It’s Not Normal: Urinary Incontinence

Cleveland, MaryJo 4x6Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio

 

This month we are going to talk about one of those problems that no one wants to talk about. Urinary Incontinence. There, I said it. Now you can too.

Urinary incontinence is the involuntary loss of urine and boy, is it common. Probably 50% of older women and 15% of older men suffer from this problem. But most older adults don’t tell their healthcare provider about it. Why? If you have followed this blog at all, you already know the answer. Because people think it’s normal, and that nothing can be done about it. Fortunately, people are wrong!

If you have episodes of involuntary loss of urine, please talk to your healthcare provider. The first thing he or she will do is ask you many questions. Don’t be embarrassed to answer these honestly! Honest answers will help determine the cause and the approach to treatment.

Some of the questions will likely include:

  • How frequently is it happening?
  • Is it affecting your work, social life, or sex life?
  • Do you lose small amounts or do you soak your clothing or pad?
  • Is it worse when you cough or sneeze?
  • Do you have to rush to the bathroom to avoid and accident?

There are basically five kinds of incontinence:

1.  Stress incontinence - this is the loss of small amounts of urine when you exert pressure on your abdomen and bladder-coughing, sneezing, laughing, lifting heavy objects. This happens because the muscle that keeps the bladder closed has weakened over time. In women, this is usually due to pregnancy and childbirth and in men it can happen if the prostate has been removed.

2.  Urge incontinence - this is loss of larger amounts of urine with little or no warning. You have seen commercials for this kind of incontinence.  This is also known as overactive bladder.  This is often caused by infections, bladder irritants, or brain diseases such as Alzheimer’s disease or strokes.

3.  Overflow incontinence - this is a frequent dribble of small amounts of urine and the inability to completely empty the bladder. This is often due to diabetes and is more common in men due to prostate problems.

4.  Mixed incontinence - this is combination of  the above patterns.

5.  Functional incontinence - this is incontinence due to something outside of the bladder. In older adults it is because of physical or mental impairments that prevent them getting to the bathroom in a timely manner. Continue reading

Summer Travel Tips for Older Adults

Krupa Shah, MDKrupa Shah, MD, MPH
Assistant Professor

University of Rochester School of Medicine & Dentistry
Division of Geriatrics & Aging, Department of Medicine
Rochester, New York

According to a survey conducted by AARP, those age 50 or older take on average six non-business related trips at least 50 miles from home each year.  And Travelzoo, Inc, a global internet media company, tells us that 40% of Americans are planning to take more summer vacations compared to last year.  The most popular type of vacation is the road trip, both for a short weekend or for a longer period of time.

Going on vacation can be a much more enjoyable experience with a little advance planning to make sure that we all stay safe and healthy.

  •  Be sure to pack all your medications.  Before you leave, check if you need refills during your trip.  Most pharmacies will accommodate flexible refills when they know you will be travelling away from home. Also carry a list of your current medications, their doses, and the time of day you take them.
  • Remember to actually take all your medications. Vacations often change our normal daily routine. It is important to make time for correct medication use during all the fun and new places that a summer vacation may bring.  Asking others who are with you to help remember, or setting a small timer, carrying a calendar or using a pill organizer may be helpful.
  • Be aware of side effects.  Some medications can cause side effects related to more time outside in the sun, like increased sensitivity to ultraviolet (UV) rays. It may be helpful to review all medications with your pharmacist, and ask for further consultation with your doctor if you have any questions. Continue reading

Remembering Maya Angelou

We at the Health in Aging Foundation are saddened by the loss of Maya Angelou today.  In 2002, we presented Ms. Angelou with the Lifetime of Caring Award for her embodiment of graceful aging.  It was a festive occasion that included Ms. Angelou charming the crowd with a few lines of “This Little Light of Mine” and leading a standing ovation for the Girls Choir of Harlem.  In her remarks she reminded us to live a full, rich life and not take its everyday gifts for granted.  She closed with a few lines from her poem, On Aging.

On Aging

When you see me sitting quietly, like a sack upon a shelf,
Don’t think I need your chattering.  I’m listening to myself.
Hold! Stop! Don’t pity me!  Hold!  Stop your sympathy!
Understanding if you got it, otherwise I’ll do without it!

When my bones are stiff and aching and my feet won’t climb the stair,
I will only ask one favor:  Don’t bring me no rocking chair.
When you see me walking, stumbling, don’t study and get it wrong.
‘Cause tired don’t mean lazy and every goodbye ain’t gone.

I’m the same person I was back then, a little less hair, a little less chin,
A lot less lungs and much less wind.
But ain’t I lucky I can still breathe in.

Safe Today. Healthy Tomorrow.

Cleveland, MaryJo 4x6

Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio

May is Older Americans Month and this month the Health in Aging Foundation is focusing on injury prevention with the theme “Safe Today. Healthy Tomorrow”. For this reason, we are going to take a slight detour from our “It’s Not Normal” series and go into more detail on how seniors can keep free from injury. In a sense, it is a continuation of last month’s entry on preventing falls.

 

So, what do you think of when you hear the phrase “Safe Today”? Here are the 5 things that came to my mind first.

1.  Wear seatbelts! Most seniors will continue to drive into their 80’s and want to be safe drivers. The single most important thing you can do to prevent injury or death in the event of an accident is to wear seatbelts. The National Safety Council estimates that wearing your seatbelt will reduce your chance of injury by 50%! Yes, sometimes they are uncomfortable and wrinkle our clothes. Wear them anyway. And while you’re at it, require that everyone else in the car wear theirs too.

2. Don’t wear high heels! (Gentlemen, you can skip this paragraph.) I have no data to present here; this is purely an anecdotal observation. I have seen beautifully dressed, well-made-up women totter precariously into my office in 2-3 inch heels complaining of balance problems! They are clearly setting themselves up for trouble. Appropriate footwear is key to comfort and safety. Fortunately, ballet-style shoes are popular and tennis shoes are now made in every color imaginable. So, set a new fashion trend by putting a stable gait ahead of vanity and wear sneakers with your skirts.

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It’s Not Normal: Falls

Cleveland, MaryJo 4x6Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio 

It is the middle of winter here in Cleveland and we have experienced an unusual amount of snow, sleet and ice. In fact, if you live anywhere with winter, I’ll bet this weather has been challenging. One problem that we see more of in the winter is falls. I ask all of my patients if they have experienced a fall.  Can you  guess the most common answer I get? It isn’t “no”— it’s “not yet.”  Isn’t that interesting? That answer means that they expect to fall sometime. In other words, they think it’s normal. But we are here to find out otherwise!

Falls are certainly common. Most people can tell you about friends or family members who have fallen and suffered a serious injury from a fall, such as a broken hip. Most people also tell me that falling is one of the things they fear the most. The good news is that while falls are common, they are not inevitable. There are well defined risk factors that make it more likely for someone to fall.   And there are also recommendations on how to prevent falls. These recommendations will require you and your healthcare professional to work closely together.

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