CareNotes: The Home Care Newsletter Vol 3. Issue 4
Finding your way: A guide to depression medications for seniors
On average, about one in every six adults experiences depression at some point in his or her life. The good news is that depression can be treated to give you a better quality of life. However, finding the right treatment that fits your needs can be sometimes tricky.
The most common treatments are antidepressant drugs, counseling or a combination of the two. When an adult is prescribed a drug to treat depression you’ll want to understand its benefits and side effects because certain treatments work better for some than others. For example, four of every 10 people will find that the first antidepressant they take may not ease their symptoms, and they’ll need to try a different drug to get the best results.
The right treatment maybe hard to find and sometimes it can become confusing and frustrating. To help you work with your doctor or nurse to select the right medicine, my agency, the Agency for Healthcare Research and Quality (AHRQ), developed a guide on antidepressants for adults with depression. In addition to discussing the different drugs used to treat depression, the guide also gives practical information on depression.
Scientists used a type of research called comparative effectiveness to develop the guide, which summarizes the findings of nearly 300 published studies. Comparative effectiveness research focuses on a specific health problem and asks what the pluses and minuses are of the current treatments.
This research does not dictate your choice. That decision is always left to you and your doctor. But it does provide information that can help you and your doctor make the best choice.
For many years, AHRQ has sponsored this type of research through its Effective Health Care Program. The federal government is boosting funding for this kind of research so that doctors, nurses and patients have solid scientific information on which to base their treatment decisions. In fact, this guide is just one of several consumer guides available from AHRQ. When it comes to treating depression, any drug’s success depends on hitting the right balance between relieving symptoms and minimizing side effects.
This guide concludes that most people can find an antidepressant that works for them. Six out of 10 people feel better with the first drug they try. However, most people need to take an antidepressant for six weeks before they get the full benefit.
The guide also summarizes important information about possible side effects—including weight gain, constipation, diarrhea and sexual problems—and which drugs are more or less likely to cause these side effects. For example:
- People who take mirtazapine (sold as Remeron) gain more weight than people who take citalopram (Celexa), fluoxetine (Prozac) or other antidepressants.
- People who take venlafaxine (Effexor) experience nausea and vomiting more often than people who take other antidepressants.
Medicines can improve the quality of your life if you suffer from depression. Armed with good research, you and your doctor can make the best choice for you.
Travel tips for seniors on the go!
Going on a trip? Are you traveling by plane, train or bus and you want to pack light? Here are some great travel suggestions for Seniors Citizens who plan to travel for a one week stay to almost anywhere for two:
- If you have to take our shampoos, lotions, tooth paste, mouth wash, etc. either buy the small traveler sizes or, if small bottles available, transfer liquids to these.
- Pack only cotton underwear (3) and cotton socks (men 3 pr.- women one pr. panty-hose, one pr. knee-highs one pr. cotton socks), and roll these to save space (they can be placed into shoes). Note: you can wash these items while there.
- Pack items of clothing to ‘layer’, i.e. one light-weight cotton knit cardigan to wear over two or three different cotton knit shirts or blouses (NO bulky sweaters).
- No more than TWO pairs of shoes (one pr. comfortable walking and one pr. dress), the comfortable clothes will probably be worn in travel.
- Two pairs slacks (we’ll probably travel in a third) or skirts (if preferred). Choose items that can mix/match with everything packed.
- Pack medicines, book/magazine, snack, flat slippers (in case the feet swell) and only other necessary items in the carry-on tote. If there is a necessity for dress clothes, pack these in the fold-up hanging bag, shoes can fit in these, also, along with odd/end items.
- Don’t carry on board anything but the tote and a jacket/coat (when necessary-but don’t pack them); leave the ‘handling’ to others. If going to visit friends/family, and want to take gifts, box them and mail ahead of time; let the postal dept. help! Pack your needs, but pack them wisely! Happy traveling!
Airport Security Measures
Before you go on that senior travel tour make sure to check security measures and what you can and cannot take on board with you. Go to www.tsa.gov and click on “travel and consumers.” You will find a list of prohibited and permitted items for checked and carry-on luggage.
Invest in Portable Luggage
How many of us are still dragging around those heavy pieces of luggage? Well, it’s time for some new pieces! You know the kind that has the expandable tote-handle and wheels! Ah, what relief for our backs! I found these sizes to be so handy: 21″/22″ Carry-on (but don’t carry on :o) 27″ Upright, then add the 15″ Tote (to carry with you containing your medications and other absolute senior travel necessities), and the hang-up/zip-close ’suitor’ that has great extra compartments. These latter two MUST have handles, so you can lap these over either the Upright or Carry-on extended handles, and shuffle along your way! Don’t throw out the old luggage, however; use to store old keepsakes, clothing, books, whatever, and place in the attic to one day give to your grandchildren!
Traveling Off Season, The Senior Way!
Remember when we were younger and took the kids on vacation? And how crowded places of interest were? We had to make reservations far in advance to get a motel room. I’ve enjoyed a much slower pace of senior citizen travel and find it not hard to get reservation when traveling in the ‘off-season’; that is, when kids are back in school! We’ll also be giving families a break by not competing with their ‘time’. So try to plan your trips around this time of year (school summer vacations); you’ll find your trips more relaxing and easier to make plans.
AMA issues older driver safety guide
In a recent study done by the American Medical Association (AMA), it was found that motor vehicle injuries are the leading cause of injury-related deaths in adults over 65 years old. On averaege per mile driven, the fatality rate for drivers 85 years and older is nine times higher than for drivers 25 to 69 years old. AMA has now released a new Physicians Guide to Assessing and Counseling Older Drivers.
“For many, a driver’s license symbolizes independence and the decision to retire from driving can have both practical and emotional implications on a patient’s life,” said AMA President-elect Cecil B. Wilson, M.D.
“Physicians play an important role in the safe mobility of their older patients, and we encourage them to make driver safety a routine part of office visits for their senior patients.”
The AMA’s guide helps physicians talk to their older patients about driving safety and help them to better understand the public health issues involved. The guide covers topics that include screening, assessing functional abilities, handling evaluations and referrals, conditions and medications that may impact driving, addressing safer driving and counseling those who are no longer able to drive.
The Physician’s Guide to Assessing and Counseling Older Drivers was developed by the AMA in cooperation with the National Highway Traffic Safety Administration (NHTSA).
Why Are Older Drivers at Risk?
There are two reasons why older drivers have a higher risk of traffic fatalities: Drivers age 75 years and older are involved in significantly more motor vehicle crashes per driven mile, and older drivers are considerably more fragile and more likely to suffer a fatal injury in the event of a crash then their younger counterparts.
The excess crash rate of older drivers results from impairments in the following functions that are important for driving:
- Vision – Vision is the primary sense utilized in driving. Adequate visual acuity and field of vision are important for safe driving, but tend to decline with age as a result of physiologic changes and an increase in diseases such as cataracts, glaucoma, macular degeneration, and stroke. Glare, impaired contrast sensitivity, and an increase in time to adjust to changes in lightness and darkness are other problems commonly experienced by older drivers.
- Cognition – Driving is a complex activity that requires a variety of high-level cognitive skills, including memory, visual processing, attention, and executive skills. Certain medical conditions (such as dementia) and medications that are common in the older population have a large impact on cognition.
- Motor function – Motor abilities such as muscle strength, endurance, and flexibility are necessary for operating vehicle controls and turning to view traffic. Even prior to driving, motor abilities are needed to enter the car safely and fasten the seatbelt. Changes related to age and musculoskeletal diseases (such as arthritis) can decrease an individual’s ability to drive safety and comfortably.
Declines in these functions make older drivers vulnerable to crashes in complex situations that require good visual perception, attention, and rapid response. As a result, older drivers are more likely to experience crashes at intersections, especially when a left-hand turn is involved.