Acupuncture for Alzheimer’s and Dementia

senior in hat

Alzheimer’s disease and dementia impact over 5 million people in the United States. According to the Alzheimer’s Association, nearly 70,000 people in Colorado live with memory loss. With Alzheimer’s and dementia on the rise, complementary care options are critical for helping manage this widespread health crisis. Acupuncture can be an effective part of treating the many symptoms that occur with Alzheimer’s and other forms of dementia.

Alzheimer’s is a difficult condition to treat. Like many complex diseases, the causes are not well understood. Western medical intervention can help patients manage certain symptoms, but conventional treatment options have been ineffective in halting the progression of the disease. Given the increasing number of patients diagnosed with this illness, and the growth of our aging population, pharmaceutical companies and research institutions are scrambling to find a cure for this devastating disease.

Alzheimer’s and dementia primarily affect people over 65, though early-onset dementia does occur. There are currently 5.5 million people living with Alzheimer’s or dementia in the United States, and that number is expected to rise as our population ages. The widespread prevalence of these conditions has shot up dramatically over the last 17 years; since 2000, deaths from Alzheimer’s disease have gone up 89%. Alzheimer’s is now the sixth leading cause of death in Colorado and the United States as a whole.

The course of cognitive diseases like these can be long. Some patients live a decade with progressively complicating symptoms. There are currently no known cures or preventative methods to stop Alzheimer’s disease. This means the full burden of the disease usually comes in old age when one’s health may already be compromised. It is not uncommon for older adults living with Alzheimer’s or dementia to have diabetes, heart disease, or other chronic illnesses.

Even in elders who do not exhibit memory loss, old age brings a host of physical and mental difficulties. Acupuncture excels in treating many conditions that show up in our later years, including arthritis, digestive issues, insomnia, hypertension, depression, and anxiety. It is important to remember that although Alzheimer’s and dementia are memory disorders, patients may suffer from physical illnesses that are manageable through complementary medicine, such as massage and acupuncture.

We know that the personality changes that accompany dementia can be challenging, both for patients and caregivers. Recent research in the U.S. on the efficacy of acupuncture in treating depression and anxiety in Alzheimer’s patients has been promising. These diseases can instigate profound feelings of despair and cause an increase in social isolation. Acupuncture, different from talk therapy, offers a body-mind treatment that can calm feelings of anxiety and lift the mood. Treatment offers patients the chance to interact with someone outside their normal sphere of care, which can stimulate social connection.

Acupuncture also excels in treating pain of all kinds. Many seniors report living with pain, which can lead to a decrease in physical activity and changes in sleep patterns. Movement is critical for maintaining health and inspiring participation in activities that bring us joy. Many dementia patients are still capable of physical exercise and should be encouraged to stay active as a way of promoting their overall health. Acupuncture keeps seniors moving by alleviating back, knee, neck, and foot pain.

Expanded research on using acupuncture and Chinese herbs in treating Alzheimer’s is being explored in China and Japan where prevalence of the disease is also on the rise. While we cannot claim that East Asian medicine currently offers a strong method for halting or reversing this disease, we can provide supportive care in the realm of helping to manage co-existing symptoms. Hopefully, as research on Alzheimer’s and dementia increases, comprehensive approaches to treatment will become available to patients at all stages of the disease. Ideally, we will discover ways of preventing these conditions as well.

At Boulder Acupuncture and Herbs, we treat patients in the early and middle stages of Alzheimer’s and dementia. We use both acupuncture and Shiatsu to help manage pain, depression, fatigue, and anxiety in patients with cognitive disorders. Our approach to each patient is dependent on the client’s comfort level, receptivity, and physical condition. Some patients may be seen privately, while others need a care partner present. We can also visit patients in their homes or in memory care facilities in Boulder.

The challenges of living with dementia can be overwhelming for many patients, especially during the early stages of the disease when rapidly changing capabilities can cause intense distress. Similarly, caring for a loved one diagnosed with dementia is also incredibly challenging. Managing this disease is a group effort, and we want to be of service. Call us to discuss how acupuncture might help ease the discomfort of living with dementia.

Community Acupuncture: Affordable Treatment for Seniors in Boulder

Boulder Acupuncture and Herbs is the only community acupuncture clinic in Boulder to specialize in treating seniors. We offer convenient, low-cost acupuncture appointments three afternoons a week in our clinic at Frasier Meadows Retirement Community. This clinic, which is open to the public, helps us reach our mission of making acupuncture accessible to older adults in Boulder County.

Curious about whether community acupuncture is a good choice for your condition? Let’s explore the benefits of this unique style of treatment.

How does community acupuncture work?

Community acupuncture is conducted in a group setting with multiple patients receiving treatment at the same time.

community acupuncture chair
Recliner in our community acupuncture clinic

Like conventional acupuncture treatments, community acupuncture sessions start with the acupuncturist asking about your health condition. After this initial intake, you will receive treatment while relaxing in a recliner chair. Once you are comfortable and settled, the acupuncturist moves to the next client. Patients are never left alone in the treatment room and are encouraged to ask for assistance at any time, including being covered with extra blankets. Twenty to thirty minutes later, we will remove your needles and send you on your blissful way.

One of the more convenient aspects of community acupuncture is that patients do not need to disrobe. Most of our clients simply remove their shoes and socks and lift their pant legs to their knees. Clients typically receive acupuncture needles in the lower legs and arms, as well as the scalp and ears. This style of acupuncture is particularly helpful for patients who are in wheelchairs, as it does away with the need to transfer to a massage table.

One question that comes up for potential patients is whether community acupuncture is less effective than a private session. Typically, the answer is no. Why is that? The efficacy of this style of treatment lies in the acupuncture meridian system.

How are community acupuncture treatments different from private acupuncture?

Community acupuncture makes creative use of the remarkable network of communication in the body known as the meridian system. Invisible to the eye, the meridian system crisscrosses the body in a web of energetic connections linking organs, muscles, sinews, and bones.

Acupuncture taps into this intricate system to affect change all over the body. By inserting acupuncture needles in key locations along the meridians, we impact symptoms anywhere on the pathway of that energy channel. For example, we can treat back pain through needles in the hands and headaches with acupuncture in the feet and calves.

The flexibility of the meridian system is what makes community acupuncture so effective. In reality, all acupuncture treatments use the meridian system to create change in the body. Yet because group acupuncture sessions focus on points on the arms, legs, and head, these treatments simply access this network via alternative pathways.

A few conditions we regularly treat in our community clinic include:

  • Arthritis
  • Headaches
  • Hypertension
  • Stress, anxiety, and depression
  • Insomnia
  • Diarrhea and constipation
  • Low appetite
  • Colds, flus, and low immunity
  • Neuropathy
  • Knee, back, neck, and shoulder pain

Is there ever a time when community acupuncture is not a good fit? Yes. Let’s look at a few instances when private treatment is the way to go.

When do I need private treatment?

Although we love community acupuncture, some patients benefit more by booking private sessions with our acupuncturist.

Clients who wish to share very sensitive information may choose to be seen solo. Although we make every effort to help you maintain your privacy, the community acupuncture clinic is certainly a group environment. If you have concerns about privacy, please call our office ahead of time, and we may be able to discuss important aspects of your health history over the phone. This applies to patients being treated for anxiety, depression, or trauma, and those being seen for reproductive health.

Patients with advanced dementia or Alzheimer’s disease may find the community acupuncture setting overwhelming. Clients with cognitive difficulties are usually more content in a private, one-on-one treatment with our acupuncturist. In some instances, patients with memory impairment may be accompanied in the community clinic by a caregiver who can assist the acupuncturist in keeping the patient comfortable and oriented during the treatment.

In some situations, our acupuncturist will recommend that you be seen privately to adequately address your health condition. Some forms of hip pain, shoulder pain, and low back pain may require local needling of those affected areas, which is difficult to conduct in a chair. Our goal is to help you feel better as quickly as possible while being mindful of your out-of-pocket expenses.

When in doubt, ask our acupuncturist about which treatment option is the best for your specific condition.

Community acupuncture builds community

Community acupuncture was developed to offer acupuncture to people who might not otherwise be able to afford this exceptionally effective form of treatment. At Boulder Acupuncture and Herbs, we are committed to including seniors in this mission.

Group acupuncture offers patients, caregivers, and families the opportunity to receive treatment at the same time. With notice, we can often schedule treatments back-to-back for patients and caregivers. This benefit alone can save caregivers hours in transportation and waiting room time, not to mention the added bonus of simultaneously receiving a personal acupuncture treatment.

The shared healing environment of the community acupuncture clinic is encouraging, supportive, and inclusive—all qualities that contribute to good health. Although patients are encouraged to rest quietly during treatment, a noticeable sense of camaraderie develops in the quiet of the clinic as multiple patients experience acupuncture. Patients report feeling energized by this collective sense of wellbeing. As you might imagine, our acupuncturist loves it, too.

Booking your community acupuncture treatment

Community acupuncture treatments are scheduled in advance by calling (720) 668-6638. Appointments are available three afternoons a week:

  • Monday 3:30-6:30 p.m.
  • Wednesday 3:30-6 p.m.
  • Thursday 1:30-4:30 p.m.

The cost of treatment is $35 for the first visit and $25 for follow-up sessions. Our clinic takes cash, check, and credit cards.

Accessibility, affordability, and quality care make our community clinic an ideal choice for seniors and their caregivers. If you have never tried this modern form of acupuncture, we encourage you to book a session. You may be pleasantly surprised by how convenient, effective, and uplifting community acupuncture can be.

Good health for all!

Prescription Opioid Abuse in Elders

brain

The prescription opioid epidemic in the Unites States has reached unprecedented numbers. The Department of Health and Human Services states that nearly 80 people die from opioid-related overdose in the Unites States every day. These deaths come from both recreational drugs, like heroin, and prescription painkillers. Seniors are particularly at a risk because they are often prescribed these medications for pain. Luckily, acupuncture can offer immediate help with prescription opioid abuse in elders.

But first, how does opioid abuse develop? Prescription painkillers are best used to manage acute pain, meaning post-surgical discomfort or after sustaining an injury or fall. Chronic pain, such as that associated with arthritis or old injuries, is less responsive to opioid intervention and can actually create a cycle of tolerance and dependence.

How did we reach this point of widespread addiction to pain medication?

A contributing factor was the medical community’s shift to treating pain as the “fifth vital sign” starting in the 1990s. This meant that after heart and respiratory rates, blood pressure, and body temperature, doctors screened patients about pain. For patients living with pain, this was a blessing. As many chronic pain sufferers will attest, intractable pain can lead to depression, loss of income, and strained personal relationships. There is no doubt that chronic pain changes the landscape of life.

Despite their efforts to alleviate pain, the medical community’s move to prescribe high-powered medications to help millions of patients has resulted in a complex public health problem.

Although the face of the opioid epidemic is not typically portrayed as a senior aging at home, we know elders are impacted by this trend. Kaiser Health News reported that in 2011, 15% of Medicare patients were prescribed opioids after a hospital visit. Ninety days after being discharged, 42% of those patients were still taking those medications. Clearly opioid abuse is becoming a concern for elderly patients.

The Dangers of Opioid Abuse in Elders

Painkillers change pain perception by activating opioid receptors in the brain. The relationship between a pain site and the way the brain recognizes pain are altered by the addition of prescription medication. As the brain becomes accustomed to the flood of introduced opioids, its receptor sites multiply. This is why opioid drugs are so highly addictive. The body becomes chemically dependent on receiving this additional influx of opioid to function comfortably.

The side effects of opioid use in seniors are especially worrisome, including changes in cognition and poor motor control leading to falls. When taken in high amounts, these medications are particularly dangerous. For elders with memory impairment, accidentally doubling up on doses can be deadly.

Unlike younger adults seniors do not metabolize opiates at the same rate, meaning more of the drug is likely to stay in the body for a longer period of time. Family members or friends who sympathetically offer painkillers should be aware that elders carry a greater risk of overdose due to decreased liver and kidney capacity. Never share opioids with a senior.

Even when elders are appropriately prescribed opiates, these medications can bring unwanted negative symptoms, including:

  • nausea
  • constipation
  • urinary retention
  • sedation
  • skin rashes
  • compromised respiration
  • cardiac symptoms
  • lowered libido
  • heightened pain perception
  • decrease in bone density

For some patients multiple doses of opioids per day can lead to physical dependence in less than one week. It is important that elders have a recovery plan in place to transition off of these drugs as soon as possible.

This is where acupuncture can help.

Acupuncture Helps Prescription Opioid Abuse in Elders

 Pain creates neural pathways in the brain that stimulate the body to release its own naturally occurring opioids, including endorphins. When pain thresholds are exceeded, such as after surgery, the body cannot control the sense of discomfort. Prescription opioids are particularly useful in helping the body manage this type of severe pain.

Over time, as the trauma from surgery or a fall heals, communication between the pain site and the brain relaxes. In an ideal scenario, painkillers—natural and introduced—are no longer needed. When the body does not heal effectively, pain can linger, continuing to send alarm messages to the brain. Chronic pain creates a particularly insidious cycle of depletion in the body, requiring higher and higher doses of medication to provide relief.

The insertion of acupuncture needles naturally stimulates the release of endorphins, assisting the body in repairing itself. Acupuncture also combats inflammation, which reduces feelings of pain and stiffness. It increases blood flow, helping tissues flush out stagnant blood and encouraging the lymphatic system to repair compromised areas. And, most importantly, it interferes with the distressed messages ricocheting between the brain and distal pain sites, leading to a real change in pain perception.

All of this occurs over repeated acupuncture treatments. Patients suffering from chronic pain, and especially those on opioids, should expect to receive multiple acupuncture treatments to change underlying dysfunction. In some cases, acupuncture is incapable of resolving the pain entirely, especially if the trauma happened years—or decades—ago. Our goal is to help patients feel as comfortable as possible given their personal health history and constitution.

It is important to remember that acupuncture does not work like a pill. Once a patient has become accustomed to taking medication, especially an opiate, the expectation that acupuncture will bring substantial relief right away is misplaced. A course of treatment can last anywhere from two to six months, and sometimes longer, depending on the severity of the condition.

Chronic pain is a complicated problem. It requires clients, and practitioners, to be patient with the body as it repairs itself. Additionally, if a patient is addicted to opioid medications, the process of reducing prescription dependence is particularly challenging. It requires a team approach, which can include medical care, physical therapy, massage, and acupuncture. Get help when it’s needed, and don’t give up too quickly.

Alta Mira recovery center in California says that drug dependence in elders can be overlooked or dismissed because of a perceived lack of urgency. This attitude is often motivated by our cultural beliefs about the limits of old age. At Boulder Acupuncture and Herbs, we are committed to offering seniors access to drug-free alternatives that do not erode quality of life, no matter your age.

If you or a loved one is caught in the cycle of chronic pain, call us today. If you’ve sustained a recent injury, get in to see our acupuncturist right away. Acupuncture will speed up the recovery process and lower your risk of developing drug reliance. And if opioid abuse is already a concern, talk with us about how we can work with you and your doctor to break the cycle of dependence.

For more information on chronic pain in elders, see our article Pain Management in Older Adults.

 

Works Referenced

Chau, Diane, et al. Opiates and Elderly: Use and Side Effects. Clinical Interventions in Aging. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546472/.

Esposito, Jenny. Silent Epidemic: Seniors and Addiction. U.S. News and World Report online. December 2, 2015. http://health.usnews.com/health-news/patient-advice/articles/2015/12/02/silent-epidemic-seniors-and-addiction.

Gold, Jenny. Opioids Can Derail the Lives of Older People, Too. http://www.npr.org/sections/health-shots/2016/12/20/502470255/opioids-can-derail-the-lives-of-older-people-too.

Prescription Opioid Abuse In The Elderly An Urgent Concern. Narcanon website. http://www.narconon.org/blog/narconon/prescription-opioid-abuse-in-the-elderly-an-urgent-concern/.

Sphar, Brittany. Opioid Considerations in the Elderly. Presentation at University of Colorado Internal Medicine Department of Geriatrics Grand Rounds. March 17, 2016. http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/geriatrics/grandrounds/Documents/15-16/GeriatricGrandRounds-Sphar-031716.pdf.

The Opioid Epidemic: By the Numbers. U.S. Department of Health and Human Services. Updated June 2016. https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf.

Why Opioid Addiction in Seniors Remains a Hidden Epidemic. Alta Mira website. Posted September 2016. https://www.altamirarecovery.com/blog/opioid-addiction-seniors-remains-hidden-epidemic/.

 

Acupuncture: Breaking the Cycle of Pain and Depression in Seniors

Chronic pain andsenior playing piano depression are frequently diagnosed in senior patients. Conventional medical treatments for these conditions include surgery, prescription medications, and physical therapy. For some seniors, these measures are not enough. Once initiated, the antagonistic relationship between depression and chronic pain can become debilitating, requiring higher doses of medication and increasingly complicated surgeries. Acupuncture can successfully break the cycle of pain and depression in seniors, offering exponential relief from both physical and mental symptoms.

In our previous article, Acupuncture: An Ideal Treatment for Senior Depression, we learned that depression impacts 14% of seniors in Colorado. Recognizing the physical and psychological symptoms of depression in older adults is important, as they can be different from those of younger patients. We now know that chronic pain is a key indicator for depression in elders.

Pain has a wide-reaching impact on senior health. Just under half of elders report living with pain—and those numbers can climb to as high as 80%. Pain distorts daily life and can lead to mental health complications, such as social withdrawal, depression, and anxiety. Managing the link between pain and psychological discomfort is critical for effectively treating elders. The Western medical community has long recognized this connection, though the side effects of conventional treatment options can create a new set of difficulties for seniors. Let’s look at how pain and depression are treated by medical doctors.

Pain and Depression in Western Medicine

The relationship between depression and pain is well documented in Western medicine. Chronic pain patients are three times more likely to suffer from depression and anxiety. Similarly, depressed patients are more susceptible to chronic pain. With this link identified, many psychiatric pharmaceuticals, such as SSRI and tricyclic antidepressants, treat pain in addition to mood.

Pain patients often have difficulty sleeping, present with lower energy, feel concerned about their future, and report that daily activities require an extra push. The brain pathways created through serotonin, a neurotransmitter that contributes to feeling well, are modified in patients with chronic pain, as well as those with depression. These changes can cause heightened pain perception, instigating negative shifts in mood. This is one reason why many patients living with chronic pain are on more than one medication, including sleep aids and mood stabilizers, in addition to pain prescriptions.

Because pain is so prevalent in elders, many patients are also prescribed opioids, such as Fentanyl and OxyContin. These drugs can heighten social withdrawal and lethargy, especially when prescribed in high doses. For patients whose physical activities, mental stimulation, and social interaction have diminished, fewer opportunities exist to break the cycle of pain and isolation. Many elders become completely reliant on medication to manage their pain, contributing to feelings of depression.

The constellation of symptoms accompanying chronic pain can be difficult, and costly, to manage. Older adults living with pain and depression especially present a complicated health picture and are at a greater risk of being medicated for overlapping conditions. Since most senior depression develops later in life, often accompanied by chronic pain, we cannot ignore the relationship between physical discomfort, mental health, and drug interactions.

Luckily, acupuncture offers a low-cost, drug-free option for treating this complex problem.

Treating Pain and Depression in Seniors with Acupuncture

Elders often experience dramatic changes in health, social roles, financial stability, living conditions, and support systems in their later years. The vulnerability accompanying old age is profound. Losses in ability can create both mental and physical handicaps in patients who were once vibrant and self-directed. Even more than increasing pain levels, loss of ability to take part in previously well-loved activities poses a greater risk for depression in elders. We must keep seniors mentally and physically engaged.

Acupuncture is a full-spectrum, drug-free pain treatment option with impacts far beyond the relief of physical symptoms. Through strategically placed stainless steel needles, we can positively interact with muscle fibers, blood pathways, and biochemical responses in the organs, including the brain. Acupuncture breaks the cycle of pain by disrupting dysfunctional communication trails between the brain and the body. This allows the body to reset its pain receptors while simultaneously healing the location of the trauma.

One way we do this is by treating the brain, and distal parts of the body, through points on the ear. The ear has a direct line of communication to the brain and can be used to stimulate the release of endorphins, shift the flow of blood from one part of the brain to another, and send messages to the rest of the body. Treatments combining the use of ear acupuncture with points elsewhere on the limbs and trunk are effective in treating many different ailments.

The number-one reason older patients try acupuncture is to manage chronic, recalcitrant pain. Though because the benefits of acupuncture are not well publicized in senior populations, many patients I see only consider acupuncture after years of surgery, physical therapy, and medication. Their pain levels are often quite high, even after conventional medical intervention. Lurking beneath the surface of the physical symptoms, depression and anxiety often hide in the background, aggravating pain perception.

Acupuncture offers a win-win option in breaking the cycle of pain and depression because we address physical and psychological symptoms at the same time—all without the intervention of drug therapy. Best of all, if you or a loved one is currently on medication for pain, insomnia, or depression, acupuncture will not negatively interfere with those prescriptions. It is a safe addition to your healthcare plan that can fill in the gaps left by more conventional treatments.

Our elders need alternative options for managing pain and depression. Boulder Acupuncture and Herbs is committed to offering affordable treatment options to seniors living with these debilitating conditions. If you have questions about how acupuncture can become a part of your treatment plan, call us today.

In our next article, we will look at a growing healthcare concern in senior populations, opioid addiction, and how acupuncture can help.

 

Works Referenced

Chou, Kee-Lee. (2007). “Reciprocal relationship between pain and depression in older adults: evidence from the English Longitudinal Study of Ageing. Journal of Affective Disorders. Volume 102.

Colorado Department of Public Health and Environment. 2016. The health of Colorado’s older adult population data infographic. http://www.chd.dphe.state.co.us/Age/Healthy-Aging-in-Colorado-Infographic.html

“Depression and Pain.” (2009) Harvard Health Publications online. http://www.health.harvard.edu/mind-and-mood/depression_and_pain.

Korff, Michael, et al. (1996) “The Relationship Between Pain and Depression.” The British Journal of Psychiatry. Volume 168.

Acupuncture: An Ideal Treatment for Senior Depression

senior alone on bench

Depression impacts 14% of seniors in Colorado. The symptoms of depression in older adults can range from fatigue and poor appetite to hopelessness and thoughts of suicide. Most elders living with depression do not develop symptoms until later in life and are often unfamiliar with treatment options. In addition, many may be reluctant to share details about their experience due to a perceived social bias against mental illness. Acupuncture, because of its unique ability to simultaneously address both the physical and emotional aspects of health, is an ideal treatment for senior depression.

The factors leading to depression in seniors are different from those of younger adults. Many of these factors are linked to physiological changes that may appear with age. Patients with advancing stages of certain diseases, such as Alzheimer’s and dementia, often develop depression due to organic changes in the brain. Other seniors are impacted more by the social implications of aging, including a loss of freedom, autonomy, purpose, and meaningful identity.

In this article we will first become familiar with physical and mental considerations in identifying senior depression. We will then look at when acupuncture is an ideal choice for an elder living with this condition. Because of the far-reaching, and potentially devastating, effects of depression, we must understand how to offer the right assistance at the right time.

 

Physical Symptoms in Senior Depression

Particular diseases are linked to depression in older adults. Patients with Alzheimer’s disease, Parkinson’s, dementia and those recovering from stroke carry a greater risk of developing depression due to physical changes in the brain. Elders with cardiovascular disease, hypo- and hyper-thyroidism, and Type II diabetes also show a propensity for depression. Often patients are treated for mood changes in the context of managing these chronic illnesses.

When identifying depression in a senior, it is imperative to determine if mood changes are due to the progression of a disease, either previously diagnosed or currently unidentified. Mental health shifts can point to hidden physiological changes that must not be overlooked. Always consider whether a change in mood is coming from physical illness before starting treatment for depression.

Even with this screening in place though, many seniors my not articulate their feelings of sadness, hopelessness, or anxiety openly to family or caregivers. The signs of depression in seniors can be difficult to identify and are sometimes dismissed as being part of “old age”—even by the patient herself. While aging does bring unique life challenges, certain physical changes should not be ignored.

 

Possible Physical Indications of Depression in Seniors

Insomnia: Insomnia and depression are closely linked in elders. Patients with lifelong sleep problems have a higher risk of developing depression. A recent onset of insomnia may also indicate a senior is having a mood shift. Correcting the insomnia is important, as poor sleep lowers immunity, clouds cognition, and can lead to accidents and falls.

Fatigue: Daytime exhaustion may be a sign of poor sleep, but this is not always the case. Fatigue can point to a variety of issues, including physical complications from hypotension or hypothyroidism. Fatigue can also be a sign of mental disengagement and avoidance. Both fatigue and depression can create a sensation of being physically “dragged down,” leaving the patient feeling helpless to complete the basic Activities of Daily Living (ADLs) or engage socially with friends and family.

Lack of Appetite: Disinterest in food can also be a sign of depression in seniors, a condition we see more in women than men. The implications of poor nutrition are numerous, including blood sugar instability, increased frailty and risk of falls, and dehydration. Diseases of the digestive tract should be ruled out, including constipation.

Physical symptoms are sometimes the only clues we have to helping seniors with mental health concerns. If you notice changes in sleep, appetite, or energy levels, see a medical doctor to rule out infection or disease. Often shifts in mental outlook are directly related to changes in physical health, especially in patients managing complex diseases. A clear diagnosis is always the first course of action.

 

Mental Symptoms in Senior Depression

Depression can be tied to a number of triggers in older adults. For some, the losses of aging—including diminished physical vigor, reduced mental clarity, changing social roles, and grief over losing a spouse—can be overwhelming. Lack of control over the processes of illness and death may cause some seniors to feel regret, sorrow, and fear. Caregivers should be able to offer solace and companionship to elders who are navigating this difficult terrain.

Life changes that may trigger depression in a senior include:

  • Death of a spouse
  • Moving to assisted living, a memory care unit, or a skilled nursing facility
  • Deterioration of physical health
  • Memory loss, especially in the early stages of Alzheimer’s
  • Change in financial status
  • Sudden isolation
  • Loss of a social role, either in the family or community

Seniors may also experience a state of “depression without sadness,” meaning they can be depressed even in the absence of an emotional trigger. They may say they have nothing to feel sad about, and yet, as caregivers, we may observe physical or emotional changes that suggest there is something deeper going on. The following indicators may help us identify hidden symptoms of depression.

 

Possible Mental Indications of Depression in Seniors

Anxiety: Seniors who are anxious are more likely to develop symptoms of depression if triggered by a life-changing event. Also, elders who live with both anxiety and depression may not respond as quickly to conventional treatment (medication and psychotherapy). Helping seniors feel less anxious may lead to emotional resiliency and feelings of self-empowerment and stability in the face of difficult life transitions.

Lack of Interest in Life: Engagement, purpose, and connection are important during every phase of life. Some elders see the last phase of life as an opportunity to let go of relationships, roles, or obligations they no longer need or enjoy. For some, self-reflection becomes their main focus. Others use this time to create relationships, travel, or learn new hobbies. A lack of interest in life, including hopelessness about the future, could be a sign of depression in an older adult and should be taken seriously.

Grief: Grief, or bereavement, is differentiated from depression. At the same time, untended grief can turn into depression, especially if the loss of a loved one coincides with another trigger, such as a move to an assisted living facility. Some elders may feel they need to “get over it” but are unable to transform their grief in a timeframe that feels reasonable to them. It is important to tap into a network of care for elders working through loss of a loved one. Luckily, hospices across the country offer grief counseling and support groups for the bereaved. These services are often free and can make an enormous difference in an elder’s recovery.

Mental and physical symptoms often mix to present a complicated health picture in older adults. The combination of emotional loss and changes in physical wellbeing can initiate feelings of despair in elders who have lived long lives of independence and vitality. Attending to both physical and emotional needs is crucial for maintaining a positive mental outlook in seniors and offering the best care possible.

 

Acupuncture for Depression in Seniors

Acupuncture is a unique drug-free alternative that treats a spectrum of body-mind concerns in older adults. Treatments are automatically designed to address physical issues, as well as mental discomfort. In fact, acupuncture theory is built on an inherent relationship between physical wellbeing and mental health.

Acupuncture is particularly powerful in treating seniors because we begin by addressing physical discomfort. Older adults usually feel safe talking about pain or the progression of diseases, such as hypertension and COPD, with an acupuncturist. Patients understand that acupuncture helps with physical ailments, and they can measure changes in physical health after seeing a practitioner.

The benefit of having an acupuncturist on your caregiving team is that patients receive emotional support in the context of physical care. This mimics the Western medical model of going to the doctor for physical pain and being asked about mood. I find patients respond well to this approach and are grateful that I ask about their mental wellbeing.

When I treat older adults, I always ask about mood. Some patients talk openly with me about their feelings; others are more private with their answers. I work to create a relationship of trust so that patients understand I am committed to helping them both physically and emotionally. Each of my treatments addresses the body-mind spectrum.

If patients wish to share how they’re feeling, acupuncture treatments almost always allow time for connecting. While clients are resting with needles inserted, I offer to talk if they feel inclined. This combination of authentic listening, attention to physical care, and gentle touch make a noticeable difference in an elder’s life.

At Boulder Acupuncture and Herbs, senior mental health is important to us. We are connected to social workers, psychotherapists, geriatric medical doctors, and other alternative medical practitioners who can help. If acupuncture is not the ideal treatment for you or a loved one, we will refer you to the right provider.

Emotional wellbeing is an important part of healthy aging. Our mission is to provide full-spectrum care for every senior we see in our clinic. When you work with us, you can be confident we will always consider your mental health concerns in the context of treating your physical condition.

 

Works Referenced

Carnarius, Megan (2015). A Deeper Perspective on Alzheimer’s and Other Dementias: Practical Tools with Spiritual Insights. Findhorn Press (Scotland, UK).

Colorado Department of Public Health and Environment. 2016. The health of Colorado’s older adult population data infographic. http://www.chd.dphe.state.co.us/Age/Healthy-Aging-in-Colorado-Infographic.html.

Fiske, Amy, et al. (2009). “Depression in Older Adults.” Annual Review of Clinical Psychology. Accessed via National Institutes of Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852580/.

Acupuncture for Urinary Tract Infections

women

Urinary tract infections, also called UTIs, are a common occurrence in older adults, especially women. In Western medicine UTIs are caused by the presence of bacteria, often E. coli, in the bladder. These bacteria travel up the urethra, and if left untreated, can also affect the kidneys. Managing a urinary tract infection quickly is important. If left untreated, these infections may spread, causing damage to the bladder, kidney, urethra, and genital tissue.

The symptoms of a UTI include burning on urination, the sensation of needing to urinate and being unable to void, itching in the genitals, or pain in the lower abdomen. Patients may also have an overall feeling of being unwell, including fever, irritability, or insomnia.

Healthy urine should pass easily, be straw-colored and free of cloudiness. In the case of a UTI, the urine may be dark in color, cloudy, milky, or even streaked with blood. The presence of blood in the urine indicates the infection is severely irritating the lining of the kidneys, bladder, or urethra.

Women are more likely to contract UTIs because of the short length of their urethras, or the passage between the bladder and the outside. Many women who suffer from UTIs show a chronic recurrence of these symptoms. For women who wear padded protection against accidents, a lack of breathability in the vaginal area can create an environment for bacteria. Also, patients who are unable to bathe regularly present a higher risk for developing a urinary tract infection.

Western medicine treats UTIs with antibiotics. Depending on the severity of the infection, the duration, and the patient’s history of naturally managing UTIs, alternative treatments are available.

We will focus on acupuncture, Chinese herbs, and dietary medicines, though there are other resources for UTIs in Western herbalism and homeopathy. My experience is that women often discover the best combination of alternative treatments for their particular body; no “one way” is right for every patient.

Chinese medicine treats the cause of UTI in many different ways, depending on the patient’s age, constitution, symptoms, and overall health picture. UTIs come about due to a variety of factors, including environmental, biological, and emotional. Certain types of UTIs are initiated by psychological upset and can be traced back to stress or anxiety. In Chinese medicine these infections are treated differently than UTIs caused by tight-fitting clothing, hygiene issues, or eating the wrong foods.

UTI symptoms fall on a spectrum. Some women experience intense burning with urination. Other women feel bloated and swollen, as if their urine cannot pass through the urethra because the passage is narrower than usual. Still others may feel no pain at all but notice their urine is cloudy. I have also known of women who simply felt like they had the flu but could not point to the bladder being the cause of their discomfort.

Once I have determined the cause of the problem, I develop an acupuncture plan and may prescribe a Chinese herbal formula designed to address the infection. Most UTIs can be cleared up with a few treatments and a week of herbs. If your symptoms are recurring though, we need to determine what is triggering the infection and eliminate the irritant.

The vagina and opening of the urethra are sensitive to changes in temperature and the presence of chemicals. I recommend all women wear cotton underwear, which is the most breathable fabric available, to keep the vaginal area cool and dry. If you wear pads or panty liners to manage incontinence, choose products that are made of organic cotton and a minimal amount of plastic. Organic cotton cloth diapers are a good solution for patients who need round-the-clock protection. Currently, there are no organic cotton disposable adult diapers on the market. I am hopeful these become available soon. Above all, make sure the underwear, pads, or diapers are changed regularly to minimize the risk of bacteria from the colon entering the urethra.

Drinking plenty of water will help your body flush the bacteria out of the bladder. You may also add 100% cranberry juice to your diet. Just make sure your juice does not contain any added sugar or high-fructose corn syrup. All bacterial infections are “fed” by the simple sugars found in sweet fruits and refined sweeteners. The best dietary change you can make to make the body inhospitable to bacterial infections is to cut refined sugars and alcohol.

A simple, effective home remedy for UTI is drinking corn silk tea. Corn silk is the “hair” that grows around the corn ear and is sloughed off before eating the kernels. This “silk” is soothing to the urinary tract and also has a mild taste. You can make a tea from the silk or buy encapsulated corn silk to be taken as a pill. This remedy is not for patients who are taking blood thinners (Coumadin, Plavix, etc.) or diuretics for high blood pressure or edema. If you are not taking these contraindicated medications and are experiencing recurring UTIs, consider buying a bottle of corn silk pills to keep on hand for future infections.

It is critical to remember that some urinary tract infections are best managed with antibiotics. Longstanding infections, or infections in patients who have compromised immune systems, should be addressed through Western medicine. If you are unsure whether your symptoms should be treated with antibiotics, make an appointment with your doctor. For mild infections, acupuncture, herbs, and dietary therapy may offer relief.

We are happy to talk with you about your symptoms and your health history to determine if Chinese medicine is the right choice for you.

Acupuncture and Surgical Recovery

According to the article “Common Surgical Procedures in the Elderly”[*] published by the American Geriatrics Society, older adults receive 20% of all surgeries conducted in the United States. Comprising only 13% of the population, the patient-to-procedure ratio for older adults undergoing surgery is quite high.

Surgery is an important part of modern healthcare. Many life-threatening and painful conditions are helped by surgical intervention, including cardiac events and broken bones. Older adults may undergo many surgeries to address a variety of health problems as they age.

Whether you have a procedure planned or are recouping from surgery, consider adding acupuncture to your rehabilitation program to shorten and ease your recovery time.

Acupuncture works by stimulating the body to initiate its own healing capabilities. Inserting needles in the skin at specific points reduces inflammation, releases endorphins, stimulates the immune system, and promotes blood flow to compromised areas. Recovering from surgery stresses the body’s natural repair and defense systems, especially in older patients with weakened immune and metabolic responses. Acupuncture provides gentle, supportive treatment during those vulnerable weeks after surgery when the body is asked to do significant self-healing. It stimulates the appetite, promotes elimination, and can reduce dependence on pain medication, all of which speed recovery and improve quality of life through the rehabilitation process.

Post-surgical acupuncture can be done in a variety of settings. Patients may be treated in bed, in a wheelchair, on a massage table, or in a recliner. Our clinic specializes in elder care, which means we can treat older adults with mobility restrictions and special needs, including hip, knee, and back surgeries. 

A series of acupuncture treatments can also help you prepare before receiving a medical procedure. Acupuncture boosts your immunity, calms your nervous system, and helps you sleep, which are important to recovery. Plan to see your acupuncturist once a week for three weeks before your surgery, and aim to schedule your last appointment a day or two before your procedure. Once you’ve had your surgery, schedule a series of follow-up appointments to help you through rehabilitation.

After surgery, it is important to closely manage your post-surgical pain. As pain levels rise, so do instances of insomnia, high blood pressure, and anxiety. By combining acupuncture with traditional pain management, many patients find they are able to reduce their pain medications, helping them feel more alert and avoiding side effects like constipation. Remember, pain is best managed through treatment before it becomes unbearable. Schedule appointments with your acupuncturist prior to going in for surgery to insure you are able to get in after your procedure.

Surgery can be worrisome, especially in older patients, and particularly if the recovery process is long. At Boulder Acupuncture and Herbs, we see patients in their homes or in rehabilitation facilities, like Frasier Meadows Healthcare Center, so that you can start treatment right away. If you have a surgery planned, call us to schedule a series of appointments aimed at helping you recovery quickly, safely, and with fewer complications.

[*] http://www.americangeriatrics.org/gsr/anesthesiology/common_surgical_procedures.pdf

Pain Management in Older Adults

older adult on bicycle

Chronic pain is the number one reason seniors visit an acupuncturist. As many patients age, pain management becomes a daily consideration. Years of wear and tear on knees, shoulders, hips, and feet can show up later in life, limiting patients’ mobility, interfering with sleep, and greatly impacting their quality of life.

Acupuncture is an ideal pain management approach for seniors because it is drug-free, easy to implement, and relatively low-cost.

But why is pain such a common complaint in older adults? As we age, our bodies tend to become less flexible. The blood and fluid necessary to keep our joints and muscles supple decreases naturally with age, both because we are not extracting as much nutrition from our food and because our hormone levels change. Much of the energy required for daily function gets used up by the organs, leaving the limbs weak, stiff, and painful.

The body is a contained network of blood, fluid, and nutrients moving through our muscles, organs, and bones. Exercise assists the body in flushing waste products from the system and bringing fresh oxygen to the limbs and brain. Like exercise, acupuncture creates movement in the body, which is particularly helpful for seniors who have a hard time being active.

When we stop moving our limbs, the heart, lungs, and blood vessels are forced to pump the circulatory system without added assistance, which can be quite difficult depending on the health of these organs as we age. Lack of movement also causes joints and muscles to stiffen, making it harder for blood and fluids to pass, adding to sensations of pain.

Acupuncture needles create movement in the circuitry of the body by tapping into the meridian system, a network of invisible electrical impulses that precede the creation of blood, bones, lymph, and organs. This system of impulses connects all parts of the body in a web. It is the explanation for why an acupuncturist can insert a needle in the hand to ease back pain and why a point on the back of the calf can help with hemorrhoids.

Use of the meridian system is also a major distinction between acupuncture and what is referred to as “dry needling.” Dry needling is a technique that uses acupuncture needles to break up stagnation in a muscle, but this technique does not make use of the meridian system. An acupuncturist’s knowledge of the meridian system offers her many different ways of treating a patient’s pain. For example, just because a patient has pain in her shoulder does not mean we are limited to only needling the shoulder. The meridian system can relay a message to the shoulder through stimulation in other parts of the body.

The meridian system is self-regulating in the sense that its natural inclination is toward health and wellbeing. You are biologically “wired” for health. However, influences like diet, lifestyle, emotional difficulties, and sleep patterns can disrupt the smooth flow of the meridian system. Since the circuitry of the meridian system comes before the blood and lymph networks, it is important to treat the root cause of pain, which actually starts on the level of the meridians.

The meridian system, along with the blood, muscles, bones, and cartilage, can take on unhealthy patterns as a response to physical trauma, such as breaking a hip, overusing the knees, or wearing shoes with poor support. I often look at pain as the body having adopted a “habit” of organizing itself in a particular way around a trauma as a means of protection. Acupuncture helps disrupt this response.

In a way, we can consider acupuncture passive exercise for the meridian system. By encouraging the body to redirect its energy in a healthy pattern, those knots of pain can gradually unravel. Chronic pain is not always easy to alter, but by giving the body a consistent message through acupuncture, we can often make a big impact on very stubborn problems, all without the use of medication.

Pain management is an important consideration in aging. Because exercise is not always a realistic way to work out stiff bones and muscles—especially if a patient is in a wheelchair or recovering from surgery—acupuncture should be considered in senior pain management plans. It is a simple adjunct therapy that can make a significant difference in a senior’s daily life, enabling them to enjoy the things they used to love or discover new joys in their later years.

Acupuncture for Vibrant Aging

elder woman

Not many patients realize that acupuncture is a preventative medicine as well as a trauma medicine. In fact, some of the earliest developments in Chinese medicine come from Taoist practitioners who sought to preserve their health against the inevitabilities of death and old age. Longevity meant everything to early acupuncture practitioners.

Even in modern America, acupuncture is an ideal medicine for elders. With its negligible side effects, flexibility in administration, gentle nature, and low cost, acupuncture is an important contributor to vibrant aging. It is never too late to implement preventative care.

When we imagine aging, we often think of physical pain, mental confusion, difficulty moving, fatigue, and low appetite. Our zest for life diminishes, and living with discomfort becomes the new normal. Chinese medicine challenges this image of old age. In fact, our approach to health maintenance is that the body/mind/spirit are born with an innate ability to correct imbalances, regardless of age. While none of us can avoid getting older, we can subtly change our body’s energetic tendencies, leading to a better use of resources.

As we age, it becomes even more important to consciously use our body’s wisdom as a guide to healthy living. Unnecessary energetic outputs, whether mental or physical, drain us of the stamina we need to eat, sleep, move, and think clearly. The ability to gain nourishment from our food, rest at night, exercise our bodies, and perform mental functions are, and always have been, the markers of good health. Acupuncture assists older adults with these basic life-giving activities.

If someone you know is struggling with the aging process, consider acupuncture. Our medicine cares for patients well into their senior years and can provide relief from many symptoms that accompany this change in life.

And remember, it is never too late to plan for the future when it comes to your health.