Chronic obstructive pulmonary disease (COPD) is a disabling condition with breathlessness caused by symptoms of chronic bronchitis and emphysema. The productive cough characteristic of bronchitis reflects an abnormal response in the mucus glands that usually operate to keep the airways moist. The chronic inflammation of these small airways causes thickened walls that are blocked by the excess mucus. In emphysema the tiny air sacs (alveoli), where gas exchange takes place, are reduced and narrowed so complete emptying of the lungs becomes impossible. This leads to ‘dynamic hyperinflation’, which increases the work of breathing and lowers the efficiency of respiratory muscles, so increasing breathlessness.
Injuries related to falls are common in older adults and contribute to functional decline and premature admission to care homes. This randomised controlled trial studied the effectiveness of a two-year exercise programme of balance retraining in reducing falls. Women aged 75-85 living locally were eligible to participate if they were able to walk but took seven seconds or more to walk six metres.
Smoking is a major modifiable risk factor for disease and death, and smoking cessation is beneficial in reducing these risks. However, even though cardiovascular events occur mainly in older adults, this age group has been understudied when it comes to the cardiovascular risks of smoking and the potential benefits of smoking cessation.
Frontotemporal dementia is a neurodegenerative disorder characterised by loss of neurons in the frontal and temporal lobes. It is a common cause of early-onset dementia but can also start in older age. It presents with behavioural symptoms or language disturbance (primary progressive aphasia), and patients can also develop symptoms of motor neurone disease. It is a highly heritable disease with one third of patients having a family history and a mutation in one of three genes. The ideal time to treat neurodegenerative disease may be before clinical presentation, at a point where the minimum of irreversible neuronal loss has occurred and cognitive function is still preserved.
For many people who have had a stroke, weakness or paralysis on one side - hemiparesis or hemiplegia - is the most obvious symptom. However, brain damage, including stroke, can cause a range of impairments that may be less obvious but equally devastating for people and their families. This article provides an overview of communication, movement and perception difficulties, and the strategies nurses can use to help people cope with any changes to their lives.
When someone has a stroke it can cause death or severe disability. However, advances in treatment have changed the way professionals need to respond. Nurses must recognise the signs of stroke and understand why prompt action can save more of the brain. They also need to recognise and respond appropriately to transient ischaemic attacks, which can warn of impending stroke, and to support people in reducing their individual risk.
This article aims to explain the difference between venous and arterial leg ulcers, methods of treatment and prevention for each kind of ulcer, and the social and emotional impact of venous ulcers.
Nurses who are confident in their own skills but who know where to draw upon specialist help can provide enormous support for nursing home residents coming to the end of their lives. Promoting a palliative care approach can promote a sense of well-being in older people who are dying.