If you're in a new relationship, make sure you discuss each other's expectations to ensure that each of you know what you want from your time together. Among thigs to discuss:
Even if you've been with your partner for some time, talking openly about your needs can bring you closer. If you find you are struggling to enjoy a fulfilling sex life with your partner because of sexual dysfunction or illness, then talking to your doctor could be helpful. Relate offer specific sex and relationship counselling for older people.
Some people feel anxious about having sex, especially if it's with someone new, if you are resuming your sex life with your partner after illness, or if you've been alone a long time.
Many people feel self-conscious with a new partner. Remind yourself the other person probably feels the same. It's important to be open with your feelings as this will put you both at ease.
The best thing you can do is take time to relax together. This could mean having a glass of wine, having a chat, or spending time cuddling – whatever works for you.
If you're struggling to relax:
Sex releases the same chemicals that are released when you exercise. This lifts your mood and can make you feel more relaxed.
It's important to be aware that sex might not happen with the spontaneity you enjoyed when you were younger. Men and women may experience different problems, but there are possible solutions and treatments.
Once you reach the menopause around the age of 50, the symptoms can go on for months or years and may knock your confidence.
You may experience problems maintaining an erection. This is quite a common problem which affects over 40% of men aged 60 and over, so you're not alone. Try not to worry about it, as anxiety can make the problem worse, and be assured that there are things you can do to overcome the problem.
There are lots of causes of erectile dysfunction: it could be a physical or emotional issue, or relate to medication you are taking. Other common sexual dysfunctions could include premature ejaculation or a loss of sexual desire.
It's best to talk to your GP to find out what might be causing these problems, and about possible solutions, which may include medication for impotence such as Viagra. You should always seek medical advice from your doctor before trying any impotence treatment, especially if you are taking medication for other conditions such as high blood pressure.
Problems like these can lead one or both partners to feel disappointed or rejected. Talk together as a couple and know that the causes for sexual problems can often be addressed by medication, therapy, or trying new things together.
If you find that you are feeling a lack of confidence in the bedroom, this can affect your desire for sex.
Our society places great emphasis on looking young in order to be attractive and this can lead some older people to feel that they are no longer desirable. But you can be confident and attractive at any age.
To help boost your confidence you could:
If you're self-conscious about your body, adopting a healthy diet or taking up regular physical activity can help boost your confidence as well as give you more energy.
According to research, rates of sexually transmitted infections (STIs) among older people have doubled in the past decade. Contraception isn't there just to prevent pregnancy, it reduces the risk of contracting an STI or passing one on to someone else too.
An STI is an infection passed from one person to another through sexual contact, and sometimes by genital contact. Common STIs include genital warts, chlamydia, HIV and gonorrhoea.
If you're sexually active, whether you're heterosexual, gay, lesbian or bisexual, it's a good idea to get into the habit of having an annual sexual health check because not all STIs have symptoms. If left untreated, some STIs can have serious health problems.
If you are seeing a new partner you should continue to use condoms to prevent getting an STI. You should only stop using condoms if you and your partner are both clear of STIs.
Sex is good for you - it can boost your immune system, lift your mood, and make you feel closer to your partner. However, if you have health issues, it's sensible to check with your GP before you resume your sex life to make sure you are fully fit to do so.
If either you or your partner has had recent surgery or a heart attack, it's important to be signed off by your consultant, usually around four to six weeks after treatment. Read information on sex and heart conditions on the British Heart Foundation website.
If you experience joint pain or have arthritis, the physiotherapy department of your local hospital may have some leaflets or information about what positions can help you enjoy sex with greater comfort. Read information on sex and arthritis on the Arthritis Research UK website.
If one of you has had a serious or long-term illness, it can really affect your sex life. You may be worried about hurting or overexciting your partner, or if your illness has left scarring or required amputation, you may worry whether your partner still finds you attractive. Illness may have also changed the nature of your relationship, making one of you more dependent on the other than before. Macmillan and Cancer Research UK both have information about how cancer can affect your sex life on their websites.
It's really important to communicate and talk about your concerns and feelings with your partner. You could try new things together, to see what feels good for both of you. You could also talk to your GP about your concerns, especially if sex causes physical pain or discomfort.
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There is strong evidence that indicates that feeling close to, and valued by, other people is a fundamental human need and one that contributes to functioning well in the world.
It's clear that social relationships are critical for promoting wellbeing and for acting as a buffer against mental ill health for people of all ages.
With this in mind, try to do something different today and make a connection.
Regular physical activity is associated with lower rates of depression and anxiety across all age groups.
Exercise is essential for slowing age-related cognitive decline and for promoting well-being.
But it doesn't need to be particularly intense for you to feel good - slower-paced activities, such as walking, can have the benefit of encouraging social interactions as well providing some level of exercise.
Today, why not get physical? Here are a few ideas:
Reminding yourself to 'take notice' can strengthen and broaden awareness.
Studies have shown that being aware of what is taking place in the present directly enhances your well-being and savouring ‘the moment' can help to reaffirm your life priorities.
Heightened awareness also enhances your self-understanding and allows you to make positive choices based on your own values and motivations.
Take some time to enjoy the moment and the environment around you. Here are a few ideas:
Continued learning through life enhances self-esteem and encourages social interaction and a more active life.
Anecdotal evidence suggests that the opportunity to engage in work or educational activities particularly helps to lift older people out of depression.
The practice of setting goals, which is related to adult learning in particular, has been strongly associated with higher levels of wellbeing.
Why not learn something new today? Here are a few more ideas:
Participation in social and community life has attracted a lot of attention in the field of wellbeing research.
Individuals who report a greater interest in helping others are more likely to rate themselves as happy.
Research into actions for promoting happiness has shown that committing an act of kindness once a week over a six-week period is associated with an increase in wellbeing.
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One in five older people living in the community and two in five people living in care homes experience depression or poor mental health.
Research shows that there are five key issues that can have an impact on the mental wellbeing of older people:
Even though there are laws in place to help with some of these issues – for instance, the Equality Act 2010 addresses age discrimination – you may feel that you can't influence society-wide problems like pensioner poverty. However, as an individual, there is a lot you can do to protect your own mental wellbeing.
Getting older and retirement both involve a change in lifestyle for most people.
There is no longer a compulsory retirement age, with the default age of 65 having been phased out. It is important to note that retirement age is not the same as state pension age, which can range between 61 and 68 depending on gender and date of birth.
The age of retirement is decided by the employee, because not everyone feels ready to retire at the same time. If you want, or need, to keep working, discuss this with your employer. Or, you may see this as an opportunity to work part time, change to flexible working hours, or find a new job.
Being retired doesn't mean you aren't still busy. Being retired (or semi-retired) can be a busy life. Friends and family can have plans for your time, filling it with anything from childcare to DIY tasks. It is important to make time for your own interests. This can be a chance to try a new activity or learn new skills.
If your work or career is a major part of your life, consider how to deal with the changes to:
If you haven't had many interests outside of work it can be hard to ‘find something new to do’ and it may take a few attempts before you find something that's right for you. Take your time and think about the skills you possess that can be put to good use and give you fulfilment – perhaps try helping out with a local community organisation or doing conservation work.
Social interaction is important for maintaining your wellbeing. If you are used to sharing life's ups and downs with others at work, keep up friendships once you retire. Others who are your age are great sounding boards for dealing with the challenges of retirement and can understand the transition into retirement. You should also look to develop new friendships with people of all ages. Friendships with both older and younger people help to keep you in touch with the world as it changes.
See also ‘3. Ask for help’
Some people do develop mental health problems or conditions, such as depression, dementia or memory loss, as they get older, but it isn't an inevitable part of old age. However, if you think you are developing a mental health problem or condition, don't worry and just take action, as there are treatments available.
You might think that pursuing new learning and work is just for young people, but volunteering, career changes and returning to education are becoming more popular with people over 50. Many organisations depend on the skills and experience that older people possess. Don't dismiss volunteering as for ‘do-gooders’: many people can tell you it's an essential part of getting work experience. Volunteering can even be good for your health.
Managing problems, difficulties and worries becomes easier if we talk about our concerns. It's a good way to rationalise our thoughts and make sense of a situation or of how we feel. It can make us feel supported and not alone.
Who you want to talk with depends on what's worrying you. You could try:
There are suggestions about who to talk to in ‘3. Ask for help’
Talking about problems and concerns doesn't mean you have to discuss your emotions, or lay yourself completely bare about how you’re feeling. Some people may find this helpful, while others prefer to keep conversations on a practical level. Talking about how you feel, or your emotions, isn't a sign of weakness: it's about taking charge of your wellbeing.
Having a chat is never a one-way street. Sharing your thoughts can help others find the courage to talk about their problems. If you don't want to talk about yourself, ask others how they feel.
Hearing that others have similar worries and thoughts can make it easier to discuss something that's bothering you.
Being able to talk with others should be an everyday event. Don't put off having a chat, and avoid building it up to be a big event, like ‘we must talk about the wills’, as this can make it daunting for you and the other person. An ongoing conversation over days or weeks allows everyone time to think and give considered input.
‘Conversations don't have to be all about life's difficulties. Tell each other about the enjoyable events too!’
Who do we ask or where do we go when we need help or advice?
Support from friends and family is invaluable. However, they may lack the specialist knowledge you need despite their best intentions.
Whether you need help fixing a leaky gutter or with managing limited finances, the following organisations can either help you directly or point you in the right direction.
Admitting that times are emotionally tough isn't easy. Asking for help can be harder. Difficult feelings can stop you from getting on with life. Feeling down or anxious for prolonged periods doesn't just impact on you, but can also affect those around you; for instance, if your mood or reactions are unpredictable.
As well as advice from official sources, such as those given above, Internet forums, chatrooms and networking sites can allow you to share your own experiences with others facing the same issues.
Age UK and some local councils offer training courses in using email and the Internet.
‘Your GP can help in practical ways, as well as offering a listening ear; for instance, they can recommend exercise therapy, counselling, help from a specialist, or support from another part of the health service.’
Allowing an issue to become a constant worry can be bad for our mental wellbeing. Having a plan to deal with it puts us back in charge and can help improve how we feel.
These are some things that can cause worry as you get older:
It is also important to plan for pleasurable things, such as spending time with family, developing new hobbies, and enjoying your leisure time. If you don't have a plan for your time, you may find that others plan it for you.
A plan can help you think through all the aspects of a problem or situation. By preparing a plan, you are likely to expose and deal with many of your worries in advance.
You may need to do some research, like finding out about the state pension, National Insurance top ups, pension credits, and buying an annuity.
The government's website (www.gov.uk) is a good place to start when fact-finding.
Your plan should have a clear aim, such as staying active. A regular review of your plan helps to make sure you are still on track.
Include in your plan the sort of feelings you could experience and how you could deal with them. Discussing wills or care needs with loved ones may be emotional – how will you react?
How you use a plan is up to you – it's for your benefit. Consider whether you want to write it down or not. This may depend on whether you want to share it with others.
By having a plan, you always have something to refer back to and to use when you face a problem.
Of course, not everything can be planned for, and plans need to change as situations alter; for example, a change to the benefit system may affect your financial planning. Review and amend your plans as you need to.
As we get older, we may find ourselves looking after grandchildren, elderly parents, partners, friends, or neighbours. Caring for others can keep relationships strong and people close.
Helping others makes us feel needed and valued, as well as boosting our self-esteem. These things are good for our mental wellbeing.
Care could be looking after your grandchildren during school holidays, or the long-term and full-time care of your partner or elderly parents. Being a carer isn't always easy. Many find it demanding both physically and emotionally.
Looking after a loved one whose mental and/or physical health is deteriorating can present extra challenges for carers. If this issue affects you, contact your GP, Age UK, or your local social services. There is help and support widely available.
Caring for others can be rewarding, such as seeing your grandchildren taking their first steps or sharing a laugh with a neighbour. However, there can be stresses and strains along the way.
Try not to overburden yourself with care responsibilities. Hard though it seems, it is alright to say ‘no’. Making time for yourself is good both for you and for the person you care for.
If you feel under pressure to keep saying ‘yes’, then contact Carers UK, Counsel and Care, or Crossroads Care for advice or help with respite care to enable you to recharge your batteries.
A local carers’ support group may help to make you feel less isolated with your responsibilities. Talking with other carers helps to release frustrations, as they understand the pressures that caring can bring. There can also be opportunities to share resources, skills and knowledge so that everyone (other carers and the people you care for) benefits. The organisations mentioned above can help, and your GP or local council may know of local groups, services and facilities.
If you are interested in helping care for others locally, then the organisations listed above would be glad to hear from you. Voluntary schemes offer a range of help to people in the community; for instance, WRVS provides meals on wheels.
To offer your help, visit www.do-it.org.uk for more information.
Friends can keep you on track when life is difficult. They can offer a different view on a problem as well as practical help, or can be a sounding board for your thoughts.
Friendship takes time, and sometimes effort. It is easy to lose touch with people, especially if their life seems too busy for you or if you are feeling down. Having friends is a positive way to maintain good emotional health, even when doing so may sometimes seem like hard work.
Don't lose touch with the people who are important to you – it's never too late to get back in touch with old friends.
You may have friends and family scattered around the country or world. Explore keeping in touch by phone, email, webcam, Skype, Facebook, or letter.
The world is constantly changing, and you are not alone if you feel out of step with it. Technology has had a big impact on the way we communicate. You may feel that the values and attitudes you have are no longer respected. But not everyone from the younger generation lives up to their media reputation.
Keeping in touch with people from other generations can help to keep this in perspective and can make you realise that there are like-minded people of all ages.
Consider volunteering with youth work, chatting more with friends’ grandchildren, or helping out at a local school.
Having friends of your own generation is important, too. They can better understand life from your perspective. Plus, it's good to reminisce sometimes about old TV favourites or the types of cars you used to own.
If you’re used to a close circle of friends at work, will you keep in touch when you retire? You may find that work friends were great when you shared common problems, but that the friendship changes when you no longer work together.
Don't shy away from making new friends – perhaps through a new shared interest, such as walking, travelling or reading.
Friendships do change with time. Sometimes it is difficult to give the time we want to every friendship. Friendships can go sour for many reasons. If a friendship starts to hurt you, mentally or physically, then don't be afraid to take a break from it, or end it.
Keeping in touch with friends is also about considering what is good for them. Don't be offended if your children can't talk when you phone at 6.30pm as they sit down for a family meal or are starting to help with their own children's homework. Likewise, calling people when they are at work won't always get the best result; try meeting them for lunch instead. Similarly, if you don't want to be called after 9.00pm because it's time to get ready for bed, let your loved ones know!
Staying active and sleeping well are proven ways to look after our wellbeing.
Regular physical activity and exercise can:
Being active doesn't necessarily mean going to the gym; t’ai chi, Pilates, gardening, dog walking, dancing, or being part of a walking group are all good ways to get some exercise. Being active doesn't have to cost much money. Many councils offer activities at lower rates for older people.
The Mental Health Foundation booklet ‘How to look after your mental health using exercise’ suggests ways that you can get active and stay active.
Physical activity can be as effective as anti-depressant medication in treating mild to moderate depression, which is why exercise therapy is available on prescription in many areas. Information is available at www.nhs.uk, or your GP may be able to help.
Getting a good night's sleep allows your body and mind to rest, repair and re-energise. Not sleeping well can cause a range of problems, including:
In the longer term, trouble sleeping can lead to mental health problems such as anxiety, stress and depression.
Sleep patterns can change with age and may be influenced by:
Good sleep doesn't just mean lots of sleep, as the amount of sleep that each person needs is different. The Mental Health Foundation's booklet ‘Sleep Well’ suggests ways that you can improve your sleep. You can also talk to your GP about sleep problems, as they may be able to change your medication or suggest solutions to other health issues that may be keeping you awake.
Keeping your mind active is important, too. There are many ways of doing this, such as:
What we eat and drink affects how we feel. Sometimes there's an immediate effect, for instance with alcohol. Other things we consume can have long-term impacts.
The human body and mind needs a mix of nutrients to work properly. Eating at least five portions of fruit and vegetables each day is recommended, and is a vital part of a healthy diet.
Stopping your body from dehydrating is important, whatever the weather. You may want to consider limiting your intake of sugary drinks, caffeine, and alcohol as, in excess, they can have a negative effect on your wellbeing.
The odd alcoholic drink is unlikely to harm you if you drink them in moderation and if alcohol doesn't conflict with any medication you are taking. Stay within the recommended daily alcohol units.
Popping to the pub or club for a drink can be a good social experience, but solitary habitual drinking is often a sign of a problem. Drinking alcohol is not a good way to manage difficult feelings.
Visit www.drinkaware.co.uk for more information and advice.
Sharing food or a drink is an enjoyable social event. Make it a reason to meet up with friends, even if it's just for a cuppa in the local café.
Eating properly when coping with bereavement can be difficult, especially if you are not used to cooking for one or preparing meals at all. During this time, your appetite may be affected by your emotions. Try not to eat alone all the time. Take up offers from friends and family to eat with them. Find out if there are any lunchtime clubs that operate in your area, perhaps as part of a reading group or other interest groups.
For more information on alcohol, see the Mental Health Foundation's guide to alcohol and mental health
Doing things that we enjoy makes us feel good about ourselves and about life; plus, it can keep our mind and body active. Whatever we call them, interests, hobbies and pastimes can provide a chance to socialise, or to find time for ourselves.
Some people enjoy their work so much that they don't want to retire. Explore the options with your employer. As there is no longer a default retirement age, there are a number of options available to explore.
If work has taken up most of your life, it may be time to look around for a new interest to immerse yourself in. Meaningful activity is vital for good emotional health, so try to start new activities before you retire. Don't be scared to try a few things before settling on the ones that you enjoy.
‘Sometimes when I'm sitting on the bus, I let my thoughts flow and it really helps me.’
You may have skills to share with others. Look at local volunteering options, or join a specialist interest group. Time Bank is a skill-share scheme where you benefit from other people's skills in exchange for your own. Or you may want to learn new skills or develop an old one. Local councils and universities run a range of education and learning opportunities, often at lower rates for older people.
Pets make wonderful companions and can bring social benefits, too.Walking the dog gives you daily exercise, is a reason to go out, and is a way of meeting people. House rabbits love to play, and cats crave a warm lap to curl up on.
Your local vet or the RSPCA can advise about the best type of pet for you.
Always make time for your own hobbies and interests. If you are a busy carer, you must still find time for your own interests in order to look after your own wellbeing.
While being retired or semi-retired may appear to others to be a permanent holiday, the reality is different. There are still jobs that need doing, like cleaning, car repairs, financial paperwork, and shopping. Plus, we may have new responsibilities as a carer.
Creating a routine for your day or week can give life a structure or rhythm. However, a break from this refreshes the mental batteries.
Plan free time in your weekly routines for things you enjoy, whether it's time in the park or in the art gallery.
A break needn't be long: just time for what you enjoy and for letting your mind recharge. Look at how you spend your time. Can you find half an hour each day to pick up a book or sit with a crossword? What about every week? Is there time for an afternoon out?
It's whatever relaxes you and helps you take a break.
Having a break need not cost a fortune. There are many bargains to be had – sometimes for booking well in advance, others for those who book last-minute. Some travel companies offer special rates for older people. Does your council offer free or discounted public transport for over 65s? Are there lower rates or free entrance to local attractions?
You may find it hard to relax if you feel under pressure to be doing something else. This can be because you feel guilty about not caring for others, or because you aren't used to having time to spend on yourself.
Relaxing doesn't have to be about sitting down or physically relaxing. It's about doing something you enjoy.
Having a hectic life may mean you want time alone when you have a break. Or do you want the company of others to stimulate your mind and make you think of things other than the stresses of life? Having a break can be a chance to meet new people and explore interests. It can be as active or as restful as you want – from a pottery course or learning first aid, to a walking weekend or trying paragliding!
The Mental Health Foundation publish a range of materials that may help you, many of which can be downloaded for free from our website:
The above information was brought to you from www.mentalhealth.org.uk
According to a study published in the Journals of Gerontology, Series B: Psychology and Sciences, an active sex life could improve cognitive ability in older adults. The research, conducted by the University of Oxford in partnership with University of Coventry, involved 73 participants comprising 28 men and 45 women, aged 50-83.
Participants were required to complete a series of questions on their general health, lifestyle as well as frequency of sex.
Meanwhile, to measure the participants’ cognitive ability, the study also included Addebrooke’s Cognitive Examination-III (ACE III), a test designed to measure verbal fluency to reflect cognitive ability through several methods, such as naming as many animals as possible in 60 seconds and reciting words beginning with the letter “F.”
Read also: Human face projects sexual urges: Study
Furthermore, to determine visuospatial perception (a cognitive function, referring the capability to process and interpret visuals), participants were asked to visualize an object.
Results showed that the most sexually active respondents scored the highest in both test.
However, the study also discovered that the frequency of sex did not influence the participants' attention span, memory capacity or language skills, as they all performed equally well in this area.
The University of Oxford’s website reported that the study was created based on previous research from 2016, which discovered that more sexually active older adults scored highly on cognitive tests.
“People don’t like to think that older people have sex – but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general well-being,” said Dr. Hayley Wright, lead researcher from Coventry University's Center for Research in Psychology, Behavior and Achievement. (jes/kes)
“Our society is ageing yet, too commonly, the health needs of older people can go unmet ... It is essential that we focus greater attention on supporting the process of growing older, and strive for a society in which everyone can look forward to a healthy later life.”The British Medical Association (BMA).
Find out more:
FPA is one of 150 member associations of the International Planned Parenthood Federation (IPPF). IPPF is a global service provider and a leading advocate of sexual and reproductive health and rights for all.
FPA supports Sexual rights: an IPPF declaration which states that sexuality, and pleasure deriving from it, is a central aspect of being human whether or not a person chooses to reproduce. Sexuality is not merely a vehicle for individuals to satisfy their reproductive interests. The entitlement to experience sexuality should be safeguarded.
A recent BMA report considered the following key topics in the area of health and care concerning older people:
The final report recommended several important measures including:
Social isolation is strongly linked to
loneliness among older people in the UK.
The BMA's report found that
10 per cent of people aged over 65 years experience
constant or frequent feelings of loneliness.
This social isolation and loneliness can have a significant
impact on the quality of life and mental health of older
adults which, according to the BMA, further underlines the importance of identifying and reducing barriers to older people's participation in society.
Social isolation, when experienced in older age, also raises the risk of mortality. Studies have shown that the impact of reducing social isolation on survival among patients aged in their 60s was comparable to the benefits of giving up smoking and greater even than the effects of obesity and physical inactivity.
Pharmacy teams can play an important part in recognising older customers in their community who may be at risk of social isolation.
The three major life events most strongly associated with social isolation in the elderly are:
Levels of loneliness are also found to be higher among older adults from ethnic minorities living in the UK, particularly where language or communication barriers exist.
Age UK makes the important point that, although linked, social isolation and loneliness are not the same and each may require different interventions, particularly in older individuals. For example, older people experiencing social isolation may need more practical, logistical support, such as help with transport, whereas lonely or depressed patients may want someone to talk to and will depend on more emotive aspects of care.
A key way that pharmacy can help to tackle social isolation among the elderly is by supporting patients in their independent living. Important tools to facilitate this include mobility and daily living aids, many of which are available via larger pharmacy outlets.
Monitored dosage systems are another useful resource that pharmacy can provide to help older patients (particularly those on polypharmacy) to keep track of their medications.
Pharmacy teams can further help older customers by signposting them to valuable sources of support such as charities working with the elderly; local groups and activities targeted at older individuals (e.g. friendship group meetings; University of the Third Age), and volunteering organisations. Community pharmacies can also help older people access important practical services, such as medication home delivery and NHS transportation providers.
Steadily worsening joint pain in older people is typically a sign of osteoarthritis (OA), the effective management of which centres on three core principles:
Exercise is an essential lifestyle prescription for any patient with OA as it strengthens joints, builds muscle and is proven to alleviate symptoms. Weight loss is also important in any individual with joint pain who is overweight or obese to help ease strain on the joints. OTC options for the relief of joint pain include paracetamol and NSAIDs such as ibuprofen and diclofenac.
Topical formulations of the latter may be particularly effective for treating joint pain and swelling in the knees or hands. When recommending any analgesic to an older patient, it is particularly important to consider potential contraindications, co-morbid conditions and concomitant medications. Supportive therapies that may be recommended to help with joint pain in the elderly include TENS machines, thermotherapy or assistive devices like splints, insoles or walking aids.
A range of creams, lotions and suppositories available OTC for the treatment of haemorrhoids can be recommended to older customers for the short-term relief of symptoms such as pain, swelling, itchiness and general discomfort. However, customers should be cautioned not to apply topical OTC therapies for more than one week as prolonged use can lead to irritation of the sensitive skin surrounding the anus. It is also important to combine topical treatment with lifestyle changes that can stop haemorrhoids worsening and maximise the chance of spontaneous healing.
These include preventing constipation by eating a high-fibre diet, increasing fluid intake and trying to avoid straining when passing stools. Cases of very painful or persistent haemorrhoids, and any older patient who reports symptoms of anal bleeding, should be referred to their GP for further investigation.
Bladder weakness is a common problem among older adults that can cause significant embarrassment and impact negatively on selfesteem. Numerous pharmacy products and devices are available to tackle urinary incontinence, the most popular being absorbent pads and pull-ups (e.g. TENA).
These are embedded with a special hydrophobic layer that draws urine away from the surface of the pad and ensures the skin remains dry. Female customers should be advised to avoid using sanitary pads as these are less effective at locking away moisture and can lead to dampness and skin irritation. Similarly, tampons are not recommended for women with stress incontinence as a means of stopping leakage from the bladder neck.
Lifestyle advice for customers with bladder weakness should include staying hydrated (1.5-2 litres of fluid a day is recommended), eating a balanced diet, maintaining a healthy weight, stopping smoking and practising pelvic floor exercises. Pharmacists should also be aware of medications that can affect bladder function, particularly alpha adrenergic antagonists that can cause bladder leakage and diuretics that increase urine flow.
The likelihood of developing dry eye increases as a person ages, with an estimated one-third of those aged over 65 suffering from this problem. The cornerstone of OTC care is lubricant eye treatments, which include a range of drops, gels and ointments.
Also known as artificial tears, these products replace the natural fluid that is missing from the tear film. Preservative-free eye drops should be recommended for patients who need to apply eye drops more than six times a day, contact lens wearers or anyone with severe dry eye disease. Other treatment options include oily tear eye drops containing synthetic guar gums or liposomal sprays.
The latter is applied to the edges of the eyelid with the eyes closed and then spreads across the surface of the eye to create a new oily film. Eye ointments used overnight can help keep eyes moist and prevent tear evaporation but may also cause blurred vision and are not suitable for contact lens wearers. Regardless of the product recommended, it is important to remember that older customers may have difficulty applying eye drops and mechanical devices such as squeeze bottles and single-dose containers may be needed.
Older people are at increased risk of earwax build-up as the ear's natural wax becomes drier with age. OTC eardrops containing sodium bicarbonate, urea hydrogen peroxide, olive oil or almond oil can be recommended to help soften the earwax and allow it to fall out naturally.
These products are not suitable for anyone with a perforated eardrum or ear infection. If symptoms are particularly severe or fail to improve after three to five days of eardrop use, suggest the patient visits his/her GP, as hearing tests and/or ear irrigation may be required.
General healthy eating advice applies equally to older individuals as it does to the population as a whole. However, obesity is prevalent among the older population and it is important to remember that both basal metabolic rate and physical activity decreases with age, leading to a reduced daily calorific requirement.
The digestion, absorption and metabolism of nutrients also changes as the body ages. Evidence indicates that malnutrition is common among older adults, particularly those living in institutions, suggesting low intake of a range of important micronutrients.
The skin's ability to synthesise vitamin D also diminishes with age, so a 10mcg supplement should be recommended for older people in line with latest guidance stating that everyone in the UK requires 10mcg of vitamin D a day. They should also be advised to increase their consumption of vitamin D-rich food sources.
Mental health remains another important, but often overlooked, problem in the elderly population. The BMA's report estimates that more than one in every five individuals aged over 65 years suffers from depression, yet 85 per cent of those affected said they receive no help from the NHS.
“We must tackle the under-diagnosis and under-treatment of mental health conditions in older adults, to make sure that their mental health is treated as importantly as their physical health,” says Professor Kumar.
“We know that only a small proportion of older people with depression seek treatment, with research suggesting that, although 20-40 per cent of older people in the community show signs of depression meriting treatment, only 4-8 per cent consult a GP.”
The Royal Pharmaceutical Society has highlighted some useful ways in which pharmacists can help identify older patients who may be in need of help and support with mental health issues but are reluctant to ask:
A carer is defined as any individual who provides unpaid care for a family member, partner or friend who cannot manage independently due to, for example, ill health, frailty, disability or mental health issues.
‘In the UK today there are a staggering 6.5 million people providing a level of unpaid care to a relative, close friend or neighbour,’ says Professor Kumar.
‘Caring is something that most people do, but which they are not prepared or trained for, and which can have a devastating impact on carers' lives in terms of work, health, income, family and other relationships. We must ensure there is a focus on carer-friendly health services, which support carers not only to look after their loved one, but to look after their own health and well-being as well.’
Community pharmacy already provides a number of the key services that help to support and assist carers in the UK. These include practical help to order and collect prescriptions from GP practices, home delivery of medication, MDS services to help carers effectively manage the medication of the person in their charge, and signposting to support organisations specifically dedicated to helping carers in their day-to-day lives.
To further enhance this support it is vital that carers are identified and informed about the range of services available to access via their local pharmacy. To this end, the Pharmaceutical Services Negotiating Committee (PSNC) has developed two template leaflets to assist pharmacy contractors when advising carers on the services they offer and to provide carers with information on managing medicines.
These are available to access at: psnc.org.uk/services-commissioning/locallycommissioned-services/carerfriendlypharmacy.
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