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Psychotropic Medications: Are They Helping or Harming Seniors?

Scottsdale home care agencyMedications that are capable of affecting the mind, emotions and behaviors are called psychotropic medications. These include commonly used pain medications called opioids as well as medications used to treat depression, anxiety, mood disorders, sleep problems, dementia and other mental illnesses. When given to older adults, psychotropic medications are typically intended to improve quality of life and ability to function. The doctor must assure, however, that the patient is accurately diagnosed, that the dose is correct, that harmful side effects don’t occur and that the psychotropic medication doesn’t interact badly with other medications that the patient is taking.

At Nightingale Homecare, the top provider of home care in Paradise Valley, we want to help seniors and their caregivers better understand the types of psychotropic medications they may be prescribed, how they can help, and the effects they may experience.

Some examples of psychotropic medications include:

  • Depression medications (e.g. Zoloft, Paxil, Elavil, Effexor, Wellbutrin)
  • Anxiety medications (e.g. Valium, Xanax, BuSpar, Ativan, Halcion)
  • Mood stabilizer medications (Depacote, Lithium)
  • Antipsychotics (e.g. Risperdal, Haldol, Zyprexa, Seroquel)
  • Stimulants (e.g. Adderal, Ritalin)
  • Anti-dementia medications (i.e. Aricept, Namenda, Exelon, Cognex)
  • Sleep medications (e.g. Ambien, Sonata, Lunesta, Remeron, Desyrel, Pamelor,)
  • Opioid pain medications (e.g. Percocet, Vicodin, OxyContin, Morphine, Meperidine, Hydromorphone, and Fentanyl)

The use of psychotropic medications and opioids has increased steadily in older adults over the last ten years. In the United States, people over the age of 65 represent just 13 percent of the population, yet this age group takes over one-third of the drugs prescribed in this county. What is even more disturbing is that a recent study found that the number of older Americans who take three or more brain-affecting medications has doubled in the last ten years. For adults age 65-80, nine out of ten have prescriptions for psychotropic medications written by a doctor that is not a psychiatrist.

Although they can be beneficial at times, psychotropic and opioid medications can also be dangerous when taken by older adults, especially when taken long-term. The elderly are more sensitive to the effects of these medications because most drugs are eliminated from the body through the kidneys and liver, both of which may work less efficiently in later years. Another age-related change is an increase in the amount of body fat. Seniors are at high risk for “drug toxicity,” or the result of drugs accumulating in the body because the drugs are often stored in fat. Drug toxicity is very serious and can be fatal.

Even though there is a well-known connection between the use of psychotropic medications in older adults and the potential toxicity from them, health care professionals often do not recognize what is happening. More than likely, they attribute the symptoms of medication toxicity to some sort of new health condition or worsening of an existing health condition.

Side effects from psychotropic drugs are more frequent and severe in older adults, especially feelings of sleepiness or being “out of it.” Memory and movement problems are also very common and can lead to falls, fractures and other accidents.

Most older adults who take psychotropic medications also take other prescribed and over-the-counter medications. Because of this, careful evaluation is needed to make sure that unwanted, uncomfortable or dangerous side effects and interactions are not occurring. Bad medication reactions commonly include: hallucinations, confusion, dizziness, constipation, drowsiness, weakness, slurred speech, lack of balance or coordination, slow and shallow breathing, poor judgement, falls with broken bones, addiction and even death. In addition, a recent study found that use of benzodiazepine (or anti-anxiety medication) results in a higher risk of developing Alzheimer’s disease.

Hospitalization due to bad drug reactions occurs about four times more frequently in older patients than in younger ones – and, these bad reactions could have been prevented in almost 90% of cases!

Due to the risks involved, psychotropic medications should only be prescribed by a senior’s doctor after very careful consideration, and only after trying medications or treatments that pose a lower health risk.

When considering treatment foranxiety, depression, psychological distress, sleep disorders and chronic pain,non-pharmaceutical strategies are often considered preferable to drug options in the elderly. These include:

  • Exercise
  • Meditation
  • Physical therapy
  • Acupuncture
  • Thai chi
  • Cognitive behavioral therapy
  • Yoga
  • Biofeedback
  • Chiropractic therapy
  • Guided imagery
  • Progressive muscle relaxation
  • Hot and cold treatments
  • Deep breathing
  • Relaxation training

When it comes to pain management, there is a perception that opiate pain medications are the best treatment, but studies have determined that there is no advantage to using opioid pain medications for the treatment of chronic pain in older adults when the pain is not caused by cancer. For non-cancer pain, opioids are recommended for a maximumof 3-7 days, and some over-the counter pain medications may actually be more effective.
Nightingale Homecare is committed to keeping seniors safe and well through trusted in-home care services, skilled nursing care, and more. Contact us today at (602) 504-1555 for further information on psychotropic medications or for set up a consultation for home care in Paradise Valley and the surrounding area.

The Top Benefits of Skilled Nursing Care at Home

Elderly Care Sun City

With the vast majority of older adults preferring to remain at home throughout aging, in-home senior care, such as companion care, help with personal care needs, meal preparation, transportation, and other non-medical services are invaluable. But what happens when a senior has medical needs that require skilled nursing care, such as a chronic condition like COPD, CHF, or diabetes? Or what about those who are recovering from a fall or surgical procedure? Is a nursing home or transitional care facility a necessity in those cases, or is it possible to receive skilled nursing care at home?

The Sun City home health care team at Nightingale Homecare is pleased to share that not only is this a possibility, but it’s been shown to reduce the risk of rehospitalizations and enhance healing and overall health and wellbeing. Here are just a few of the additional benefits seniors can receive through the services of skilled nursing care at home:

  • One-on-One Care: Quality of care is greatly enhanced when a senior is cared for by his or her own personal nurse and/or home health aide, as opposed to the average ratio of 10 seniors per one caregiver in a nursing home. Changes in condition or any other concerns can be picked up on and addressed immediately without the need to wait until care staff are available.
  • Comfort: There’s no place like home, as the saying goes, and that’s especially true when recovering from an illness, injury or surgical procedure. Seniors can sleep better, eat healthier, and experience reduced stress and anxiety when in their own familiar surroundings and the assistance of skilled nursing care at home.
  • Independence and Freedom: The intangible benefits of being able to choose what and when to eat, where to sleep or relax, when to invite family and friends to visit, and even something as simple as whether to allow the family cat to curl up beside you are priceless in boosting a senior’s feelings of remaining in control of his or her life choices.

If you’d like to explore skilled nursing care at home for your senior loved one, Nightingale Homecare is on hand to help, with a full range of both skilled and non-medical in-home care services for seniors. Just a few of the many ways we can help, right in the comfort of home, include:

  • Medication management
  • Infusion services
  • Ventilator/respiratory services
  • Wound care
  • Blood draws
  • Chronic care management education
  • Tube feedings
  • Stoma care
  • Nursing evaluations
  • Specialized care for Alzheimer’s disease and dementia
  • And much more

Contact us any time to learn more about elderly care Sun City and the surrounding area depend on at (602) 504-1555.


Don’t Let the Stages of COPD Leave You Breathless

Stages of COPDIt impacts tens of millions of Americans, for a variety of reasons, but smoking and long-term chemical exposure are the top causes. And many simply struggle with the symptoms without even realizing there’s an official diagnosis for the breathing problems they’re facing. COPD, while currently without a cure, can be treated to ease symptoms, reduce the risk of developing further complications, and enhancing quality of life.

COPD can be broken down into four typical stages, although each person encounters the disease uniquely. Understanding these four stages and reviewing the particular symptoms and concerns your loved one is experiencing with the physician is a good starting point. Nightingale Homecare’s Arizona home health care professionals share helpful information on what to expect in each stage of the disease:

  • Mild (Stage 1): A chronic cough and an increase in mucous produced are often the first symptoms noted – and for some people in this stage, they aren’t bothersome enough to be very noticeable or to warrant a visit with the doctor.
  • Moderate (Stage 2): During this stage, COPD patients begin to struggle with shortness of breath, in addition to the continuing cough and mucous production. Symptoms are more troubling, and the doctor may prescribe a long-acting bronchodilator to help.
  • Severe (Stage 3): Frequency of symptoms is increased in this stage, as well as severity. Normal day-to-day functioning may become compromised at this point, and additional treatment methods may be employed by the doctor, such as oxygen therapy, corticosteroids, or other medications.
  • Very Severe (Stage 4): Symptoms continue to increase in both frequency and severity, and surgery may be considered. There is also an increased risk for serious health complications during this stage, such as heart and blood pressure problems, pneumonia, and lung cancer.

Depression is also a common risk factor in those with COPD, so it’s important to share any and all concerns – physical and emotional – with the senior’s medical team.

You can also call on the skilled medical care professionals at Nightingale Homecare for assistance. Our registered nurses and caregiving staff are available to help with all necessary care needs for those with COPD, from oxygen therapy, inhalation treatments, ventilator management and care, and other skilled care services, to compassionate companionship to engage in conversations, share in enjoyable activities together, and help with meals, housework – and everything in between. And, our Pathlink chronic disease management program helps those with conditions such as COPD learn a variety of innovative techniques to better manage their disease and improve their overall quality of life.

You can reach us at (602) 504-1555 any time with questions, to request additional COPD resources, and to learn more about our Arizona home health care for seniors.

Do You Know These Unexpected Side Effects of Stroke?

StrokeThe latest facts and statistics surrounding strokes are alarming. Impacting someone in the U.S. every 40 seconds – more than 795,000 each year – strokes are the top cause of severe long-term disability, reducing mobility for more than half of those who encounter them over age 65. And one out of every 20 deaths in America is attributed to stroke.

There are several common side effects of stroke such as muscle paralysis, blurred vision, and slurred speech. However, when a senior experiences a stroke, there are particular side effects that may come as a surprise to both the senior and his or her loved ones. As experts in Arizona home health care, including caring for those recovering from stroke, we at Nightingale Homecare share the following types of lesser known effects of stroke, and how you can help manage them:

  • Moodiness. A combination of the physical and emotional upheaval that can occur following a stroke can result in depression and other mood disorders. It’s important to let the senior’s physician know about any mood swings you notice so that he or she can provide treatment to help stabilize the senior’s emotions.
  • Unusual behavior. Erratic behaviors can occur following a stroke, such as spontaneous crying or laughter without cause. Again, it’s crucial to bring any inappropriate behaviors to the attention of your loved one’s medical team. Keeping a log with dates, times, and any triggering events that may have initiated the behavior can be helpful.
  • Exhaustion. Beyond simply feeling tired a lot, post-stroke exhaustion may require more than just getting more rest to correct. The National Stroke Association explains it as a sudden drop in energy level that can come on without warning, resulting from a variety of factors. The senior’s doctor can help identify the exact cause and how to best help.
  • Insomnia. Whether from a change in circadian rhythm or the effects of obstructive sleep apnea, which can develop post-stroke, a stroke survivor may suddenly begin sleeping during the day and feeling restless and wakeful during the night. Check with the older person’s medical professional to determine if a sleep aid is permissible temporarily to help the person adjust to a more normal sleeping pattern once again.

One of the best ways to help someone recovering from a stroke is by partnering with a professional in-home caregiver, such as those at Nightingale Homecare. Our Arizona home health care team is fully trained and experienced in the nuances of post-stroke care, and can help with personal care needs, exercise and other physical activity, running errands, preparing meals, as well as a full range of skilled nursing care and professional therapy services – allowing family members to take a much-needed break from providing care with the confidence that their loved one is in the best of hands. Contact us at (602) 504-1555 to learn about our in-home care for seniors.

Steps You Can Take Today to Ease End of Life Care Concerns

end of life careFacing a terminal condition or illness with a loved one is perhaps one of the more difficult journeys this life can offer. The end of life is likely something that rarely, if ever, you have discussed with a loved one in any depth. Facing the end of one’s life, whether it be years, months or days, can be fraught with a multitude of emotional decisions, and having a framework in place can make those conversations a bit easier. You may have never considered many of these care options, and having an open conversation may prove helpful for everyone involved.


Knowing what goals you and your loved one have in mind for his or her care can drive many of your decisions. Author Hank Dunn writes about the three goals in care delivery at end of life:

  • Cure: Most treatment for an illness or condition initially begins with this focus.
  • Stabilize: When the illness or condition cannot be cured, treatment is focused on stabilizing symptoms.
  • Preparing for comfortable end-of-life care: When the illness or condition cannot be cured or stabilized, the focus is on comfort care.

At different times during the care journey, these goals may be changed, and in no particular order. They may also be combined. For instance, in end stage cancer, the patient may have end-of-life care plans in place, but also be taking antibiotics to cure a pneumonia.


These considerations may be helpful to begin the discussion:

  • Learn about the terminal illness or injury with your loved one. Speak with your loved one’s physicians and get as much information from the professionals involved in your loved one’s care. You may choose to get a second opinion in order to feel comfortable about prognosis and treatment options.
  • After learning about the options, discuss them in detail with your loved one, and any other involved family/friends. Then clearly set the goals for the health care team. Goals can change as your loved one’s health status changes, so be prepared to reassess goals frequently.
  • Learn about advance directives and put them in place if your loved one is ready. Advance directives are instructions patients leave for others when they are unable to make health care decisions. Health care professionals can help obtain information for your loved one on advance directives.
  • If your loved one’s goal is to prepare for a comfortable death, consider asking his or her physician for a hospice referral.
  • Learn about artificial hydration and nutrition. Talk with your loved one and the health care team about the potential advantages and disadvantages of the use and delivery options along with the alternatives of these care options. Your loved one can change his or her mind at any junction, but having the conversation well in advance will prepare you for the unknowns related to artificial hydration and nutrition.
  • Learn about the stages of grief. People don’t always cycle through the stages in perfect order, and steps may be skipped altogether, but understanding the stages can help explain what you and your loved one are experiencing. It can help you understand and experience patience for your loved one as well as for yourself.
  • Having a long, thoughtful conversation when your loved one is able will help you answer the question, “What would my loved one want?,” when he or she can no longer answer. Are the goals of care in line with his/her wishes for quality of life?

Probably the most important advice is to take it one day at a time. This can be a beautiful and meaningful journey, but it can also be stressful and more emotionally challenging than anything you have ever experienced. Reach out to friends and family to help ease the burden. You may also want to talk with a professional grief counselor if you are struggling with the journey. And, call on the professional Phoenix senior care team at Nightingale Homecare for in-home assistance throughout aging, including end of life care and support for family caregivers. We’re here for you any time and just a phone call away at (602) 504-1555.