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Types of Compression Socks and Why The Elderly Need Them

Caring for the elderly can be a very difficult task. When people reach their golden years, they often require special care routines and considerations since they can experience a decline in physiological functions such as blood flow and reduced muscle capacity.

Aging is also associated with a variety of diseases such as diabetes, hypertension, and cardiovascular disease. Because of this, it is important to find ways to help the elderly improve their quality of life and overall health and wellness.

There are several things your can do for you elderly love ones at home that can improve their quality of life. Compression socks are garments that are specially designed to prove comfort and support to your lower legs. There are several health benefits to wearing compression socks. Here are some ways they can greatly benefit the elderly and why you should encourage your elderly loved ones to use them.

Types of Compression Socks

Compression socks are often prescribed by medical professionals for patients that are experiencing poor circulation and blood flow. Many of these people also experience increase in swelling due to venous disorders or hypertension.

These socks come in various materials that can provide a range of pressure but work through similar mechanisms. Socks can cause a uniform pressure on the leg, or they can apply pressure through a gradient.

The pressure provided by compression socks that forms a gradient for your leg works because it combats the effects due to gravity, which can hinder the blood in your legs from returning to your heart.

By applying this gradient, the veins in the leg are constricted which encourages the blood to return to the heart. As a result, blood circulation in the body is improved. This also prevents swelling, as fluid that has accumulated is also cleared by the improvement in overall circulation.

Compression socks reduce swelling because in addition to improving blood flow, they reduce muscle vibrations reducing muscle fatigue since the muscle in your legs become more stable.

The added blood flow also clears lactic acid, the metabolite responsible for making your legs feel tired and sore. Uniform compression also has benefits, but it is important to find the proper fit.

Finding the Right Compression Socks

In order to maximize the benefits of compression socks, it is important to find the socks that will provide the proper amount of pressure and support without constricting blood flow.

Compression socks, when used correctly, should be firm but not constricting or too difficult to remove. Using socks that are too loose will not provide the benefits of using compression socks. Wearing socks that are too tight could actually restrict blood flow leading to more serious health concerns.

Most compression socks come in several different sizes, length and materials. They can cover your calves or go all the way up to your knees. You should work with your elderly loved ones to determine what type of socks are best suited for them.

Compression socks should not be difficult to put on. Although some elderly may require assistance putting on their socks, if they do not go on easily, it is a good indicator that they are not the right size. They should never cause any discomfort or be hard to put on or take off.

Get Clearance from Medical Professionals

Like any type of medical therapy, you should check with medical professionals before using compression socks with elderly loved ones and patients. There are certain medical conditions that you should not use compression socks with, such as severe arterial disease in the legs, congestive heart failure, skin infections or immobility.

This could raise even more concerns and could potentially lead to leg amputation or even death. It is also best to use compression socks during the day before any swelling may occur. You should also monitor the use to ensure that they are not causing constriction and are still comfortable.

Other ways to encourage blood flow and circulation

There are also several other ways you can encourage blood flow and improve circulation in the elderly. Taking a light walk or engaging in other activities are a great way to improve circulation. It might be a great way for your loved one to get some exercise and maybe get some fresh air and take in some scenery.

You can also try giving them a massage such as a Swedish or deep tissue. A Swedish massage tends to focus on the entire body whereas a deep tissue focuses on specific parts of the body.

A massage can improve blood flow and circulation and also has many benefits for overall health and wellness. Not only will it allow your elderly loved one to feel more relaxed, studies have shown there are several touch benefits that come from interactions like massages and hugs.

Overall, compression garments for the elderly can be used therapeutically or as a preventative measure for those at risk or for those who need help improving circulation related issues. You should always check with a medical professional to see if it is safe for your elderly loved ones to use compression socks.

You should always use socks that are the proper size so that they are comfortable and do not cause blood constriction. Using compression therapy at home is one way you can keep your elderly loved ones healthier and happier.

AUTHOR BIO: Sarah writes for Her goal is to educate her readers about the importance of taking care of one’s self with the help of compression gear.

8 Best Nutrition Drinks and Shakes For Seniors

Nutrition drinks are an excellent way of adding vitamins, minerals, and other healthy substances to your body. However, just drinking one a day won't necessarily provide the nutrition your body needs. Believe it or not there are certain do's and don'ts when it comes to using nutrition drinks.

How To Correctly Use Nutrition Drinks

Nutrition drinks can provide significant benefits, but only when you use them correctly. The first thing you should do is look at the label to determine the proper use of a given drink. Some drinks are meal replacements and are meant to provide total nutrition for one meal. Other drinks are supplements and are intended to be taken alongside other foods.

Never consume more than one nutrition drink per-day unless directed to by a doctor. Or unless the drink is meant to be the only thing you consume each day.

Kinds Of Nutrition Drinks

There are several common types of nutrition and meal replacement shakes, including:

  • Protein: Protein shakes are designed to provide nutrients and are especially helpful if you live an active lifestyle and want to build or maintain muscle
  • Energy: Energy drinks are meant to help you feel awake and energetic throughout the day. Remember to pace yourself – even if you feel great, you shouldn't try to act beyond your abilities.
  • Diabetic: Diabetic drinks focus on helping you regulate diabetes. They can't cure it, but they can lessen its effects.
  • Weight Loss: As the name suggests, these drinks are focused around helping you lose weight. Few drinks can accomplish this all by themselves – instead, they're meant to be used as part of a balanced diet and exercise plan.

Elderly Nutrition Requirements

Seniors often have special nutrition requirements. Aside from needing fewer calories than younger people, you may have medical conditions that impact your diet and the overall functioning of your body.

Most nutrition drinks provide a dense source of multiple nutrients, making them an ideal way to get the nutrients your body needs in as few calories as possible.

How Nutrition Drinks Help

Nutrition drinks help by providing an easy way to get the nutrition that might otherwise be spread out in many different foods. Also, the liquid form of the drinks is often easier for seniors to consume than solid foods.

These drinks can either be taken as a side with a meal or as a replacement for the meal itself – and when they do replace meals, they can reduce the burden of needing to prepare food.

8 Nutrition Drinks And Shakes

The following are eight of the best drinks and shakes currently on the market. Most of these come in several flavors, with chocolate and vanilla being the most popular.


#1: Boost Drink

Boost Drink is a series of nutrition drinks, with options covering protein, complete nutrition, and weight loss needs.

It comes in chocolate, strawberry and vanilla flavors.

#2: Ensure

Ensure's shakes are a gluten-free, lactose intolerance-friendly series of complete meal replacement shakes.

As complete nutrition drinks, Ensure is suitable for most seniors. It comes in 6 different flavors including: vanilla, chocolate, strawberry, butter pecan, coffee latte and dark chocolate.



#3: Glucerna

Glucerna is focused around helping people with Type-2 Diabetes, providing a low-sugar and high-protein option.

Glucerna is also available in bars.

Glucerna comes in vanilla, strawberry, chocolate and butter pecan


#4: Nutrisystem Shakes

Nutrisystem's line of protein shakes are focused on helping with weight loss and feeling full for a more extended period.


It helps to cut down on hunger pangs and lets you focus on the rest of your life.

Nutrisystem shakes come in vanilla, chocolate, mocha caramel and even on-the-go bars.


#5: Medifast

Medifast is part of a medically-supervised weight loss program. Most people who use these shakes are morbidly obese and need to lose a significant amount of weight.

So you may find the next option to be a better choice if you don't fall into that category.

Medifast shakes come in strawberry, mocha, french vanilla, orange cream and dutch chocolate.



#6: Ideal Shape

Ideal Shape is another set of weight loss shakes.

While it's more affordable than Medifast, it's also meant for people who are closer to a healthy weight to begin with.

Ideal Shape Protein shakes come in a variety of 18 flavors including: key lime, vanilla, cookies and cream, and many more!


#7: Huel

Unlike the other options on this list, Huel is a nutritionally complete shake.

This means that a day's supply has all of the proteins, carbohydrates, and fats you need, as well as at least 100% of all essential vitamins and minerals.

(Note that this does not mean it's nutritionally complete for seniors with special dietary needs – but most will find it more than suitable.)

#8: Shred

Shred caffeinated protein drinks are especially high in protein, offering 42 grams of it in each 16 ounce shake.

Aside from helping with muscle mass, that's more than enough protein to ensure you'll feel full for quite some time.

These Myoplex Shred drinks come in mocha, chocolate and cinnamon flavors.

Other Meal Replacement Alternatives

Nutrition drinks are one of the easiest ways to get the nutrients you need, but they're certainly not the only way. Other options include meal replacement powder (which is usually mixed with a liquid like water or milk) and meal replacement bars (a solid variant, and somewhat dense to fit in everything you need).

As always, it's best to follow your doctor's recommendations if you have any medical condition that impacts your dietary needs.

COPD Stages – Tips For Treatment and Management

Chronic Obstructive Pulmonary Disease is one of the leading causes of death in America. With that being said, it affects millions of people worldwide and there are certain things you should know about it.

What is Chronic Obstructive Pulmonary Disease?

COPD, also known as emphysema and chronic bronchitis, is a progressive disease that causes difficulty breathing. Common symptoms include tightness in the chest, wheezing, shortness of breath, and excessive production of mucus while coughing.

Approximately 75% of cases of COPD develop as a result of smoking. The other cases tend to develop by long-term exposure to irritants like fumes and air pollution. These irritants can damage the lungs in ways similar to smoking. COPD can also develp by a genetic issue known as alpha-1 antitrypsin deficiency (AAT).

As a progressive disease, COPD gets worse over time and has a 40%-70% mortality rate over five years. The mortality rate depends mainly on the severity of the illness and any positive or negative lifestyle factors. There is no known cure, but there are steps that can be taken to minimize the effects. These are discussed in more detail below.

Most cases are diagnosed in middle age or older individuals. COPD is not contagious, so there is no risk of spreading it to others.

What Determines the Stage of COPD?

Doctors measure COPD in two ways. First, the GOLD (Global Initiative for Chronic Obstructive Lung Disease) standard measures progress based on forced expiratory volume in one second (FEV1)  – essentially, this measures how much you can exhale to determine lung strength.

The other measure is the BODE Index (Body Mass, Obstruction of Airflow, Dyspnea, and Exercise Capacity) Index, which primarily focuses on its effect on quality-of-life and severity of symptoms.

Mild Stage COPD

In the first stage, people have 80% or more of their normal lung strength. Many people in this stage don't even realize they have COPD, although they may have slight coughing and feel like they're not as strong as they used to be.

Medical treatments tend to be the most effective when they start early, which is why it's important to see your doctor and have a physical on a regular basis.

Moderate Stage COPD

The second stage of COPD includes somewhere between 50% and 80% of normal lung capacity. This is the point when most people notice they have a problem, and in many cases will seek medical care for their trouble breathing.

COPD does not have a cure, but doctors often recommend pulmonary rehabilitation to patients who have this stage of COPD. This rehabilitation is a combination of education, support, and exercise, with the express goal of helping patients learn how to breathe better.

Severe Stage COPD

Severe COPD is characterized by lung strength between 30% and 50% of normal. People at this stage tend to experience a significant drop in their quality of life, most often experiencing fatigue and difficulty exercising.

Medication is significantly more common at this stage, with prescriptions including steroids and combination inhalers to help reduce inflammation and allow the body to function as smoothly as possible.

Very Severe Stage COPD

End-stage COPD is characterized by lung strength of less than 30%. Even relatively minor breathing issues can be potentially fatal, and the general lack of oxygen can lead directly to other medical problems. To combat this, doctors may suggest oxygen therapy.

What Affects COPD Life Expectancy?

Merely having COPD reduces life expectancy, from about 0.3 years in stage 1 to 5.8 years in stage 3 or 4. Smokers and former smokers have the most significant loss in life expectancy, while people who have never smoked have the least loss.

Once COPD is diagnosed, the main thing affecting life expectancy is a patient's overall lifestyle. Patients who continue to be exposed to lung-damaging situations (such as smoking, breathing in other fumes, or even having a chest injury) may see their prognosis worsen, while those who exercise and avoid toxins may almost completely stop the progression of the disease.

COPD Treatment

COPD is treated in several different ways. In the earliest stages, doctors usually focus on lifestyle changes. This means breathing clean air, exercising regularly, and living a healthy life.

Around the time someone progresses to Stage 2, patients are given more education and often provided with a COPD inhalers to be used once or twice a day. The primary goal here is to slow the progression of COPD as much as possible – and while life may not be entirely comfortable at this stage, people are still capable of independent activity.

At Stage 3, doctors usually start providing COPD medication to help chemically control the progression of the disease and mitigate the worst symptoms. This continues into Stage 4, but treatments will become more invasive over time.

At any stage, doctors may suggest an experimental breathing treatment. Whether you decide to accept is up to you, but they may show better results than standard treatments. Alternatively, they may not suggest experimental treatments. Tests don't progress to using human subjects unless researchers have good reason to believe they're effective, but they are experimental for a reason and success cannot be guaranteed.

COPD Breathing Tips

If you've been diagnosed with COPD, there are several things you can do to help breathe better.

First, and most importantly, you should try to breathe air that's as clean as possible. This may involve setting up an additional filtration system in your home, wearing a particle mask in public, or even wearing some form of breathing mask during the later stages.

COPD's progress is often accelerated when additional damage to the lungs occurs, so preventing this is vital.

Next, your doctor may recommend breathing exercises for COPD to help you control your flow of oxygen. Most people don't learn these strategies right away. It takes time and practice to learn them, but once you have, it's easier to maximize the value of each breath you take.

Finally, you'll need to learn to manage situations where heavy breathing is required. Getting adequate exercise is an important part of maintaining your body's strength, but breathing too hard while you're not getting enough oxygen isn't going to help. You may want to follow these tips for exercising with breathing problems.

Everything Seniors Should Know About the Shingles Vaccine

The Shingles virus is a common problem, especially for seniors 60 years and older. At any age this is not a virus you want to catch, so you must be aware of everything there is to know about it. It's better to be safe than sorry, right?

What Is The Shingles Virus?

The Shingles virus is one of the most common viral infections in the population – in fact, roughly half the population will show symptoms by the time they're 80.

Shingles comes from the varicella-zoster virus, the same disease strain that causes chickenpox, particularly in young children.

Unlike most viruses, however, it's not something you're going to catch from someone else – instead, shingles occurs when the virus reactivates within your body. This is most common when someone's immune system has weakened (mainly from age), which is why it's most common in seniors.

If you're asking “is Shingles contagious?”, the answer is no. You can't spread Shingles to others, regardless of how severe your case is. However, you can spread the varicella-zoster virus itself, and that can infect people and cause chickenpox in people who haven't already experienced it.

Most people will only get Shingles once, and direct symptoms usually vanish within one month. Unfortunately, lingering nerve pain from Shingles can last for weeks or months beyond the disease. Which is why it's best to get treatment, or try to avoid getting it in the first place.

Who Should Get The Shingles Vaccine?

Most people over the age of 60 should get the Shingles vaccine. The only currently-approved vaccine is Zostavax.

The vaccination lasts for about five years. The CDC does not currently recommend a schedule for the Shingles vaccination for anyone younger than 60, but every five years starting at age 50 is appropriate for most people.

Who Should Not Get The Shingles Vaccine?

Unfortunately, certain groups should not get the Shingles vaccine. These include:

  • Anyone who has significant allergic reactions to any of the components of the vaccine, notably including neomycin and gelatin
  • Anyone who has a weakened immune system (from drug therapy, cancer treatment, cancer affecting the immune system, or any disease like HIV/AIDS)
  • Women who are, or who may become, pregnant in the four weeks after getting the vaccine
  • Anyone who is currently ill

Do not get the Shingles vaccine if you fall into any of these categories. If you are still concerned about getting Shingles, talk to your doctor and ask if there is any point at which the Shingles vaccine will be appropriate for you.

If you have never been tested for allergies, it may be best to have that done starting around age 50. Doing this will help your doctors know if any vaccines are dangerous to you, and it's easier to check for a problem beforehand than it is to treat a major allergic reaction.

How Well Does The Shingles Vaccine Work?

The CDC reports that the Shingles vaccine has a 51% success rate for reducing the risk of developing this disease. Reports also note that the risk of post-herpetic neuralgia (pain in the place where shingles rashes were present) drops by 67%. The vaccine is less effective on people aged 70 and older, but still recommended.

Researchers are working to make the Shingles vaccine more effective. The goal is to create herd immunity, where about 95% of the population is immune to a given disease. This can prevent the spread of a disease and reduce the number of people who suffer from it.

What Are The Side Effects Of The Shingles Vaccine?

Like many vaccines, there are several side-effects that the Shingles vaccine can cause.

Approximately 1 in 3 people suffer mild irritation around the site of the injection. About 1 in 70 report a slight headache. There are no severe side effects associated with the vaccine.

Also, it is safe to be around other people once you've had the vaccine. There is currently no documentation of infecting other people with chickenpox after having had the vaccine – although, since 99+% of the population has already had chickenpox, it is difficult to test for this sort of thing. Nevertheless, this is one of the side effects of shingles vaccine not considered to be a problem.

Nevertheless, people who develop any rashes are encouraged to keep them covered.

Any reactions beyond this – including fast heartbeat, dizziness, weakness, difficulty breathing, hives, or swelling – in the minutes to hours after the vaccination are a sign of a severe allergic reaction. If you see someone experiencing any of these symptoms, call 911 immediately.

Paying For The Shingles Vaccine

As a senior if you have medicare or medicaid most likely you will not have to worry about the cost of the vaccine itself. Regardless, it's always nice to know how the expense will be taken care of.

Medicare Part D covers the Shingles vaccine cost, but usually does not pay it in full. Some plans require copays, while others will reimburse you at a later time. Medicare Part B does not cover this vaccine.

Medicaid sometimes covers this vaccine. Contact your insurer for more information.

Private Insurance usually covers the cost of Shingles vaccine, but much like Medicaid, it's possible your plan does not. Coverage is less common in private insurance for people 50-59 than it is for people 60 and older.

The out-of-pocket cost for Zostavax is usually between $200 and $300, depending on where you get it. Vaccination assistance programs may provide Zostavax to you at no charge if you have limited income and cannot afford it. Visit Merck's page on this program or talk to your local pharmacy for more information.

Danger Of The Shingles Virus In The Elderly

The main danger of Shingles isn't the disease itself – the effects are short-term, full recovery is common, and it's almost never as dangerous as the flu or other common infections.

However, seniors often experience persistent pain after having Shingles, and this can significantly reduce your quality of life for as long as the pain lasts, usually weeks to months. Aches and pains are common with age, so adding any more suffering on top of that can be distinctly unpleasant. Being vaccinated helps to reduce the number of seniors living with pain while simultaneously making the population as a whole healthier.

Frequent Urination In Men – Symptoms and Treatment Options

Frequent urination, sometimes known as overactive bladder (OAB), is a problem believed to affect between 7% and 27% of men, with many studies averaging around 15%. While most people with frequent urination can partially control it, there are situations where men can entirely lose control of their bladders and urinate whether they want to or not. This is known as urge incontinence.

Most people experience it primarily during the day, but there are cases where people experience frequent urination at night as well.

What is Frequent Urination?

Frequent urination is the need to relieve yourself eight or more times per day, with many people needing to relieve themselves as often as once an hour while awake. Most people who experience this problem have it for several years, though studies have suggested that as many as 39% will see the symptoms vanish within one year.

It's important to note that there is some variance in the diagnosis. For example, a person who exercises a significant amount each day and is constantly drinking water may need to urinate more frequently than most people, but this is merely a part of their lifestyle rather than a genuine medical problem.

OAB is not life-threatening, and generally not permanent. There is no evidence that it is contagious.

Causes of Frequent Urination in Men

The primary cause(s) of frequent urination is unknown. However, there is one thing that most researchers agree on when studying what causes frequent urination. Namely, frequent urination becomes more common with age. It's thought that the weakening of certain muscles may be partially responsible for this condition.

Diagnosis of Excessive Urination

OAB is diagnosed by observing the symptoms after other potential causes have been ruled out.

Other potential causes of excessive urination include viral infection, a reaction to certain medications, injury to the bladder area, bladder cancer, and excessive consumption of liquids.

Treatment of Frequent Urination in Men

There are several methods that doctors use to treat frequent urination. The most notable of these is lifestyle management. You may be asked to:

  • Restrict the amount of fluid you consume
  • Avoid caffeine
  • Retrain your bladder
  • Perform Pelvic Floor Muscle (PFM) exercises
  • Attempt to void yourself on a set schedule

Depending on your symptoms, your doctor may also suggest medication. These typically include antimuscarinic pills and adrenergic receptor agonists. Most doctors do not recommend medication right away since the majority of drugs are no more effective than lifestyle adjustments and come with the risk of side effects.

It's important to note that these treatment options rarely solve the problem. Medication, for example, may only reduce the number of times you urinate each day by two or three. Instead, these treatments are focused mainly on reducing the impact of the symptoms until the body can heal on its own.

Surgical intervention is rare and typically used only as a last resort. In these cases, doctors may inject Botox, enlarge the bladder, or use electrical stimulation.

When to See A Doctor

If you think you have frequent urination, the first thing you should do is begin measuring your symptoms. Find a diary and start keeping track of how often you feel the urge to void yourself and how frequently you actually do. Record this for several days.

If you find that you're relieving yourself seven or fewer times per-day – and you aren't drinking excessively – then you're probably not suffering from OAB.

On the other hand, if you're recording eight or more incidents per day for several days in a row, then you may have an overactive bladder. Schedule an appointment with your doctor and continue to record the times of your urges until you can get in to see them. This will help your doctor diagnose the problem.

If you experience pain while urinating, you may have an infection or another serious issue. In this case, contact your doctor immediately. Painful urination is not a normal part of OAB, and you should not delay seeking treatment.

Prevent Frequent Urination in Men

Since the cause of frequent urination is mostly unknown, there isn't much that can be done to prevent it. However, there are a few things to keep in mind.

First, you should try to avoid straining your bladder. Rather than holding it in until you're done with something, you should try to relieve yourself before the pressure gets too intense.

Next, you should try to consume a healthy amount of liquid each day, based on your lifestyle needs. According to the Mayo Clinic, the average adult male should have about 15.5 cups of liquid (or 3.7 liters) per day. Fluid needs do vary, though – if you feel you're having too much or too little to drink, adjust your lifestyle accordingly.

Finally, try to maintain a healthy weight and exercise on a regular basis. People who are fit tend to have fewer health problems than those who aren't.

There is no guarantee that the methods described above will prevent frequent urination, but based on the knowledge we have, they may help.

4 Ways to Help Calm An Individual With Sundowner’s Syndrome

If you have a relative or loved one who has dementia, you’ve probably heard the term “sundowner’s syndrome” or sundown dementia. You may have even experienced it in periods where your loved one behaves erratically or agitatedly in the hours around sunset.

In this article, we’ll explain to you what sundowning is, what sundowner’s syndrome is, and finish up with a few tricks that you can put into action to help ease the symptoms of sundowning.

What is Sundowner’s Syndrome?

So, what is sundowning? Essentially, sundowning is a symptom associated with dementia and Alzheimer’s disease, in which an elderly individual’s circadian rhythm glitches and causes agitation. During the middle stages of Alzheimer’s disease and dementia, the individual’s circadian rhythm responsible for maintaining their sleep and wake cycle begins to break down.

This means that in periods where a healthy person would be starting to gear up for production of hormones associated with reduced energy levels and subsequent sleep, the sundowning individual experiences an increased level of energy, resulting in confusion and restlessness. Confusion and restlessness often result in agitation which is directed at the caregivers, which can be painful to experience.

Symptoms of Sundowning

Specific sundowning symptoms include:

  • Agitation
  • Restlessness
  • Wandering
  • Confusion
  • Knowledge that sundowning behavior is abnormal
  • Frustration at inability to think clearly
  • Nonsensical or counterfactual complaints
  • Psychomotor agitation (shaking hands or trembling legs)

A sundowning person may be hard to deal with and may even seem combative with any attempts to help them out, but remember to stay compassionate. People experiencing sundowning aren’t in a good state of mind and feel bad during the episode. Often, sundowners are suffering from degenerative arthritis, leaving them in pain.

What Causes Sundowners?

Aside from the fundamental cause of sundowner’s disease– dementia and Alzheimer’s–, there are a few other factors which can trigger an episode.

Summertime and fall time are especially difficult for those with sundowners disease. Periods of long sunsetting– or extremely short sunsetting can throw suffering seniors in for a loop.

Too much napping during the day can also trigger sundowner’s syndrome. If the senior’s energy levels are too high during the afternoon due to napping during the day, this may translate into enough energy to be extremely agitated and confused, resulting in a sundowners episode.

Caffeine is another potential culprit of a sundowner’s episode. While also potentially useful as a remedy for sundowner’s syndrome in specific cases, seniors who take too much caffeine in the middle of the day are more likely to have a sundowning episode later in the day.

Like many other degenerative neurological disease symptoms, prior episodes of sundowner’s predict future episodes so long as the underlying disease remains at the same state of progression. It’s also common to experience sundowning episodes after major medical interventions like surgery, as these tend to throw off seniors’ circadian rhythms.

Diagnosing Sundowner’s Syndrome

The primary way of diagnosing sundowner’s syndrome is by describing the patient’s symptoms to a gerontologist. Barring that, look for the following key symptoms:

  • Delayed sleep/wake cycle
  • Agitation climaxes before the sun is finished setting
  • Agitation resides 1-2 hours after sunset
  • Confusion escalates from early afternoon until sunset
  • Self-awareness of confusion decreases from early afternoon until sunset
  • Frustration at inability to think clearly dissipates and may be replaced by anger toward caregivers
  • Trembling or pacing
  • Getting lost in familiar areas around afternoon time

If your relative meets most of the above criteria, there’s a good chance that they’re sundowning.

4 Ways to Ease Sundowning

Thankfully, there are a few tactics which you can use to ease your loved one’s sundowning symptoms.

Don’t Impose Order on Sleeping at Night

Sometimes sundowning individuals get extremely agitated when they’re forced to return to a particular place to sleep every night. Instead of forcing them to sleep in their bed every night, allow them to sleep where they lie, but keep a close eye on where they choose.

It’s often prudent to leave a dim light on wherever they choose to sleep so that their level of confusion upon midnight awakening will be reduced. If your relative has arthritis in hands, you may want to incorporate an easy to use a light dimmer to avoid stressing them further.

Impose Order on Daytime Sleeping

Policing daytime sleeping can help to prevent sundowning by robbing the potential sundowner from the extra energy they need to reach an agitated and confused state. Simply put, you want your relative to be sleepy at the right time of day, which is night time. If you relative is falling asleep in the early morning or midday, it’s acceptable to give them a little bit of caffeine.

Use an Herbal Tea or Pharmaceutical Drug for Calming Preventatively

Often, chamomile can be calming in advance of episodes. Likewise, during episodes, antipsychotic medications are effective at calming sundowners.

Preoccupy Their Attention

Some caregivers have found that by giving a patient a task or activity to do, it helps ease agitation and other sundowning symptoms.

One memory care facility even experimented with giving their residents fidget spinners to help calm them down.

FAQ About Sundowner’s

Q: Is sundowner’s dangerous?

A: Not in its right, so long as your relative doesn’t harm themselves or others in their agitation or wandering.


Q: Does sundowner’s ever fully go away?

A: Sundowner’s syndrome goes away when underlying dementia or Alzheimer’s disease progresses to the next level.


Q: How do I prevent myself from developing sundowners?

A: There isn’t enough scientific evidence to say specifically, but taking steps to prevent dementia will likely have the result you’re looking for.

Does Medicare Cover Chiropractic Care?

In short, yes. However, there are some details you need to know before scheduling a visit to the chiropractor.

How Often Are Chiropractic Services Covered?

Chiropractic services are covered by Medicare when they're deemed medically necessary. Medicare Part B covers up to 80% of costs, with no maximum on the number of visits.

For Medicare, “medically necessary” generally means anything needed to treat, prevent, or diagnose any illness, disease, injury, or condition. In other words, if you are experiencing something that is debilitating or a problem for your life, it's likely to be covered.

Note that Medicare may not cover all of the services a given chiropractic center provides. Anything ‘extra' – such as product purchases not directly related to medical treatment – is unlikely to be covered. If you're not sure whether or not a given item is likely to be covered, contact your Medicare provider or ask your chiropractor for more information.

Remember, chiropractors need to be licensed by Medicare to bill them – not all Chiropractors accept Medicare.

Note: Medicare Advantage (MA) insurance plans might or might not cover chiropractic treatments. Most of these do, but payments can vary from standard Medicare rates. If you're on a Medicare Advantage plan, talk to your provider for more information.

List of Chiropractic Services

Services can vary based on your provider, so the following should not be treated as a comprehensive list. However, some treatments are common to most practices, including:

  • Chiropractic Adjustments: Adjustments focus on getting your bones (especially the vertebrae) back into position.
  • Kinesiology: Kinesiology allows a chiropractor to understand what's causing aches, injuries, or slowed healing. A session may involve testing your reflexes, checking your muscle resistance, and looking for reactions to potential allergens. This is an important part of treatment since it's difficult to create an effective care plan without knowing what the problem is.
  • Nutrition: Some chiropractic centers provide nutritional guidance. Others may directly sell health supplements to help patients in certain situations.
  • Exercise Plans: Similarly, you may be given an exercise plan to follow. As this is part of medical treatment, it's important that you follow the schedule provided. Failure to do so could slow the rate at which a problem is resolved, drive up your costs, and reduce your overall standard of living.
  • Massage: Massages may or may not be part of your chiropractic care. Many treatments include at least a small amount of massaging to loosen the body and make adjustments safer, but longer massages are available on a more location-by-location basis.

Many other services are available at some locations.

If you've received a referral to a chiropractor from your doctor, you may have been given instructions to look for specific treatments and services. Make sure the chiropractor you contact provides all of the services your doctor recommended. If no chiropractor in a reasonable distance offers those services, ask if any would be willing to offer them or talk to your doctor about an alternative care plan.

What Makes Chiropractic Care Unique

Chiropractic care works by physically adjusting your body and teaching ways to keep it in good condition. Chiropractic care isn't as fast as surgery (not counting any recovery times you may need), but it also has fewer risks of side effects than surgery and medication. This makes it one of the safest and most affordable treatment methods for certain conditions.

Other Medicare Covered Services

Medicare covers a wide variety of potential services. Options like heat therapy, electrical stimulation, and therapeutic ultrasound may be covered at a chiropractor's office.

One common service that isn't covered is acupuncture. Even if the treatment is recommended by a doctor, Medicare may not cover any of the cost of acupuncture treatments.

For more information about what is and isn't covered by Medicare, visit

What Are The 7 Stages of Alzheimer’s Disease And How to Slow Them Down?

Alzheimer’s disease is progressive. Someone begins with no symptoms and then gradually moves through seven stages of Alzheimer’s.

What is Alzheimer’s?

Alzheimer’s is a form of dementia. According to the Mayo Clinic, Alzheimer’s disease is distinguished by cognitive changes like memory loss, impaired judgement, and the loss of language.

Someone with Alzheimer’s experiences gradual and progressive brain changes that come to interfere in every aspect of his or her life. Among the areas of impairment are the memory, thinking and reasoning, decision-making, planning and performing tasks, general behavior, and personality.

How Does Alzheimer’s Progress?

Alzheimer’s moves from very mild to extremely severe in seven distinct stages. Developed by Dr. Barry Reisberg in the early 1980s, the seven stage Global Deterioration Scale helps people understand what’s happening.

The stages of this illness are predictable, each with symptoms and behaviors that worsen and cause methodical decline.  The first three are considered the pre-dementia stages, and the last four are the dementia stages. Knowing about the seven Alzheimer’s stages will help you plan and prepare.

Stage 1

The first of the three early stages of dementia involves no cognitive decline or memory problems. There are no symptoms to alert someone that he has Alzheimer’s disease. At this early stage, the only cause for concern may be a family history of dementia.

Stage 2

The person in Stage 2 begins to experience mild impairment. She finds herself forgetting where she put things, and she occasionally forgets the names of people she knows well. However, as of yet this might seem like normal forgetfulness.

Stage 3

It’s here that someone with Alzheimer’s begins to notice mild cognitive impairment in addition to steadily declining memory. He has problems concentrating and struggles to recall information he just read or to remember new names. He loses or misplaces things more often. Further, his family members and coworkers are beginning to notice declining performance.

Stage 4

This stage features moderate decline. It’s in Stage 4 that someone can receive the diagnosis of Alzheimer’s disease.

Now, the person has difficulties remembering things from her past. Complex tasks like traveling and managing money are becoming increasingly challenging so that she now needs help. She also has decreasing knowledge of events that have happened recently

Psychologically, someone in Stage 4 is likely to begin to withdraw from challenging situations. She’ll begin to have a flattened affect, or emotionless expressions. Denial is a common problem starting in Stage 4.

Stage 5

By Stage 5, the person needs assistance in order to live. Memory problems abound, and he forgets names of people close to him, information from his past, and his own address. By now, time has become disorienting and confusing.

At this stage, while impairment is significant, he still knows his own name, the names of the people close to him, and factual information about himself and others.

Psychologically, he might be angry and suspicious, but with support, these are usually kept in check.

Stage 6

This is moderately severe Alzheimer’s disease. The person forgets everyone’s name but her own, and she’s largely unaware of both past and present events. She can go places, but not without assistance. Night wandering begins. The disease disrupts the sleeping cycle so that she often sleeps during the day and is up and about at night.

Now she needs help choosing appropriate clothing, dressing, practicing hygiene habits, and using the bathroom. She needs direct assistance with almost all physical needs and tasks.

Psychological and personality changes can be extreme. The person with Alzheimer’s experiences increased paranoia and can be afraid to be alone. She experiences shame. Obsessions and anxiety are common. Sometimes, this once-peaceful person becomes violent.

Stage 7

The final stage of Alzheimer’s is severe. Almost all functioning, mental and physical, is gone. He can’t speak other than occasional utterances. Psychomotor skills like walking or using his hands, have disappeared. His body becomes rigid, inflexible, and he can no longer sit up or even hold his head up. He can’t respond to the world around him. His brain has forgotten how to do almost everything.

How to Slow/Prevent Progression of Alzheimer’s

Researchers are developing medications to slow or even prevent Alzheimer’s, but nothing has been proven effective in clinical trials. While more research is underway, there are things that people can do to stay healthy overall and equip themselves to stave off Alzheimer’s. These include

  • A healthy, drug-free lifestyle
  • Movement and activity
  • A healthy diet
  • Mentally engaging activities that involve problem-solving and memory work
  • Treating medical conditions like high blood pressure

There has been much chatter about the use of coconut oil to slow dementia. An Oxford University study examined whether there was a link between coconut oil and Alzheimer’s. They found that patients did see benefits, but that the benefits are short-term and temporary.

Black seed oil is another way some help to slow the progression of the disease. A study in the Journal of Ethnopharmacology helped to back the idea that black seed oil is good for those who have Alzheimer's or are at risk for developing the disease later in life. The study showed that those who participated in taking 1000mg of the black seed oil capsules had improved memory and brain function.

While unfortunately there is nothing known to prevent or slow the progression of Alzheimer’s, keeping yourself healthy overall and knowing the 7 Stages of Alzheimer’s will help you live well with the disease as long as possible.

Common Types of Arthritis and Their Symptoms in Seniors

Arthritis is a complicated subject, yet a critical one to understand for anyone taking care of senior citizens. Arthritis can cause many different symptoms which manifest themselves in many different ways, and it’s one of the largest diseases which reduce the quality of life that seniors experience.

In this article, we’ll walk through an explanation of arthritis, its causes, and offer a few tips on how to ease arthritis and avoid it in the first place.

What is Arthritis?

Arthritis is a degenerative or autoimmune disease which causes pain and swelling in the joints. Arthritis also causes joint stiffness, tenderness, and muscle pain distinct from the site of the joint. Arthritis is a serious disease that can have many different causes.

Causes of Arthritis

The primary cause of arthritis in senior citizens is wear and tear on joints paired with overexertion. Joints that are in constant use, like in the fingers, are at high risk. Additionally, load-bearing joints like the knees and hips are also at high risk.

People who have experienced prior injury to a joint are more likely to later develop arthritis in that joint; the same goes for those who neglected to exercise the muscles operating a given joint. Arthritis can occur both from overuse of a joint, or from underuse, making it a disease the elderly are especially susceptible to.

Common Types of Arthritis


Osteoarthritis is the most common form of degenerative arthritis, and it’s also the stereotypical arthritis case for senior citizens. Arthritis in hands, knees, elbows, and other major joints is all but assured after a lifetime of use or a day of overexertion.

Osteoarthritis is the cause of the hobbling and often shaking that the elderly exhibit while trying to move around. It’s a combination of weakness, stiffness, shakiness, pain, and inflammation that is frequently totally debilitating.

Rheumatoid Arthritis

Unlike osteoarthritis, rheumatoid arthritis is an autoimmune disorder of the cartilage surrounding joints. In a healthy immune system, these pieces of cartilage are maintained carefully. In rheumatoid arthritis, the immune system instead attacks the cartilage, causing it to decay.

Rheumatoid arthritis presents with symptoms not common to osteoarthritis, including rash, fever, hives, and abnormally high body heat. Rheumatoid arthritis can strike people at any age and isn’t necessarily linked to the extent of a joint’s use.


Though relatively uncommon in the Western world thanks to good nutrition standards, the disease called gout can induce a specific form of arthritis which differs from osteoarthritis and rheumatoid arthritis substantially.

In gout arthritis, harmful byproducts of metabolism accumulate in certain joints, causing them to come inflamed, painful, discolored, and swollen. Arthritis from gout is treatable and uncommon.

General Arthritis Symptoms

No matter the type of arthritis, the following symptoms occur:

  • Pain
  • Tenderness
  • Swelling
  • Heat in joints
  • Malaise
  • Loss of flexibility
  • Inability to do previously enjoyed activities
  • Reduction in physical fitness
  • Avoidance of visits to doctor
  • Involuntary confinement to the home

Diagnosing Arthritis

Doctors typically diagnose arthritis using reports from the patient, which are then used to guide the doctor’s selection of physical manipulation to test for swelling and pain. Once the doctor has confirmed that swelling and pain fit the mold of arthritis, the doctor can order a series of laboratory tests or imaging studies to confirm the diagnosis.

Importantly, the diagnostic process of arthritis in seniors is very straightforward, and won’t require extensive imaging tests or blood work. Only in young and healthy individuals who have arthritis will these additional tests be necessary; osteoarthritis can be diagnosed by touch and patient interview.

What Can You Do to Relieve Arthritis?

There are some tactics that seniors with osteoarthritis can do to ease the pain and disability that arthritis brings. Not all of these interventions are equally effective, so pick carefully.

Yoga And Other Exercises

Studies show that gentle exercise like in yoga is a great way to stave off the onset of osteoarthritis. Unfortunately, yoga can’t help those who are severely in pain or have extreme stiffness already. Yoga for seniors is a preventative strategy for arthritis or perhaps a treatment for mild arthritis only.

Arthritis Gloves

Certain gloves purport to apply pressure to the joints of the hand in a way such that their arthritic inflammation is reduced. While some people may experience relief from these gloves, they probably won’t help everyone. Additionally, if a senior citizen has arthritis primarily outside of their hands, the gloves won’t be able to help.

Essential Oils For Arthritis

Essential oils are largely a sham treatment for arthritis which purports to ease inflammation. Some individuals may experience relief from their arthritic pain via the placebo effect when using essential oils so that it may be worth a try anyway.

Arthritis Creams

Arthritis creams are valid and common treatments for arthritis which typically contain a topically delivered corticosteroid, mild anesthetic, or anti-inflammatory drug. Many of these arthritis creams will be prescription only, and not all creams have the same components or intended use case.

Be sure to ask the doctor about any arthritis creams that are prescribed, as some have contraindications with cosmetic products or other creams.

NSAIDs and Tylenol Arthritis Treatments

As osteoarthritis is a disease characterized by its swelling and pain, non-steroidal anti-inflammatory drugs like Tylenol, Advil, and Aleve are excellent over the counter options to treat arthritis. These drugs ease the pain of arthritis while also easing the swelling causing the pain, offering a double punch against arthritis’ effects.

Consult with a doctor before using NSAIDs to ensure proper dosing and to make sure that there aren’t any other drug interactions going on which may cause harm.

How to Prevent Arthritis

Preventing arthritis is an imperfect science, but there are a few tips which are helpful to practice. First, stay physically active in low-impact sports like swimming. Unlike in high impact sports such as running, low impact sports allow for the muscles surrounding joints to get a workout without putting any extra stress on the joint they manipulate.

Aside from participating in low-impact physical activity, avoid using joints that have been injured as much as possible. Though it sounds stupid, one of the biggest predictors of arthritis development is a prior joint injury. Treat your injured joints very tenderly, even after they’ve healed. Doing so will guarantee that they won’t have any additional wear and tear which might develop into arthritis.

Understanding A DNR (Do Not Resuscitate) Order

Resuscitation saves lives. When someone's heartbeat stops, CPR (cardiopulmonary resuscitation) is used to get the heart started again.

CPR can be performed in an emergency by a trained emergency response worker, and it can also be provided by a trained bystander if necessary. Regardless of who performs the CPR, the goal of CPR remains the same — to save a life.

What is Resuscitation?

nurse showing DNR orderThe meaning of resuscitate can vary depending on where one's heart stops beating. Resuscitation can involve chest compression and breathing into one's mouth, electric shocks to restart the heart, breathing tubes, and medicines. Hospitals with trained personnel and specialized medical equipment will obviously be more likely to provide effective CPR.

It's unfortunate that most cardiac arrests happen at home, where only about 12% of victims survive if nobody administers CPR. CPR performed by bystanders or medical staff increases this survival rate.

We know that CPR can save lives. However, what if you or someone you know does not wish to be resuscitated in the event of an emergency?

Making the Decision

You alone hold the power to choose to be revived or not. This decision is not an easy one, and there are a variety of things to consider before making the decision.

This decision affects not only the individual in question but also those around them. DNR (Do Not Resuscitate) means that you will not be resuscitated if your heart or breathing stops.

Some people with debilitating illnesses choose not to be resuscitated if they experience cardiac arrest. A DNR order, they figure, can save money for themselves and their loved ones. End-of-life care is not cheap, which partly drives many to consider no resuscitation. 

Others choose to create a DNR order because they have a condition that makes resuscitation likely to fail. In this case, a DNR order can prevent additional pain before the end of one's life. CPR is not a gentle procedure and can cause injuries of its own.

These are just a few reasons for signing a DNR form. As always, consult your local healthcare practitioner for help and advice, or if you have any questions.

If you have considered the above and wish to proceed, all you have to do is fill out a Do Not Resuscitate form.

If you do want to be resuscitated in the event of an emergency, you do not have to do anything. Resuscitation is the default decision in an emergency.

Creating a DNR Order

You can complete a DNR form with your local doctor. Your doctor will fill out the form with you and answer any questions you may have.

Your doctor can also help you order a Do Not Resuscitate bracelet or necklace. This bracelet is a simple and effective way to display your DNR decision and prevent unwanted resuscitation.

If, at any time, you change your mind, consult your doctor immediately and have them make the change for you. Notify your family and caregivers of your decision as well.

The paperwork and process can vary from state to state, but your local physician will always know how to create a DNR order for you.

Be sure to include your DNR decision in your living will or tell your POA

DNR Order Options

A DNR order does not prevent all forms of treatment — it only prevents resuscitation via CPR or a ventilator. There are additional options that one should be aware of when choosing whether to be resuscitated or not.

In addition to creating a DNR order, you can also opt in or out of other forms of treatment, depending on which state you live in:

  • whether or not to receive antibiotics
  • whether or not to be transferred to a hospital in an emergency
  • whether or not to receive nutrition via tubes

“Comfort care,” sometimes designated AND (Allow Natural Death), can be specified. In this case, everything will be done to keep a patient comfortable and without pain during their final moments. An AND order can prevent additional pain for those with terminal illnesses. The term “AND” is relatively new and may not be in use in all hospitals. Your physician will be able to understand and assist you in choosing end-of-life comfort care if it is something you want.


If you have questions not addressed below, please consult your local physician.

What do “cardiac arrest” and “respiratory arrest” mean?

Both of these signify the event in which one's heart or breath stop, or both.

What is CPR?

CPR (cardiopulmonary resuscitation) refers to the procedure take to restore someone's heartbeat or breathing. CPR often involves mouth-to-mouth resuscitation and chest compression. More advanced methods of CPR include inserting a tube into a patient to restore breathing, injecting medicines, or shocking the patient with electricity to start their heart beating again.

CPR can be performed by a hospital's staff, or by bystanders. Individuals who are not practicing physicians can take classes and learn CPR so that they can save someone's life in an emergency.

Who can request a DNR order for themselves?

Anyone 18 years of age or older may request a DNR order. If younger than 18, one can request a DNR order if they have graduated from high school and have been married or emancipated.

Can somebody request a DNR order for someone else?

Sometimes. If someone is able to request a DNR order for himself or herself, then they are the only person who can do so. The only exception to this is if they have given explicit permission for someone else to request a DNR order on their behalf. A living will may include permission for another person to ask for a DNR. If someone is not able to request a DNR for himself or herself, then another person may sometimes decide for them.

Can an EMS provider ignore a DNR order?

Yes, if there is reasonable evidence that a DNR order has been canceled. EMS can also ignore a DNR order if a conscious patient requests to be resuscitated. Family members can sometimes override DNR orders if a patient is unconscious or otherwise unable to voice their desire to EMS. Physicians can also order that a DNR order be ignored.

What is an “end-stage medical condition” or a “terminal condition”?

An “end-stage medical condition” or “terminal condition” is an incurable and irreversible condition in an advanced stage, that will — according to the attending physician — result in death, even if treated.

What does “permanently unconscious” mean?

“Permanently unconsciousness” means that, according to current medical standards, a patient will never regain consciousness. A permanently unconscious patient has entered a coma they will never recover from.

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