Older Adults Health Care: Home-Care Helpers : Part 2

by Food and Drug Administration (FDA)

(Page 3 of 3)

A number of ailments that commonly afflict the elderly require tube feeding, which often can be done at home. Some people receiving chemotherapy, for example, may need to supplement their meals with a nutritional solution given in a tube inserted through the nose and into the stomach or surgically inserted directly into the stomach or small intestine. Stroke patients having difficulty swallowing may also need such tube feeding, as may some patients with oral cancers or various gastrointestinal diseases. Health practitioners can teach patients and their caregivers how to administer tube feedings at home, and how to record intake, output, and the patients' weight so their nutritional status can be assessed.

Some people receiving radiation therapy, which can impede the gut's ability to digest or absorb food, and others with certain disorders need to be fed a nutritional solution via a catheter inserted surgically in a vein near the collar bone. This type of intravenous feeding, too, can be done at home after initial training by a health professional. Products used for intravenous feedings at home are called home total parenteral nutrition. FDA, which regulates these products as drugs, ensures their safety and effectiveness.

Kidney failure afflicts many older adults, particularly those with high blood pressure or diabetes. Patients with kidney failure can be treated in the home with peritoneal dialysis, in which the patient's blood is purified by a solution (dialysate) inserted into the abdominal cavity through a surgically inserted catheter. (See "Kidney Disease — When Those Fabulous Filters Are Foiled" in the March 1990 FDA Consumer.)

A process known as continuous ambulatory peritoneal dialysis allows the patient to go about normal activities during the day. Peritoneal dialysis is usually continued at night with the aid of a machine that allows dialysis to be performed while the patient sleeps. Home peritoneal dialysis is not difficult and can be done without supervision after initial training by health personnel at a dialysis center, according to Ruth Hubbard, R.N., a scientific reviewer at FDA.

Some patients with kidney failure are also treated at home with hemodialysis, in which their blood is channeled through a device that removes impurities and excess fluids. This procedure takes about three or four hours and is usually done about three times a week. In addition, hemodialysis at home requires the assistance of a trained partner to help the patient set up the equipment and monitor progress during treatment.

Both hemodialysis and peritoneal dialysis can be done in the hospital, but "the advantage of home dialysis," says Hubbard, "is that it doesn't restrain the patient to a strict schedule and people are able to participate in their own care and have more control."

Other portable equipment used in the home include blood transfusion devices and home x-ray units that are brought to the home and operated by trained personnel. Many laboratory tests, in addition, can now be done in mobile labs that drive right up to the patient's door.

Avoiding Medication Hazards

Usually, one of the most important parts of home care for older people is the medications they take on a regular basis. The various ailments to which senior citizens succumb often require them to take several medications simultaneously. Mixing medications can have serious consequences, and older adults may be especially prone to side effects from medications. New guidelines developed by FDA request drug companies to study drugs in older patients. (See "Testing Drugs in Older People" in the November 1990 FDA Consumer.)

To avoid harmful reactions to medications, people over 65 should be sure to let their doctors know every drug they are taking, including over-the-counter drugs. Pharmacists can also help trouble-shoot damaging combinations of drugs. Senior citizens should be alert to any drug side effects and report them to their doctors immediately.

The key to a medication's effectiveness is taking it properly. Medications should be taken as instructed — at the proper time and according to other instructions, such as only taking the drug on an empty stomach or with meals. A medication schedule that indicates, in a chart-like fashion, which medications should be taken and when can help ensure that medicines are taken properly. The schedule should be posted where it can be consulted often and where the patient can easily mark off drug doses as they are taken.

Many older people find the child-proof caps on drug bottles difficult, if not impossible, to open. You can ask your pharmacist to give you regular caps, but be sure to keep the medication away from children.

By being conscientious about taking their medications, and seeking out the devices and personal services they need, older people can live long and comfortable lives in the familiar surroundings of their own homes.

Home-Care Resources

The following publications or organizations can provide additional information on home care for older people:

American Association of Retired Persons, 1909 K St., N.W., Washington, D.C. 20049, [phone]. This organization puts out a booklet called "The Do-able Renewable Home," which details how to adapt a home to fit special needs.

Area Agencies on Aging. The phone numbers for these agencies can be found under the local or county government listings in the phone book. They provide referrals to local organizations or services that cater to the elderly.

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.