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The Honolulu Advertiser

Posted on: Sunday, December 5, 2004

Health troubles weigh heavy on folks as they age

 •  Families struggle as Hawai'i ages
 •  One day at a time: caring for dad
 •  Families urge streamlined approach to elder services
 •  Coping with the toll of aging
 •  Seniors struggle to find a way to get around
 •  Day programs keep seniors active, connected
 •  Caregivers face range of emotions
 •  Look inward, stay involved, make a plan
 •  Resources for seniors
 •  Questions? Experts help with answers

By Robbie Dingeman
Advertiser Health Writer

Hawai'i seniors worry about health issues that range from grappling with the unknowns of Alzheimer's and dementia to everyday problems with bladder control and managing the medications that many take to cope with chronic illnesses. That's according to Dr. Bret Flynn, geriatric specialist at The Queen's Medical Center.

Married 59 years, Eugene and Leota Louderback do their best to deal with health issues. A good sense of humor is an important part of coping, they say.

Jeff Widener • The Honolulu Advertiser

Flynn sees people struggling with these aging-related health issues every day.

They include Eugene Louderback, 80, who has memory troubles associated with dementia and had a pacemaker put in about five years ago. His wife, Leota Louderback, 75, has diabetes and kidney problems, and has undergone two back surgeries and angioplasty for a heart condition.

The Louderbacks' story isn't only one of struggle, though. They took charge of their health problems by acknowledging that they could no longer do everything for themselves. They changed their living arrangements and got help.

The affectionate couple, married for 59 years, moved out of the Waipahu home where they'd lived for decades and into an assisted-living apartment this year.

How to tell when assistance is needed

A person needs help when he or she:

• Doesn't remember to eat meals (or care for food properly).

• Is prone to falls or other accidents.

• Has problems with familiar tasks (can't pay bills, leaves the stove on).

• Forgets or won't take medicine.

• Is frequently incontinent.

• Misplaces things (which show up in unusual places, or accuses others of stealing).

• Uses poor judgment (dresses inappropriately, trusts strangers, buys unneeded things).

• Becomes lost when walking or driving in familiar areas (may lose car after parking).

• Suffers steadily deteriorating health.

• Feels isolated or becomes withdrawn.

Source: Honolulu Department of Community Services, Elderly Affairs Division

Both are cheerful now in their new rental apartment at the Plaza at Punchbowl, joking with visitors and greeting their neighbors and staff members by name. The man who takes their lunch order knows what they'll order before they ask — fruit plate for him and chicken strips for her.

Both feel fortunate to be as relatively healthy as they are. They smile fondly at one another and get past their differences without too much stress.

When they each recall an incident differently, Leota moves past it with a useful phrase: "We don't remember it the same."

The Louderbacks set a good example — and Flynn encourages other seniors to follow their lead. He suggests seniors prevent problems and maintain the best possible health and well-being as they age by actively communicating with their doctor, staying connected with family and community and remaining active.

Flynn advises people to keep walking or practice yoga or tai chi to improve balance and prevent falls, which can prove devastating.

Flynn also urges patients to read, go to museums, do crossword puzzles and spend time with friends and family. "Being socially active is very good for the brain," he said.

He also urges seniors to ask for help as challenges develop.

People don't need to choose between living in their homes without help and moving to a full-care facility, he said. Home care is becoming more available for people who are aging but who can still live independently by having helpers go to them.

Even medical professionals can attend to seniors in the community. "As a physician, I can come out and do home visits," he said.

Flynn encourages the elderly to be frank with their doctors and their family members about how they are feeling and coping. "Take simple forgetfulness. Could that be a warning that there's something more serious like dementia or Alzheimer's?"

Best practices for maintaining health during aging:

• Be open with your doctor and ask questions.

• Talk to family and friends about your concerns and well-being.

• Keep active, physically and mentally.

Source: Dr. Bret Flynn, geriatric specialist at The Queen's Medical Center

Patients who are evaluated learn more about treatment, cope better and can find support groups.

Flynn worries that many people older than 65 won't talk about health concerns, including some that can be treated. Loss of bladder control is one of those major issues.

"Patients are ashamed or they assume that it's something normal as you grow older," Flynn said. "That isn't normal; you should be able to control your urine throughout life."

Although incontinence is a physical issue, it can make people isolate themselves socially, Flynn said, causing other problems. He said patients are surprised to find that something as simple as an infection could cause the problem, and that it can be easily treated and cured.

Managing medications is a particular concern for Raymond Bihis, a registered nurse who is a care-management manager for University Health Alliance, one of the state's smaller health insurance companies. Bihis, who helps members understand chronic illnesses that often come with aging, stresses the importance of taking medications properly and checking to see that prescriptions don't conflict.

Even over-the-counter medications like Benadryl can have side effects for the elderly, including extreme dizziness, Flynn warns. "We react very differently than when we were younger," he said.

He also warns against sharing medications — a practice that sometimes goes on at senior clubs. A doctor may tell a patient that he is prescribing a medication to strengthen the heart of a patient. She chats with a friend who says: "I'd like my heart to be stronger too." Flynn's advice: don't share.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.