INCONTINENCE IN ELDERS

Incontinence means lack of voluntary or self control over urination or defecation. This condition occurs when there is problem with the muscles and nerves that helps the bladder to hold or release urine or motion. It can happen in any age but it’s more common in older adults because of structural changes in the aging bladder and urethra. There are two types of incontinence. 

1. Urinary Incontinence
2. Faecal Incontinence

URINARY INCONTINENCE: 
Lack of self control over urination. Commonly seen more in women than men.
Causes:
1. In women - pregnancy , child birth and menopause contribute to incontinence
2. In men - prostate problems
3. Weak bladder muscles
4. Over active bladder muscles
5. Nerve or muscle damage
6. Urinary tract infections
7. Heavy smoking
8. Over weight
9. Due to some medical conditions like Diabetes, Multiple sclerosis, Parkinson’s disease.
10. Anxiety
11. Hysterectomy- when you underwent surgery to remove your uterus, the muscles and ligaments that support the bladder may be damaged
12. Due to some medication like using diuretics, sedative and sleeping pills

Symptoms: 
1. Stress Incontinence-  urine leaks out during coughing, sneezing, laughing, exercising or lifting something heavy and the things that put pressure on the bladder
2. Urge Incontinence- urine leaks out after feeling a sudden, strong urge to go. One may feel the urge to go when they touch or hear running water. This is called Over active bladder
3. Mixed Incontinence-  both stress and urge incontinence at the same time, more common in women
4. Overflow Incontinence - not able to empty the bladder completely so urine leaks out once the bladder is filled up, commonly seen in men
5. Functional Incontinence  seen in any medical conditions
6. Total Incontinence - is the continuous leakage of urine.
> Avoid these foods and drinks might irritate the bladder :
• Coffee, tea, Alcohol
• Acidic fruits like grapes, oranges and lemons
• Spicy foods
• Carbonated beverages
• Milk and milk products
• Sugar and honey

TIPS:
1. Daily do pelvic floor exercises
2. Quit smoking
3. Avoid lifting heavy weights
4. Loose weight
5. Cut down caffeine and alcohol
6. Eat right foods
7. For good night sleep try to limit your fluid intake before bed time

TREATMENT: 
According to the cause the treatment will be planned by the doctor
>Medication
>Medical devices
>Behavioural therapy- Lifestyle changes such as Fluid and diet management,
Weight control,
Educating about bladder irritants such as caffeine, spicy foods, Alcohol.
> Bladder Training- can involve learning to delay urination by gradually lengthening the time between bathroom trips
> Surgery- Needed, If not subsided by medical treatment

PHYSIOTHERAPY TREATMENT: 
Pelvic Floor Muscle strengthening exercises helps a lot to control Incontinence. By regularly following the exercises, one can expect results such as less frequent urine leakage in few months.
Kegels Exercise:
To find the right muscle to do this exercise stop urination in the midstream. The muscles you see here to stop are pelvic floor muscles. Focus on tightening of these muscles when you have an empty bladder. Breathe normally when you doing this exercise. Don’t squeeze thighs, buttocks and stomach while doing this exercise instead of your pelvic floor muscles. Regularly do this exercise atleast 3 sets of 10 repetitions in a day.
NOTE: Don’t make a habit of using kegels exercises to start and stop your urine stream which may leads to urinary tract infections. Do this exercise while your bladder is empty.
Electrical Nerve stimulation:
This treatment was done by doctors and physiotherapists only. Your treatment may consists of 12 weeks during which you have 15 min stimulation sessions twice a day. This kind of stimulation is used to strengthen the muscles by contracting them frequently. Electrical nerve stimulation is used for both urge and stress and for mixed type of incontinence.


FAECAL INCONTINENCE:
Inability to control bowl movements causing stool or faeces to leak unexpectedly from the rectum. It is commonly seen in older adults.

Causes: 
1. Damage to the muscles around Anus
2. Vaginal child birth may damage anal sphincter
3. Anal surgeries
4. Diarrhoea
5. Chronic constipation cause nerve damage leads to incontinence
6. Bowen diseases like ulcerative colitis
7.Stroke
8. Alzheimer’s disease
9. Spinal cord injuries
10. After radiation therapy treatment for prostate cancer

>Foods to avoid:
Alcohol
Diary products like milk, cheese
Caffeine
Spicy foods

TREATMENT: 
According to the cause of bowel incontinence , the treatment will be planned by qualified doctor.
> Diet : Increase intake of fiber which can make stool more bulky and easier to control. Avoid caffeine and drink plenty of water. Meet your dietitian regularly and take the diet sheet from them which was planned for you
> Bowel training: Schedule bowl movements at the same time each day.
> Medication
> Biofeedback helps in education, psychological support, behavioural therapy and bowel retraining
> Surgery- if incontinence is not subsided and persists even after maximum medical therapy then doctors may plan surgery

PHYSIOTHERAPY TREATMENT: 
>Pelvic floor exercises- kegels exercise
> Electrical Nerve stimulation


NOTE:  Please consult your doctor before starting any exercise program

ALZHEIMERS DISEASE

ALZHEIMERS DISEASE 

Alzheimer’s disease is a chronic neuro degenerative disease. It is an irreversible, progressive brain disorder that usually starts slowly and worsens overtime which will destroys memory and thinking skills and ability to carry out the simple tasks. In a person with Alzheimer’s disease, the tissue has lesser nerve cells and connections. 

Risk Factors: 

Aging 

Family History 

Carrying some genes 

Symptoms:

Memory loss

Confusion 

Irritability 

Meaningless repetition of own words

Personality changes

Anger

Mood swings 

Loneliness 

Depression 

Hallucination

Loss of Apetite

Restlessness 

Inability to combine muscle movements 

Confusion with time or place

Sleep disorders 

Difficulty in completing familiar tasks at home 

Diagnosis:

There is no definitive test for detecting Alzheimer’s disease. So careful and proper medical evaluation is needed to diagnose. 

> Health History: Any other medical conditions and Medications you take 

> Family History: Any illnesses in the family

> Personal History: Marital status, living conditions, employment. 

> Mental State Examination: 

• Memory Questions 

• Counting skills

• Attention span 

• Problem solving skills

> CT scan to show brain changes 

> MRI shows brain changes linked to the disease 

> Neuropsychological testing which helps to study the relationship between brain and behaviour and helps in diagnosing disease and planning treatment of conditions that effect thinking, emotion and behaviour.

AVOID THESE BAD HABITS WHICH HURTS YOUR BRAIN AND LEADS TO DEMENTIA: 

1. Avoid using gadgets in the bedtime because you may miss out on sleep 

2. Avoid too much alone time 

3. Avoid eating too much Junk food which will effect your learning, memory and mental health 

4. If you are just sitting on a chair more time and not doing any exercises and not moving enough then chances of developing cardiovascular diseases, diabetes and high blood pressure which all are linked to Alzheimer’s disease

5. Avoid smoking because it makes brain worse 

6. Avoid eating too much food, even if you eat right food also your brain may not be able to build the strong network of connections that help you think and remember. You may  also become obese and leads to certain diseases which causes dementia 

7. Avoid staying in the dark rooms too much because if you are not exposing to natural light you may get depressed and that can slow down your brain. 

PREVENTION: 

1. Regular exercise plan 

2. Following proper and healthy diet 

3. Manage the risk of certain diseases like cardiovascular disease, diabetes and high blood pressure 

4. Control intake of Alcohol and smoking 

5. Maintain healthy cardiovascular system 

6. Take proper cognitive training regularly throughout life.

TREATMENT: 

There is no known cure for Alzheimer’s disease. The death of the brain cells cannot be reversed. There are no disease modifying drugs but some drugs are there to help to reduce the symptoms and improves the quality of life. Doctor will assess you and advices you accordingly. 

Physical therapy:

Exercises play an important role in this disease. It is beneficial for both physical and mental health. So it is good to continue it as long as possible because exercises help to improve memory, reasoning, thinking skills, judgment and helps in reducing risk of cardiovascular disease, diabetes and also helps in strengthening the bones and muscles. Your physical therapist will assess you and he will plan treatment accordingly. Plz start any exercise program by doctors advise and under supervision of qualified physical therapist. Try to work out atleast 30 minutes and 5 days a week. 

> Initially start with warm up exercises 

> Walking 

> Stretching Exercises 

> Aerobics 

> Frankels Exercises to improve coordination 

> Cardio workouts 

> Community workouts like Swimming, dance, lawn bowling, water aerobics 

> Chair Exercises for people who are not physically moving. You can encourage them to do activities like Neck and shoulder rotations, twisting upper body and leg movements and quadriceps muscle exercises for knee joint 

> Encourage them to do any activities as they wish because some activity is better than none

BRAIN EXERCISES 

Along with the physical exercises, the brain exercises also plays an important role to keep brain sharp and improves emotional health. Brain exercises are like some enjoyable activities that stimulates brain continuously and keep your recall abilities high. 

1. Puzzles like Sudoku, cross words and sliding puzzles. The puzzles target several sections of brain and stimulates reasoning and problem solving functions

2. Learn any new skill by attending lectures and classes

3. Books reading is a less stress way to keep brain sharp. Avoid watching TV as it lowers the brain function 

4. Gardening helps to improve social skills and cognitive abilities. While doing gardening you can directly exposure to sunlight and helps in producing vitamin D in the skin. This vitamin D is using as a treatment for dementia 

5. Listening to music enhances motivation and decreases anxiety and also stimulates the brain hormones 

6. For hand eye coordination, sewing and needle work which always keeps the brain functioning 

7. Yoga and meditation are able to decrease stress, blood pressure, pain and increase healing and decreases inflammation

Plz consult your doctor before starting any exercise program

SAILORS HEALTH ISSUES AND PHYSIO EXERCISES

SAILORS HEALTH ISSUES AND PHYSIO EXERCISES: 

Working on ships is one of the most hazardous occupations. They prone to certain diseases and health hazards due to the nature of the onboard work, change in the climatic conditions, working hours, personal habits and the type of cargo they are carrying e.t.c.,

The common health issues like 

• Cardiovascular diseases 
• Musculoskeletal  disorders 
• Hypertension
• Mental health problems 

TIPS : 

• Do regular exercises not only keeps you physically fit but can boost your self-esteem and help you to concentrate, sleep and feel better. Even for controlling weight, blood sugar stabilises, improves digestion and improves self confidence. 
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• Watch your alcohol intake properly so that you can control its effects on your physical and mental health. 
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• Eat proper healthy food on time. 
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• Enjoying yourself helps beat stress and boosts your self-esteem so do any activity you like. 
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• If you are facing any problems then share your feelings with your friends and family which is a positive step towards good mental health.
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• Take rest which is good for your health, it could be a five-minute pause from the task or a half hour lunch break in a different location on the ship.

EXERCISES: 

    Each person have different abilities and health issues to perform the exercises. So, before starting the exercise program in the ship please meet your doctor and physical therapist. They will assess you and plan the exercise program for you.

1. Warmup for 5-10 minutes. Exercises such as walking, slow jogging, knee lifts, Arm circles, Trunk rotations. 
2. Muscular strengthening exercises like weight lifting which increases strength and along with that manual muscle exercises also helps to strength the muscles. 
3. Muscular endurance exercises such as push-ups , Pull-ups and sit-ups.
4. Cardiorespiratory exercises like brisk walking or treadmill walking, jogging, swimming, cycling or static bicycling.
5. Stretching exercises help in improving the flexibility of your joints and muscles. 
6. Yoga and Aerobic exercises 
7. Cool down exercises again for 5-10 minutes before you are going to stop doing exercises. The exercises like slow walking   and low level exercises. 
8. If you have any musculoskeletal pains then carry TENS machine along with you which is easy to use and gives pain relief. 
9. When you have both musculoskeletal pain and swelling then Hot and cold packs give more relief.

 Please consult your doctor before starting the exercise program