Asthma is a disease common in people over age 65. If not treated properly, asthma can cause serious problems for older people.
If you are an older adult, or you take care of older adults, this information will be useful in order to better understand how asthma works and how it should be managed in individuals age 65 and more. Also keep in mind that this information can’t replace the medical advice you get from a physician.
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Eloise had a long list of things she wanted to do after she retired. But after several months have passed she started coughing, wheezing and had difficulties with breathing. She immediately recognized the symptoms of asthma because her young grandson had asthma too, but she couldn’t believe she started experiencing symptoms of asthma at such an old age. When she visited her physician he confirmed that she had asthma for sure. Her plans had to be postponed until she and her physician decided what kind of lifestyle changes should she make, and what kind of medications should she take.
What is asthma?
Asthma is a disease that obstructs the airways because of an increased responsiveness of twitchiness of the airways to various stimuli such as allergens and irritants. The lining of the airway and increased secretion of mucous happens as a result of constriction of muscles and inflammation around the airway. This causes coughing, and difficulty in breathing.
Fast stats . . . The U.S Department of Health and Human Services Administration on Aging reports that around two million Americans older than 65 have asthma. According to the American Academy of Allergy, Asthma and Immunology, seniors are most exposed to this disease and therefore asthma should be considered as a very important disease.
How is asthma different in older people
Most people experience the first symptoms of asthma at a very young age. But anyone can develop asthma at any age. Often seniors in their 70s or 80s develop symptoms of asthma for the first time. The most common reasons why asthma happens are allergens, respiratory infections or viruses, and air pollution. Irritants and allergens are substances found in our everyday environment. People with asthma experience chest tightness, coughing, wheezing and shortness of breath.
As a result of the asthma, older people are exposed to a greater risk of developing respiratory failure, even during mild episodes of symptoms.
Do you know . . . Older adults who have mild asthma symptoms have the same difficulties in breathing such as younger adults with a severe asthma episode?
Asthma in younger people often goes into remission, but in the case of older adults, it remains a serious, and in many cases a disabling disease.
Why is it difficult to diagnose asthma in older adults?
It is very difficult to diagnose asthma in older adults because symptoms of other health conditions are similar to asthma symptoms, which may mask any specific asthma-like symptoms. One of the most frequent symptoms of asthma in older adults is coughing and production of sputum (the fluid coughed out) from the lungs. Your physician may recognize these symptoms as congestive heart failure or chronic bronchitis. The symptoms of asthma can be easily mimicked because emphysema and heart disease are more common in older adults, especially ones who smoke.
Beneficial to know . . . Younger people often show symptoms of asthma if they have difficulty in breathing after exercise, or wheezing. But the opportunity for asthma to present itself lessens in older adults because they stop being active. If you experience asthma symptoms such as: Shortness of breath, tightness in the chest, chronic cough or wheezing while you’re walking, gardening, shopping or doing housework, make sure to contact your physician as soon as possible.
If symptoms of asthma remain unnoticed and untreated, older adults can develop worsening health risks.
Who is more likely to develop asthma as they grow older
Younger people with asthma may experience temporary resolution and the disease may come back when they’re adults. Also, adult patients who experience sinus disease may develop asthma or other severe diseases later on.
How can asthma be treated?
Asthma can be treated with the help of medication which can keep the disease under control. Symptoms of asthma can also be relieved by making lifestyle changes, especially if asthma is triggered by allergies, certain foods, or substances in the environment. Regular vaccinations for pneumonia and influenza are strongly recommended for older adults with asthma.
Keep in mind . . . Acute asthma symptoms can be treated by short-term usage of oral steroids, but it is not recommended to use oral steroids for longer periods of time in older asthma patients, because oral steroids can cause severe side effects such as high blood pressure, ulcers or weakening of the bones.
It is very useful to make an asthma management plan with your physician if you suffer from asthma. It will help you figure out what to do when your asthma symptoms become unbearable and outline a specific treatment and lifestyle practices.
Older patients who experience asthma should make sure to ask their physician about asthma treatment if there is something they don’t understand. It is really important to inform the physician about how well is the treatment working. Patients also need to tell their physician if they forget about taking their medications, or if they have difficulty using devices such as an inhaler.
Do not forget . . . No matter where you go, always take your management plan with you, and when you visit your physician make sure to update it. You can also bring your inhaler with you and consult with the physician if you have any questions regarding the device.
Are considerations special when older adults with asthma are treated?
Yes. First of all older adults take other medications for various health issues which may enhance some side effects or make asthma symptoms worse, so the treatment can be complicated.
Secondly, older patients are more likely to have memory problems or mental confusion than younger patients. This may be the result of illnesses such as Alzheimer’s, dementia or even normal aging. Older people may find it difficult to follow treatment instructions, especially if they take various medications for different health conditions.
Additionally, many asthma medications require a certain degree of dexterity and manual coordination because they come in form of an L-shaped metered-dose inhaler. It is very difficult for older people to use this kind of medication devices and receiving the correct dosage. Older asthma patients can avoid problems with using L-shaped inhalers if they start a treatment with oral medications or a dry powder.
Who should treat this particular aspect of asthma or allergies?
Many older asthma patients get treatment from their family physician or internist, however, if you have severe persistent asthma and your symptoms are not in control within 3-6 months, or you experience severe asthma episodes that require an emergency treatment, you should visit an asthma specialist. Pulmonologists or allergists/immunologists (who specialize in the treatment of lung diseases) have specialized in treating asthma, and are called board-eligible or board-certified if they completed training in those specialties.
Is asthma treatment covered by the health insurance?
Most of the health insurances cover asthma treatments for patients. You should check with your insurance carrier for more details. You may want to find out things like:
- What coverage is offered for pre-existing conditions?
- Does the insurance carrier offer specialized asthma-related services or patient education
- Do you need a referral to an asthma/allergy care specialist from your family physician or internist?
- Is a flu shot covered as part of asthma care? A pneumonia vaccine?
- What medications are not covered by your plan?
(Sometimes it takes time for a new medicine to be approved, and even though your physician knows about them, your insurance may not cover them yet.)
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