Columns

A pharmacist explains what to know when you worry about taking many medicines: drug interactions and duplicate prescriptions, with examples such as warfarin and vitamin K2 and duplicated stomach medicines, and how to use a medication handbook and a regular pharmacist.

A nurse explains eating and swallowing problems in ALS (amyotrophic lateral sclerosis): a five-level severity scale for eating (FRS), mouth exercises and swallowing techniques, breathing function and the timing of gastrostomy, and surgery to prevent aspiration.

A nurse explains the options when someone can no longer eat by mouth (tube feeding such as gastrostomy or a nasogastric tube; peripheral or central IV nutrition and subcutaneous infusion; or doing nothing), the pros and cons of each, and what matters most in the decision.

Difficulty eating can sometimes be eased by adjusting the “environment”: posture, the table and the type of meal. A dentist explains checkpoints for foot position, neck angle and the position of food, and which professionals to consult.

A dentist breaks eating by mouth down into recognizing food, chewing (mastication) and swallowing (deglutition), and explains the role of the tongue and how aspiration and swallowing disorders occur.

A registered dietitian explains what carbohydrates do and how much to eat each day: their role as the brain’s energy source, what happens when they run short, excess carbohydrates and body fat, and why being slightly plump rather than thin is said to help older adults live longer.

A registered dietitian explains why protein matters for older adults and how to get enough: muscle loss and fall risk from shortfalls, a simple per-meal guide, easy additions such as eggs in miso soup, canned fish and kinako, and cautions for people with reduced kidney function.

A registered dietitian explains cooking ideas that reduce coughing during meals: why thin liquids, crumbly foods and thin, flimsy foods cause coughing, and solutions such as thickening with potato starch, thick sauces, alternating swallows and swapping ingredients.

A registered dietitian explains cooking tips for older adults whose chewing has weakened: chicken meatballs with tofu, chicken coated in potato starch before simmering, stir-fries with thin shabu-shabu pork, cutting vegetables across the fibers, and peeling tough skins.

A pharmacist explains what side effects are: blood pressure medicine working too well, constipation, allergic reactions and painkillers straining the kidneys, plus tips for noticing side effects early, such as telling professionals about your constitution and having a regular pharmacist.

What to do about a missed dose depends on the medicine. A pharmacist explains why dosing frequency is set as it is (absorption, blood levels, metabolism and excretion), why taking two doses at once is risky, how to decide using a painkiller as an example, and what to ask at the pharmacy.

A nurse explains eating and swallowing disorders caused by strokes such as cerebral infarction and hemorrhage: damage to the medulla, why problems often appear after a second stroke, cases of eating rehabilitation in hospital and at home, and where to seek help.

A dentist explains how dentures may help prevent falls in older adults: age-related changes in walking speed and stride, the higher fall risk of people with 19 or fewer teeth and no dentures, and a study in which denture treatment reduced falls in older people with dementia.

A nurse explains eating and swallowing problems in Parkinson’s disease: how disease progression relates to eating, the risk of aspiration without coughing, taking medication before meals, cohesive foods rather than finely chopped ones, supporting posture, and neck and shoulder stretches.

Older adults living at home in Japan can consult a registered dietitian who visits them. Learn how to make up for shortfalls in protein, vitamins and fiber, use frozen vegetables, cook for people who find chewing hard, and ask a care manager or dietetic association for help.

A dental hygienist explains why oral care is needed even for people who cannot eat by mouth: less saliva and a dry mouth, growing bacteria, a family’s oral care at the end of life, and how to choose and use sponge swabs and oral moisturizers.

Loss of appetite and weight loss may come from problems after swallowing, such as constipation or esophageal disease. Based on home-visit nursing cases, a nurse explains fiber and lactic acid bacteria, eating with a narrowed esophagus, and positions that prevent reflux.

A welfare equipment specialist explains the difference between a silver car (a senior shopping cart) and a wheeled walker: who each is for, long-term care insurance coverage, how the handle changes posture, base of support and fall risk, and preventing a rounded back.

A physical therapist explains breathing techniques that take five minutes a day to keep caregiver fatigue from building up: why fatigue makes breathing shallow and upsets the autonomic nervous system, deep breathing with a chest stretch, equal-interval breathing and alternate-nostril breathing.

A physical therapist explains how caregivers can prevent low back pain: the forward-rounding strain that caregiving puts on the lower back, the idea of “stored fatigue,” a 15-second standing back-arch stretch before and after care, and a bedtime stretch.