Pneumonia

What are the Symptoms of Pneumonia?

First a Cold, Then High Fever: It is true that most cases of pneumonia start out with the typical symptoms of
a cold –- sneezing, sore throat, runny nose, even a low-grade fever. You may even have a mild cough. If,
however, you develop a fever over 101 degrees F, you need to see a doctor as this may indicate that a
bacterial infection is present, which could lead to pneumonia and/or bronchitis.
Chest Pain That Feels Worse With Deep Breaths: This may feel like aching or dull pressure under your
breastbone, which hurts more if you cough or take a deep breath.
Muscle Aches: Often, people with pneumonia feel a general "malaise," which includes achy muscles and
discomfort. There can also be joint pain.
Purple or "Dusky" Skin Color: This indicates that not enough oxygen is getting into the blood. In the case of
pneumonia, the fluid in the lungs impairs function.
Headaches: The headache is often made worse by the action of coughing.
Shortness of Breath: This feels like not being able to get enough air. Often, this causes the person to gasp,
even though they are not exerting themselves at all.
Clammy Skin: The skin will feel damp and cool to the touch. The person may be pale. The clamminess is
caused by sweating.
Shaking Chills: Chills can be described as "feeling cold from the inside out." The person is unable to feel
warm, regardless of the temperature in the room or how many blankets or clothes they have on. These
chills can cause a person to shake so much that their teeth chatter. Some people refer to chills as "rigor."
Productive Cough: This means that sputum (a mixture of saliva, mucus and sometimes pus) is produced
when coughing, as opposed to a dry, hacking cough. "Sputum" is also referred to by some as "phlegm."
Discolored or Bloody Sputum: Sputum can be clear, but it can also be yellow, green or have flecks of blood
in it. The yellow or green color comes from leukocytes (white blood cells that indicate infection). Bloody
sputum indicates a severe lung infection. All of these could point to pneumonia.

Bottom Line

Responding quickly when any of these symptoms are present in an older person may mean the difference
between a hospital stay (or even death). Seeing a doc immediately is crucial -– don't be afraid of "wasting
his time" or appearing to be a "hypochondriac." It is much better to make an unnecessary trip to the doctor
than a prolonged trip to the hospital because you waited too long to get checked.
Common Cold
Seniors with the Common Cold
.
Colds are Spread depending on the virus type, any or all of the following routes of transmission may be
common:
 Touching infectious respiratory secretions on skin and on environmental surfaces and then touching the
eyes or nose.
 Inhaling relatively large particles of respiratory secretions transported briefly in the air.
 Inhaling droplet nuclei: smaller infectious particles suspended in the air for long periods of time.

Prevention
Handwashing is the simplest and most effective way to keep from getting rhinovirus colds. Not touching the
nose or eyes is another. Individuals with colds should always sneeze or cough into a facial tissue, and
promptly throw it away. If possible, one should avoid close, prolonged exposure to persons who have colds.

Treatment
Only symptomatic treatment is available for uncomplicated cases of the common cold: bed rest, plenty of
fluids, gargling with warm salt water, petroleum jelly for a raw nose, and aspirin or acetaminophen to relieve
headache or fever. Nonprescription cold remedies, including decongestants and cough suppressants, may
relieve some cold symptoms but will not prevent, cure, or even shorten the duration of illness. Moreover,
most have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, and should be
taken with care. Nonprescription antihistamines may have some effect in relieving inflammatory responses
such as runny nose and watery eyes that are commonly associated with colds. Antibiotics do not kill
viruses. These prescription drugs should be used only for rare bacterial complications, such as sinusitis or
ear infections, that can develop as secondary infections. The use of antibiotics "just in case" will not prevent
secondary bacterial infections.
What is Arthritis...and Why Does it Hurt So Much?
Arthritis can attack joints in almost any part of the body. Some forms of arthritis cause
changes you can see and feel—swelling, warmth, and redness in your joints. In some
the pain and swelling last only a short time, but are very bad. Other types cause less
troublesome symptoms, but still slowly damage your joints.
Warning Signs
Here are some warning signs that might point to arthritis:
 Lasting joint pain
 Joint swelling
 Joint stiffness
 Tenderness or pain when touching a joint
 Problems using or moving a joint normally
 Warmth and redness in a joint
If any one of these symptoms lasts longer than 2 weeks, have your parent see their
regular doctor or a rheumatologist. If your loved one has a fever, feels physically ill,
suddenly has a swollen joint, or has problems using their joints, see your doctor sooner.
Your health care provider will ask questions about the elder's symptoms and do a
physical exam. He or she may take x-rays or do lab tests before suggesting a treatment
plan.
Types of Arthritis
Osteoarthritis (OA) is the most common type of arthritis in older people. OA symptoms
can range from stiffness and mild pain that comes and goes with activities like walking,
bending, or stooping to severe joint pain that keeps on even when the elder is resting or
trying sleep. 

Rheumatoid Arthritis (RA) is an autoimmune disease. In RA, the body attacks the
lining of a joint just as it would if it were trying to protect you from injury or disease. For
example, if your elderly parent had a splinter in their finger, the finger would become
inflamed—painful, red, and swollen. RA leads to inflammation in the joints. This
inflammation causes pain, swelling, and stiffness that lasts for hours. This can often
happen in many different joints at the same time. Your aging parent might not even be
able to move the joint. People with RA often don't feel well. They may be tired or run a
fever. People of any age can develop RA, and it is more common in women. 
Gout is one of the most painful forms of arthritis. An attack can begin when crystals of
uric acid form in the connective tissue and/or joint spaces. These deposits lead to
swelling, redness, heat, pain, and stiffness in the joint. Gout attacks often follow eating
foods like shellfish, liver, dried beans, peas, anchovies, or gravy. Gout is most often a
problem in the big toe, but it can affect other joints, including the ankle, elbow, knee,
wrist, hand, or other toes. Swelling may cause the skin to pull tightly around the joint
and make the area red or purple and very tender. 
What Causes Gout?
These risk factors are associated with gout.
 Genetics. Many people with gout have a family history of the disease. Estimates
range from 20 to 80 percent.
 Gender. Gout is more common in men than in women.
 Weight. Being overweight increases the risk of developing gout because there is
more tissue available for turnover or breakdown, which leads to excess uric acid
production.
 Alcohol consumption. Drinking too much alcohol interferes with the removal of
uric acid from the body.
 Diet. Eating too many foods that are rich in purines can cause or aggravate gout.
 Lead exposure. In some cases, exposure to lead in the environment can cause
gout.
 Other health problems. Renal insufficiency, high blood pressure,
hypothyroidism (underactive thyroid gland), psoriasis, hemlytic anemia, or some
cancers.
 Medications. Medications may put people at risk for developing hyperuricemia
and gout are: Diuretics, Salicylate-containing drugs, such as aspirin, Niacin, a
vitamin also known as nicotinic acid, Cyclosporine, a medication that suppresses
the body's immune system and Levodopa, a medicine used in the treatment of
Parkinson's disease.

Reactive Arthritis is a form of arthritis, or joint inflammation, that occurs as a "reaction"

to an infection elsewhere in the body. Reactive arthritis is also known as Reiter's
syndrome. Besides this joint inflammation, reactive arthritis is associated with two other
symptoms: redness and inflammation of the eyes (conjunctivitis) and inflammation of
the urinary tract (urethritis). 
Other forms of arthritis include psoriatic arthritis (in people with the skin condition
psoriasis), ankylosing spondylitis (which mostly affects the spine), reactive arthritis
(arthritis that occurs as a reaction to another illness in the body), and arthritis in the
temporomandibular joint (where the jaw joins the skull).

How Is Rheumatoid Arthritis Treated?

Doctors have many ways to treat this disease. The goals of treatment are to:
 Take away pain
 Reduce swelling
 Slow down or stop joint damage
 Help people feel better
 Help people stay active
How Is Osteoarthritis Treated?
Doctors often combine treatments to fit a patient's needs, lifestyle, and health.
Osteoarthritis treatment has four main goals:
 Improve joint function
 Keep a healthy body weight
 Control pain
 Achieve a healthy lifestyle
Osteoarthritis treatment plans can involve:
 Exercise
 Weight control
 Rest and joint care
 Non-drug pain relief techniques to control pain
 Medicines
 Complementary and alternative therapies
 Surgery

Treating Gout
With proper treatment, most people who have gout are able to control their symptoms
and live productive lives. Gout can be treated with one or a combination of therapies.
The goals of treatment are to ease the pain associated with acute attacks, to prevent
future attacks, and to avoid the formation of tophi and kidney stones. Successful
treatment can reduce discomfort caused by the symptoms of gout, as well as long-term
damage to the affected joints. Treatment will help to prevent disability due to gout.
The most common treatments for an acute attack of gout are nonsteroidal anti-
inflammatory drugs (NSAIDs) taken orally (by mouth), or corticosteroids, which are
taken orally or injected into the affected joint. NSAIDs reduce the inflammation caused
by deposits of uric acid crystals, but have no effect on the amount of uric acid in the
body.

The doctor also may consider prescribing medicine such as allopurinol, probenecid, or
febuxostat to treat hyperuricemia and reduce the frequency of sudden attacks and the
development of tophi.
People who have other medical problems, such as high blood pressure or high blood
triglycerides (fats), may find that the drugs they take for those conditions can also be
useful for gout. Both losartan, a blood pressure medication, and fenofibrate, a
triglyceride-lowering drug, also help reduce blood levels of uric acid.
The doctor may also recommend losing weight, for those who are overweight; limiting
alcohol consumption; and avoiding or limiting high-purine foods, which can increase uric
acid levels.
High Blood Pressure in Seniors
High blood pressure is a blood pressure reading of 140/90 mmHg or higher. Both numbers are important.
Nearly 1 in 3 American adults has high blood pressure. Once high blood pressure develops, it usually
lasts a lifetime.
The good news for caregivers and their aging parents is that it can be treated and controlled. High blood
pressure is called the silent killer because it usually has no symptoms. Some people may not find out they
have it until they have trouble with their heart, brain, or kidneys. When high blood pressure is not found
and treated, it can cause:
 The heart to get larger, which may lead to heart failure.
 Small bulges (aneurysms) to form in blood vessels. Common locations are the main artery from
the heart (aorta); arteries in the brain, legs, and intestines; and the artery leading to the spleen.
 Blood vessels in the kidney to narrow, which may cause kidney failure.
 Arteries throughout the body to "harden" faster, especially those in the heart, brain, kidneys, and
legs. This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.
 Blood vessels in the eyes to burst or bleed, which may cause vision changes and can result in
blindness.
"It's not always easy, even for a physician, to know when someone is having a heart attack," says Dr.
Travis Stork, an ER physician and co-host of the popular TV show "The Doctors."
You can arm yourself by recognizing these overlooked signs of a heart attack:
1. Indigestion
Indigestion – an everyday occurrence for some folks – can indicate a heart attack is approaching,
especially in women, according to research by the National Institutes of Health. With this unpredictable
symptom, look for it to be combined with jaw, chest or back pain, anxiety or excessive sweating.
2. Pain and discomfort in the stomach, neck or jaw
Stork says if it is not related to any physical injury and the symptoms don't add up, that's when caregivers
need to be concerned. Look for a case where an individual is starting to have what physicians call
"referred pain" from their jaw to their arm and there's no good explanation. On top of that, they may
complain of generalized weakness or lack of energy.
3. Headaches
Researchers say migraine headaches can be a warning sign of a heart attack, and women in particular
who experience migraine with aura (a migraine accompanied by sensory symptoms, like flashes of light,
blind spots or tingling in your hand or face) can have double the risk of heart attacks.
4. Fatigue
Stork says that when it comes to fatigue, a heart attack tends to be something different than you've
experienced before. The words "It just doesn't feel right" are a warning sign as a physician. That doesn't
mean someone is having a heart attack, but the heart attack symptoms we talk about are when women, in
particular, listen to their bodies and typically will say, "I haven't felt this way before." It's more than I'm
tired, it's just a generalized weakness associated often with other subtle symptoms like shortness of
breath. "In many cases, when I ask patients further, they will say, ‘Well, I have had a little tinge in my
chest but I didn't think that much of it.' When you put it all together, you need to be concerned," Stork
says. Feeling stressed out, having a headache and being tired might be things that a person experiences
on a daily basis, he explains. "But if you're feeling fatigue and maybe a little more short of breath than
normal, and if something just doesn't feel right, don't ignore those symptoms."
5. Generalized weakness
Stork says that as a caregiver, when you notice that the person you're caring for has dropped from their
baseline, that's the red flag. They may try to minimize it, if they're stoic, but if you notice a big change,
that's when it's worth giving the doctor a call.
Overall, Stork says that as a caregiver, it's not your job to diagnose a heart attack. "I don't think the
concern should be so much, ‘Is this as heart attack?' as much as the concern should be, is something
potentially wrong here to the point where we need to seek further medical attention?"
Who Gets Diabetes? Top 10 Risk Factors
Certain factors can increase the risk of developing type 2 diabetes (which is most common in older
people). (Diabetes is not contagious – you cannot "catch it" from another person.
Obesity
Over 80 percent of people with type 2 diabetes are overweight. The more overweight you are, with a body
mass index (BMI) of 25 or more, the greater your risk of diabetes.
Exercise Levels
Physical inactivity has been shown to contribute to diabetes. The less exercise you do, the greater your
chances of developing diabetes.
Impaired Glucose Tolerance (IGT)
A healthy person's blood sugar is usually between 70 and 110 mg/dL (milligrams of glucose in 100
millilitres of blood) or, in millimols, between 3.9 and 6.0 mmol/L. Impaired glucose tolerance is a level of
blood glucose which is higher than normal, but not high enough to be in the range where doctors classify
this as diabetes.
Race
African Americans, American Indians, Alaskan Natives, Asian Americans, Pacific Islanders and Latinos
are at higher risk for developing Type 2 diabetes.
High Blood Pressure
A blood pressure reading of 140/90 mm Hg or higher is considered high blood pressureand puts you at
greater risk of developing diabetes.
High Cholesterol
A poor cholesterol profile increases risk of developing diabaetes. On average, here are the numbers
which are considered high cholesterol: HDL cholesterol ("good" cholesterol) levels of 35 or lower and/or
triglyceride levels of 250 or higher.
Age
Approximately 18.4% of Americans over age 65 have type 2 diabetes.
Pre-diabetes
Before people develop type 2 diabetes, they almost always have "pre-diabetes"—blood glucose levels
that are higher than normal but not yet high enough to be diagnosed as diabetes.
Family History
Research has shown that people are more at risk if there is a history of diabetes in close family members.
The closer the relative, the greater your risk of diabetes.
Previous Gestational Diabetes
Having a history of gestational diabetes, or having at least one baby weighing more than 9 pounds at
birth, increased your risk of developing Type 2 diabetes later in life.
The Future of Diabetes
Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment
of the population is aging. Also, Hispanics/Latinos and other minority groups at increased risk make up
the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and
sedentary. The Centers for Disease Control and Prevention (CDC) projects the prevalence of diagnosed
diabetes in the United States will increase 165 percent by 2050.
There are 3 main types of diabetes: Type 1, Type 2 and Gestational.
Type 1 Diabetes
Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for
fighting infection (the immune system) turns against a part of the body.
Symptoms include:
 Increased thirst
 Increased urination
 Constant hunger
 Weight loss
 Blurred vision
 Extreme fatigue
If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening
diabetic coma, also known as diabetic ketoacidosis.
Type 2 Diabetes
The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes
have type 2. This form of diabetes is most often associated with older age, obesity, family history of
diabetes, and physical inactivity,
Type 2 diabetes, formerly called adult-onset or noninsulindependent diabetes, is the most common form
of diabetes. This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle,
and liver cells do not use insulin properly.
Symptoms may include:
 Fatigue
 Frequent urination
 Increased thirst and hunger
 Weight loss
 Blurred vision
 Slow healing of wounds or sores
Some people have no symptoms.
Treatment includes taking diabetes medicines, making wise food choices, exercising regularly, controlling
blood pressure and cholesterol, and taking aspirin daily—for some. Read more on Type 2 Diabetes. 

Gestational Diabetes
Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually goes
away after the baby is born, a woman who has had gestational diabetes is more likely to develop type 2
diabetes later in life.

5 Ways to Control Diabetes

These 5 steps will help caregivers manage their aging parent's diabetes and live a long and active life.
1. Educate Yourself About Diabetes in the Elderly
The more you know about diabetes, the better you as a caregiver can work with your health care team to
manage your elderly parent's disease and reduce their risk for problems. You should know what type of
diabetes your parent has. If you do not know, ask your doctor whether they have type 1 or type 2
diabetes. Terms that suggest that diabetes is not serious, such as "a touch of diabetes," "mild diabetes,"
and "sugar's a little high," are not correct and should no longer be used.
2. Take Care of the ABCs of Diabetes
A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucoseaverage), Blood
pressure, and Cholesterol.
Talk to your health care team about how to manage your A1C (blood glucose or sugar), Blood pressure,
and Cholesterol. This will help lower your chances of having a heart attack, a stroke, or other diabetes
problems. Here's what the ABCs of diabetes stand for:
 A for the A1C test
The A1C Test shows you what your blood glucose has been over the last three months. The A1C
goal for most people is below 7. High blood glucose levels can harm your heart and blood vessels,
kidneys, feet, and eyes.
 B for Blood pressure. The goal for most people is 130/80. High blood pressure makes your
heart work too hard. It can cause heart attack, stroke, and kidney disease.
 C for Cholesterol.
The LDL goal for most people is less than 100. The HDL goal for most people is above 40. LDL or
"bad" cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke.
HDL or "good" cholesterol helps remove cholesterol from your blood vessels.