Arthritis%20in%20the%20Elderly

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Arthritis in the Elderly

• Quality of Life

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Arthritis in the Elderly

• Making a difference in 46 million lives in the
  United States.
• Our GOAL is to improve the quality of life,
  decrease pain and suffering, and increase the
  patients ability to live life to its fullest.
• People seek health care for two main reasons
• To regain their health or to maintain their
  health.

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Arthritis in the Elderly

• Arthritis in the elderly is no different than
  that of younger patients.
• What is different is how their bodies process
  medication and how medication affects their
  internal organs.
• The liver and the kidneys both decrease in size
  in the years beyond age 70.
• Metabolizing medications and excreting
  medications can be affected by the aging process.

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Arthritis in the Elderly

• Management of Chronic Arthritis Pain
• Must consider the co-morbidities and other
  medications.
• Tailored to the individual
• Include non-pharmacological and pharmacological
  interventions.
• Based on an accurate diagnosis.

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Arthritis in the Elderly

• Baby boomers were born between 1946-1974.
• Grew up exercising and will probably continue
  exercising into their 70s.
• Many are working beyond normal retirement age.
• 2/3 of the working population will have arthritis
  by 2030.
• Musculoskeletal pain is common and can be
  disabling.

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Arthritis in the Elderly

• Age does not depend upon years, but upon
  temperament and health. Some men are born old,
  and some never grow so.
• 
  Tryon Edwards

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Arthritis in the Elderly

• 106 Types of Arthritis!
• 5 most common in the elderly
• 1. Osteoarthritis-most common and often called
  the wear and tear type. 50 have over age 50.
• Caused by the breakdown of cartilage that the
  is covering over the bones. Pain is caused by
  bone rubbing on bone or the mechanic of the
  joints are now off.

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Arthritis in the Elderly

• 2. Rheumatoid Arthritis-immune mediated disease
  that attacks and erodes or destroys cartilage.
  Weakens tendons leading to deformity and
  dysfunction of the joint.
• 1.3 million Americans are affected.
• Causes systemic symptoms of pain, fatigue, fever,
  anemia, etc.

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Arthritis in the Elderly

• Seronegative Inflammatory arthritis.
• Psoriatic, Anklysosing Spondylitis, Reactive
  Arthritis, Enteropathic arthritis.
• Primarily cause inflammation and damage where the
  tendons and ligaments attach. Can be very
  destructive and debilitating.

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Arthritis in the Elderly

• Soft Tissue Arthritis
• Some forms are Bursitis and Tendonitis.
• Often from injuries or overuse.
• Usually do not leave permanent damage.
• Painful and correct diagnosis is essential to
  treatment.

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Arthritis in the Elderly

• Connective Tissue Diseases
• Systemic Lupus, Sjogrens Syndrome, Scleroderma,
  Polymyositis, Mixed Connective Tissue Disease
• These are auto-immune diseases that cause
  inflammation and arthritis by the body attacking
  itself by producing anti-bodies against the body
  itself.

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Arthritis in the Elderly

• Mechanism of Pain in Arthritis.
• Arthritis is a broad, general term for
  inflammation in or around the joint.
• Inflammation is a process by which your body
  defense system of WBCs and chemicals protect the
  body from infection and foreign substances.
  These can be bacteria, viruses, or auto-immune
  antibodies. Normally the body uses the immune
  system to protect you.
• Inflammation can lead to structural damage,
  functional damage, and pain.

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Arthritis and the Elderly

• Every Patient Carries His or Her Doctor Inside
• 
  Albert Schweitzer

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Arthritis in the Elderly

• Perception about Pain and Pain Control
• Baby Boomers and those greater in age often do
  not want to take medication.
• Medication is looked on as a Drug.
• The feeling that they are going to have pain as
  they get older. Just expect this
• Taking medication makes them feel like they are
  not strong or a weakling.

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Arthritis in the Elderly

• Multiple Methods to treat the pain of arthritis.
• Analgesics
• NSAIDS
• Stronger analgesics ( i.e. opioids)
• Adjuvant drugs for the particular type of
  inflammatory arthritis.
• Caution increased sensitivity to the drugs,
  drug-drug interactions, co-morbidities.

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Arthritis in the Elderly

• Non-pharmacological treatments.
• CAM-
• Physical therapy, Exercise, Joint Mechanics.
• Supports for the various parts of the body.
• Surgical intervention.
• Injection of the joints or tissues.
• Laughter, support, Laughter.

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Arthritis in the Elderly

• Health is a state of complete physical, mental,
  and social well-being, and not merely the absence
  of disease or infirmity.
• World Health
  Organization

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Arthritis in the Elderly

• The Mind Body Connection
• Hope is the power of the mind that we can all
  harness.
• Expectation, belief, and faith are the key
  elements of hope.
• Block pain in the body by the release of
  Endorphins
• The brain chemical transmitters play a
  significant role in our well being.

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Arthritis in the Elderly

• Four chemical transmitters in the brain largely
  influence the emotions, attitude, and mental
  function of our patients.
• They are Serotonin, Acetylcholine, GABA
  (gamma-amino butyric acid), and Dopamine.
• Neurotransmitters is like a baseball, and
  receptors in the body act as a catchers mitt.
  The brain can manufacture the correct amount
  given the raw materials. This keeps everything
  in balance.

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Arthritis in the Elderly

• Ingredients for healthy body are sleep, food,
  exercise, and a purpose to be here.
• Sleep should be 8 hours to be optimum.
• Food should be balanced with nutritional value.
• Exercise should be 30 minutes total (does not
  have to be at one time) 3-4 times a week.
• Purpose Everyone needs.

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Arthritis in the Elderly

• Questions not answered (Many).
• Should narcotics be used in the elderly?
• What to do with the elderly in pain in the
  nursing care facilities.
• Are alternative medicines safe and do they do
  anything?
• As a health care provider what can you do to have
  a positive impact on this problem?

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Arthritis in the Elderly

• ATTITUDE
• Life if short. There once was a woman who awoke
  one morning and looked in the mirror. She had
  only 3 hairs left. Well, Ill braid my hair
  today and she did and had a wonderful day.
• The next day she woke up and looked in the mirror
  and had only 2 hairs left on her head. Hmm. I
  think Ill part my hair down the middle today and
  she did. She had a grand day.

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ATTITUDE

• The 3rd day she had only one hair left. Today
  Im going to wear my hair in a pony tail and she
  did and had a great day.
• On the 4th day she looked in the mirror and there
  was no hair. Yaa! I dont have to fix my hair
  today.
• Its all in the ATTITUDE.

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ATTITUDE

• The 3rd day she had only one hair left. Today
  Im going to wear my hair in a pony tail and she
  did and had a great day.
• On the 4th day she looked in the mirror and there
  was no hair. Yaa! I dont have to fix my hair
  today.
• Its all in the ATTITUDE.

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• Live Simply
• Love generously
• Care deeply
• Speak kindly
• Pray continuously