Tag Archives: seniors

Opioid Crisis in Older Adults

Thank you to JaNae Gregg, UNC student and volunteer for her guest blog post!

Chronic pain is an awful burden that many people of a variety of ages have to suffer from. Unfortunately, the most common treatment for chronic pain is delivered in the form of an addictive substance, such as an opioid.  It has become more apparent that there is an opioid crisis happening in the United States; everyday more than 115 people die from an opioid overdose.

Roughly 21 to 29 percent of patients prescribed opioids end up misusing them, often times leading to an overdose. In some cases, patients who are being prescribed opioids don’t often know that mixing their medications can lead to overdose or that not following the prescribed instructions can lead to an overdose. The questions now are, how do help fix this crisis? And
what are other alternatives to treating chronic pain without the use of opioids?

Good Day Pharmacy has recognized the opioid crisis and is beginning to take major leaps into helping their patients become aware.  The pharmacy has begun training with their team members to start the “opioid management discussion.” A part of this discussion has to do with the use of Naloxone (don’t worry, I didn’t know what this was either).  Naloxone is a new medication designed to help reverse an overdose from occurring. The Good Day Pharmacy team is spreading the word about this incredible new medication and teaching their patients how to use it. Naloxone can be given in three different types of ways. The three ways include: pre-packaged nasal spray, auto injectable (pre-filled auto injection), and injectable (professional training required).  This new medication will help stop an overdose if it begins to occur, but that doesn’t mean that preventing overdoses from occurring shouldn’t be taken into consideration.

Prescription pain medication is heavy duty and not something to be taken lightly or without knowledge. It is always important to look into all options for chronic pain management before landing on opioids.  To help bring an end to the opioid crisis and dependency on pain medication I have provided a list of options for chronic pain management. This could be for anyone who would like to stop using opioids and try something different or for anyone who is just now seeking help for their chronic pain.  Of course these treatments may not work for everyone, but it is important to keep an open mind when seeking pain management.

  • Alternative treatments for chronic pain include:
  • Acupuncture
  • Marijuana
  • Exercise
  • Chiropractic manipulation
  • Supplements and vitamins
  • Therapy
  • Stress-reduction techniques (yoga, relaxation therapy, hypnosis, massage, biofeedback)

Sources:
https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio
https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
https://www.webmd.com/pain-management/features/alternative-treatments#2

Falling: The #1 Reason for ER Visits in Larimer County

University of Colorado Health established a fall prevention meeting to gather professionals in the Fort Collins area to discuss a red-hot topic: FALLS. When UCH asked Covell Care and Rehab to participate in this ongoing collaboration we said YES before we could muster a second thought. So many clients come to see our therapists because of a fall or an injury sustained during a tumble.

We also know people develop a great fear of falling once a fall occurs. This does not only apply to people over 65. For example, a client we saw for therapy lived across the street from her daughter. During a rushed morning, her daughter raced down the stairs to the laundry room and missed the bottom stair. At the age of 44, she broke her ankle and fell to the floor. She ended up wearing a walking boot for 6 weeks and in PT for 4 weeks. She stated, “I will always think of that bottom stair and hope I don’t miss it for the rest of my life.” Boom. The fear is real!

Once the fear creeps in, it actually becomes a precursor for another fall. Think of when you feel nervous. Tense muscles, quick response times, anxious and impulsive. These four qualities don’t help prevent falls. The secret to improving your fall prevention must include raising your confidence and trust that you will NOT fall.

We all know to pick up tripping hazards, plug in nightlights, be careful on ice, etc. But, check this list out of 5 more obscure fall prevention strategies. Need help implementing them? Just call us.

  1. Build confidence to erase the fear of falling (phenomenon explained above)
  2. Avoid rushing to the bathroom
  3. Don’t just work on strength and cardio: Work on balance!
  4. Implement strategies to manage new environments safely
  5. Improve your flexibility

Let’s examine each of these categories:

  1. To build confidence in falling you need a coach. A personal trainer or a PT and/or OT will help you push your comfort levels–even make you feel like you may just fall when you work with them! But, they will help you push your limits in a safe and CONTROLLED manner. PT and OT can work to challenge you with that “just right level” so you can begin to feel more accomplished with every visit. Perhaps you fell off of your bike and now you feel anxious to hop on that seat. Therapists can help you ride that bike again and won’t leave your side until you reach a 10/10 comfort level. Maybe you fell in the shower and your heart races a bit every time you take a shower. An OT will work with you to build strategies that make you feel in control again and eventually let that fear go.
  2. Don’t rush to the bathroom. Even if you know you are careful and mindful all the time, that level of awareness can vanish when the bladder knocks loudly to get there NOW! If you ever pull into your driveway or walk to your apartment and put the key in the door and feel a sudden urge to urinate that may mean your bladder is in control and YOU are not. A strong urge can lead to incontinence (if it has not already) and this can cause more issues. This strong urge can reduce through therapy focused on bladder retraining, urge suppression techniques and simple behavior changes.
  3. So often people tell us they walk an impressive ____ distance a day. You know what you get better at when you walk a lot? Walking! Not balance. You need good balance to manage changing directions, suddenly stepping over an item and to keep you on your feet. Balance training will allow you to avoid falling and a PT or personal trainer can work with you to improve this. Always ask to know your balance test scores at the evaluation and discharge of your treatment so you can see your progress on paper! This helps build your confidence; see #1!
  4. People with cognitive impairments such as concussion, dementia, post stroke, brain injury, etc can find a delay in interpreting their environment quickly. In a familiar environment like home a person retains muscle memory that helps them navigate through those places with ease. In a new environment like a restaurant or parking lot the environment throws a lot at a person: New noises, commotion, changes in walking surface areas, poor lighting, not enough contrast, more people and the list goes on… All of these issues demand attention and demand it now! When a person lives with a cognitive deficit the brain needs more time to process and in a new situation, time and the environment this is hard! Take you time. People can help you know what to expect. Watch for curbs, areas with poor contrast and ask for help in those areas. People with you can point out dips in the sidewalk, help you up and down a step, open the door for you and tell you what to expect at the threshold when you enter.
  5. What do you need to do if you trip? Get your balance, right? What if you feel stiff and can’t stretch your arms out to balance? What if your ankles don’t move to accommodate a pebble you stepped on? You got it. Fall! Work with a personal trainer or PT on flexibility (along with balance!). Consider Tai Chi, Yoga, chair stretching to help you move with better quality. And you will likely feel better during the day and enable yourself to do more tasks without thinking about how hard it is!

    fitness, personal training, falls, OT, PT

    OT working on balance and confidence

Ask us more about preventing falls. You don’t need to end up on the hospital’s list of fallers and if you need help, support, want to ask questions about your fall risk, just ask us! 970 204 4331