Preventing Disasters In The Elderly Part 2

By Frank A. Williams, M.D.

How Can I Tell When Someone is Getting Sick?

Learning to recognize when someone is getting sick is important:  the longer this takes the sicker they become. 

The better you know your loved one’s daily habits the easier it is to tell whether they are getting sick.

Let’s discuss some of the most common subtle important signs that may be a clue:

  • They tell you they are sick. People will sometimes tell you they are not feeling well.  Take it serious.  Ask what is wrong and whether they have fever, chills, or pain anywhere.
  • They stop eating. This is the earliest sign of a disease occurring especially urinary tract infections or pneumonia.  Other common causes include medications causing inflammation of the stomach (gastritis), heart attacks, and dental problems.
  • They seem more forgetful or their personality changes. Losing memory or acting strangely is often a sign of  dementias, urinary tract infections, strokes and medication side effects. 
  • They are wetting or soiling themselves.  This can indicate infection, diabetes, cancers, severe constipation, dehydration, and stroke.
  • Blood in diapers or the toilet.  Often the elderly are not aware this is occurring.  This may indicate hemorrhoids, cancers, ulcers, infectious diarrhea, perforations of the gut (especially when there is pain).
  • Changes in normal skin color may be a subtle sign of losing blood (anemia) or dehydration–especially when the mouth is dry and people are not drinking fluids.
  • Slurred speech may indicate strokes, medication side effects, and infection.
  • Getting sick, be it nausea or vomiting, every time a medication is taken often indicates underlying kidney or liver problems, dehydration, or medication side/adverse effects. When was the last time blood or urine was tested by your doctor?
  • Malodor or stinky breath or sweat can indicate kidney, liver, and gut problems as well as poor oral hygiene and problems with the teeth.
  • Redness around the heels of the feet or at the tailbone area can indicate bedsores forming. These bedsores occur because of too much pressure on the skin from lying without turning.  Bedsores occur when patient movement is limited especially in bed or wheelchair bound stroke patients, hip fractures, knee surgery and overweight patients. Bedsores may be deeper than they look and can kill.
  • Shortness of breath, cough, and chest pain may signal problems with the heart or lungs. The most common conditions include congestive heart failure, heart attacks and pneumonia.  Asthma does not usually develop at a late age and can indicate heart problems (cardiac asthma).
  • Having difficulty walking and holding on to the walls or railings or people can mean imbalance or weakness. This commonly occurs with infections, dehydration, medication side/adverse effects, and malnutrition.
  • Losing weight is a common sign of trouble. I find that dehydration, severe constipation, bowel obstruction, cancers, and medication side effects are the most common cause.
  • Abdominal pain or swelling, swelling of legs, eyes and arms may indicate problems with the liver, kidneys, medications, and serious infections.
  • Medication side effects are not dose related. They can occur when a new medication is taken even after one dose.
  • Medication adverse effects are dose related—the more medication and longer it is taken the greater the likelihood that an adverse effect may be the cause.
  • Problems with multiple medications include drug interactions which can cause any of the above symptoms.

I recommend that you buy the following equipment at your pharmacy and have your doctor show you how to use them:

  1. Stethescope 
  2. Blood pressure cuff.  I prefer the wrist cuff.  Spend about $80.
  3. Pulse oximeter.  This measures oxygen levels in the blood.
  4. A digital and an old fashioned thermometer with thermometer covers.

Don’t hesitate to call your doctor when you are concerned about your loved one—you may save their life.

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