Grugger’s Way

I’ve recently joined the ranks of those for whom a SHINGLES VACCINE is recommended. 

People who have had chicken pox sometime during their lives are susceptible to Shingles, a painful affliction that can affect anyone, at any age, but is particularly prevalent in people over sixty years old.  

So I received my vaccination.  So what else do I need to think about as I get older?

My discussion with my physician indicated that I should be sure to maintain my “tetanus” booster every ten years.  I just received a booster last year.  I’m good.

She also suggested that I get the flu vaccine every year, about November or so.  This I have completed the past three years, with no side effects and, most importantly, no flu.  I’m normally pretty heathy anyway, and I am a hand-washer, and there are very few contacts with children any more, so I have avoided the flu and colds for the past few years.

As we age our immune systems do tend to become less effective.  That makes us more susceptible to pneumonia too, particularly if we are hospitalized for some other condition, or even if we have a cold or flu at home.  Pneumonia kills a surprising number of older folks every year, and it is frequently not the primary disease or affliction that the victim was being treated for; it was the weakened condition of the immune system due to the primary affliction that allowed the pneumonia to take hold, or so I have read.

The pneumonia vaccine should be given to people who are most susceptible: those who have problems with their heart, lungs, liver, or kidneys.  

So, a pneumonia vaccine after I turn age 65, and that should be good.  If a person has received a pneumonia vaccine before age 65, then one additional shot might be recommended at some point after age 65. 

Remember I am just an ordinary person, not a doctor, so I depend upon what I am told or what I read.  Be sure to always obtain competent medical assistance and advice for any disease or affliction.

Agoraphobia, the fear of being out in public, away from familiar surroundings, or in situations where we feel a lack of control over our environment, is about the only phobia that develops for first time during elderly years, other phobias noted amongst the elderly have normally developed long before reaching “elder” status.   

Treatment for agoraphobia can be problem, not because older folks are not willing to be treated, but because of medical complications with the most common treatment, Selective Seretonin Reuptake Inhibitors (SSRI) and how they interact with other medications commonly taken in one’s later years as antiarrhythmics (like Rythmol and Tambocor), beta blockers (like Toprol and Inderal) or antipsychotics and other antidepressants.  SSRI’s can also impair liver function.  Additionally, there is a long list of general side effects, some of which many of us would think are worse than the agoraphobia.

Diagnosing agoraphobia amongst the elderly can be difficult because they sometimes take medications that can cause the same behavior or suffer from any number of physical problems that might appear to have the same symptoms.

Another problem is cost.  There are many of us in our later years who just can’t afford counseling and other treatments for agoraphobia, which can be exacerbated by adult offspring who often feel the condition is just a normal part of aging and therefore doesn’t require, or merit, treatment at great cost.

It is also important to remember that legitimate fears are not phobias, e.g., fear of falling and not being able to get up or to obtain help is a legitimate fear that could limit a person’s willingness to be outside of the protected confines of the personal home.

While agoraphobia in younger people is often associated with panic attacks, and the fear of having a panic attack in a public place, when agoraphobia develops in older people it frequently develops out of other fears that get out of control.  Older people realize that their reflexes are slower, their hearing and vision are reduced, and their bones are more brittle.  Taking normal precautions is a proper reaction to the fear of having accidents. When things get out of control and a person becomes nearly immobile, or confined to the home, means that normal fears may have progressed beyond the point of control.

The only way to properly diagnose and treat agoraphobia is to consult with a mental health professional.  Never take a drug that is helping someone else. Everyone’s needs and physiological makeup are unique.

One other note:  Although agoraphobia is more common among women than men, no purely scientific evidence has emerged to explain the difference.  Social and cultural behavioral differences and expectations between the genders have been offered as possible reasons.  

PLEASE NOTE:  THIS BLOG OFFERS THE OPINIONS OF THE AUTHOR ONLY AND DOES NOT PROVIDE PROFESSIONAL MEDICAL ADVICE.  ALWAYS SEEK COMPETENT MEDICAL ASSISTANCE FOR ANY AFFLICTION.

The new Obama Administration has posted an Agenda on the White House.gov website.

The new President has already articulated many of his plans for the future, but the website offers more details on about two dozen of the most important issues.

There seems to be something for everyone, seniors included.  The Obama plan for the tax structure would eliminate Federal Income Taxes for senior citizens with incomes are under $50,000 per year.

This would indeed provide some tax relief to seniors, who have recently found themselves continuing to pay taxes on the Social Security benefits that they assumed would not be taxed due to anticipated lower income bracket by the time social security benefits would be drawn upon.

Times have changed recently, and seniors often are supplementing their social security with part-time jobs; again, facing  income taxes on this money, and often pushing themselves into a higher tax bracket.  Not a happy situation, as most of the seniors I know are hard-pressed to make ends meet.

Of course, the President’s plans have yet to be introduced in Congress; and the details and definitions are not explained on the web site (there is still an immense amount of work to be done).   I assume the $50,000 number refers to gross income. I don’t know how the term “senior citizen” will be defined, age-wise.  It could be 65 or 70; it could be based on whether or not one is drawing social security benefits, or could be limited when only one spouse qualifies.

At any rate, I do think that tax relief in one form or another will be reaching us this tax year, 2009, and probably some form of tax structure revamping that will benefit the middle class as well and senior citizens for the next few years, particularly in light of the difficult economic times we all face.

Anger in Assisted Living Facilities

What?  The old folks are Angry?  I don’t have to wonder why.  I’ve spent just enough time with relatives who are “confined” to these facilities to understand full well why they might be angry.  First of all, a HUGE percentage feel like they’ve been abandoned by their families.  Sort of
like being left out in the desert along the trail with a canteen of water and a bit of hardtack:

“Yer a goner, fer sure, ol’ timer, and we jest cain’t spare the fixin’s to keep haulin you along.” 

There are plenty of reasons an elderly person can no longer live alone, on their own.  They often are frail, forget to turn off appliances like irons and stoves, have trouble with balance, have trouble getting up out of bed or up off a couch.  They have dietary restrictions or simply fail to feed themselves due to a lack of appetite or ability to prepare food.  They often are depressed.

Yes, depressed.  And then they are placed in a “facility” where about 23 percent of the other people there are depressed too.  They all get more depressed and more angry.  They are angry that they are old.  They are angry that that have been removed from their homes. They are angry at the other residents.  They are often resentful and intolerant.  They don’t like the staff and feel neglected or mistreated.  Nice way to spend the “golden years,” huh?

The fact of the matter is that many of these assisted living residents could benefit from professional anger management assistance.  They rarely get any help in this regard.  Medical staff at assisted living facilities rarely refer a resident for such services.  Cost may be part of the problem, but I believe attitude is the greater problem.  I don’t think staff at these facilities are often trained to recognize depression-related anger or informed of the services that might be of assistance to the residents in their care.

We are in this aging population who will need to be served by such facilities.  We are the fastest-growing segment of the population, and I believe we deserve better care than what most assisted-living residents are now receiving.  I think prison inmates receive more attention and better care than our elderly.  Society is just too often ready to give up on the elderly, figuring that they will “die off soon….or eventually, anyway.”

If you are interested in further reading, see Anderson and Anderson Anger Management , which is in part the source of the idea for my blog post today.