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A n important reason w hy it m ay be hard to recognize problems is the insidious nature o f Senes cence, the increase in vulnerability that occurs with the frailty that comes with aging. The effects are not al w ays dramatic or apparent on the surface. A s cells lose strength, we all begin to experience the effects o f se nescence - dulling o f the senses, a loss o f muscle strength, diminished mental capacity to integrate in formation - and we are no longer able to make deci sions about as many things simultaneously as we once did. The elderly, who suffer more pronounced effects, find it more difficult to cope with activities o f daily living, e.g. getting up in the morning, cooking, or tak ing medications. A dramatic clue that something is wrong is weight loss. W hen depression sets in, an older person m ay lose interest in food, stop cooking, and develop poor nutrition habits. Malnutrition and dehydration are the major causes o f illness among the elderly. W hen visiting your relative, try to evaluate if he or she is eating properly. Look discreetly into cabinets and re frigerators, and look for signs o f food preparation. The most frightening changes you see m ay not always be physical. One day, when talking to your relative on the phone, you notice a change in her speech, or she m ay seem disoriented, and is not mak ing any sense. Y o u imagine all sorts o f things, and perhaps you m ay imagine that she is becoming senile. But some elders suffer from dramatic changes in be havior, which are often misdiagnosed as senility. These changes in behavior often stem from illness, loneliness, depression or alcohol consumption. Often they are related to prescription drugs. Elderly people m ay forget or refuse to take them, take too many o f them or take them too often, or sim ply have problems with side effects. If you suspect that your older relative is exhib iting personality changes, you must be aware o f the medications (both prescription and non-prescription) that he or she is taking. It is easy to overdose on pre scription drugs, even if they are being taken properly. W ith senescence, there comes a deterioration o f the tissues and the diminished capacity o f the vital organs to tolerate the strength o f drugs and alcohol. Over 60% o f the elderly misuse the drugs they take, and they take a lot o f drugs. Studies show that one-third o f all pre scription drugs are consumed by the elderly, some o f whom take 4-8 different pills a day. Sometimes physi cians are not aware that a patient is seeing other doc tors and m ay prescribe a medication that patient is al ready taking. Some o f the drugs m ay not be compatible, causing dementia-like symptoms. Because o f a slower metabolism, (senescence), there is a greater risk o f experiencing the toxic effects o f drugs: mental confu sion, sickness, or even death. B elow is a list o f strate gies for safety precautions and for monitoring an elder's medication consumption: • Investigate which drugs your elder is taking; fre quency and dosage • Speak to all the physicians; make sure they are aware o f all drugs that are being taken. • Find out if your elder is being overmedicated. Speak to the doctor and the pharmacist about drug incom patibility. • Find out about drug side effects. • Keep a list o f medication your elder is taking and bring it to the doctor’s appointment. • M ake sure that your elder is taking the medication properly and on time. Prepare a chart, or distribute pills into a w eekly compartment. Depression in the elderly is less recognizable, but represents a major threat to health and wellbeing. It is often triggered by a loss - loss o f spouse or child, loss o f health, loss o f friends, loss o f financial security, loss o f home, loss o f quality o f life. The effects o f losses on the elderly are isolation, depression, con fused thinking, physical neglect, questions about own coping ability, withdrawal. Once the depression starts, it is hard to stop the downward spiral. A confused person’s thinking leads to a fear o f being unable to cope, which in turn leads to further insecurities that cause the person to withdraw. B y the same token, fam ily members or friends m ay also withdraw from the older person be cause they are hurt by what appears to be a rejection o f them. In an attempt to help a relative, we m ay indeed encounter some rejection, or even hostility. However, if we take a risk to try to understand the reason for this behavior, it will help us to communicate better and will help us provide the proper intervention. If you suspect that your relative is displaying one or more o f these signs o f distress, it is time to intervene and take action. Behavior changes in the elderly can be caused by many things, including circumstantial senility. This is a condition that occurs when elderly people with draw from circumstances o f life that seem too much to cope with. (Fewer than 7 % o f the elderly have true dementia.) People affected with this condition doubt their ability to handle their affairs and make their own decisions, and this self-doubt leads to a deeper erosion o f self-confidence, blocking their ability to make deci sions. For example, many are not able to handle pay ing bills (rent, telephone) or take medications properly. W hen faced with this problem, be mindful that this condition is reversible, with the proper interven 14 “НАШЕ ЖИТТЯ”, ЖОВТЕНЬ 2002 Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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