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Managing arthritis in the home care setting
Posted on May 18th, 20175/18/17 |
By Sharon Roth Maguire, MS, RN, GNP-BC
Chief Clinical Quality Officer, BrightStar Care
So many of our clients deal with the pain and challenges of arthritis. Nationally, the Centers for Disease Control and Prevention (CDC) reports that more than 54 million U.S. adults have been diagnosed with some form of arthritis. That’s nearly 23 percent of the adult population. By 2040, the number of people diagnosed with arthritis is projected to be 78 million.
Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis we see in our clients. Each type poses unique challenges for people and their caregivers at home. An in-home care provider can help people and family caregivers implement strategies to reduce pain and optimize the home environment.
Reducing joint stress from osteoarthritis
Osteoarthritis involves the breakdown of joint cartilage over time. This condition also is known as degenerative joint disease, or DJD. Beyond the age of 40 or so, all of us experience some degree of osteoarthritic changes in our joints. This is due to the normal wear and tear on the joints throughout our lives, as well as past joint injuries. Osteoarthritis tends to concentrate in a few joints, such as the hip or knee.
Osteoarthritis challenges can make it hard for people to live on their own. Depending on which of their joints are affected, individuals with osteoarthritis may have trouble:
- Opening and closing lids and jars
- Transferring to and from chairs and beds
- Using tools like can openers, forks, and spoons
People with osteoarthritis often have an altered gait or gait instability. This means the disease has changed the way they walk. We see this most often in people who walk hunched over because of arthritis pain in their backs.
Gait instability can change a person’s center of gravity, which can increase the risk of falling. The CDC notes that adults with arthritis are more than twice as likely to report two or more falls or have an injury related to a fall as an adult without arthritis. A professional home inspection, conducted by a BrightStar Care RN Director of Nursing and under the Joint Commission’s National Patient Safety Goals, can reduce the risk of a loved one falling in the home and possibly suffering a serious injury.
Osteoarthritis frequently can lead to a joint replacement, such as a new hip, knee, or shoulder. An in-home caregiver can provide care after joint-replacement surgery for people who aren’t old enough to qualify for Medicare, as well as those who need or want in-home care beyond what Medicare or their insurance covers.
We’re glad to speak to your family about the benefits of our in-home arthritis care. Call 866-618-7827, or contact a BrightStar Care® home care agency near you.
Medication management for people with rheumatoid arthritis
While osteoarthritis usually is concentrated in a few joints, rheumatoid arthritis, or RA, is a systemic disease. That means it can affect the entire body. Rheumatoid arthritis is an autoimmune disorder in which the body’s immune system attacks the joints. Without proper treatment, the joints can become damaged or deformed.
Rheumatoid arthritis can affect children and adults. Juvenile rheumatoid arthritis, or JRA, can affect infants, toddlers, and children all the way up until age 16. In some cases, JRA can lead to children growing too slowly, developing problems with their eyes or internal organs, having arms and legs of different lengths, and other serious problems. Kids with JRA need care from skilled child care providers to manage the condition.
People who have rheumatoid arthritis often need medications called biologics, which are produced from living organisms rather than chemicals. Many biologics must be injected or infused, which requires highly technical skill. We’re one of the few providers within the home care space that is capable of administering these medications. Every Director of Nursing in our company is a member of the Infusion Nurses Society, which sets the standard for infusion therapy.
Individuals who have been diagnosed with arthritis are likely to be on medications to relieve their pain. Some of these medications can have serious side effects, particularly if patients are taking opioids. If your loved one is taking an opioid-based pain reliever, ask your loved one’s doctor how to best address these risks:
- Increased risk of falls
- Opioid-induced constipation
- Problems with thinking or memory
An in-home care nurse can recommend strategies for reducing side effects from arthritis medication. In some cases, people can benefit from non-medication techniques, such as hot and cold applications, massage, proper positioning, and other approaches.
Ongoing home care for people with arthritis
People dealing with arthritis may need to make adjustments in nearly every aspect of their lives — from how they get out of bed to how they reach for a jar in the pantry. Devices like mechanical grabbers and other options can help your loved one reach and grab things without having to bend or twist as often.
Staying fit and active is another way to minimize the effects of arthritis. Losing just one pound of body weight translates to a four-pound reduction in the amount of stress affecting the knees of an overweight person with osteoarthritis. That adds up quickly. For example, losing just five pounds results in a 20-pound reduction of extra pressure on your knees.
Moderate-intensity exercise strikes the right balance of healthy activity without putting too much stress on joints. Yoga and tai chi are great examples of moderate-intensity exercise that people with arthritis can do in their homes or in structured class settings. Many individuals with arthritis have an exercise plan their doctors have recommended. We can help them follow that plan or help create one if necessary.
Having arthritis doesn’t mean your loved one needs to be in bed or in a chair all day. Working with an in-home nurse or caregiver can help people with arthritis manage their pain and remain independent.
Filed under: Arthritis