The Importance of an Asthma Action Plan - Nurse
Caring for a Senior with Asthma
From confusion over medications to problems with their inhaler, older people with asthma may need special caregiving help to manage their daily treatment regimens.
By Madeline R. Vann, MPH
Medically Reviewed by Kevin O. Hwang, MD, MPH
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Aging makes lots of things more difficult for seniors to do independently. Safely managing asthma treatment is one of them. It’s just one of many aspects of care that changes as asthmatics get older. If you're caring for an older person with asthma, things you can do to help include ordering asthma treatment supplies and keeping track of how much medication your loved one needs to take.
Overseeing Asthma Treatment: The Changing Needs of Seniors
“I actually find that older people are more compliant with medications, [but] they may have technical difficulty with the devices,” says Richard Honsinger, MD, MACP, an asthma specialist at Los Alamos Medical Center in Los Alamos, N.M., and a member of the public education committee at the American Academy of Allergy Asthma and Immunology. While they may want to keep up with their asthma care, seniors often face a new set of challenges, including:
- Arthritis, which makes using inhalers challenging
- Confusion over how much medication to use in a nebulizer
- Difficulty paying for medications, inhalers, or asthma supplies, which can keep them from taking medications when they need them
“If patients cannot use inhalers well, they can use a spacer or a nebulizer,” says Dr. Honsinger. But they will need to be aware of how much medication is in the nebulizer. Taking too much of a prescribed asthma medicine or repeating a dose if symptoms don’t go away may have severe health consequences, says Richard Castriotta, MD, associate director of the division of Pulmonary, Critical Care and Sleep Medicine at the University of Texas Medical School at Houston.
Elderly Asthma Care: Following the Rule of Twos
Dr. Honsinger says that caregivers need to know the “rule of twos,” used to determine whether the prescribed asthma treatment is working well. The “rule of twos” says that elderly asthmatics need a change in asthma treatment if they:
- Need a rescue inhaler or rescue medication in a nebulizer to control asthma symptoms more than twice a week.
- Are awakened by nighttime asthma more than two times in a month.
- Need refills of their asthma rescue inhaler (or medications for the nebulizer) more than twice a year.
- Go to the emergency room for asthma more than twice a year.
- Need oral corticosteroids, another type of rescue medication, more than twice a year.
Caregivers must track these events and prompt their loved one to talk to their doctor right away about their asthma treatment. “[Older patients] tend to wait until the next appointment instead of coming to see doctor when they are sick,” says Honsinger.
Caregivers must also pay attention to their loved one’s overall health. Respiratory infections may seem innocent at first, but they can aggravate asthma and result in complications if symptoms are not addressed. “A peak flow meter can be used to assess the asthma control,” says Honsinger. A peak flow meter is a hand-held device that measures how forcefully an asthma patient can exhale. As asthma symptoms increase, the peak flow meter will show a decrease in force. Your doctor should talk to both you and the patient about when to give rescue medications.
Asthma Care: Scheduling Regular Doctor Visits
Besides calling the doctor when your loved one's asthma treatment is not controlling symptoms effectively, know that regular doctor visits are necessary. People with mild asthma have to visit their doctor annually, but expect quarterly visits if your loved one has moderate or persistent asthma. Honsinger advises weekly visits for people whose asthma is uncontrolled.
By helping your loved one with their asthma treatment and regular doctor’s visits, you will enable them to control their asthma more effectively and make life more manageable for everyone.
Video: Asthma 101
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