Dehydration occurs when the body’s cells are deprived of a regular amount of water.  The human body is made up primarily of water.  When babies are first born, their bodies consist of approximately 76% water.  Adult females are made up of approximately 50% water, while their male counterparts have approximately 60% water – as we age that amount can drop to around 45%.  All our organs and systems in our bodies depend upon water to function properly and to survive.

Not drinking enough water, excessive sweating, excessive heat and/or low humidity, as well as side effects from certain medications can cause dehydration.  Even illness and diarrhea can cause dehydration. 

The elderly are one segment of the population that is prone to dehydration.  Dehydration can be linked to infections, one being Urinary Tract Infections which can be life threatening in an elderly person. 

Signs & Symptoms of Dehydration:

• Thirst (although some elders do not recognize that they are thirsty)
• Headache
• Fatigue
• Lethargy
• Muscle weakness
• Confusion
• Dark urine
• Chills
• Sunken eyes*
• Loss of elasticity in skin*
• Fever*

*denotes possibly Severe Dehydration and medical attention should be sought.

Dehydration can be prevented by drinking at least 4 – 8 glasses of water per day, depending on your activity level and the temperature outside.  Know your medications!  Which ones are and which ones are not diuretics.  If you are taking any diuretics, you must consume more water to counterbalance the water the medication is leeching from your body.   Medications for kidney failure, congestive heart failure, COPD, and high pressure are just some of the medications that are considered diuretics. 

Cantaloupes, melons, strawberries, tomatoes, celery, cucumbers, asparagus, broccoli and other fruits and veggies consist of 90% water and will help with hydration.  So eat up!

Please remember that Dehydration, if not noticed or diagnosed in time can lead to death.  So please, keep cool and drink plenty of water, especially if you are taking any diuretics or are sick.

Author: Joan Carter, Your Home Companion Contributor

Seventeen years later President Jimmy Carter renamed the month “Older American’s Month” and therefore helped to continue an annual event.

Older American’s Month is a way to recognize and pay tribute to any and all Older Americans who have contributed, donated, or bestowed to our city, state or country, especially to those who have fought and defended to keep our country safe and free.  Some of the contributions recognized each year are also from past events.

This year’s theme for Older American’s Month is “Unleash the Power of Age!”

Therefore, this month is a time to recognize the power of the elderly and encourage their contributions now and in the future.  It is also a time to appreciate the fact that the elderly can and are a valuable asset to our community.  We can learn from their wisdom and experience, if we just take the time.

So help us “Unleash the Power of Age” by publicly acknowledging their continued achievements. 

Older American’s Month 2013 Unleash the Power of Age for our seniors, elderly and older Americans.

With so many questions concerning mesothelioma, what it is and who is at risk, we turned to www.asbestos.com to see if they could answer some of the questions that we are often asked.  They were very happy to help us out.  Below is a blog they’ve written for us to share with you.  

Malignant mesothelioma is a rare cancer caused by a long-ago
exposure to asbestos, the naturally-occurring mineral that was used so
overwhelmingly for commercial purposes throughout much of the 20th
century.

It can take anywhere from 10 to 50 years after someone is first exposed to asbestos before mesothelioma develops and symptoms begin to appear. Even then, the disease is often misdiagnosed because the early symptoms mirror those of less-serious, more-common illnesses.

Mesothelioma is an unusual cancer that a majority of the time attacks the thin lining surrounding the lungs or abdomen. It diffuses throughout the cavity, unlike many cancers that begin as a solid nodule or mass.

Early symptoms of mesothelioma, and other asbestos-related diseases, include shortness of breath, fatigue, coughing, chest pains and reduced respiratory function.

Because it is a rare cancer – an estimated 3,000 new cases are diagnosed in the United States each year — many medical professionals rarely see it, which can slow down an already lengthy diagnostic process. It takes considerable testing before a positive diagnosis can be confirmed by a specialist.

Although there is no cure for mesothelioma, the latest multi-modality approach can enable patients to survive for several years. The key is getting an early diagnosis before the cancer metastasizes, thereby making surgery still an option.

The majority of cases of mesothelioma are caused by past occupational exposure, which is important when discussing symptoms with a physician. This is another key part of the diagnostic process. If you recall asbestos exposure, mention it to the physician. An exposure history can help the doctor as he looks for answers to your symptoms.

Professions most at risk for developing asbestos-related diseases are construction work, ship building and ship repair, auto repair, plumbing, railroad work, factory work and military service. Most occupations within the military, and especially in the U.S. Navy, once were linked extensively to asbestos exposure. All branches of the military were
known to use asbestos widely.

Second-hand exposure is also an issue. There are many cases where a spouse is exposed to asbestos brought home on clothing that a worker was wearing.

Asbestos was once coveted for its ability to insulate, strengthen and fireproof almost anything. It was once used in almost all commercial and residential construction, in floors, walls, ceilings and roofs. It has been used in thousands of products.

The use of asbestos in America peaked in the mid-1970s but declined rapidly once its toxicity became so well known. The residual effect of that asbestos peak is just now being felt.

Structures built before the 1980s that are being remodeled, renovated or demolished today also are putting people at risk. Asbestos becomes especially dangerous when disturbed and the microscopic fibers become airborne. They often are unknowingly inhaled or ingested.

Anyone suspected of developing mesothelioma, or any other asbestos-related disease, should see a specialist with experience in handling the disease. Although mesothelioma once came with an especially dire prognosis – six to 18 months to live – people today are
living considerable longer because of recent medical advances and treatments.

Author: Tim Povtak joined Asbestos.com in 2011 following many years as a reporter/writer in the newspaper industry.

Although symptoms for Type 2 Diabetes are rare, in type 1 Diabetes the symptoms are many.  Here are some of the symptoms for Type 1 Diabetes:

• Increase in thirst and appetite
• Increase in urination
• Nauseau and/or vomiting
• Blurry vision
• Atypical weight gain and/or weight loss
• Cuts that take a long time to heal
• Cotton mouth or dry mouth
• Overly tired
• Excessive itching in either the vaginal or groin area
• Yeast or vaginal infections

Call your doctor immediately if you are making frequent trips to the bathroom, at least once an hour, you have cramping or abdominal pain, are nauseous, weak and excessively thirsty.

If you cannot attend the workshop you can view it online as a webcast. Please click on the link below or copy and paste the link to register to view online. There will not be a call in number to view the webcast. http://www.surveygizmo.com/s3/1171381/BGH-Webcast-Elder-Abuse-and-Its-Prevention-04-17-18-13

Elder abuse, whether it be violence, or any other form is a world-wide problem. The workshop will discuss the different types of elder abuse (financial, physical, emotional, sexual or neglect), how to identify it and how to prevent it.

With our elder population continuing to grow, this workshop is a must, whether you can physically attend or view the webcast online.

The workshop will be held at:
The Keck Center (100)
500 5th Street NW
Washington, DC 20001

For more information please contact:
Megan Perez
(202)334-2534
GlobalViolencePrevention@nas.edu

To attend the Elder Abuse Workshop in person, copy and paste the link below in a new web browser.
http://www.surveygizmo.com/s3/1171196/BGH-Elder-Abuse-and-Its-Prevention-04-17-18-13

March 26th, Dr. Conrad May, (Assistant Professor in geriatric medicine at the University of MD) will be giving a seminar on dementia and providing tips on healthy aging at the Kent County Middle School in Chestertown.

Other topics to be discussed will include legal needs for the elderly and signs and symptoms of dementia.

THIRD ANNUAL SYMPOSIUM ON HEALTHY AGING: Moving in the Right Direction
Tuesday, March 26, 2013
Kent County Middle School
402 East Campus Avenue
Chestertown, MD 21620

To learn more about the symposium or to register you can call Homeports at (443)480-0940 or click on this link to be directed to their registration page: http://www.homeports.org/

Every Friday from now until April 12th the Talbot Senior Center in Easton, MD is offering tax help for AARP members.  This is by appointment only.

Please call the Talbot Senior Center in Easton to set up an appointment anytime between the hours of 9:00am – 2:00pm, Monday through Friday.  The phone number is (410)822-2869.

Brookletts Place
Talbot Senior Center
400 Brookletts Avenue
Easton, MD
410-822-2869

Remember – Taxes are due this year on Monday, April, 15, 2013.  AND you have AARP to help make sure you make the deadline.

 Forms of Arthritis

Rheumatoid arthritis is an autoimmune disease that occurs when your body’s immune system attacks the joint lining as if to defend it from injury. This leads to inflammation tenderness and ultimately destruction of the joint capsule with resulting deformity called “Heberden’s nodes.” Rheumatoid arthritis can attack any joint at any age, and women are more affected then men. This condition also affects the other organs of the body such as the heart, muscles, blood vessels, nervous system and eyes.  Gout is another very painful form of arthritis that occurs with a build up of excess uric acid in the joint surfaces. A gout attack often follows after eating certain foods like shellfish, liver, dried beans, peas or anchovies. The big toe, ankle, knee, wrist or hands are commonly affected joints.

Other forms of arthritis include psoriatic and or reactive types of arthritis, and arthritis in the TMJ (jaw joint). 

Common Treatment

Each type of arthritis is handled a little differently, but there are some common treatment choices. Rest, ice, heat, splints, using modified appliances such as bottle openers or handle bar assists, and medications such as NSAIDS —non steroidal anti inflammatory medications (e.g., ibuprofen, naprasyn (Aleve), acetaminophen (Tylenol)) are used to control the pain and inflammation of joints. Corticosteroids are also used but they do have significant side effects with prolonged use, such as osteoporosis. Non-chemical methods of pain control include the use of a TENS unit which works on the GATE control theory of pain. Self-massage and gentle yoga or Tai’chi movements are also helpful. DMards (disease modifying anti rheumatic drugs) are used for rheumatoid arthritis such as methotrexate and drugs like Prednisone for an acute attack of gout. Whenever you have a warm and swollen joint, the RICE protocol—rest, ice, compression and elevation—is a good rule to follow.

The right kind of exercise is very important since the joint gets its nutrition and lubrication with movement. A good idea is to take every joint through its normal range of motion every morning.  A good exercise program should also include an aerobic component such as walking or using a stationary bike. Light resistance exercise is also needed to build muscle strength to relieve pressure on the joints. This can be accomplished with the use of light dumbbells and or resistance bands.  Water exercise is ideal since it combines the advantages of weight relief from the joints and still provides resistance for building muscle strength. It is also important to watch your weight and eat a nutritious, balanced diet.

This handout was written by Asha Bajaj, PT, DPT.  Advance Magazine

Clinical Evaluation

When evaluating a patient for gout, the ACR Task Force Panel (TFP) recommends a thorough history and physical examination, gauging the frequency and severity of attacks, and assessing for signs such as tophi (Tophi are lumps of crystallized uric acid that appear on joints affected by gout) and synovitis (Synovitis refers to inflammation in the lining of a joint).

 
Nonpharmacologic Management in Established Gout

The TFP recommends a number of nonpharmacologic interventions aimed at lessening attack risk, lowering urate levels, and promoting general health while preventing the development of comorbidities (in medicine, comorbidity is either the presence of one or more disorders or diseases in addition to a primary disease or disorder). Dietary recommendations are divided into 3 groups: Foods to avoid are organ meats (ie, sweetbreads, liver), foods containing high-fructose corn syrup, and excessive alcohol use*; foods to limit are large portions or concentrations of meat and seafood, naturally sweet fruit juices, sugar, desserts, and salt; and foods that are encouraged include low-fat or nonfat dairy and vegetables. Weight loss in those who are overweight, smoking cessation, and exercise are also recommended as general lifestyle health considerations in patients with gout.

*In advanced gout or during periods of high disease activity, all alcohol should be avoided.

Medscape News

If the Republican-controlled legislature approves his plan when it meets next month, Florida would also become one of the largest states to require virtually all recipients of Medicaid to enroll in private managed-care plans, which can limit which health providers patients can see.

That development has put health providers and consumers in a quandary: Most are elated that more than 1 million Floridians are in line to gain health coverage starting in 2014 and that hundreds of millions in federal dollars will flow into the state to cover their medical services. But they’re also concerned that the coverage will be delivered through managed-care plans with a mixed record of providing quality care in Florida.

Consumer groups worry about whether the health plans will have enough providers, especially in rural areas, and whether they’ll approve services in a timely way.

Nursing-home operators fear that for-profit insurers may try to move residents into lower-cost settings, even when that may be unsafe.

And doctors and hospitals say they’re concerned about getting paid on time and about having trouble getting services approved for their patients.

“Hospitals’ experience with managed care varies plan to plan in the ability to get patients into the right level of care . . . and plans paying claims efficiently and in a timely manner,” said Bruce Rueben, president of the Florida Hospital Association.

Scott is not the first Republican governor to support the Medicaid expansion, which the Supreme Court made optional for states when it upheld the health-care law last June. The governors of Ohio, Arizona, Michigan, Nevada, North Dakota and New Mexico preceded him in announcing plans to expand their programs. But Scott’s decision is arguably more significant due to his state’s size (19 million people), its large number of uninsured (4 million) — and his outspoken opposition.

Other states that have put nearly all their Medicaid recipients in managed care include Arizona, Tennessee, Kentucky and Pennsylvania, according to Joe Moser, interim executive director of Medicaid Health Plans of America, a trade group. “It’s a proven model and not a new concept,” he said.

About two-thirds of states already use managed-care companies as a part of their Medicaid programs. Florida has done so for nearly two decades, with more than a third of its 3 million Medicaid recipients in the private health plans. These HMO-style plans get paid a set amount of money by the state to provide coverage, and the enrollees generally get care only from doctors, hospitals and other providers who have contracts with the plans.

In five counties, including those encompassing Fort Lauderdale and Jacksonville, the state has run a pilot program mandating most recipients be in managed care. Originally there were a number of problems, including patients having trouble getting access and patient confusion about the plans. In addition, a number of plans dropped out because of fears about losing money.

A 2009 University of Florida study, however, showed that the pilot, which did not include those needing long-term-care, helped save the state about $100 million a year without increasing consumer complaints. But the study could not determine whether the savings came from the plans providing less care or being more efficient.

Under the tentative deal approved last week by the administration, virtually all Medicaid recipients would have to enroll in such a plan, including more than 100,000 living in nursing homes and those receiving long-term-care services at home and in community-based settings.

“People have a right to be concerned about quality of managed care because it does not have a strong track record in Florida,” said Joan Alker, co-executive director of the Georgetown University Center for Children and Families.

Another example that critics cite is Wellcare Health Plans, Florida’s largest Medicaid plan, which last year agreed to pay more than $137.5 million to the federal government and nine states including Florida to settle accusations that it bilked government health programs and systematically dumped patients with expensive health needs. The Tampa-based company never lost its state Medicaid contracts.

But Republican lawmakers who control the legislature say they have addressed past shortcomings with better oversight of managed-care companies, increased reimbursement for doctors and more stringent penalties, including fining plans up to $500,000 if they drop out.

Scott, a former hospital executive who ran hospital giant HCA, said paying managed-care companies fixed fees helps the state budget by making costs more predictable and also can improve care because the state can hold companies accountable. Florida’s Medicaid program costs the state $21 billion a year.

Four companies dominate Florida’s Medicaid managed care market — Wellcare, Wellpoint, Centene and UnitedHealthcare — which have 75 percent of enrolled recipients. All stand to gain thousands of new customers and millions in additional revenue.

One of the biggest challenges will be moving the elderly and disabled into managed-care plans.

Robert Beck, a lobbyist who represents home and community-based long-term-care providers, said the state has few personnel to assist in the enrollment of the 40,000 people needing home and community-based services through Medicaid. He said the state promises to mail information to people getting long-term-care services, but he doubts most will even open the letter. If people don’t choose a plan, the state will automatically choose one for them.

“Any 85-year-old woman with dementia does not do well applying for Medicaid,” Beck said.

As a condition of its approval, the Obama administration is requiring an independent authority to monitor the transition and also to measure quality-of-care requirements, an agreement that critics of the managed-care industry praised.

“We are happy the administration listened to us and put transparency and accountability in place for the managed-care plans so care is adequately delivered and people can access the benefits,” said Laura Goodhue, executive director of Florida CHAIN, a consumer advocacy group.

Kaiser Health News
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
Article Phil Galewitz http://www.washingtonpost.com/national/health-science/in-florida-a-health-care-quandary/2013/02/24/6ed3e36c-7ec9-11e2-b99e-6baf4ebe42df_story.html