Cancer screenings Most cancers do not display symptoms in the early stages, and routine screenings are the best method for detecting cancer long before an older adult notices symptoms. The good news is that Medicare now covers a number of the screening tests for cancer. Information may be obtained by calling Medicare at 1-800-633- 4227. Age, medical history, lifestyle, and other factors will be taken into consideration in determining whether an older adult should have a particular screening. Breast cancer Breast cancer affects 1 in 8 (12.4%) of women born in the United States, and occurs most often in women over age 50 (National Cancer Institute, 2012). A mammogram x-ray can detect cancers that are too small to be felt by hand. The U.S. Preventive Services Task Force (USPSTF) recommends that women ages 50 to 74 have a mammogram screening every other year (USPSTF, 2016b). There is insufficient evidence to recommend for or against mammography in women age 75 and older. Women in this age group should discuss further screenings with their primary care provider (USPSTF, 2016b). Colorectal screening The USPSTF advises screening with a colonoscopy should start at age 50 and continue through age 75. The interval between screenings will depend on the test results. People older than age 75 should discuss the risks and benefits of screening with their healthcare provider (USPSTF, 2016d). Cervical cancer screening It is recommended that women between the ages of 21 and 65 have cervical cancer screenings with a Papanicolaou (Pap) smear every 3 years. Some women ages 30 to 65 may elect to have a Pap smear and human papillomavirus testing every 5 years. Cervical cancer screening is not recommended in women older than age 65 (USPSTF, 2016c). Pelvic examination This includes an examination of the uterus, vagina, ovaries, bladder, and rectum to determine whether there are any changes in size or shape. Recommendations how often to perform this examination vary depending on medical history. The Prevention Many cancers are preventable because they are related to use of tobacco products, environmental exposures, and foods and beverages. Teach older adult patients these cancer-preventing lifestyle choices: ● Do not use tobacco products of any kind. ● Avoid the ultraviolet rays of the sun or from artificial sources. ● Choose foods with less fat and more fiber. Being seriously overweight increases the risk of many types of cancers. ● Do not consume more than one alcoholic drink per day.
pelvic examination has not been proven to reduce mortality from ovarian cancer (Westhoff, Jones, & Guiahi, 2011). Prostate cancer A digital rectal examination can be a useful screening tool for detecting prostate cancer in the early stages, and therefore, it is recommended for men at their annual examination (Mayo Clinic, 2015b). The USPSTF no longer recommends screening for prostate cancer with the prostate-specific antigen test; however, some men still choose to have this test (USPSTF, 2016e). Healthcare professionals should encourage men to discuss the risks and benefits of prostate cancer screening with their primary care provider. Skin examination Skin cancer is the most common form of cancer among older adults. Evidence is insufficient to recommend routine examination. However, people in high-risk categories, such as having fair skin, living in tropical areas, having a history of skin cancer, and being exposed to sunlight should consider having a screening examination performed annually (USPSTF, 2016a). Treatment When an older adult is given the diagnosis of cancer, he or she should be made aware of the urgency of getting treatment quickly. There are various methods for treating cancer. Treatment depends on the type of cancer, the cancer’s stage, the patient’s medical history, and the patient’s ability to tolerate treatment. Treatments include surgery, radiation, chemotherapy (anticancer) medications, and biological therapy, which is a method of enhancing the patient’s natural ability to fight infection and disease. There is usually a treatment team that consists of an oncologist, a surgeon, a radiation oncologist, and perhaps others, such as a dietician or a physical therapist. Most patients want to obtain a second opinion before selecting a treatment option, and many insurance companies now pay for this. Often, cancer patients take part in clinical trials for new treatments. These clinical trials offer alternative choices and options for the patient. ● Visit a healthcare professional for an annual routine examination and any time warning symptoms of cancer develop (Donnelly, 2016). Teaching older adults to watch for warning signs may help them detect possible cancers when they are still in early stages. This early detection often provides more treatment options and better outcomes.
HEARING LOSS
● Missing parts of conversations and continually asking people to repeat themselves. ● Loss of high and low tones; no longer able to hear birds singing. ● Turning the television, radio, or telephone volume loud. ● Inability to distinguish speech from background noises, or to follow dinner time conversation when others are talking or music is playing. ● Straining to read lips and facial expressions. ● Difficulty hearing on the telephone. ● Difficulty following a conversation when two or more people are speaking. ● Misunderstanding what people say; accusing others of mumbling. ● Agreeing or nodding the head during conversations when the person is not sure what has been said. (NIDCD, 2016b)
Hearing loss is extremely common in the older population, especially among men. One-third of older adults between the ages of 65 and 74 and one-half of those older than age 75 have hearing loss – yet only 20% seek help (National Institute on Deafness and Other Communication Disorders [NIDCD], 2016b). Hearing loss has an effect on socialization and relationships and may lead to either avoiding social events or appearing and feeling cognitively impaired. Some older adults are not aware of their impairment, and many are reluctant to report problems or obtain treatment. They may feel embarrassed, upset, and lonely. This causes frustration among everyone who comes in contact with the person, such as his or her spouse, family members, and friends. Patients who acknowledge a hearing loss should be referred to an audiologist for complete assessment and determination of whether a hearing aid could help. For patients who do not admit to a loss or who cannot receive treatment, use good communication skills to ensure that they understand what you are telling them (NIDCD, 2016b). The following signs are common symptoms of untreated hearing loss:
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Book Code: PTNY3622B
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