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Choosing to Live at Home
May 8, 2000 -- When Sharon Miles' elderly mother grew frail a dozen years ago in Albuquerque, mother and daughter had a problem. "I was taking care of her with no support system here in town," says Sharon Miles. "It was overwhelming. She needed help bathing, eating, getting around. Finally, I had to place her in a nursing home even though neither of us wanted that." It was one of the toughest decisions Miles had ever made.
"Now, by contrast, people don't have to do that until it's really necessary," she says. Staying at home, or "aging in place," as it has become known, while not necessarily inexpensive, is becoming increasingly feasible for many older people. And Miles herself has become part of the solution.
After the experience with her mother, Miles returned to school for a degree in social work, with course work in gerontology, and gained experience arranging care for seniors at an HMO. Then, as a member of the relatively new profession of geriatric care managers, she formed her own company. Her current clients, most of them in their mid-80s, all live at home with outside help -- coordinated by Miles.
Putting Together a Plan
As a member of the National Association of Professional Geriatric Care Managers, Miles specializes in helping seniors live independently for as long as possible in their own homes -- which, according to the American Association of Retired Persons (AARP), is what 85% of them want to do. Care managers can assess what's needed, arrange for services, help with legal, financial, and insurance issues, coordinate various government, private, and community services, offer counseling, and act as a liaison for distant families.
A typical new client call comes from a son or daughter, Miles says. "Last year a daughter in Michigan found me through the national association's web site and called about her mother living alone in the Albuquerque home where she'd been for 45 years. The children had noticed that their mother was forgetful and not keeping up with the bills. They worried that she wasn't taking her medications. She had a little dog for company and didn't want to move out of her home.
"The children flew in, and we all met at the mother's home. She'd lost weight, was sloppily dressed, when she'd always been so neat; and the bathtubs were dusty." With the family, Miles developed a care plan. The mother now wears a beeper that she can use to call a neighbor if she falls. She receives hot lunches from the community's Meals on Wheels service. A homemaker/caregiver comes in every morning for about four hours to help her dress, make sure she has breakfast, and take her to doctor's appointments. A shower chair, handheld shower head, and grab bars were installed in the bathroom, with assistance provided by a city program. Miles removed slippery throw rugs and replaced them with rubber-backed ones. She continues to monitor the plan, keep in touch with the children in Michigan, and is ready to respond to any changes in the woman's needs.
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Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
