Auto Immune Disorders in the Elderly

Course overview

SYMPTOMS Symptoms of an autoimmune disease vary widely and depend on the specific disease. A group of symptoms that occur with autoimmune diseases may include: •Dizziness •Fatigue •General ill-feeling •Low-grade fever •Joint pain All of these symptoms are so generalized that doctors cannot diagnose autoimmune diseases without more specific testing. As many people can see by the symptoms, they could also be caused by the common cold. It is no wonder that some people can go to the doctors for months before they are correctly diagnosed with a specific autoimmune disease. Autoimmune disorders are diagnosed, evaluated, and monitored through a combination of autoantibody blood tests, blood tests to measure inflammation and organ function, clinical presentation, and through non-laboratory examinations such as X-rays. There is currently no cure for autoimmune disorders, although in rare cases they may disappear on their own. Many people may experience flare-ups and temporary remissions in symptoms, others chronic symptoms or a progressive worsening. Causes The cause of autoimmune diseases is unknown, but it appears that there is an inherited predisposition to develop autoimmune disease in many cases. In a few types of autoimmune disease (such as rheumatic fever), a bacteria or virus triggers an immune response, and the antibodies or T-cells attack normal cells because they have some part of their structure that resembles a part of the structure of the infecting microorganism. Autoimmune disorders fall into two general types: those that damage many organs (systemic autoimmune diseases) and those where only a single organ or tissue is directly damaged by the autoimmune process (localized). However, the distinctions become blurred as the effect of localized autoimmune disorders frequently extends beyond the targeted tissues, indirectly affecting other body organs and systems. Some of the most common types of autoimmune disorders are listed in the definitions at the beginning of this tutorial. Treatment The goals of treatment are to reduce symptoms, control the autoimmune process, decrease organ damage, and maintain the body's ability to fight disease. The treatments used depend on the specific disease and the symptoms. Some clients may need supplements to replace a hormone or vitamin that the body is lacking. Examples include thyroid supplements, vitamins, or insulin injections. If the autoimmune disorder affects the blood, blood transfusions may be needed. People with autoimmune disorders that affect the bones, joints, or muscles may need help with movement or other functions. Medicines are often prescribed to control or reduce the immune system's response. They are often called immunosuppressive medicines. Such medicines may include corticosteroids (such as prednisone) and nonsteroid drugs such as cyclophosphamide, azathioprine, or tacrolimus. Unfortunately, the side effects of these medications used on a long term basis create almost as many negative symptoms as the actual autoimmune disease process itself. Caring For The Elderly With Autoimmune Disorders The goal of care is to help the elderly resident continue their normal habits and way of life they maintained before their diagnosis. They will have multiple symptoms or fatigue, joint pain, low fever, dizziness, and generally not “feel well”. The best way to help these elderly is to recognize and acknowledge their feelings, handle them gently, when you’re helping them with activities of daily living, and wait for them patiently. Their skin may be “paper thin” and tears easily and bleeds easily. Just imagine that every time you grab someone who’s been on Prednisone for over one year that you might create a skin tear, how would you feel? You can recognize them because they usually have black and blue bruises all over their bodies. The intent of moving them gently is to keep them from further injury. They also HURT. As you saw in th