Supporting who we are, what we need, and how we age as individuals — Ethnogeriatrics & Minority Health Month

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Sharon A. Brangman, MDVJ_Periyakoil
Professor of Medicine
Division Chief, Geriatrics
SUNY Upstate Medical University


VJ Periyakoil, MD

Director,
Stanford Successful Aging Program

Clinical Associate Professor
Stanford University School of Medicine

 

While each person is unique and wonderful, no two bodies are the same—and no two people will age in identical ways. That’s one of the joys, and also one of the challenges, in caring for older adults.

Geriatrics, the healthcare field specialized in caring for older people, has given us great knowledge about the health issues commonly seen in older adults and guides how to provide high-quality care to aging Americans. Even so, we also know that there will be twists, turns, and uncharted destinations along every person’s journey toward healthy aging. However, if older adults work in partnership with their healthcare team and family, life with quality is an attainable goal for all. In fact, that’s one of the critical life lessons we can take away from National Minority Health Month this April.

What is National Minority Month?
National Minority Health Month helps raise awareness for disparities in health and care among specific groups of people known as minorities. Minority groups like American Indians, Alaska Natives, Asian Americans, African Americans, Hispanics/Latinos, Native Hawaiians, and Pacific Islanders account for more than 35% of the U.S. population. Health and care aren’t completely different from one of these groups to the next, but minority health experiences do help highlight how certain conditions, concerns, and challenges may impact some of us differently than others. That’s an important distinction—so important, in fact, that an entire field of geriatrics known as “ethnogeriatrics” has developed around ways to provide culturally competent care to older adults from diverse ethnic and racial backgrounds.

Ethnogeriatrics is about finding important intersections between ethnicity, aging, and health to provide high-quality care. A perfect example of this type of work is a new tool that the American Geriatrics Society (AGS) developed with AARP to help a specific group of older adults who are Chinese Americans better understand and drive their own well-being.

“Chinese American Older Adults: A Guide to Managing Your Health”
This free resource highlights the most common health concerns in the Chinese American older adult community and ways that patients and caregivers can talk to healthcare providers about addressing them.

Health concerns like hepatitis B, certain types of cancer, depression, tuberculosis, cardiovascular disease, diabetes, and some genetic diseases are common among Chinese Americans. Many of these conditions require not only expert care but also sensitivity to cultural norms that can help or hinder care depending on how they are addressed. Continue reading

How much sleep do older adults need?

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Belinda Setters, MD, MS, AGSF, FACP
Director, Mobile ACE & Transitional Care Programs
Associate Clinical Professor
Geriatric Medicine & Palliative Care
Robley Rex VA Medical Center

When most of us talk about sleep needs, we usually think about children. We know children need a certain amount of sleep to stay active and healthy and to grow into adulthood. Children have a bedtime and parents (and grandparents!) work hard to ensure they are in bed on time and get the sleep they need every night. But most of us don’t think about how much sleep we get or need as we grow older. And yet, sleep is just as critical to our health as we age.

As we age, our brains may tell us to go to sleep earlier. This is likely why so many folks fall asleep right after the evening news or dinner. Despite this, most older adults don’t always get a full 8 hours of sleep or awaken feeling refreshed. This may be because our brains don’t cycle through deep sleep as well or as much as they did when we were younger. Restless legs, arthritis, and breathing disorders can also keep us awake. And then there is the bladder. Older adults with prostate or bladder disorders often get up at night to use the bathroom. This disrupts sleep as well. Our bodies adapt as we age to adjust to these changes and as a result our sleep patterns adapt as well.

But do we really need 8 hours of sleep as we get older? Does napping make up for this lack of sleep at night? Is it possible to sleep too much?

The National Sleep Foundation says yes—to all of those questions. In an expert panel convened by the Foundation, sleep experts and other specialists reviewed extensive research on sleep needs by age groups, including older adults. Their February 2015 report reflects the most up-to-date recommendations on sleep needs. The panel found that while sleep patterns change with aging, adults 65-years-old and older still need between 7-8 hours of sleep nightly, and ideally over a continuous period of time.

The panel further determined that—while this range is ideal for older adults—some people may need slightly less or more sleep to meet their individual needs. Some people may have a sleep pattern that results in feeling fully refreshed with only 6 hours of sleep, for example.  Meanwhile other people may need an extra hour or so, for a total of 9 hours nightly. To account for these variations, the panel noted a range just outside the recommended hours most folks need. This can be seen in the diagram released with the report below. Continue reading

Supporting a Healthcare Culture Free From Inequality

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Joseph Shega, MD              
Director of Hospice and Pallative Medicine Research
Section of Geriatrics and Palliative Medicine
Department of Medicine
University of Chicago
Chicago, Illinois

I’m pleased to let our readers know about an important new position statement from the American Geriatrics Society focusing on equitable treatment for lesbian, gay, bisexual, and transgender (LGBT) individuals subject to unfair discrimination in health care and society. The statement takes a look at current issues of prejudice due to age, sexual orientation, gender and other personal characteristics that can lead to stigma and discrimination—even in health care. It makes recommendations for better and equal care in the following ways:

  • Advocating policies for equal treatment
  • Training for healthcare professionals on LGBT needs
  • Raising awareness of the unique circumstances facing LGBT older adults
  • Enhancing research supporting the above

Check out this infographic and visit AmericanGeriatrics.org for the press release and the full position statement on how institutions, healthcare professionals, policy makers, and members of the public can help support a healthcare culture free from inequality.

About the Author
Dr. Joseph Shega is a geriatrician and the Chair of the American Geriatrics Society’s Ethics Committee—the group that lead the effort for the development of the “Care of Lesbian, Gay, Bisexual, and Transgender Older Adults” statement.

 

HIV: Not Just a Young Person’s Disease

Sangarlangkarn

Aroonsiri Sangarlangkarn, MD MPH
Geriatrics Fellow
Brookdale Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai
New York, New York

Did you know that by 2015, fifty percent of people with HIV (human immunodeficiency virus) in the United States will be over 50 years old? Or that 17% of new HIV infections happen to older adults?

People living in the 1980s would be surprised to hear these facts. When HIV was first discovered in 1981, we did not have effective medications to treat HIV, and many people died young, soon after they were diagnosed.

The good news is that healthcare has come a long way since then. Today, we have effective medications for HIV, called antiretroviral therapy, and people rarely die from HIV anymore. Now that people with HIV are living longer, we have more and more older adults who have HIV.

The bad news is that we still cannot cure HIV, and aging with HIV is not easy. Chronic HIV infection and long-term effects of HIV medications can lead to other health problems. For example, patients with HIV may be at higher risk for bone loss, making them more prone to getting osteoporosis compared to people without HIV. Osteoporosis is just one of the problems— chronic HIV infection increases risks for many other chronic diseases. It can also carry a stigma that can make it hard for older adults to make new friends or keep their social network.

So, what can you do to protect yourself from HIV as you age? Here are some tips:

Stay updated on safe sex practices: Unprotected sex with an infected partner is the most common way people get HIV.Practicing safe sex is a must. Even if you no longer worry about unwanted pregnancies, you still need condoms to protect you from sexually transmitted diseases, HIV included. If you are recently rejoining the dating scene, make sure to stay up to date with new information on HIV and safe sex practices—information might have changed from the last time you heard about it.

Get more information from HealthinAging.org’s section on Sexual Health and the Safe Sex Tip sheet.

Get tested: Knowing your HIV status is important, and everyone should get tested. This is because HIV infection is hard to detect without a test.  Its symptoms mimic many other diseases, including symptoms related to advancing age. Moreover, after the initial infection passes, you might not have any symptoms until it is too late.  Untreated HIV weakens your immune system and leaves you open to getting  sick from infections.  Do not wait until it is too late—get tested today.

If you have HIV:

  • Find a healthcare provider and a pharmacy that specialize in HIV. HIV is a complicated disease, so you want to make sure your healthcare professionals have experience dealing with HIV.
  • Take your medications as prescribed. If you do not take medications correctly, your HIV pills may be less effective in the future.
  • Exercise and eat a healthy diet. This helps your immune system stay healthier and keep HIV under control.

Aging with HIV is a new experience, and it is an important topic in medical research. In fact, the American Geriatrics Society has partnered with other organizations to develop a website about HIV and Aging to help provide updated research and treatment guidelines to HIV doctors. Feel free to share this website with your healthcare provider, and visit it often to find out the latest updates on this topic.

Get Involved: Live Happier Longer

Coleman, Jessica 4x6Jessica L. Coleman, DO
Geriatrics Fellow
Summa Health System
Akron, Ohio

 

We all know that volunteering for local organizations is a great use of free time. But did you also know that it can not only improve your mood, but also help prolong your life and prevent memory loss?

Volunteering has been shown to be one of the most effective ways for older adults to stay active, learn new skills, make new friends, and be healthier.

Getting involved in your community can be as easy as heading to your local library to read to children after school, volunteering at your local hospital,or joining a service league in your area to meet others who also enjoy giving back.

Consider some of the following ways to connect with and contribute to your community:

  •  Foster Grandparent Programs: Connect with local children who need the love and support of an older adult to guide or comfort them. Work with troubled teens, young mothers, or premature infants—everyone can benefit from having an involved and caring grandparent.
  • Retired and Senior Volunteer Programs: Using the skills and talents you have gained over a lifelong career, serve as a volunteer in your community rebuilding homes, tutoring, or organizing neighborhood watch programs.
  • Senior Companions: Help keep a fellow senior independent and in their own home by assisting with daily tasks such as shopping or paying bills. You can provide respite for caregivers, family members, and make valuable friendships. Continue reading