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Caregiving and Osteoporosis
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Louise_WebMD_Staff posted:
I am the caregiver for my 74yo mother who has some bone loss. Her doctors haven't discussed it since she moved in with me so I can't tell you extent or whether it really is osteoporosis or not. She was 5'10" when I was a child and now is shorter than me. (I am 5'4") Some of it is posture related. She has a large number of health issues-including neuropathy and arthritis. She has a history of strokes and heart disease as well as has insulin dependent diabetes.

What as a caregiver can I do (other than feed her a healthy diet and ensure she takes medication as directed) to help her bone health?

I have worked with her doctors to adjust medications to reduce the amount of time she is light headed. When she first moved in with us, she fell several times and I was concerned she would become seriously injured.
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NATIONAL OSTEOPOROSIS FOUNDATION
Susan Allison, RNC, BSN, MPA responded:
Dear Louise,

Possibly the doctors have been so concerned with your mother's other health issues that bone health has fallen below the radar. You should request a copy of her latest bone density test if she has had one. If not, ask the Dr. if he/she feels one should be ordered. Make an appointment for you and your mother to discuss the test results and any treatment recommendations.

Loss of such a significant amount of height can signal vertebral compression fractures, found in many people with osteoporosis. You can suggest that a VFA (vertebral fracture assessment) be done at the time of the bone density test, if that technology is available at the facility. Otherwise request a prescription for a thoracic and lumbar spine xray to evaluate your mother's spine for vertebral compression fractures. If she has had these fractures, the doctor will usually diagnose her with clinical osteoporosis and treat her with an approved osteoporosis medication, taking into consideration her other medications and health conditions.

Calcium and Vitamin D are critical components to an osteoporosis treatment plan. Specific recommendations on type and dose should be discussed with the doctor.

Especially important in your mother's case is fall prevention. You have already taken a significant step to reduce her risk of falls and fractures by reviewing the medications which may contribute to dizziness and lightheadedness with her doctors. If her health allows, ask your mother if she would consider joining a Tai Chi class, often available at senior centers, to improve her balance. Also be sure she has had recent vision and hearing exams as deficits in these senses can contribute to falls.

For more details on fall prevention strategies, safe movement and more, you can contact NOF directly by visiting http://www.nof.org/response_form/contacts.asp . Complete the online form and make sure to select "Health Information & Education Requests" in the Question Dept. field. Please reference WebMD and fall prevention. NOF will email you a series of safety handouts.
 
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Louise_WebMD_Staff replied to Susan Allison, RNC, BSN, MPA's response:
They haven't done a bone density test or VFA since she has been here-more than 15 months now. I will bring that up at her next appointment. She definitely had significant issues and they focused on the big ones at first.

She has had vision and hearing exams recently (and some eye surgery) Tai Chi might be a stretch though. Our big accomplishment in the past three months is that she gets out of bed every day and walks to the other end of the house to the living room.

Thanks for the ideas and commentary. I appreciate it.


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