October 23rd – 29th is Respiratory Care Week. During this week healthcare professionals and patients recognize respiratory therapists and acknowledge the importance of respiratory care. Older adults, especially those with two or more chronic conditions, require constant assessment of both acute and chronic respiratory function. Many factors including aging, genetics, pollutants and irritants can affect lung health. The common cold and flu can cause upper respiratory infections and chronic respiratory conditions, such as pneumonia and bronchitis.
Older adults are more susceptible to pneumonia, inflammation of the lungs caused by an infection with a bacterium or virus, following the flu or during lengthy hospital stays. Age-related changes in the lung strength compound the effects of heart and lung diseases. Patients with a history of smoking or long-term exposure to environmental pollutants may be at increased risk for Chronic Obstructive Pulmonary Disease (COPD). COPD is characterized by difficulty exhaling or in “blowing air out.” Chronic conditions or age-related decline in heart function can limit mobility and capabilities for exercise. This may decrease aerobic exercise that can strengthen respiratory muscles and support breathing.
Older patients with serious breathing problems take in less oxygen and therefore have less energy for many day-to-day activities. As a result, they can often feel tired, anxious, and depressed. Aging alone influences gradual function decline of the respiratory system. Decreased oxygen flow, strained air intake, and peak gas exchange can all be due to aging. The weakening of the respiratory muscles reduces the effectiveness of lung defense systems.
However, patients with chronic and complex conditions can learn controlled breathing techniques that can be especially beneficial. Working with respiratory and pulmonary specialists, older adults can learn to pace breathing to inhale deeply lessening experiences with ribcage stiffness and muscle weakness. Rigidity in the ribs and painful fragile bones and muscles leads to shortened breaths and a poor oxygen supply. Shallow breathing can make a patient more sluggish and can prevent them from maintaining an active lifestyle.
Chronic Care Management (CCM) and Transitional Care Management (TCM) can help patients connect with the right breathing specialists. Care Managers can assess for breathing strengths and body function. CCM and TCM care teams can help coordinate respiratory therapy post-discharge from hospitals and skilled care facilities. They can also help identify experienced health educators and specialists that can teach older adults with lung problems positive techniques for breathing.
Care Managers can work with family caregivers and in-home care providers to eliminate particular triggers to poor respiratory health such as household pests and dust mites trapped in carpets, bed linens, pillows, and curtains. They can remind caregivers and patients to reduce indoor air pollution through the use of HEPA air filters, spotting and eliminating mold and proper ventilation. They can even help them be mindful of the use of aerosol sprays or scented products that can cause breathing problems.
Older adults can breathe easier with the right supports and health education. Care Managers can facilitate therapeutic approaches to improve breathing, including medication management. Working with both patients and healthcare providers, like respiratory and pulmonary specialists, through monthly reminders and care planning, Care Managers can be the essential connection for good breathing.
Written by Joseph F. West, ScD on Tuesday, 25 October 2016. Posted in Respiratory Health, Pulmonary, Lung Health, Health Literacy, COPD, Breathing, TCM, CCM