My Mom always says she can tell when winter is coming, she can feel it in her bones. Yes, she has arthritis. I wanted to know if that is just an old wives’ tale or was there truth to it, so I did a little research. Turns out there is some truth to it after all. A fall in barometric pressure, which often occurs as a cold front approaches, can cause joints to expand, which may result in pain. Low temps may also increase the thickness of the synovial fluid that acts as the joint’s shock absorber, which makes joints stiffer and more sensitive to pain. There are nearly 100 different types of arthritis affecting some 50 million people in the United States. Let’s discuss common arthritis related diseases and what can be done to help elevate the pain associated with it.
While OA (Osteoarthritis) and RA (Rheumatoid arthritis) may be the most commonly recognized types of arthritis, there are other related conditions that are often found in older adults. They include:
• Fibromyalgia: a condition that causes pain in the muscles and soft tissues and is often accompanied by fatigue, poor sleep and sensitivity to touch, especially in certain tender points on the body.
• Gout: a condition that occurs when the body produces too much of a substance called uric acid, which can lead to the development of uric acid crystals in the joint (typically the big toe) and causes severe pain and swelling.
• Osteoporosis: one of the most common arthritis-related diseases, this condition causes bones to lose mass and become thin and brittle, which can lead to painful fractures, rounded shoulders and loss of height.
If your loved one is in pain, it may be hard for them to juggle the details of medical care alone. He or she may need help getting to doctor’s appointments, remembering details of appointments, taking medications and making sure prescriptions are refilled. You can be an extra set of eyes and ears for your family member and an aid in navigating the best health care plan for him or her.
Being able to communicate concerns you have about your spouse or parent to the doctor and staff members is essential. But you also need to make sure that your participation does not erode your family member’s own relationship with the physician, instead supporting and augmenting it, a sometimes delicate balance. Here are ways you can develop a positive relationship with the physician and support your loved one’s relationship as well.
What you can do to help
• Educate yourself. Learn all you can about the different types of arthritis, its complications and the side effects of arthritis drugs (if any). Websites with excellent information include the Arthritis Foundation, www.arthritis.org; the National Institute of Arthritis and Musculoskeletal and Skin Diseases, www.niams.nih.gov; and the American College of Rheumatology, www.rheumatology.org.
• Attend doctor’s visits. The doctor may offer a lot of information at once and sometimes in language that can be tough to understand. By being at each visit, you can take notes and also ask the doctor to explain technical terms you and your family member may not understand. During Covid, you may not be allowed to join physically in the doctor’s office visit, but may I suggest virtual options to still be a part of the conversation? Perhaps, use a tablet on a zoom call or Duo (for android phones), or Facetime on iPhones to participate in the Dr. Visit.
• Prepare ahead. Ask your spouse or parent what they want to talk to the doctor about and write those concerns and questions down before the doctor’s visit. Add your own observations about any six medical changes you’ve noticed, like increased pain, lack of appetite and sleeplessness.
• Acknowledge disagreements. Let the doctor know if there are areas of care that you and your family member don’t agree on. Discuss those concerns in private with the doctor. If you’re an adult child caring for a parent, the most important thing is for you to know what your parent is feeling and what she needs from you. Ask about her worries and concerns about her future, about her arthritis, about her medical care and about your involvement. Try to find out what her preferences are about where she wants to live and what kind of care she wants and needs. Try to remember that your parent probably values independence as much as you do.
Questions to ask the doctor
• Ask the doctor how you can be an ally in guiding your family member’s care. His first obligation is to his patient, and he may ask for your help in watching for certain changes and symptoms, for instance, or in ensuring that the person takes their medications.
• Ask for explanations. Ask the doctor to explain what any new tests or prescriptions are for, what the alternatives are, what any side effects might be, and, in the case of medication, ask if there are dangers of adverse interactions with medications your loved one is currently taking. Have a list of those medications with you at every appointment.
• Ask the doctor about other resources. Find out if there are other healthcare services like physical therapy, occupational therapy and mental health services. And ask about help for yourself as well: What assistance is available to caregivers? Are there caregiving support groups that your doctor can refer you to?
People handle pain and discomfort in all sorts of ways. Some people keep a stiff upper lip, feeling embarrassed or uncomfortable with complaints. Others may complain indirectly by acting out of sorts or grouchy. Others may get down in the dumps. Below is a roadmap to some of the challenges.
Emotional challenges: How you can help with arthritis may also experience depression, anxiety and/or a feeling of helplessness because they are no longer able to do things they used to do. They can also feel isolated, like no one quite understands what they are going through. And stress from chronic pain can stalk them as well.
You can help by doing the following: Listen and empathize. You may feel like you need to solve everything when in fact what your loved one may want most is to express their emotions of sadness and loss.
• Encourage them to talk about how they are feeling, and any concerns or fears.
• Make a date, even if it’s a virtual call. That can help your loved one feel less isolated and alone.
• Practice deep breathing together. Listen to music with a cup of tea or warm beverage and relax.
• Encourage some movement. If your spouse or parent is able, ask him or her to go for a short walk with you outside. Exercise can lift spirits and lessen pain. Ask the doctor what kind of exercise would be helpful.
• Ask for help. Tell the doctor that your family member seems depressed and anxious. The doctor may be able to prescribe an antidepressant or anti-anxiety medication that can help. Some antidepressants also help with pain.
Physical challenges: The range of physical challenges from arthritis can be extensive: The person may have difficulty walking, trouble with household tasks like opening jars and turning doorknobs, or even problems with dressing and combing his or her hair. And pain may make sleep hard to come by. But there are ways you can help ease physical restraints and discomforts.
• Arrange for physical and occupational therapy. A physical therapist can develop an exercise routine for your family member that will likely include range-of-motion exercises that will make it easier for him to do things like comb his or her hair or stand up or sit down; strength training that will strengthen the muscles that support the joints; and some cardiovascular exercise like walking or swimming that will help him maintain overall fitness. An occupational therapist will assess what your family member can and can’t do and address ways to help make difficult tasks easier. For instance, she may suggest small household changes like door latches instead of twist knobs that won’t stress the joints.
• Employ heat and cold. Heat works by stimulating blood circulation, which can reduce muscle spasms and relieve pain. Encourage your family member to take a warm shower each morning to relieve morning stiffness. Applying heating pads or patches to painful areas for 15 minutes at a time can help as well.
• Try massage. Research shows that regular massage can reduce pain and stiffness and improve range of motion and joint function. An added bonus is that massage also reduces anxiety, a common accompaniment to chronic pain. Researchers have found that massage lowers stress hormones and increases feel-good neurotransmitters like serotonin. Make sure the doctor thinks it’s a good idea and get a referral to a massage therapist familiar with arthritis.
• Address sleep difficulties. Pain robs sleep. And fatigue increases pain. Talk with the doctor about ways that your spouse or parent can sleep more soundly. Try to persuade your family member to avoid caffeine and alcohol, which disturb sleep. And share some minutes of soft music, deep breathing, and warm milk before going to sleep in a cool, dark room.
• Prepare nutritious meals. Some foods can help fight inflammation, while others may trigger arthritic flares (increase in symptoms). And maintaining a healthy weight can also help manage joint pain. Fruits and vegetables, fish, fiber and whole grains can help fight inflammation. High fat foods may trigger arthritic flares.
Julie Ann Soukoulis is the owner of Home Instead Senior care office in Rohnert Park, mother of two and passionate about healthy living at all ages. Having cared for her own two parents, she understands your struggles and aims, through her website, www.homeinstead.com/sonoma to educate and encourage seniors & caregivers. Have a caregiving or aging concern? She’d love to hear from you at 586-1516 anytime