Seniors & Epilepsy
For many years, epilepsy was viewed as a condition of childhood. We now know that although epilepsy often does begin in the first decade of life, people are even more likely to have this disorder in their sixties or seventies.
It can be a very upsetting experience to be diagnosed with epilepsy, no matter what your age. For seniors, shattered expectations of the "golden years" can be treated, and possible changes in lifestyle can produce a great deal of stress. For others who have lived with epilepsy all their lives, new challenges and concerns present themselves in the senior years.
About Epilepsy
Epilepsy is known as a seizure disorder. Seizures can take many different forms, including lapses of awareness, episodic shaking, or convulsions. Seizures usually don't last very long, normally only a minute or two, and then they subside.
What Causes Epilepsy?
Most of the time, we don't know why epilepsy occurs. In a few instances, doctors can trace seizures to specific causes such as head injury from a car accident, the aftermath of a serious infection such as meningitis, or even from lead poisoning.
We do know that after the age of 60, other factors come into play. Stroke is the most frequent cause of epilepsy among seniors. Blocked arteries deprive parts of the brain of blood and oxygen, and the resulting damage may produce seizures. Similarly, heart disease can also produce seizures because it too reduces the amount of oxygen to the brain. Other known causes of epilepsy after age 60 include brain tumours, alcohol abuse, kidney or liver failure, and head injuries, often the result of falling.
Treatment
Doctors prescribe anticonvulsants to treat epilepsy. These drugs are very successful in preventing or dramatically reducing the frequency of seizures. A lower dosage is often prescribed for seniors because of changes in the way the body absorbs, processes and eliminates drugs.
Seniors often are required to take other types of medications for various conditions. It is vitally important to make physicians and pharmacists aware of all medications you are currently taking. Certain drugs, prescriptions, as well as over-the-counter medicine, may negatively interact with epilepsy medication. Even an antacid or headache tablet could cause a potentially dangerous drug interaction.
People may experience greater sensitivity to medications as they age. Combinations of drugs may produce altered moods and changes in behaviour. When a senior suddenly becomes depressed, forgetful, anxious, extremely tired, or in any way feels different than they usually do, it is important to tell the doctor. It may be possible to completely eliminate these side effects by adjusting or changing medications.
NEVER STOP ANTICONVULSANT MEDICATION ON YOUR OWN.
It can be difficult to keep track of medications, particularly if a person is required to take various types, at different times of the day. Many seniors find that memory aids such as charts, pill-boxes with divided segments, and wristwatch alarms are useful to ensure that medicine is taken correctly.
Driving
Anyone, regardless of age, who has a seizure disorder should discuss with a neurologist whether or not it is safe to drive. If driving is not an option, seniors may choose to use public transportation, or obtain assistance from local transportation services designed for seniors and disabled persons.
Other Concerns
When a senior is diagnosed with epilepsy, one of the unfortunate reactions of well-meaning family members, is over-protectiveness. Although they may have the best of intentions, families can unnecessarily cause a senior to forfeit his or her independence.
For the most part, seniors who are generally in good health can continue to live independently. Technology can offer helpful solutions for concerned family members. Portable phones, beepers, and wall or neck alarms can reassure families that help is within reach if it is needed. The most important thing is to discuss these issues, perhaps in the presence of an objective third party such as a physician, so that everyone feels comfortable with a senior's living arrangements.
Many seniors remember when epilepsy was incorrectly regarded as a form of mental illness. In the not so distant past, people with seizures were shunned, sent off to institutions, or kept isolated at home. But thankfully, times are changing. Epilepsy is now a well understood neurological disorder, no different than any other physical illness. For the most part, seniors can continue to live a full, productive life, with only minor adjustments to lifestyle.
Seizures Among Seniors on the Rise
A rising incidence of epilepsy among seniors - and a lack of research on epilepsy in older patients - may pose problems for Canadians physicians who care for an aging population.
Although many believe that epilepsy primarily affects children and young adults, this neurological seizure disorder can strike at any age. Recent studies, published in medical journals such as Neurologic Clinic, indicate that the incidence of epileptic seizures rises substantially in people over 65 years of age. Despite the well-documented prevalence of epilepsy in seniors, the same studies further state that more research is required to improve clinical care for patients in this age group.
Dr. Joseph Bruni, head of neurology at The Wellesley Hospital in Toronto, Ontario, and associate professor of medicine at the University of Toronto, says that his experience confirms these findings.
"The incidence of epilepsy peaks in childhood, plateaus in the adult years, then rises rapidly again in people over the age of 65," he states. "After dementia and stroke, epilepsy is the most common neurological disorder found in seniors, yet we know little about treatment and prognosis in this age group."
In view of Canada's aging population, the need to learn more about how to deal with epilepsy in seniors has some urgency. Between 2011 and 2031, the largest generation in Canadian history - the "Baby Boomers" - will be turning 65. During that time, Statistics Canada estimates that the number of Canadian seniors will nearly double, growing from 12 per cent today to more than 23 per cent.
Experts like Dr. Bruni warn that the prevalence of epilepsy in older people and the rapidly aging population point to a health-care problem that must be addressed by the medical community.