exposed to urine or faeces is more susceptible to irritation and damage
- Malnutrition – can lead to skin thinning and poor blood supply, meaning that skin is more fragile and susceptible
- Obesity – being overweight in combination with, for example, immobility or being restricted to sitting or lying down, can place extra pressure on capillaries, reducing blood flow to the skin
- Circulation disorders – lead to reduced blood flow to the skin in some areas and can lead to pressure sores
- Smoking – reduces blood flow to the skin and, in combination with reduced mobility, can lead to pressure sores
- People who use a wheelchair are most likely to develop a pressure sore on the parts of the body where they rest against the chair. These may include the tailbone or buttocks, shoulder blades, spine and the backs of arms or legs
Pressure Injury Prevention
Taking Steps to Prevent a pressure injury before it occurs can save you, or the person you care for a lot of unnecessary distress. Steps you can take include:
- When sitting in a chair or wheelchair reposition after 15-20 minutes
- When lying in bed, reposition at least once every two hours
- Try to avoid lying directly on your hips or heavily on your heels
- Pressure relieving mattresses and cushions for sitting can increase comfort and buffer the area from direct pressure – but only re-positioning and ‘getting off’ the area can greatly reduce your risk of pressure injuries. If you can’t re-position yourself ask someone to help you
- Try to lift your bottom by using your arm strength when transferring from your chair or bed. If you need help with transfers, try to help using your arm strength as much as possible. Sliding or edging backwards/forwards on your bottom, especially if you have very thin skin can shear the delicate area and result in skin tears, infection and pressure sores
- If you are going into hospital, going to see a movie, or travelling where you need to sit for long periods take a pressure cushion with you. Pressure relieving equipment may not be available at the hospital. It is always better to be prepared. Most equipment stores will allow you to hire pressure care equipment for short term use
- If you are sitting in recliner with your legs elevated ensure the edge of the leg rest support does not dig into your calves/ankles. If it does, put a pillow or cushion under your calves, ankles or knees – whatever position is most comfortable. But be mindful that sitting with your legs elevated can place more pressure on your tail bone
- Avoid sitting in your chair with your legs stretched out so that your heels are pressed onto the floor. Crossing one leg over the other in this position increases the pressure to your heels
- If you sleep on your back and do not stir during the night, place a pillow under your calves so that the edge of your heel is no longer on the mattress. Sometimes placing the pillow under the bottom sheet can prevent the pillow from moving during the night
- Avoid having the blankets tucked in tightly, especially at the foot end of the bed. The extra pressure of the blankets can increase risk of pressure injury at the heels or toes
- Avoid sitting in a Wheelchair without appropriate cushioning. Avoid using wheelchairs that are too big or too small for you
Daily skin care to prevent pressure sores:
- Check the skin at least daily for redness or signs of discolouration. The best time is usually just before you shower
- Make sure you dry yourself thoroughly, including under the breasts, scrotum, between the toes and any area creating creases such as tummy folds if overweight
- As for help if you cannot wash/dry/or moisturise any areas of the body or use an aid if applicable to help you
- Keep the skin at the right moisture level, as damage is more likely to occur if skin is either too dry or too moist. Avoid wearing clothing that cannot breathe such as nylons
- Try to avoid hot showers and unless incontinent or active, limit showering to every second day with a basin wash in between. Over showering and hot showers can increase drying out the skin
- Use moisturising products to keep skin supple and prevent dryness and chafed skin
- Never massage bony areas because the skin is too delicate. Dab the area gently Never massage or rub red areas as this can cause more damage if tissue has begun to break down under the skins surface. Instead pat or dab to wash/dry/cream and try to keep off the area as much as possible. Speak to your GP if the area of redness becomes painful or doesn’t improves
What to look out for:
Speak to your GP or health carer if you notice any signs of pressure areas such as:
- Red/purple/blue skin
- Dry patches that won’t heal
- Shiny areas
- Areas of the body warmer or cooler to touch – compared to the rest of the body
- Skin tears
- Pain or discomfort on an area of the body which continues after the cause of pressure has been removed
NOTE: Spending a lot of money on pressure prevention equipment is not always necessary unless you or the person you support are completely bed bound and depend on others for transfers. An occupational therapist can assist to help identify areas that may be more susceptible to pressure injury and provide advice to reduce to this risk. He/She will also be able to recommend the most suitable pressure relieving equipment. Sometimes it can be something you already have at home!
Information, Resources and References
- Newcastle Community Health Centre 4016 4530.
- Newcastle District Nursing Service (02) 4953 8444 provide private at home nursing, including wound care, for those of you that need nursing assistance but are not eligible for NSW Health or government subsidised services. Note – there is a cost for this service which is not disclosed on the website. Call (02) 4953 844 for more information.
- Pressure Sores
- Pressure Injury brochure
- Pressure Injury Prevention
- Pressure Injuries – Just the Facts Sheet
Shingles is unpredictable and there is no way to know when it may strike.
Some Facts on Shingles:
- Almost all Australian adults have the virus that causes shingles within them
- Most people find they have shingles once it’s too late
- Shingles is caused by the reactivation of the varicella zoster virus, the same virus that causes chickenpox. If you have had chicken pox, you are susceptible to Shingles
- Tender, painful skin signals the start of shingles. The skin then turns red and breaks out in tiny fluid-filled blisters
- Shingles is typically a painful, blistering skin rash which usually appears as a band or belt on one side of the body
- The condition Shingles is not contagious but the Varicella Zoster virus that causes it is. Therefore, you can infect someone who has never had chickenpox or no longer have the antibodies against it
- The condition is no longer contagious once the blisters have formed a scab and or are well covered
- A common debilitating complication of shingles is post herpetic neuralgia (PHN), a form of nerve pain, which is difficult to treat and may persist for months or even years
- While shingles often resolves without complications, some people may continue to experience ongoing nerve pain for months or even years after the rash has healed
Why you’re susceptible to Shingles in older age:
- 27 percent of Australians aged between 70-79 have already had shingles
- Shingles is usually triggered when the body’s natural immunity is weak
- As we get older our immune systems become less affective which increases the chance of picking up viruses and getting sick
- As we age there is higher risks of having disease that affects the immune system such as diabetes, cancer and leukaemia
- Experiencing high stress, trauma and severe depression can all lower your immune system
- For older Australians, shingles can be serious, as the complications of shingles are more painful and debilitating
- There is a higher chance of an older person developing the long term complications of shingles, such as post-herpetic neuralgia
- Taking medications that can affect the immune system such as Corticosteroids that may be prescribed to treat conditions such as arthritis and asthma, allergic reactions, and autoimmune diseases such as lupus and inflammatory bowel disease
Lowering your risk of developing Shingles
If you are under 70 years old and have had the Chickenpox virus in the past, consider lifestyle changes to minimise stress on your immune system such as:
- Getting the flu and any other vaccines your health care provider recommends
- Getting plenty of exercise to boost your immune system
- Eating a balanced diet with nutritious foods to keeps your immune system strong
- Avoiding smoking (and those that do) as it weakens your immune system
- Limit your intake of alcohol
- Managing your stress and other diseases such as diabetes
- Letting your GP know that you have had Chickenpox in the past if Corticosteroid medications are prescribed
- If you are 70 years or over arrange referral for the free Shingles vaccination with your GP
- If you are under 71 years suffering from conditions that may lower your immune system, request a referral to purchase the Shingles vaccination
Information, Resources and References
Consequences Of Falling As We Age
Fall prevention is a tricky subject to broach because the word itself comes with negative self-associations such as “They must think I’m……..”
- Old and doddery
- At risk – dependent
- Unable to look after myself
But you have to believe this perception could not be farther from the truth. It is true that you may experience factors that place you at higher risk of falling the more advanced in years you get. But falling is not age specific. Everyone trips, falls or slips from time to time.
So why is all the attention and focus on you, our senior community? Because in our senior years a fall can cause a significant and often permanent injury. An injury serious enough to have lasting negative impacts on your health, wellbeing and independence; for many a fall can be fatal.
A note from Shelly, it takes a Villages’ community occupational therapist
There is nothing more heartbreaking than spending time with someone in their later years who is sprightly, independent and full of energy and then seeing all that change because of a potentially preventable fall
Consequences you may experience after a fall:
- Fractures (hip, femur, pelvis, humerus, forearm, leg and ankle
- Intracranial bleeding and traumatic brain injuries
- Complications of Long Lies (lying on the floor for an extended period of time can lead to serious complications including pressure ulcers, rhabdomyolysis, pneumonia, hypothermia, dehydration, and even death)
- Fear of falling and a reduction of quality of life
- Self-imposed limitation of activity
- Commencing a cycle of decreasing functional ability
- Cognitive Impairment
- Secondary complications from surgery, such as infection
Did you know that if you have had a significant fall you are 2 to 3 times more likely to fall again, compared to someone who hasn’t had fall?
There are many things that could increase a person’s risk to fall. The list is long – but don’t let this put you off. Not all on the list will be applicable to you and your current environment. But because the consequences of having a bad fall can have such detrimental outcomes, you owe it to yourself to become aware of potential risk – many of which you may not be aware of such as effects of medications or fatigue associated with post trauma and injury.
Once you become more aware of what may cause a fall (and why we want you to avoid them as much as possible) you will then be able to identify the ones that may apply to you and, if possible, remove or modify the situation to reduce your risk of falling.
- Advancing age
- Sensory, gait and balance problems
- Vision problems – adjusting to a new prescription
- Loss of feeling/neuropathy
- Weakening muscles and stiffening joints
- Side effects from medication (especially if taking five or more medicines)
- Poor diet and not drinking enough water
- Low calcium – increases the risk of having a fracture if you do fall
- A short-term illness, such as the flu or another infection
- Recovering from surgery
Medical conditions that can contribute:
- Diabetes (neuropathy/hypos)
- Parkinson’s Disease
- Macular Degeneration, Glaucoma, Cataracts
- Transitional Ischemic Attacks
- Acute illness and deliriums
Environment/Extrinsic Risk Factors:
- Environmental hazards (e.g. building sites, broken pathways)
- Slippery or uneven surfaces
- High or uneven steps
- Absence of rails at steps
- Poor footwear/ill-fitting shoes
- Inappropriate or absent eye wear/hearing aids
There are too many falls risks and prevention strategies to list and many may not apply to you. Sometimes it is beneficial to arrange for an Occupational Therapist to come to your home or the home of the person you care for to complete a home falls risk assessment. Not only will the ‘risk’ areas be pointed out but recommendations and assistance will also be provided to assist you to address them. For more information, contact [email protected]
In the meantime, please browse through the resources provided below.
Information, Resources and References
Resources you can print off and keep as a reference.
- 25 Ways to prevent a Fall
- Don’t Fall for It: Guide to prevent falls for the older person
- Staying Active and on your Feet
Local Resources/Programmes and Supports:
- Stepping On: NSW Health funds the Stepping On program delivered across the state by the Local Health Districts. Stepping On is an evidence-based falls prevention program to assist older people to reduce their risk of falling. Please visit the Stepping On website for more information about the program.
- Stepping On: Newcastle – Contact Angela Smith (02) 4016 4851 email: [email protected]
State and Commonwealth Resources:
- How to prevent falls
- Fractures/Falls Prevention – National Osteoporosis Foundation
- Stay on your feet: A guide to get you up off the floor after a fall
- Stay on your Feet. All you need to know to prevent your risk of falling
- Active and Healthy: provides information and resources to help guide you to fall prevention, including videos and demonstrations of exercise and a search tool to find suitable exercises classes in your area.
- Western Australia Department of Health: Consequences of Falls
- Better Health – Falls Prevention at Home
- Falls Prevention In Hospital Guidelines
- Australian and New Zealand Falls Prevention Society
- The Active and Healthy website is an online directory of physical activity programs with a falls prevention component for older people.
- The NSW Falls Prevention Network shares falls prevention knowledge, expertise and resources for those working in the hospital, community and residential aged care sectors.
- Falls Prevention E Learning – an online program that can provide the tools you need to prevent falls in the future.
Why Nutrition & Hydration Is Even More Important As We Age
You are likely aware that good nutrition, healthy eating, exercise and hydration are essential for health and wellbeing. But did you know that optimal nutrition and hydration is even more important as we age? Depletion in either can affect you physically and slow down or prevent the healing process after illness or injury.
There may be many occasions throughout your life when you lose your appetite and reasons that you reduce fluid intake such as frequent toileting, a dislike for water, side effects of medications or low moods.
As you get older there are several things that can reduce your ability to eat well such as ill-fitting dentures, difficulties swallowing or chewing some types of foods. Weight loss is common as a person grows older, however this is not a normal or desirable part of ageing. It is better for you to carry a little extra weight as you age, as this will help to see you through times of illness and when appetite is poor.
Although not always easy, it is important that you manage those occasions when your appetite is low by eating/drinking when you don’t really feel like it. Remember that every cell in your body, internally and externally, relies on optimal nutrition and hydration (most older people need between 6-8 cups of fluid each day) to function. Your health, healing and mood relies on the nutrients and hydration you feed it. Smaller but frequent nutritious snacks throughout the day is usually manageable.
The Aged Care Nutrition Services Australia is an excellent resource to gain a better understanding about the importance of good nutrition and the consequences of malnutrition as we age. A summary of which is below:
Examples of why you can lose interest in eating:
- Altered taste, smell and sight
- Ill-fitting dentures, reduced saliva, dry mouth
- Living and eating alone
- Long term illness, side effects of medications
Examples of signs you are malnourished:
- Muscle loss/wasting
- Loss of fat under the skin
- Your bones stick out
- Your skin is dry, flaky, crepe
- You look gaunt – hollow under the eyes/cheek bones
Examples of consequences of malnutrition:
- Increased risk of infections
- Poor wound healing
- Higher risk of skin breakdown/ulceration
- Impaired immunity (higher risk of Shingles)
- Higher risk of falls and mishaps
- Impaired memory/confusion
Examples of why you need optimal fluid intake:
- Keeps the kidneys working
- Decreases risk of urinary tract infections
- Helps prevent constipation
- Prevents dehydration/confusion
- Regulates blood pressure
Examples of symptoms of mild dehydration:
- Cramping in limbs
- Dry mouth
- Weakness, with a general feeling of being unwell
- Crying, but with few tears
If you or someone you support is experiencing any of the above symptoms you need to speak to your/their GP and or a Dietician and ask for help.
Information, Resources and References
- The Eating Well – A food and Nutrition Resource for Older People and their carers – is a great resource to download and have on hand. Examples of content include:
- Nutritional screening
- How to prevent weight loss
- Choosing nourishing food
- Adequate fluid intake
- Eating alone
- Shopping, cooking and eating independently
- Useful contacts for carers; and more.
- Loss of Appetite Fact Sheet includes tips to help when your appetite is poor
- Dietitians Association of Australia – Smart Eating Facts
- Healthy Eating when your Older: As well as the nutritional guidelines for the older person, this site has a fun nutrition calculator – put in your gender and age and it will work out your daily energy intake, nutrient requirements, and the recommended serves you should be consuming from the five food groups.
- Nutrition for Men
- Healthy Eating Over 60
- Nutriton Australia: Easy ways to get more fruit and veg in your day fact sheet
- Nutrition Australia: Dental health
If you or someone you support are experiencing any of the above symptoms you need to speak to your GP and or a Dietician.
- COOKING FOR ONE:
- The Senior Chef has several recipes you can use designed for the over 65 person who lives alone. Just go the Recipes section.
- The Beehive Industries – business with purpose website – has a list of low cost meals for seniors to make. Not only does it provide the recipe but also a demonstration on how to cook the meal.
- Tasty easy recipes to cook for one or two:
- All Recipes – Cooking for one:
Two easy and nutritious recipes to get you started:
Pumpkin and Potato Soup
1/2 small butternut pumpkin (300-400gms) peeled
1 medium onion, peeled
1 medium potato, peeled
1 spring onion
1 small carton (500ml) chicken stock (vegetable stock for vegetarians)
1 slice wholegrain bread
1/4 cup grated tasty cheese (Grate cheddar using a box grater)
Salt and pepper
Helping Hint: Did you know that you can get pre-peeled and pre-cut potato, pumpkin and other veges in the refrigerated section of the supermarket?
Place a little olive oil into a small frying pan, cut the bread into small squares and fry in the oil until crisp, then put aside.
Chop the onion, pumpkin, carrot, potato and bulb of spring onion finely, and cook with a little oil in a small saucepan for 5-7 minutes until softened.
Add some of the stock and boil for another five minutes until vegetables are soft.
With a fork or potato masher, mash up the cooked vegetables, add the remaining stock (add a little water if too thick), bring to boil and season to taste.
Pour the soup into a bowl, sprinkle on some chilli flakes and a drizzle of olive oil and top with bread croutons and cheese.
Vegetable Ratatouille with Beans:
1 medium eggplant
1 red pepper
1 green pepper
1 clove garlic
1 punnet cherry tomatoes or 1 can whole tomatoes
1 can cannelloni or borlotti beans
Chop all ingredients into small pieces.
Add the chopped vegetables starting with the eggplant, followed by onion, garlic, peppers and add the zucchini at the end.
Add the tomatoes and cook for 5 minutes bringing to the boil.
Drain the can of beans, rinse and add to cooked vegetable mixture
Adjust seasonings to taste.
Download the Cook Book