End of Life Issues
Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs when you are healthy, you can help those close to you make the right choices when the time comes.
End-of-life planning usually includes making choices about the following:
- The goals of care (for example, whether to use certain medicines during the last days of life)
- Where you want to spend your final days
- Which treatments for end-of-life care you wish to receive
- What type of palliative care and hospice care you wish to receive
Advance directives can help make your wishes clear to your family and health care providers.
Health fraud scams involve selling medicines, supplements, devices, foods, or cosmetics that have not been proven effective. At best, these scams don't work. At worst, they're dangerous. They also waste money and might keep you from getting the treatment you really need.
Some of the possible dangers of scam products are that they could:
- Be contaminated from being made in unclean facilities or without proper quality control
- Contain harmful ingredients that are not listed on the label
- Trigger a harmful interaction with medicines you are taking
- Cause serious, even life-threatening, injuries
Health fraud scams can be found everywhere, promising help for many common health issues, including weight loss, memory loss, sexual performance, and joint pain. They target people with serious conditions such as cancer, diabetes, heart disease, HIV, and Alzheimer's disease.
Just remember - if it sounds too good to be true, it's probably a scam. Some red flags to watch for are product claims that:
- Have personal testimonials by "real" people or "doctors" played by actors claiming amazing results.
- Say that the product can treat or cure a wide range of unrelated diseases. No one product can treat or cure many different illnesses.
- Mention conspiracy theories like "This is the cure our government and Big Pharma don't want you to know about."
- Include phrases such as:
- Ancient remedy
- Miracle cure
- No-risk money back guarantee
- Natural cure
- Quick fix
- Secret ingredient
- Scientific breakthrough
- Use scientific-sounding terms that don't make sense for the products, such as "molecule multiplicity."
- Refer to prestigious prizes, for example "Nobel Prize winning technology."
Before taking an unproven or little-known product, talk to your health care provider, especially if you are taking any prescription medicines.
Food and Drug Administration
Home Care Services
Home care is care that allows a person with special needs to stay in their home. It might be for people who are getting older (aging in place). It could also be for people who are chronically ill, recovering from surgery, orhave a disability. Home care services include:
- Personal care, such as help with bathing, washing your hair, or getting dressed
- Household chores, such as cleaning, yard work, and laundry
- Cooking for you in your home or delivering meals to you
- Money management, such as help filling out forms and making sure that your bills are paid on time
- Health care, such as having a home health aide come to your home or getting care from your provider through telehealth
You can get almost any type of help you want in your home. You have to pay for many of them. But some types of care and community services are free or donated. Sometimes government programs or your health insurance will help cover the cost of certain home care services.
NIH: National Institute on Aging
What is hyperthyroidism?
Hyperthyroidism, or overactive thyroid, happens when your thyroid gland makes more thyroid hormones than your body needs.
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods. If not treated, hyperthyroidism can cause serious problems with your heart, bones, muscles, menstrual cycle, and fertility. But there are treatments that can help.
What causes hyperthyroidism?
Hyperthyroidism has several causes. They include:
- Graves' disease, an autoimmune disorder in which your immune system attacks your thyroid and causes it to make too much hormone. This is the most common cause.
- Thyroid nodules, which are growths on your thyroid. They are usually benign (not cancer). But they may become overactive and make too much thyroid hormone. Thyroid nodules are more common in older adults.
- Thyroiditis, inflammation of the thyroid. It causes stored thyroid hormone to leak out of your thyroid gland.
- Too much iodine. Iodine is found in some medicines, cough syrups, seaweed and seaweed-based supplements. Taking too much of them can cause your thyroid to make too much thyroid hormone.
- Too much thyroid medicine. This can happen if people who take thyroid hormone medicine for hypothyroidism (underactive thyroid) take too much of it.
Who is at risk for hyperthyroidism?
You are at higher risk for hyperthyroidism if you:
- Are a woman
- Are older than age 60
- Have been pregnant or had a baby within the past 6 months
- Have had thyroid surgery or a thyroid problem, such as goiter
- Have a family history of thyroid disease
- Have pernicious anemia, in which the body cannot make enough healthy red blood cells because it does not have enough vitamin B12
- Have type 1 diabetes or primary adrenal insufficiency, a hormonal disorder
- Get too much iodine, from eating large amounts of foods containing iodine or using iodine-containing medicines or supplements
What are the symptoms of hyperthyroidism?
The symptoms of hyperthyroidism can vary from person to person and may include:
- Nervousness or irritability
- Muscle weakness
- Trouble tolerating heat
- Trouble sleeping
- Tremor, usually in your hands
- Rapid and irregular heartbeat
- Frequent bowel movements or diarrhea
- Weight loss
- Mood swings
- Goiter, an enlarged thyroid that may cause your neck to look swollen. Sometimes it can cause trouble with breathing or swallowing.
Adults over age 60 may have different symptoms than younger adults. For example, they may lose their appetite or withdraw from other people. Sometimes this can be mistaken for depression or dementia.
What other problems can hyperthyroidism cause?
If hyperthyroidism isn't treated, it can cause some serious health problems, including:
- An irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart problems
- An eye disease called Graves' ophthalmopathy. It can cause double vision, light sensitivity, and eye pain. In rare cases, it can lead to vision loss.
- Thinning bones and osteoporosis
- Fertility problems in women
- Complications in pregnancy, such as premature birth, low birth weight, high blood pressure in pregnancy, and miscarriage
How is hyperthyroidism diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, including asking about symptoms
- A physical exam
- Thyroid tests, such as
- TSH, T3, T4, and thyroid antibody blood tests
- Imaging tests, such as a thyroid scan, ultrasound, or radioactive iodine uptake test. A radioactive iodine uptake test measures how much radioactive iodine your thyroid takes up from your blood after you swallow a small amount of it.
What are the treatments for hyperthyroidism?
The treatments for hyperthyroidism include medicines, radioiodine therapy, and thyroid surgery:
- Medicines for hyperthyroidism include
- Antithyroid medicines, which cause your thyroid to make less thyroid hormone. You probably need to take the medicines for 1 to 2 years. In some cases, you might need to take the medicines for several years. This is the simplest treatment, but it is often not a permanent cure.
- Beta blocker medicines, which can reduce symptoms such as tremors, rapid heartbeat, and nervousness. They work quickly and can help you feel better until other treatments take effect.
- Radioiodine therapy is a common and effective treatment for hyperthyroidism. It involves taking radioactive iodine by mouth as a capsule or liquid. This slowly destroys the cells of the thyroid gland that produce thyroid hormone. It does not affect other body tissues. Almost everyone who has radioactive iodine treatment later develops hypothyroidism. This is because the thyroid hormone-producing cells have been destroyed. But hypothyroidism is easier to treat and causes fewer long-term health problems than hyperthyroidism.
- Surgery to remove part or most of the thyroid gland is done in rare cases. It might be an option for people with large goiters or pregnant women who cannot take antithyroid medicines. If you have all of your thyroid removed, you will need to take thyroid medicines for the rest of your life. Some people who have part of their thyroid removed also need to take medicines.
If you have hyperthyroidism, it's important not to get too much iodine. Talk to your health care provider about which foods, supplements, and medicines you need to avoid.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
Metabolism is the process your body uses to get or make energy from the food you eat. Food is made up of proteins, carbohydrates, and fats. Chemicals in your digestive system break the food parts down into sugars and acids, your body's fuel. Your body can use this fuel right away, or it can store the energy in your body tissues, such as your liver, muscles, and body fat.
A metabolic disorder occurs when abnormal chemical reactions in your body disrupt this process. When this happens, you might have too much of some substances or too little of other ones that you need to stay healthy. There are different groups of disorders. Some affect the breakdown of amino acids, carbohydrates, or lipids. Another group, mitochondrial diseases, affects the parts of the cells that produce the energy.
You can develop a metabolic disorder when some organs, such as your liver or pancreas, become diseased or do not function normally. Diabetes is an example.