The elderly have specific health needs and there are some over-the-counter ways to help them live their best lives
Elderly customers have complex health needs, including systemic dryness, wound care, and dental health issues. In this article, we will cover just a few of the more common challenges faced when dealing with the needs of the older person at the pharmacy counter.
The range of illnesses and health complications of older adults can be extremely complex, but for front-line care, the pharmacy is the most accessible port of call for elderly people and their families. This puts pharmacists and counter staff at the coalface when it comes to helping the elderly through a vulnerable time in their lives.
While more serious conditions will be managed by an elderly person’s healthcare team, including pharmacists, there are many conditions that can benefit from over-the-counter advice and care. Elderly health needs can range from the simple and straightforward, to serious illnesses, but some of the more common conditions elderly people have to deal with include:
- Arthritis and musculoskeletal problems. These commonly include rheumatoid arthritis and osteoarthritis.
- Cancer. Approximately 20 per cent of older people have some experience of cancer.
- Respiratory problems. Chronic obstructive pulmonary disease (COPD) is among the most common respiratory problem among older people.
- Diabetes. This often results in other complications.
- Cardiac disease and other heart issues. High blood pressure is known to affect 60 per cent of people aged over 60 years.
It is now recognised that mental health issues have a significant impact on a large proportion of elderly people. These can range from medical issues — such as delirium and confusion or dementia, to name just a few — to depression and anxiety.
Loneliness is also a major problem for older people and is known to adversely affect their quality of life, as well as the length of their life. Some older people do not have family members to help them manage their medications and health issues, which leaves them extremely vulnerable.
Some of the less serious issues faced by elderly people can still have a severe impact on their quality of life and cause considerable distress, such as skin problems. As the skin ages, it loses elasticity and bruises easily, also becoming prone to cut and tear more easily. Dry skin and dry eyes are also issues among many older people, and their skin can also be more prone to infections and different types of dermatitis.
Issues such as growths on the skin, pressure ulcers, poor circulation that leads to dermatitis, and pre-cancerous/cancerous lesions need to be dealt with by the person’s doctor, and the pharmacist will also make an important contribution in managing these problems.
Dryness
Dehydration is also a common issue among many older people. This can lead to chronic dry mouth, known as xerostomia, which can also be caused by side-effects of one of the medications they are taking. This results in a range of complications, such as difficulty chewing, swallowing or even speaking, and severely impacts quality of life.
One problem that often slips under the radar is a condition called Sjögren’s syndrome. According to studies, many of the symptoms of Sjögren’s syndrome are often dismissed by doctors as a normal part of the ageing process, such as dry eyes, dry mouth, and fatigue. Sjögren’s syndrome is often only diagnosed after a delay and the onset of more serious symptoms, such as burning and numbness in extremities, pain during sexual intercourse, and anaemia or low white blood cell count, among other symptoms. In Sjögren’s syndrome, saliva output is also reduced, so it is important for these people to maintain good oral hygiene to prevent cavities.
Once diagnosed, Sjögren’s syndrome must be managed by a medical professional, but there are some OTC medications that can help with dry eyes and dry mouth.
A significant and common problem for older ladies is vaginal dryness. This can affect women of any age, but is more common in women after they have been through menopause and is estimated to affect over half of post-menopausal women aged between 51 and 60. The organisation Women’s Health Concern states that following menopause: “The ovaries stop producing the female hormone oestrogen and levels are low. One of the early signs of reduced oestrogen on the vagina is reduced lubrication during sexual activity. Without the production of oestrogen, the skin and support tissues of the lips (vulva) and vagina become thinner and less elastic and the vagina can become dry. Approximately half of post-menopausal women experience vaginal dryness.
“Despite the high number of women experiencing problems related to vaginal dryness, it is still a silent problem that many people feel embarrassed to talk to their partners, friends and even healthcare professionals about. Only a quarter of affected women seek treatment. Remember, women spend approximately a third of their lives in a post-menopausal state and they need to try to maintain the quality of life that they had before the menopause. Vaginal dryness does not need to be treated as an inevitable part of growing older – something can be done about it.”
Bowel problems
Bowel problems are also a source of concern for older people. Acid reflux, sensitivity to medicines, and poor absorption of vitamins, among others, are common problems as the stomach gets older and has less ability to produce acids. This has a number of implications, including intolerance to some medications, and reduced muscle movement can lead to constipation. Increased fluid intake can help in some cases and if the person is capable of physical activity, they should be encouraged to maintain movement to help with their digestive health.
One of the most common problems among the elderly is polypharmacy, and they may be on several different medications at once. Sometimes the person themselves can become confused by the large amount and variety of medications they have to take, so if you have any doubt that a therapy you recommend may interact with another medication, always consult the pharmacist on duty to establish the proper treatment course.
Therapies
For prickly heat and chafing in delicate skin folds, skin irritation and body odour caused by common bacteria and fungi, Caldesene Adult Medicated Powder creates a barrier that seals wetness out of the skin. The active ingredient in Caldesene Medicated Powder is 10% w/w Calcium Undecylenate, and it also includes talc, perfume and calcium. It is safe for adults and older children, for use on folds, groin, under breasts, and between toes.
For the dry skin that often accompanies ageing, The CeraVe range includes CeraVe Moisturising Lotion with Hyaluronic Acid & Ceramides for Dry to Very Dry Skin. It is developed by dermatologists. Suitable for dry and very dry skin, this therapy contains ceramides and hyaluronic acid, which help boost the skin’s moisture levels while restoring its protective barrier, says the manufacturer. The formula is oil-free and non-comedogenic, so it will not clog the skin’s pores or cause irritation. This product provides instant and long-lasting skin hydration that lasts for 48 hours, with improvements to the skin barrier seen in just one hour. The formula is gentle enough that as well as older adults, it can also be used on babies over two months old.
For dry eyes, Hylo Forte Eye Drops contain a naturally-occurring substance called Sodium Hyaluronate, which replenishes the tear film and offers effective relief for more severe and persistent dry eye symptoms. It remains sterile for six months and is suitable for use with contact lenses.
Evo Tears is another solution for dry eyes that is a water-free, preservative-free eye drop that acts to stabilise the tear film lipid layer, relieving the symptoms of dry eyes. It can be used throughout the day and the revolutionary formula helps to gently restore the eye’s natural defences.
For dry mouth, Biotène Dry Mouth Oral Balance Saliva Replacement Gel contains a mouth-moisturising system that helps moisturise oral tissue. This can be recommended to customers who have oral moisture issues due to taking multiple medications, and is also useful for treating these symptoms in customers with diabetes or Sjögren’s syndrome.
BioXtra Dry Mouth Oral Gel is another trusted therapy that contains intensive moisturisers to soothe and lubricate the mouth for hours and ease the symptoms and effects of dry mouth. It helps promote healthy teeth and comfortable gums. It is especially recommended for night-time use and under dentures and helps to promote healthy teeth and comfortable gums.
As stated, it is important for elderly patients with dry mouth to maintain good oral hygiene. Included in the Kin range is Kin Care Mouthwash that contains Aloe Vera, pro-vitamin B5, vitamin B3 and betaine for regeneration, hydration and relief for sore, dry or inflamed oral areas. The formula includes ingredients to protect damaged areas and it is not recommended to ingest food or drinks for half an hour after use.
To moisturise intimate areas, YES VM Vaginal Moisturiser is a gentle, long-lasting natural vaginal moisturising gel that is designed to match the typical vaginal environment with none of the skin-damaging or concerning chemicals found in some vaginal moisturisers. It relieves vaginal atrophy and dryness, rapidly alleviates irritation, itching and burning, moisturises and soothes dry and sensitive vaginal tissues, and is gentle, with long-lasting rehydration.
To help tackle constipation, Dulcolax 5mg Gastro-Resistant Tablets are an effective option. Each tablet contains 5mg of the active ingredient bisacodyl, which helps to gently stimulate the bowel muscles. This creates predictable, overnight relief from constipation to help return the body to its natural rhythm.
Also for constipation, Senokot 7.5mg Tablets provide relief from constipation that is not chronic or long-term. This laxative can be used in the treatment of occasional constipation that is not thought to be the cause of an underlying condition, or long-term medication use.
In older adults, wound-healing is often impaired. If the wounds are chronic or long-term, the pharmacist on duty should be consulted, but the Medicare range of products contains solutions for most wound issues. Included in this range are a number of products that have been meticulously researched to treat wounds such as pressure ulcers, skin tears, and leg and foot ulcers. The range includes Mediset for mouth care; Meditull Gauze Dressings; Mediswab Non-Woven Swabs; Madigauze Swabs; Medicare Wound Closure Strips; Medipad Wound Pads; and Medisite Island and Thin Film Dressings.
