Diabetics: Beware of Tuberculosis

478746553 (1)With 382 million people affected with diabetes worldwide in 2013 and that number poised to rise to 592 million by 2035, a warning bell is being sounded with respect to the real possibility of a serious co-infection – tuberculosis (TB). Since diabetes is a disease that weakens the immune system, diabetics are 3 times as likely to develop this lung infection. We have seen this before when the HIV/AIDS epidemic burst on the scene. At that time, we experienced a quadrupling of TB in some African countries.

As our population ages, grows more sedentary and obese, The incidence of type 2 diabetes will rise. Obesity is often linked to adopting a Western diet and countries around the world have been integrating more and more of it into their diets as they have everything Western. The countries most at risk are China and India who are the leading countries for diabetes and TB sufferers respectively.

Clearly a strategy needs to be put in place where there is ‘bi-directional” screening. Diabetics should be carefully monitored for TB and TB sufferers should undergo testing for diabetes and both must be treated properly.

David York Agency is skilled at recognizing the symptoms of various diseases endemic to the elderly. We are licensed by the New York State Department of Health and provide skilled home health aide services for home healthcare and could assist in managing the total care of your senior loved one. Please call us at (718) 376-7755 or visit us on our website www.davidyorkagency.com to become acquainted with all we offer. Please like us on Facebook or follow us on Twitter or LinkedIn.

A Tool to Diagnose Depression in the Elderly and Type 2 Diabetics

According to a recent article in Home Healthcare Nurse entitled “Diabetes, Depression, and OASIS-C”, among the population 65 years and older, one in six suffers from depression and this is especially true among elderly adults who receive home care.  Identifying depression in the home bound elderly and effectively treating it may be key to decreasing their hospitalization rates and all its associated health and financial costs since the effects of depression can send the elderly adult down a path of negative complications. 

depressionAn additional finding that has some serious implications for our aging population is that research indicates depression is higher among adults with diabetes than the general population.  In fact, diabetics are twice as likely  to suffer from depression.  Under the best of circumstances, our senior citizens have increased chronic and acute diseases; with the interplay of diabetes and depression the rate of mortality, cardiac problems, diabetes related problems, functional impairment as well as hospitalizations increase.  A significant reduction in the overall quality of life ensues due to the resulting combination of events of poor self care, functional impairment and significant nutritional issues. 

Depression is a very treatable condition.  New York City Department of Health and Mental Hygiene research has shown that 70% to 80% of patients respond well to treatment and good medical care. 

As an essential start, before this issue can be adequately addressed, the patient must be seen by trained nurses and clinicians and a medical doctor should screen for any endocrine disorders.  After other medical issues have been ruled out, the Centers for Medicare and Medicaid Services (CMS) has mandated using a new diagnostic assessment tool in the form of a PHQ-9 questionnaire which is a validated instrument used in primary care to screen for depression in home care patients with Type 2 diabetes.  The questionnaire is an upgrade from the one formerly used because it measures the physical symptoms of depression as well as the level of interest in activity and mood.  With a score of 3 or higher, the patient is referred to a clinician by the home healthcare team

Training a home healthcare provider to recognize symptoms of depression will greatly increase the prospect of its treatment, especially in Type 2 diabetics and home bound elderly patients where its prevalence is so much higher.  Cooperation and communication between all the healthcare disciplines is essential in order to achieve successful diagnosis, treatment and follow-up care. 

The home healthcare team at David York Home Healthcare Agency is on the lookout for the signs and symptoms of depression in the elderly and is eager to be an active player in the treatment plan of the total elderly caregiver team.  Please call us at (718) 376-7755 or visit our website at http://davidyorkhomehealthcare.com/.  You could also like us on Facebook or follow us on Twitter or LinkedIn.