Common causes of insomnia in the elderly include pain due to arthritis or leg cramps, dyspnoea due to cardiovascular or respiratory disease, nocturia due to benign prostatic hypertrophy (BPH) or caffeine ingestion, reflux due to GORD or depression/anxiety. Medications such as salbutamol, diuretics, anticholinesterases, SSRI antidepressants, beta blockers, and corticosteroids may also be implicated. Environmental factors such as intrusive noise or light may be a problem for those in residential care. The elderly are also more likely to take daytime naps which may disturb sleep at night. The patient’s beliefs about sleep and their own sleep problem may also provide useful information.
This article could also be looked read looking at a wider patient group in mind such as those with a chronic disease as intimated above.
Download the complete article here
For more information on drug therapy in the elderly visit Pharmamotion’s post Pharmacology in the elderly: pharmacokinetics, polypharmacy and related topics for a collection of video and slide shows by health professionals around the world
The 2009 RGH E-Bulletins are archived by topic here.
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RGH E-bulletin
For those interested in Aged Residential Care the quarterly Residential Aged Care Coronial Communique produced by the Victorian Institute of Forensic Medicine is a valuable read.
The Communiqué will highlight selected cases that have been reported to the State Coroner’s Office may interest the Aged Care Community.
The aims of the Communiqué are:
• To improve the awareness of clinicians, health workers, carers and those in positions of governance about adverse events resulting from systems failures. Lessons from past cases can then be applied to their own institutions.
• To improve residential aged care workers’ understanding of the coronial system and the work performed by the Clinical Liaison Service.
Each edition focuses on a theme. The September 2008 issue (pdf) looked at diabetes with three cases emphasising the need for system approaches for managing residents with this condition.
As well as exploring the Coronial inquiry there is also an expert commentary highlighting various aspects. So in the diabetes issue mentioned above there was practical information based on the experiences of a diabetes educator who has implemented successful changes in aged care settings,
The current edition (pdf) looks at deaths caused by pneumonia in an aged care setting. Pneumonia is usually considered a natural cause of death. However to better prevent these deaths we need to closely examine what has occurred in the past.
The Communiqué is produced quarterly and is available on the site or sent electronically to your email address. Subscribing is as easy as emailing racc@vifm.org asking to be added to the Residential Aged Care Coronial Communiqué list.
If you like this post and what else you see on the blog please subscribe by RSS feed (the orange button) or by email. Visit my subscription page.
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