Nursing Homes

A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day.

Some nursing homes are set up like a hospital. The staff provides medical care, as well as physical, speech and occupational therapy. There might be a nurses' station on each floor. Other nursing homes try to be more like home. They try to have a neighborhood feel. Often, they don't have a fixed day-to-day schedule, and kitchens might be open to residents. Staff members are encouraged to develop relationships with residents.

Some nursing homes have special care units for people with serious memory problems such as Alzheimer's disease. Some will let couples live together. Nursing homes are not only for older adults, but for anyone who requires 24-hour care.

NIH: National Institute on Aging

Oxygen Therapy

What is oxygen?

Oxygen is a gas that your body needs to work properly. Your cells need oxygen to make energy. Your lungs absorb oxygen from the air you breathe. The oxygen enters your blood from your lungs and travels to your organs and body tissues.

Certain medical conditions can cause your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, and confused. It can also damage your body. Oxygen therapy can help you get more oxygen.

What is oxygen therapy?

Oxygen therapy is a treatment that provides you with extra oxygen to breathe in. It is also called supplemental oxygen. It is only available through a prescription from your health care provider. You may get it in the hospital, another medical setting, or at home. Some people only need it for a short period of time. Others will need long-term oxygen therapy.

There are different types of devices that can give you oxygen. Some use tanks of liquid or gas oxygen. Others use an oxygen concentrator, which pulls oxygen out of the air. You will get the oxygen through a nose tube (cannula), a mask, or a tent. The extra oxygen is breathed in along with normal air.

There are portable versions of the tanks and oxygen concentrators. They can make it easier for you to move around while using your therapy.

Who needs oxygen therapy?

You may need oxygen therapy if you have a condition that causes low blood oxygen, such as:

• COPD (chronic obstructive pulmonary disease)
• Pneumonia
• COVID-19
• A severe asthma attack
• Late-stage heart failure
• Cystic fibrosis
• Sleep apnea

What are the risks of using oxygen therapy?

Oxygen therapy is generally safe, but it can cause side effects. They include a dry or bloody nose, tiredness, and morning headaches.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. If you use oxygen tanks, make sure your tank is secured and stays upright. If it falls and cracks or the top breaks off, the tank can fly like a missile.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBOT) is a different type of oxygen therapy. It involves breathing oxygen in a pressurized chamber or tube. That allows your lungs to gather up to three times more oxygen than you would get by breathing oxygen at normal air pressure. The extra oxygen moves through your blood and to your organs and body tissues.

HBOT is used to treat certain serious wounds, burns, injuries, and infections. It also treats air or gas embolisms (bubbles of air in your bloodstream), decompression sickness suffered by divers, and carbon monoxide poisoning.

But some treatment centers claim that HBOT can treat almost anything, including Alzheimer's disease, autism, cancer, and Lyme disease. The U.S. Food and Drug Administration (FDA) has not cleared or approved the use of HBOT for these conditions. There are risks to using HBOT, so always check with your provider before you try it.

Stem Cells

Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body. There are two main types of stem cells: embryonic stem cells and adult stem cells.

Stem cells are different from other cells in the body in three ways:

• They can divide and renew themselves over a long time
• They are unspecialized, so they cannot do specific functions in the body
• They have the potential to become specialized cells, such as muscle cells, blood cells, and brain cells

Doctors and scientists are excited about stem cells because they could help in many different areas of health and medical research. Studying stem cells may help explain how serious conditions such as birth defects and cancer come about. Stem cells may one day be used to make cells and tissues for therapy of many diseases. Examples include Parkinson's disease, Alzheimer's disease, spinal cord injury, heart disease, diabetes, and arthritis.

NIH: National Institutes of Health

Urinary Incontinence

What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition. It can range from being a minor problem to something that greatly affects your daily life. In any case, it can get better with proper treatment.

What are the types of urinary incontinence (UI)?

There are several different types of UI. Each type has different symptoms and causes:

• Stress incontinence happens when stress or pressure on your bladder causes you to leak urine. This could be due to coughing, sneezing, laughing, lifting something heavy, or physical activity. Causes include weak pelvic floor muscles and the bladder being out of its normal position.
• Urge, or urgency, incontinence happens when you have a strong urge (need) to urinate, and some urine leaks out before you can make it to the toilet. It is often related to an overactive bladder. Urge incontinence is most common in older people. It can sometimes be a sign of a urinary tract infection (UTI). It can also happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries.
• Overflow incontinence happens when your bladder doesn't empty all the way. This causes too much urine to stay in your bladder. Your bladder gets too full, and you leak urine. This form of UI is most common in men. Some of the causes include tumors, kidney stones, diabetes, and certain medicines.
• Functional incontinence happens when a physical or mental disability, trouble speaking, or some other problem keeps you from getting to the toilet in time. For example, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer's disease may not realize they need to plan to use the toilet.
• Mixed incontinence means that you have more than one type of incontinence. It's usually a combination of stress and urge incontinence.
• Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away.
• Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
  • Bedwetting is normal for many children. It is more common in boys. Bedwetting is often not considered a health problem, especially when it runs in the family. But if it still happens often at age 5 and older, it may be because of a bladder control problem. This problem could be caused by slow physical development, an illness, making too much urine at night, or another problem. Sometimes there is more than one cause.
  • In adults, the causes include some medicines, caffeine, and alcohol. It can also be caused by certain health problems, such as diabetes insipidus, a urinary tract infection (UTI), kidney stones, enlarged prostate (BPH), and sleep apnea.

Who is at risk for urinary incontinence (UI)?

In adults, you are at higher risk of developing UI if you:

• Are female, especially after going through pregnancy, childbirth, and/or menopause
• Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
• Are a man with prostate problems
• Have certain health problems, such as diabetes, obesity, or long-lasting constipation
• Are a smoker
• Have a birth defect that affects the structure of your urinary tract

In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.

How is urinary incontinence (UI) diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms. Your provider may ask you to keep a bladder diary for a few days before your appointment. The bladder diary includes how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
• A physical exam, which can include a rectal exam. Women may also get a pelvic exam.
• Urine and/or blood tests
• Bladder function tests
• Imaging tests

What are the treatments for urinary incontinence (UI)?

Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:

• Lifestyle changes to reduce leaks:
  • Drinking the right amount of liquid at the right time
  • Being physically active
  • Staying at a healthy weigh
  • Avoiding constipation
  • Not smoking
• Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
• Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.

If these treatments do not work, your provider may suggest other options such as:

• Medicines, which can be used to
  • Relax the bladder muscles, to help prevent bladder spasms
  • Block nerve signals that cause urinary frequency and urgency
  • In men, shrink the prostate and improve urine flow
• Medical devices, including
  • A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
  • For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
• Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.
• Electrical nerve stimulation, which involves changing your bladder's reflexes using pulses of electricity
• Surgery to support the bladder in its normal position. This may be done with a sling that is attached to the pubic bone.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Caregiver Health

What is a caregiver?

A caregiver gives care to someone who needs help taking care of themselves. The person who needs help may be a child, an adult, or an older adult. They may need help because of an injury, chronic illness, or disability.

Some caregivers are informal caregivers. They are usually family members or friends. Other caregivers are paid professionals. Caregivers may give care at home or in a hospital or other health care setting. Sometimes they are caregiving from a distance. The types of tasks that caregivers do may include:

• Helping with daily tasks like bathing, eating, or taking medicine
• Arranging activities and medical care
• Making health and financial decisions

How does caregiving affect the caregiver?

Caregiving can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. Caregiving may involve meeting complex demands without any training or help. You may also be working and have children or others to care for. To meet all of the demands, you might be putting your own needs and feelings aside. But that's not good for your long-term health. But you need to make sure that you are also taking care of yourself.

What is caregiver stress?

Many caregivers are affected by caregiver stress. This is the stress that comes from the emotional and physical strain of caregiving. The signs include:

• Feeling overwhelmed
• Feeling alone, isolated, or deserted by others
• Sleeping too much or too little
• Gaining or losing a lot of weight
• Feeling tired most of the time
• Losing interest in activities you used to enjoy
• Becoming easily irritated or angered
• Feeling worried or sad often
• Having headaches or body aches often
• Turning to unhealthy behaviors like smoking or drinking too much alcohol

How can caregiver stress affect my health?

Long-term caregiver stress may put you at risk for many different health problems. Some of these problems can be serious. They include:

• Depression and anxiety
• A weak immune system
• Excess weight and obesity
• Chronic diseases such as heart disease, cancer, diabetes, or arthritis. Depression and obesity can raise the risk of these diseases even more.
• Problems with short-term memory or paying attention

What can I do to prevent or relieve caregiver stress?

Taking steps to prevent or relieve caregiver stress may help prevent health problems. Remember that if you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving. Some ways to help yourself include:

• Learning better ways to help your loved one. For examples, hospitals offer classes that can teach you how to care for someone with an injury or illness.
• Finding caregiving resources in your community to help you. Many communities have adult daycare services or respite services. Using one of these can give you a break from your caregiving duties.
• Asking for and accepting help. Make a list of ways others can help you. Let helpers choose what they would like to do. For instance, someone might sit with the person you care for while you do an errand. Someone else might pick up groceries for you.
• Joining a support group for caregivers. A support group can allow you to share stories, pick up caregiving tips, and get support from others who face the same challenges as you do.
• Being organized to make caregiving more manageable. Make to-do lists and set a daily routine.
• Staying in touch with family and friends. It's important for you to have emotional support.
• Taking care of your own health. Try to find time to be physically active on most days of the week, choose healthy foods, and get enough sleep. Make sure that you keep up with your medical care such as regular checkups and screenings.
• Considering taking a break from your job, if you also work and are feeling overwhelmed. Under the federal Family and Medical Leave Act, eligible employees can take up to 12 weeks of unpaid leave per year to care for relatives. Check with your human resources office about your options.

Dept. of Health and Human Services Office on Women's Health