Alternative Medicine and the Elderly

The physiologic process of aging makes elderly patients more susceptible to adverse outcomes with medications. Elderly patients have decreased total body water, decreased lean body mass, increased body fat, decreased serum albumin levels and altered protein binding, decreased hepatic perfusion and phase I metabolism, reduced renal plasma flow, reduced glomerular filtration rate, decreased tubular secretion function, and various alterations in determinants of tissue sensitivity. These normal consequences of aging may be confounded by others, as well as by disease processes, environment, diet, and medications.
The physiology of aging varies among individual patients, leaving some more vulnerable than others to a drug’s effects. This variability lies behind the oft-heard advice to “start low and go slow” when dosing medications in elderly patients. In addition, the number of older patients included in clinical trials for many drugs tends to be low, even though this population includes those most likely to take the drug. Factors that increase risk include atypical presentation of illness, dementia, diminished hearing or vision, use of multiple health care professionals, poor adherence to a medication regimen, and polypharmacy.
It is somewhat surprising, but according to an Ohio State University study, 70 percent of older Americans turn to alternative medicines to treat their health problems. This is surprising because so-called alternative treatments are seen more as cutting edge and out of the realm of common medical practice with fewer studies to back them. It should be advised that an elderly person be selective, however, in adopting naturopathic recommendations. Seniors are more likely to use chiropractors than any other practitioners of alternative treatments and there are least likely to use acupuncturists. Over 800 seniors were studied. The most positive aspect of this study is that seniors are seeking out care for health problems, but the downside is that they may be taking herbs or other over-the-counter products that could interfere with commonly prescribed drugs. If a senior is going to use alternative treatments, they, or someone in charge, should talk with their doctor and go over the medications.

SENIOR DEPRESSION
Depression can be debilitating for anyone, but it can be especially bad for the elderly, who have a six-times higher suicide rate. The suicide rate for elderly white men is the highest for any age group in this country. Depression in the elderly is a serious problem that can have fatal consequences when undiagnosed or mistreated. Depression in seniors is often complicated by physical ailments, a lack of a family support structure, and other factors. Even when depression is diagnosed and medicine is prescribed, seniors may take longer to respond to medication than their younger counterparts. Most anti-depressants can take weeks or even months to kick in, in the elderly, but an old drug is now showing some promise in this area. Because of the high suicide rate among the elderly, a Dr. Lavretsky says it’s important that depressed seniors get rapid treatment. Mental health workers, geriatric psychiatrists in particular, realize rapid diagnosis and treatment is imperative for the elderly, but even when depression is identified and treatment prescribed, most effective therapies require several weeks to several months before becoming effective.
A health treatment that is not classified as standard western medical practice is referred to as “alternative” or “complementary.” Alternative treatment for depression refers to health-care practices considered outside the scope of conventional Western medicine. Many are being integrated into traditional-medicine settings as their safety, effectiveness, and scientific validity are recognized.
Alternative treatments for depression rely on the fact that depression, at crux, is a biochemical illness. Whether the main triggers are physical or emotional, these triggers then induce a broad range of neurochemical changes that, in turn, leads to the feelings of depression and to the physical and psychological disruptions that being depressed then causes. Once one thinks about the biochemistry it should not be surprising that alternative treatments for depression often play an important role.
There are many alternative treatments available for depression. Each of these alternative treatment of depression addresses human suffering in different ways, but generally they seek to re-establish a balance or harmony within the body and in the lifestyle of the person being treated.
Alternative treatments for depression are as follows:
Acupuncture – The World Health Organization lists depression among the conditions for which acupuncture is effective. Some studies have shown it markedly lessens symptoms. Acupuncture can be a valuable alternative if you are unable to take antidepressants or have not found them helpful.
Biofeedback – The technique of making unconscious or involuntary bodily processes (as heartbeats or brain waves) perceptible to the senses (as by the use of an oscilloscope) in order to manipulate them by conscious mental control.
Homeopathy – A system of medical practice that treats a disease especially by the administration of minute doses of a remedy that would in healthy persons produce symptoms similar to those of the disease.
Ayurveda – An intricate system of healing that originated in India thousands of years ago.
Dietary factors – Because depressive symptoms can be exacerbated by nutritional deficiencies, good nutrition is important. Pay attention to eating a well-balanced diet. Quitting smoking is also advised.
Aromatherapy – an alternative treatment for depression – Aromas can lower stress levels, affect mood, and even change perceptions of pain. The simple scents of fruits and flowers may lighten mild depression; try inhaling the aromas of jasmine, rose, or clary sage to ease your symptoms. Frankincense and sweet marjoram, inhaled or used topically, may be helpful in reducing stress, while lavender and German chamomile oils can bring on a relaxed state.
Vitamins and Depression: like Vitamin-B(folic acid) and other supplements. No “mental illness” exists which has not been treated successfully to some degree with nutritional supplements. In the elderly, deficiencies represent a common cause of mental disturbance. As many as one in four people over 60 may have a B12 shortage and the odds increase with each decade of age. Vitamin B12 deficiency can cause moodiness, depression, memory loss, dizziness, and dementia – all common symptoms of “growing old.” If caught early enough, the symptoms normally vanish with supplementation.
Alternative treatment for depression – Diet and Depression – it affects physical health and many aspects of mental health. A vitamin or herbal supplement might promote recovery of physical or mental health and/or help manage symptoms.
Colour Therapy, for example – Warm colors of yellow, orange, and red stimulate mood in color baths, lighting, room decor and clothing. People with hypertension should avoid too much red. These same colors in food provide anti-oxidants that reduce the effects mood swings brought on by allergies.
Other research has found that using a negative air ionizer to lessen indoor allergies helps reduce mood swings.
Faith and spirituality have always been important in mental and physical healing. Today many spiritual leaders incorporate psychotherapy, offering professional counseling tailored to a belief system.

PROSTRATE CANCER

The cause of prostate cancer is unknown, but research suggests it’s linked to a combination of hormonal, genetic and environmental factors. The incidence of prostate cancer has increased in recent years, in part because it’s typically a disease of older men and the population is aging. Some studies also suggest that this increase reflects unhealthy lifestyle factors, such as a high-fat diet and sedentary lifestyle. Countries with low-fat diets have lower prostate cancer rates than junk food havens like the United States. The American Cancer Society says men who eat high-fat diets, particularly diets high in saturated fats, are at greater risk of prostate cancer.
Inactivity may also increase a man’s risk of the disease. A Harvard University study of more than 17,000 men found those who burned 4,000 or more calories a week in activities such as stair climbing and walking had a prostate cancer risk that was 47 percent to 48 percent lower than men who burned less than 1,000 calories a week. A Norwegian study reported the risk of prostate cancer was reduced by more than half in men who walked during their work hours and also engaged in regular leisure time exercise, but this protection was noted only in men over age 60.
The specific mechanisms by which exercise may exert a protective effect aren’t clear. Theories point to physical activity’s effect on hormones, immunity, body composition and psychological well-being. For people with cancer, exercise can provide numerous benefits, including increases in energy, appetite, endurance and self-esteem as well as reductions in weight loss, pain, depression and fatigue. More active men may tolerate anticancer therapies better than their less fit counterparts. In addition, men who become incontinent as a result of prostate surgery may eliminate or minimize urine leakage by doing special exercise for the muscles of the pelvic floor called Kegels.
No one knows precisely how much exercise is necessary or optimal to help prevent prostate cancer. For now, most experts say that the best guideline is the surgeon general’s exercise prescription for improved overall health: Perform a modest amount of moderate exercise (enough to burn 150 calories) on most days of the week–for example, 30 minutes of walking, 20 minutes of jogging or 45 minutes of gardening.
This amount of exercise may also help prevent the common, non-cancerous condition in older men called prostate enlargement or benign prostatic hypertrophy (BPH). A survey of more than 30,000 men, reported in the Archives of Internal Medicine, revealed that 3 hours of walking per week was sufficient to reduce the risk of BPH by about 10 percent. Couch potatoes beware: The researchers also found that the incidence of BPH increases with the number of hours of television watched per week.
Exercise Recommendations
* For Better Sex: Exercise at a level you enjoy–either moderately or vigorously–for 30 to 60 minutes, three to six times a week. Be sure that at least three of these sessions include 30 minutes of aerobic exercises and at least two include resistance exercises to strengthen muscles. Stretch after each exercise session to enhance flexibility and avoid injury.
* For Cancer Prevention: Perform a modest amount of moderate exercise (enough to burn 150 calories) on most days of the week–for example, 30 minutes of walking, 20 minutes of jogging or 45 minutes of gardening.
* To Deflate a Potbelly: Burn 250 to 500 calories most days of the week through aerobic activity such as walking or jogging. In addition, build muscles and boost metabolism by doing strengthening exercises two or three times a week.
* To “Beef Up”: Build muscles by doing strength-training exercises 2 or 3 days a week. Eat three hearty meals plus one to three snacks each day, choosing nutritious, wholesome foods.

Naturopathy

More of a philosophical approach to health than a particular form of therapy, naturopathic medicine offers a wide variety of natural, noninvasive remedies for an array of troubling minor ailments. Some naturopathic recommendations, such as certain dietary modifications and the use of selected vitamins and food supplements, have been shown in scientific studies to confer lasting health benefits, and have been wholeheartedly adopted by conventional medicine. (Natural childbirth and acupuncture also fall into this category.) Naturopathy offers a wealth of mostly harmless and possibly helpful approaches to a healthier diet and lifestyle. Many of its tenets, such as a diet high in fruits, vegetables, and whole grains, are now standard recommendations for those hoping to reduce the risk of cancer(as mentioned above), heart disease, and obesity. Its noninvasive physical therapy techniques offer significant relief from a variety of muscle and joint complaints. Again, it should be advised that an elderly person be selective, however, in adopting naturopathic recommendations. Some naturopathic prescriptions, such as detoxifying enemas and the use of homeopathic medicines, lack any scientific support. Also, heat treatments and hydrotherapy, are not necessarily the most effective way to treat an infection.
Treatment:
Naturopathic practitioners range from physicians to massage therapists, and their approach to diagnosis varies accordingly. Among all practitioners, evaluation of diet and lifestyle is considered crucial. However, if your practitioner has a high level of medical expertise, diagnosis may also involve laboratory analysis, allergy testing, X-rays, and a physical exam.
Recommendations for treatment may include any of the following, depending on your symptoms and the practitioner’s experience and philosophy:
Homeopathic Remedies: Preparations containing an extremely diluted amount of a substance that causes the symptoms, prescribed on the assumption that “like cures like.”
Herbal Medicines: Whole herbs or standardized extracts, prescribed as mild, natural alternatives to synthetic medications.
Dietary Supplements: Vitamins, minerals, enzymes, and other food substances, recommended as a natural boost to health and resistance.
Dietary Restrictions: Vegetarianism or elimination of certain food categories (such as dairy products), recommended to relieve sensitivity reactions and clear the body of toxins. Dietary advise often includes instruction on “proper combining” of groups.
Physical Medicine: Manipulation of muscles, bones, and the spine, and physiotherapy using water, heat, cold, ultrasound, and exercise, employed to relieve a broad array of ailments.
Stress Reduction: Counseling, hypnotherapy, biofeedback, and other methods, employed to heal physical damage from stress.
Detoxifying Regimens: Fasting, using enemas, or drinking large amounts of water in an effort to purify the body.
Naturopaths typically recommend an assortment of these approaches in an attempt to boost your natural defenses (the immune system), restore good health, and prevent disease.
Chances of recovery
Naturopathy endeavors to cure disease by harnessing the body’s own natural healing powers. Rejecting synthetic drugs and invasive procedures, it stresses the restorative powers of nature, the search for underlying causes of disease, and the treatment of the whole person (emotional, genetic, and environmental influences included). It takes very seriously the medical motto “first, do no harm.”
Naturopathic medicine began as a quasi-spiritual “back to nature” movement in the 19th century.
How well does naturopathy work? That depends on the aspect of naturopathy in question. Organized medicine, which ignored nutrition for decades, now swears by low-fat, high-fiber diets to prevent a host of diseases that plague industrialized societies such as ours. Mainstream doctors are also gaining new respect for certain antioxidant vitamins, such as vitamin E, as potential bulwarks against disease, and some are even acknowledging the effectiveness of certain herbs (such as St. John’s Wort for depression).
Treating Chronic Pain
An estimated 80 million Americans suffer from chronic pain. Though narcotic analgesics are extremely effective in easing acute pain, their addictive properties and side effects make these drugs a less desirable choice for long-term use and often undermine the relief they bring. That’s why they must be used carefully, if at all, for chronic pain. It is also the reason that other methods have been developed to treat and manage the problem.
Indeed, a new medical specialty known as pain management has emerged in recent years. Pain management employs a wide range of therapies to help people learn to live with pain, using only a minimum of drugs. These alternative treatments include exercise, deep-muscle relaxation training, massage, biofeedback, cognitive therapy for pain control, TENS (Transcutaneous Electrical Nerve Stimulation), neural blockade, steroid therapy, and diet counseling. Because chronic pain usually affects a person’s psychological well-being and his or her relationships, individual, group, and family therapy are also advised in most cases.
Despite all these advances, there’s still no perfect solution for pain. Many of our current medications present one drawback or another, ranging from gastric side effects to the potential of addiction. Nevertheless, there’s no denying we now have more ways of providing effective control of pain than could be imagined just a few decades ago.

As with everything, alternative medicine for the elderly should be carefully considered and monitored. The positive outcomes will be well worth it. As a caregiver of an elderly person 11 years ago, I didn’t know whether the mind changes were from the side-effects of the medications or natural, aging deterioration. How beneficial it would have been, if there were as many health alternatives available and encouraged then, as it is so today.

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