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Information for patients: Living with asthma - special concerns for older adults
What Is Asthma?Asthma is a disease of the lung airways. With asthma, the airways are inflamed (swollen) and react easily to certain things, like viruses, smoke, or pollen. When the inflamed airways react, they get narrow and make it hard to breathe. Common asthma symptoms are wheezing, coughing, shortness of breath, and chest tightness. When these symptoms get worse, it's an asthma attack.
Asthma symptoms may come and go, but the asthma is always there. To keep it under control, you need to work with your doctor and keep taking care of it.
Asthma and AgingMany older adults have asthma. Some people develop it late in life. For others, it may be a continuing problem from younger years. The cause is not known.
Asthma in older adults presents some special concerns. For example, the normal effects of aging can make asthma harder to diagnose and treat. So can other health problems that many older adults have (like emphysema or heart disease). Also, older adults are more likely than younger people to have side effects from asthma medicines. (For example, recent studies show that older adults who take high doses of inhaled steroid medicines over a long time may increase their chance of getting glaucoma.) When some asthma and nonasthma medicines are taken by the same person, the drugs can combine to produce harmful side effects. Doctors and patients must take special care to watch out for and address these concerns through a complete diagnosis and regular checkups.
Diagnosing AsthmaIf you have episodes of coughing, wheezing, shortness of breath, or chest tightness, have a complete checkup to find out what the problem is. It could be asthma or another medical problem.
Several tests may be needed to tell what is causing your symptoms. These tests include spirometry (to measure how open your airways are), a chest x-ray, an electrocardiogram (to show whether you have heart disease), and a blood test. Accurate diagnosis is important because asthma is treated differently from other diseases with similar symptoms.
Controlling Your AsthmaYou can help get your asthma under control and keep it under control if you do a few simple things.
1. Talk openly with your doctor.
Say what you want to be able to do that you can't do now because of your asthma. Also, tell your doctor your concerns about your asthma, your medicines, and your health.
If you take medicine that you must inhale, be sure that you are doing it right. It must be timed with taking your breath in. And such common problems as arthritis or loss of strength may make it more difficult. Your doctor should check that you are doing it right and help you solve any problems.
It's also important to talk to your doctor about all the medicines you take--for asthma and for other problems--to be sure they will not cause harmful side effects. Be sure to mention eye drops, aspirin, and other medicines you take without a prescription. Also, tell your doctor about any symptoms you have, even if you don't think they are related to asthma. Being open with your doctor about your medicines and symptoms can help prevent problems.
Finally, be honest about any problems you may have hearing, understanding, or remembering things your doctor tells you. Ask your doctor to speak up or repeat something until you're sure of what you need to do.
2. Ask your doctor for a written treatment plan. Then be sure to follow it.
A written treatment plan will tell you when to take each of your asthma medicines and how much to take. If you have trouble reading small print, ask for your treatment plan (and other handouts) in larger type.
3. Watch for early symptoms and respond quickly.
Most asthma attacks start slowly. You can learn to tell when one is coming if you keep track of the symptoms you have, how bad they are, and when you have them. Your doctor also may want you to use a "peak flow meter," which is a small plastic tool that you blow into that measures how well you are breathing. If you respond quickly to the first signs that your asthma is getting worse, you can prevent serious asthma attacks.
4. Stay away from things that make your asthma worse.
Tobacco smoke and viruses can make asthma worse. So can other things you breathe in, such as pollen. Talk to your doctor about what makes your asthma worse and what to do about those things. Ask about getting a flu shot and a vaccine to prevent pneumonia.
5. See your doctor at least every 6 months.
You may need to go more often, especially if your asthma is not under control. Regular visits will let your doctor check your progress and, if needed, change your treatment plan. Your doctor also can check other medical problems you may have.
Bring your treatment plan and all your medicines to every checkup. Show your doctor how you take your inhaled medicines to make sure you're doing it right.
If You Need HelpIf you ever feel depressed or under stress because of your asthma or other reasons, ask for help. Talking to close friends, family members, support groups, or counselors can help you feel better and help you keep your asthma under control.
ResourcesFor more information on asthma, contact these organizations:
the National Heart, Lung, and Blood Institute, 1998.