How to Do Self-Screening for Better Health Monitoring

Reviewed By: Rebecca Anderson, FNP-BC

When it comes to taking care of your health as a senior, staying on top of your self-screening routine is key. Although healthcare professionals are there to give screening tests and predict which health issues to look out for, you play an equally important role in this process. Self-monitoring and screening don’t replace professional healthcare, but they complement it by giving an extra layer of caution and protection. Don’t know where to start? We’ve got you. In this guide, you’ll learn all about the purpose and process of self-screening, helpful tools to use, and the types of screenings you should do.

Understanding the Purpose and Limitations of Self-Screening

Self-screening, also called self-monitoring or self-testing, is the process of assessing whether you may have signs of a certain condition at home [1]. If you notice any warning signs during a self-screening, bring them to the attention of your healthcare provider for a thorough examination.

Self-screenings help identify areas of concern that you should get checked out by a professional. For example, if someone finds a lump in their breast while doing a breast cancer self-screening exam, that lump signifies that they should get a mammogram or breast ultrasound for further information. Self-screenings cannot provide a definite diagnosis of a disorder or condition without the help of a healthcare professional. Do not self-diagnose; if you discover something concerning while self-screening, see your doctor for a professional opinion [2].

Essential Tools for Effective Self-Screening

The type of tools necessary for effective self-screenings depends on the conditions for which you are screening. Some common self-screening exams and the tools they require include:

Self-screening or monitoring for hypertension (high blood pressure) [3]: If you are at risk for hypertension, using a blood pressure monitor for self-screening or self-monitoring at home can be helpful. Bring results to your doctor for a formal diagnosis, or track your results to provide your doctor more information about an existing diagnosis.
Self-screening or monitoring for chronic conditions affecting weight [3]: Using a digital scale to help track changes to your weight can alert you to warning signs of many chronic conditions, which you should bring up with your healthcare provider.
Self-screening for sleep disorders [4]: Smart watches can capture your sleep patterns, which may provide insight into possible sleep disorders. Track your sleep and consult with your doctor if you have concerns.
Self-screening for skin cancer [5]: You can self-screen for skin cancer by looking for lumps, bumps, discoloration, or other areas of concern using a full-length mirror and a hand-held mirror. Take note of any areas you’d like to discuss with your doctor.

Similar to smart watches, there are other digital tools available for tracking your health metrics and providing more data for screening. Some of these tools include:

Pedometers, which track your steps [6]
Food-tracking apps, which keep track of your meals, hydration, and calories [6]
Electrocardiogram sensors, which track your heart rate and activity [6]
Fall detectors, which detect if you have fallen [6]

With the help of these tools and self-screening exams, you’ll be on top of your health and ready to report any possible issues to your doctor.

Physical Health Self-Screening Techniques

Cardiovascular Health Assessment

When monitoring blood pressure, there are a few best practices to make yourself aware of. First, make sure you have the proper equipment. According to the American Heart Association, using an automatic, cuff-style, upper arm (biceps) monitor is best for this [7]. Next, plan a time to monitor your blood pressure when you haven’t had coffee, alcohol, or exercised within 30 minutes before monitoring. Place the cuff on the bare upper arm at heart level and follow the instructions that come with the monitor to take the measurement. This will also measure pulse rate. It’s best to keep a blood pressure log to assess changes.

To monitor pulse rate and heart rhythm, use a heart rate monitor [8]. Depending on the type of monitor, you’ll wear this either around your wrist, forearm, or finger. Record your results and bring them to your doctor’s appointment.

When monitoring for cardiovascular conditions, certain symptoms should be considered red flags. Contact your doctor right away if you experience: sudden or significant changes in blood pressure or heart rate (very high, very low, or irregular), shortness of breath, especially at rest or when lying down, chest pain or pressure, swelling in the legs, ankles, or feet, unexplained or rapid weight gain (e.g., more than 2–3 pounds in a day or 5 pounds in a week), lightheadedness, dizziness, or fainting, or excessive fatigue or sweating without exertion[9]. These symptoms—and others—may be signs of a serious cardiovascular condition.

Skin Health Examination

To self-screen for skin conditions, thoroughly check all areas of your skin for lumps, bumps, discoloration, rashes, itching, and other abnormalities [10] using a hand mirror, full-length mirror, and/or the help of a loved one. Think of the acronym “ABCDE” to know what to look for [10]:

Asymmetry: Is one side of the area of concern shaped differently than the other?
Border: Is the border of the area of concern uneven or jagged? Does it have poorly defined edges?
Color: Are there multiple or uneven colors within the area of concern?
Diameter: Is the area of concern larger than a pencil eraser? Has it grown larger over time?
Evolution: Has the area of concern changed in size, color, or shape?

Take note of areas of concern so you can bring them up with your primary care doctor or dermatologist, and/or take photos of the areas for reference (if you are comfortable).

Some skin red flags that require immediate medical attention are bleeding bumps that don’t go away, visible veins or blood vessels, discoloration, changes in nail appearance, and slow-healing wounds [11], to name a few.

Mental Health Self-Assessment Approaches

There are many tools and resources to help you self-assess mental health conditions and concerns at home. Mental Health America (MHA) has screening questionnaires you can fill out before visiting a primary care physician to give you a better idea of your signs and symptoms [12]. You can also track your mental health by writing down any concerning thoughts or feelings each day and bringing them to your doctor.

Sleep is very connected to mental health, and poor sleep quality can exacerbate the symptoms of many mental health disorders [13]. Because of this, you may want to self-screen for sleep disorders if you are struggling with both sleep and mental health.

Self-screening and monitoring cognitive function is also important, especially for older adults, who often experience a natural decline in cognition with age [14]. To assess cognitive functioning, ask your doctor about their recommendations for at-home cognitive tests.

Specialized Self-Screening for Common Health Concerns

Diabetes risk assessment: To monitor your blood sugar levels and self-screen for diabetes, use a blood glucose testing kit from your local pharmacy [15]. The kit should include test strips, lancets (small needles used to prick your finger to draw blood), and a booklet to log your levels. Follow the instructions and bring your results to your next doctor’s appointment.
Breast self-examination: To self-screen for breast cancer, lie down and gently but firmly check the entire breast area (including the armpit) for lumps, knots, or any other abnormalities—even if they aren’t painful [16]. If you find any, notify your doctor and have them do a formal exam.
Testicular self-examination: To check for testicular cancer, in the shower, gently check the surface of the testicles for lumps, bumps, swelling, or any abnormalities—even if they aren’t painful [17]. Discuss any abnormalities with your doctor.
Respiratory health self-assessment: To screen for respiratory conditions, like asthma, ask yourself these self-assessment questions from Mount Sinai [18] about your breathing. If you answer “yes” to any of the questions, alert your doctor at your next appointment.
Digestive health tracking: To screen for digestive health issues, take the World Gastroenterology Organization (WGO) questionnaire [19] and discuss your answers with your doctor.

Creating a Personalized Self-Screening Schedule

You may wonder how often you should self-screen for health conditions. There isn’t one correct answer—the frequency of self-screening depends on your risk for developing certain health conditions. However, as a general rule of thumb, you should self-screen more regularly as you age, since older adults are at higher risk for chronic conditions [20]. Ask your doctor about the specific conditions you should self-screen based on your health history. Certain factors may affect this, like family history, pre-existing conditions, and gender. Some common conditions that older adults should get regular screenings for include, but are not limited to, high blood pressure, vision issues, cancer (breast, cervical, lung, skin, etc.), and high cholesterol [21]. You can self-screen for most of these conditions, but ask your healthcare provider for specific advice and directions.

To make self-screening easier to remember, integrate it into your regular routines. For example, if your doctor recommends a monthly skin check for skin cancer, try associating it with an existing routine or habit. For example, each month when you pay your credit card statement, remember to perform a skin check. If your self-screening schedule isn’t as frequent, associate it with an activity you only do yearly, like filing taxes or spring cleaning your garage. Remember, any concerns you find during self-screening require professional follow-ups. Try scheduling your monthly or yearly appointments in advance. When you receive the reminder that your appointment is approaching, this can also act as a reminder to perform self-screening.

Technology-Enhanced Self-Screening Options

When it comes to technology-based screening tests, it’s important to understand the pros and cons. Technology-enhanced screening options can become popular quickly, but reliability and accuracy must be the top priority—and some of these options may fall short in this department.

Wearable health monitors, like smartwatches and pedometers, give us a hands-free option to easily track health data, such as step count, heart rate, and sleep habits. They are small and convenient, allowing us to transfer data from the device to a smartphone for later reference. However, many of these wearable devices have a short battery life and inaccurate data measurements [22], which is why it’s important to do research, ask for personal recommendations, and read reviews about which wearable device to purchase.

Smartphone-based screening tools often rely on wearable device data and self-questionnaires to screen for health conditions. These tools can create detailed, personalized recommendations based on your results. However, because they are based on self-reflection, inaccuracies may be created due to bias or a lack of understanding about your symptoms.

Finally, home test kits are often accessible and affordable, as they can typically be purchased at your local pharmacy without a prescription. These tests tend to be simple, coming with short and easy-to-understand instructions anyone can follow. However, at-home test kits can have inaccurate results, possibly leading to a delay in diagnosis or treatment [23]. This is why you should not rely solely on at-home test kits—always get professionally tested for health conditions by your doctor.

Interpreting Your Results: From Data to Action

To understand your self-screening results, you first must have a general understanding of what is typical vs abnormal for what you’re testing. For example, if you are self-screening for high blood pressure, you should know that a systolic (top number) reading of 120 or higher and a diastolic (bottom number) reading of 80 or higher signifies that you may have elevated or high blood pressure [24]. If you don’t have this prior knowledge, you wouldn’t know exactly what these numbers mean and if they should warrant a conversation with your doctor. This is the same for all self-screening tests—you must first know the warning signs to look out for before starting the test to make the best use of your results.

A pattern of abnormalities should likely strike more alarm than isolated abnormalities. For example, if you experience a headache one day, but it goes away and doesn’t lead to any other symptoms, there is likely no reason to be concerned that it’s a sign of a more serious condition. However, if you experience persistent headaches that do not subside, it may be a sign of a condition, and you should consult a professional. Some isolated instances, though, should be of concern or warrant an examination. These include, but are not limited to, abnormal lumps, bumps, or growths, intense and painful headaches, chest pain that radiates into your jaw or back, anaphylactic allergic reactions, and unusual bleeding without cause [25].

Health professionals base many of their treatment plan decisions on their documentation of your health over the years. This is why it is important to share your documentation from self-screening with them so they can incorporate this data into their consideration. Instead of interpreting your results, bring them to your healthcare provider so they can make more informed and educated decisions about your health.

When to Seek Professional Medical Evaluation

Let’s break down urgent vs non-urgent concerns when it comes to what you find in self-screenings. As mentioned previously, if you find anything that is causing significant pain, alarm, or disruption to your life, alert your healthcare provider immediately. Abnormal symptoms that arise suddenly, like sharp pain, swelling, bleeding, weakness, or numbness, are signs that a serious reaction or medical emergency is occurring [25]—contact 911 immediately. Non-urgent concerns may not be emergencies, but are still important to get checked. Make a prompt appointment with your healthcare provider for a professional examination.

To communicate your self-screening findings, provide your findings in as much detail as possible to your doctor. Describe the area of concern—when you noticed the abnormality, how it feels, how long it has lasted, the frequency of your symptoms, etc. Discuss prior conditions or risks, as well as all medications you are taking, as these may have affected the area of concern. If you have seen a specialist for a health concern, make sure their notes are shared with your primary care physician, as this can help make a more conclusive and detailed diagnosis and treatment plan.

Self-Screening for Special Populations

Certain factors play into the frequency and types of screenings you should receive. Family history of a condition can drastically increase your risk of developing that condition—it can even increase the chances of developing that condition earlier than expected [26]. Alerting your healthcare provider of your family history will help them make better considerations for necessary screenings, assessments, and treatments based on your risk [27]. Make sure you have a decent knowledge of your family history so that you can provide as much information as possible to your doctor. If possible, ask your family members for their health history.

Your background may also play into your risk for certain health conditions. Certain groups of people are more susceptible to specific health conditions than others. For example, studies have shown that Black individuals—Black women, in particular—experience hypertension at significantly higher rates than Caucasian men and women [28]. Research has shown that this is likely due to the detrimental amounts of chronic stress Black individuals have faced over generations of discrimination and structural racism [28]. This is similar for other groups. Hispanic individuals are at a significantly higher risk for obesity, diabetes, hypertension, kidney disease, and liver disease than Caucasian individuals, primarily due to social determinants of health [29]. These implications must be taken into account by both the individual and their healthcare provider when screening and treating health conditions.

Building Your Comprehensive Self-Screening System

Understanding your responsibility to self-screen for health conditions—especially those you are at risk for—is a vital step in advocating for your health. With the help of screening tools, your support system, and your healthcare team, you can monitor your health effectively and proactively. Self-screening and professional medical care are a balance, working hand-in-hand to create a screening and care plan fit to your specific needs and risks.

References:

The Dos and Don’ts of Medication Management for Older Adults

Reviewed By: Laureen Lopez Berry, DNP, FNP-C

Multiple prescriptions, busy days, and a tendency for forgetfulness do not mesh well in the world of medication management. It’s quite easy to lose track of which medications you need to take, which you have already taken, and where you placed your medication bottles. Research shows that almost 50% of seniors struggle with managing their medications due to issues with administration, sticking to a schedule, access, and more [1]. Although many can relate to the struggle of properly organizing and managing their medications, it is not a subject to take lightly. Medication management is one of the most important skills seniors can possess to ensure that they properly treat their conditions. This not only keeps seniors healthy and safe but can also impact their overall quality of life and sense of independence. Let’s learn more about the dos and don’ts of medication management for older adults, as well as some tips and tricks for becoming a medication management expert.

Understanding the Challenges: Why Medication Management Gets Complicated

You may think that remembering to take your medication every day is simple enough, but there is often more to it than meets the eye. This can get complicated for several reasons:

Polypharmacy, or taking multiple medications at the same time, can make managing your prescriptions confusing. Adults over 60 years old who take more than one medication at a time are at risk for drug interactions, oversedation, dizziness that can lead to falls, and other complications [2]. They may also continue to take a medication prescribed to them in the past that is no longer needed, which increases the risks for dangerous health effects [3].
Age-related factors can affect medication processing. The combination of the natural effects of aging, existing conditions that are more prevalent among seniors, and side effects puts seniors at high risk for age-related medication complications [4].
Common barriers to medication adherence can make managing medications difficult for seniors. These barriers include a lack of understanding about the prescription and side effects, unclear instructions on administration, improper handling and storing, low health literacy, and a lack of support [5].
Cognitive changes that often arise with age [6] may increase forgetfulness or a sense of clarity. This can make seniors confused about how to take their medications, where they last put them, how often to take them, and even what conditions they have.

Essential DOs: Medication Management Best Practices

Medication Reconciliation and Documentation

The first step of successfully managing your medications is knowing exactly what you take and for what conditions. To accomplish this, create a complete medication list of every prescribed medication, over-the-counter medication, herbal supplement, and vitamin you take. Include essential information about each medication, including how often it should be taken, for what condition or ailment, and any side effects you should be aware of. Update this list often; add any new medications you start taking and cross off any medications you stop taking.

While creating this list, questions about prescriptions may arise. Contact your healthcare provider for more information about these prescriptions and answers to your questions. You may also find the answer to your question on your prescription, such as the dose prescribed and administration instructions. Although paper prescriptions are traditional, digital medication documentation has become popular in recent years. Electronic prescriptions and digital medication documentation work like physical paper prescriptions, except they reduce the risk of errors due to illegible handwriting, expedite the time it takes for pharmacies to receive and start filling the prescription, and improve patient safety by automatically flagging contraindications between medications within the electronic system [7].

Organization Systems That Work

If your drawers and cabinets are filled to the brim with medication bottles, it’s time to find a more effective organization system. The method of organization that works best for you depends on how many medications you take and how often. Still, people tend to gravitate toward daily, weekly, and monthly pill organizers. Daily pill organizers work best for individuals who take different pills at different times of the day [8]. They typically have three compartments: one for the morning, one for midday, and one for night. You can store all the pills you take in the morning in the first compartment, the ones you take midday in the second compartment, and the ones you take at night in the last compartment. The downside is that you must take the time to fill the daily pill organizer every day before you take your medication.

Weekly pill organizers typically have seven compartments: one for each day of the week. The perk of this organizer is that you only have to fill it once at the start of the week, but the downside is that it may not be suitable for complex pill regimens [8]. Finally, monthly pill organizers have 31 compartments and only need to be filled once a month—but, again, they may not work well for complex regimens.

To ensure you don’t forget to take your medications, it’s a good idea to set up reminders. If you constantly have your mobile phone with you, consider setting repeating alarms or reminder notifications for when it is time to take your medications, and be sure to clarify what medication needs to be taken. Suppose you are not on electronics a lot. In that case, it may be more effective to set visual reminders, such as placing your pill organizer on your nightstand or bathroom counter where you will see it every morning, or placing a sticky note reminder on your fridge. For complex medication regimens, write out the full regimen in detail and place the schedule in a location where you’ll see it often.

Critical DON’Ts: Medication Management Pitfalls to Avoid

There are a few big “DON’Ts” to avoid at all costs when it comes to medication management. First, never adjust your medication dosage without speaking with your healthcare provider first. If you believe you don’t need to take as much (or any) of the medication anymore, speak with your healthcare provider for their professional advice before reducing or stopping the dose [9]. Likewise, always talk to your healthcare provider before increasing the dose, as this can lead to dangerous and potentially fatal reactions [10].

How you store your medications is also an integral part of safe medication management. Each medication has guidelines on storage recommendations, but typically, medications should be stored in cool and dry places, away from sunlight [11]. Optimal storage temperatures range from 59-77 degrees Fahrenheit, and if you store the medication in a temperature outside of this range, you could risk decreased effectiveness [11].

Another major “don’t” is sharing or borrowing another person’s medication. Perhaps you forgot to pick up your prescription from the pharmacy in time, but your friend takes a similar medication. Or maybe you want to save the cost of a doctor’s appointment by borrowing your friend’s medication for a condition you have. Although these scenarios may be tempting, it is extremely dangerous to borrow and share medications. Borrowing and sharing medications can increase the risk for harmful side effects, complications, dosing errors, and a delay in seeking personalized healthcare [12].

Finally, a pitfall you should be aware of is the potential danger of cutting pills. Splitting pills to half the dose is common, but there are a few things to look out for when doing this. First, always check with your doctor or pharmacist before deciding to cut a pill. Some pills are not meant to be cut in half. Typically, only pills with a score line across them should be split, although not all of these are intended to be cut [13]. If your doctor or pharmacist confirms that your pills can be divided, it’s important to use a pill splitter to do so. Never use a knife or try to break the pill in half yourself. It’s always best practice to speak to a healthcare professional about the specific medication before splitting it so they can decide if it’s appropriate and teach you how to go about this.

Working Effectively with Healthcare Providers

Before your next appointment with your healthcare provider, update your medication list and write down any questions you have about your prescriptions. This is the perfect time to clarify concerns about storage, administration, or reducing the amount of medications you take. If you see multiple physicians for different conditions, provide their information to your primary care physician so they can coordinate care and create a medication plan that works best for you.

Technology Solutions for Enhanced Medication Management

In recent years, technological advancements have made medication management easier for seniors. For example, medication reminder apps like Dosecast and medication/prescription management apps like Medisafe help you stay on top of tracking your daily medications and prescriptions, so you can feel confident and organized.

To alleviate the burden of unscrewing bottles of medication with pesky caps, automated dispensing systems make taking medications quick and easy. Automated dispensing systems store and dispense pills as well as track missed doses [14]. As always, ask your doctor which type of dispenser may be right for you. A similar product that may help is a smart pill bottle, which tracks the time an individual takes their medication and provides reminders or alerts when they are late for their dose [15].

Managing Specific Medication Challenges

Addressing Swallowing Difficulties

You should never feel embarrassed to tell your doctor that you have trouble swallowing pills. Many people struggle with this. Up to 40% of adults struggle to swallow pills [16]. There may be alternative routes to swallowing pills depending on the particular medication, such as liquid, chewable, or dissolvable forms.

Never crush up a pill before asking your doctor about it first. They can best advise whether or not this is safe. Crushing certain pills can be extremely dangerous and can even lead to death, as many pills have special coatings that prevent the medication from releasing all at once [17]. Crushing the pill destroys this coating and can allow a dangerous amount of the medication to release.

Work with your doctor and pharmacist to find alternatives or practice techniques that make it easier to swallow your medication. For example, they may suggest practicing swallowing the medication with applesauce instead of water [18].

Managing Complex Timing and Instructions

While some medications may not require specific timing requirements, others have ones you must follow for the medication to work properly [19]. Always ensure you fully understand the timing requirements of your medication before leaving your appointment. Your doctor is there to answer any questions you may have about when to take the medication, how many times a day to take it, if it needs to be taken with food, etc. To adhere to these requirements, set automatic reminders on your phone that go off at the same time every day. You can also utilize smart pill bottles, as mentioned previously, or ask a loved one to remind you to take your medication at the same time.

Likewise, just because a medicine says it should be taken “as needed” doesn’t mean there are no precautions regarding how often you should take the medication. Always read the label of the medication and ask your doctor about how often you should take an “as-needed” medication, how many pills are appropriate in one day, and any other requirements.

You should tie your medications’ requirements into your daily routine. For example, if certain medications need to be taken in the morning with food, it’s best to wake up around the same time each day and eat breakfast before taking your medication. This will ensure that you take the medication at the same time each day and that you don’t experience side effects due to taking it on an empty stomach. Likewise, if you have a busy schedule, create a plan for how you will take your medications on the go so you don’t forget or lose your medications while you are busy.

The Role of Caregivers in Medication Support

Having a caregiver help manage your medication can make a huge difference in the ease of this process. But how much help is too much help? Everyone’s experience is different, and therefore, the amount of help you may need depends on your conditions, lifestyle, and responsibilities. For example, if you have conditions that affect your memory, you may require extra assistance with taking your medications on time every day. Likewise, if you have issues with mobility or dexterity, you may need someone to open your medication bottles and help you take your medications. It’s important to have a conversation with both your caregiver and your doctor about what medication responsibilities you can and can’t handle so that you can make an appropriate support plan.

While your caregiver may be responsible for reminding you to take your medications or being present while you take them, it’s important to maintain a certain level of independence. Although your caregiver may be handing you your medications, try to stay present during the process and understand why you are taking the medication. Make sure to tell your doctor and caregiver about side effects you may experience.

There may be some times in your life when you can handle managing your medications on your own, and some when you’ll need the extra help. Both are okay.

Medication Safety and Emergency Preparedness

It’s essential to be aware of the warning signs of adverse reactions. Common adverse reactions to a medication include, but are not limited to, upset stomach, dry mouth, and drowsiness [20]. While these adverse reactions are common and may not be dangerous, more severe reactions can also occur, like fever, swelling, wheezing, and even anaphylaxis [21]. If you experience an alarming reaction, call emergency medical help immediately. In case of emergencies, it’s smart to carry a list of all the medications you are taking with you at all times. You can keep this list in your wallet or purse.

You’ll also want to consider how to maintain your medication schedule when your normal schedule changes. For example, if you are traveling, ensure you bring enough of your medication with you to last for the entirety of your trip, plus a few extra days. You never know when a travel delay could occur.

Finally, it’s important to understand how to properly dispose of your medications. If you must dispose of your unused or expired medication, drop it off at a drug take-back location or mail it using a drug mail-back envelope [22]. If you are unable to dispose of them these ways, check the FDA flush list and see if your medication is on it. If so, flush the medication down the toilet [22]. If not, follow these FDA directions for throwing away your medications.

Building Your Personalized Medication Management System

Now that you know the dos and don’ts of medication management, assess your current medication management techniques and which areas need improvement. Implementing improved organization and safety habits can take time and support, but they are essential for your health. For ongoing medication management support, reach out to Greater Good Health. We will be there for you every step of the way as you navigate your medication journey.

References:

The Truth About Drug Interactions: What Everyone Needs to Know

Reviewed By: Laureen Lopez Berry, DNP, FNP-C

If you take more than one medication, you are potentially at risk for drug interactions. Drug interactions describe when the efficacy or safety of one medication is affected by another medication, multiple other medications, medical conditions, food, beverages, or supplements [1]. As the number of medications you take increases, so does your risk for drug interactions [2]. Seniors are at particularly high risk for drug-drug interactions because they tend to take multiple medications for chronic conditions [3]. In this guide, we’ll go over the types of interactions, the most common interactions, and warning signs to empower seniors to identify and prevent the dangerous effects of drug interactions.

Understanding Drug Interactions: Beyond the Basics

Despite popular belief, drug interactions don’t only occur when one drug doesn’t react well with another. Other less-suspected causes, like eating certain foods, can cause dangerous interactions with your medications. The types of drug interactions include [4]:

Drug-drug interactions occur when one medication affects another medication (or multiple medications). This includes both prescription and over-the-counter medications.
Drug-food/beverage interactions occur when a food or drink you consume affects a medication you take.
Drug-supplement interactions occur when a supplement or vitamin you take affects a medication you take.
Drug-condition interactions occur when a medical condition you have affects a medication you take.

Drug interactions occur because certain medications can alter the way your body processes others [5]. For example, ingredients and chemicals in one drug can increase or decrease how much, how quickly, and how effectively your body absorbs other drugs.

Not everyone is at equal risk for drug interactions. Seniors and individuals who take multiple medications at once are the most vulnerable to the dangers of drug interactions [6]. However, anyone can experience a drug interaction of any degree [7].

Minor drug interactions occur when an interaction limits the effectiveness of a medication.
Moderate drug interactions occur when the symptoms of an individual’s conditions significantly worsen due to decreased effectiveness of the drug or higher prevalence of side effects.
Severe drug interactions occur when the effects of a drug interaction are life-threatening or require medical intervention.

Common High-Risk Medication Combinations to Avoid

It’s important to check your specific medication labels and consult with your healthcare provider about potential drug interactions. However, the following are common high-risk combinations that increase the chance of a serious interaction:

Interactions with blood thinners: Blood thinners help prevent blood clots, which can reduce the risk of serious conditions such as heart attacks, strokes, and pulmonary embolism [8]. However, these medications can interact with certain supplements and over-the-counter drugs, increasing the risk of internal bleeding. Substances such as ginkgo biloba, garlic, high doses of fish oil, and NSAIDs (nonsteroidal anti-inflammatory drugs, like ibuprofen and naproxen) can enhance the anticoagulant effect. These interactions can be dangerous and should be closely monitored. Patients taking blood thinners should always consult a healthcare provider before starting any new medication [8] Patients taking blood thinners, especially apixaban or rivaroxaban, should also avoid grapefruit and grapefruit juice unless cleared by their provider. Even though interactions with warfarin are less consistent, caution is still warranted [9].
Interactions with selective serotonin reuptake inhibitors (SSRIs): SSRIs, also commonly called antidepressants, increase the level of serotonin in the brain to treat mental health disorders like depression and anxiety [10]. Consuming certain substances while taking an SSRI can increase the risk of developing serotonin syndrome, which is when the body produces too much serotonin, leading to serious side effects [11]. These substances include, but are not limited to, St. John’s wort, triptan medications (for migraines), and some prescription nausea medications [12].
Interactions with blood pressure medications: Blood pressure medications, also called antihypertensives, work to treat hypertension. Taking hypertensives with NSAIDs may cause adverse effects [13].

Food and Medication: Unexpected Interactions in Your Kitchen

Grapefruit and Medications: A Surprising Danger

Grapefruit, the delicious and seemingly harmless fruit, actually has some serious dangers when it comes to drug interactions. You may have noticed that some of your medication labels advise you to avoid eating grapefruit while using the medication. Why is this? Your body breaks down, or metabolizes, many types of medications by using an enzyme in the small intestine [14]. Grapefruit can block this enzyme, so your body can’t metabolize the medication as easily. This means that more than the safe amount of the medication can stay in your body, and for too long.

Check your specific medication’s label and ask your doctor to see if it’s safe to eat grapefruit while taking it. The medication groups that are most commonly affected by grapefruit include, but are not limited to, drugs used to treat high cholesterol, high blood pressure, anxiety, Crohn’s disease, ulcerative colitis, and abnormal heart rhythms [14].

Although grapefruit is the main culprit for these adverse drug effects, other citrus fruits can cause similar issues. As a safe measure, if your medication says to avoid eating grapefruit, you should also avoid eating pomelos, tangelos, and Seville oranges [15]. As far as non-citrus fruits, though, you’re safe to enjoy!

Other Common Food-Drug Interactions

There are some other foods you’ll want to check with your doctor about before starting certain types of medications. These foods include:

Dairy products: Avoid consuming dairy products, like milk, cheese, yogurt, and butter, for 3 hours after taking antibiotic medications, as dairy can affect how the body absorbs antibiotics [16].
Leafy greens: Eating large amounts of leafy greens and other foods high in Vitamin K can interfere with the way that blood thinners and anticoagulant medications work [17].
Tyramine-rich foods: Those who take monoamine oxidase inhibitors (MAOIs), a type of antidepressant, should avoid foods high in tyramine, which include fermented, aged, overripe, or spoiled foods [18]. This is because MAOIs make the body unable to break down tyramine, and too much tyramine can lead to issues like high blood pressure.
High-sodium foods: Eating foods high in sodium while taking painkillers can increase the risk for high blood pressure and heart disease, especially among seniors [19].

Supplement and Over-the-Counter Medication Risks

Similar to the way you must avoid certain foods while taking some medications, you may need to do the same for supplements and over-the-counter medications. Here is what to look out for:

Check if any herbal supplements interact with your medication. Herbal supplements, such as St. John’s wort and Ginkgo biloba, to name a few, have been shown to have negative effects on multiple medications’ efficacy and safety [20].
Assess whether common vitamin supplements could affect your medication. Vitamins may seem harmless, but some can disrupt the balance of your medication [21].
Ask your doctor before taking over-the-counter pain relievers with your medication. Painkillers may seem safe if they can be bought over the counter, but this does not mean they won’t interact with your prescription medications. Always ask your doctor about the potential interactions between your new medication and over-the-counter drugs—they may cause serious adverse events [22].
Be careful about natural sleep aids. Many people use natural sleep aids, like melatonin, to help them fall asleep at night. However, natural sleep aids can sometimes interact with medications and make you overly sedated [23].

Using Drug Interaction Checkers Effectively

There are many free and reputable online tools for checking if there are any potential interactions with your new medication. For example, the Drugs.com interaction checker shows a detailed list of all possible interactions. To use it, simply enter the name of your new medication as well as the name(s) of the medication(s) you are already taking. The checker will assess any potential interactions between all of these medications.

Remember, you should always check with your doctor and/or pharmacist if you have any questions about drug interactions or want to confirm the results of your online drug interaction checker.

Creating a Personal Medication Safety System

To create your own medication safety system, organization is key. Start by creating a complete list of all the medications (both prescription and over-the-counter) and supplements you take, as well as all the conditions you have. Bring this list to your next doctor’s appointment and ask them to check any new prescriptions against your list. Your pharmacist can also help you understand potential drug interactions.

Special Population Considerations

Older Adults and Multiple Medication Risks

As previously mentioned, seniors are at increased risk for drug interaction vulnerability. Older adults process medications differently than younger individuals, which may exacerbate their side effects and potential interactions with other substances or conditions. For example, kidneys tend to weaken as we age, and this can affect older adults’ ability to remove medications as quickly and effectively [24].

Certain medications prescribed to seniors for common conditions have high interaction risks, such as drugs for managing blood pressure, seizures, anxiety, and chronic pain [24]. To best understand the interactions your medications may have, have an in-depth conversation with your healthcare provider and/or pharmacist. If you are concerned about the number of potential interactions, consider reducing the number of prescription medications you take and talk about this possibility with your doctor before making any changes.

Chronic Condition Medication Interactions

Chronic conditions common among seniors can increase the risk of dangerous drug interactions. Some of these chronic conditions include:

Diabetes medications have high interaction rates with cardiac drugs, pain relievers, antibiotics, diuretics, and more [25].
Heart disease treatments, such as statins, can interact with fibrates, transplant medications, blood thinners, HIV medications, and more [26].
Pain management medications may interact with medications for hypertension, lithium, narcotics, and alcohol [27].
Mental health medications, such as SSRIs, have common interactions with blood thinners, NSAIDs, and other antidepressants [28].

When to Seek Help: Warning Signs and Emergency Response

Even if you read the drug label, use an interaction checker, and speak with your healthcare provider, there’s still a chance that medication interactions can occur. Signs and symptoms of a serious medication interaction can range from mild to serious. Interaction symptoms include rashes on the skin, bruising, bleeding, swelling, nausea, confusion, abnormal heartbeat, and more [29]. If you experience any of these symptoms, contact your doctor immediately. Call for emergency help (911) if you experience symptoms of an overdose or allergic reaction, and/or severe side effects. As a general rule of thumb, you should always seek emergency care rather than non-urgent care when your symptoms require immediate care, like trouble breathing, bleeding that won’t stop, severe chest pain, unconsciousness, or inability to move [30].

Your Medication Safety Action Plan

Now that you understand the dangers of drug interactions, we hope you will take the key steps to implement medication safety measures into your everyday life. Remember, your care team and loved ones are there to answer any questions you may have and support you throughout the process. For more support on medication management and wellness tips, contact Greater Good Health today.

References:

Heat Safety Tips: Staying Cool and Hydrated in the Summer Months

For many, the last few months have been tough because of the sweltering summer heat. But for seniors, dealing with the heat could be more difficult – even more dangerous. As we age, adjusting to the heat becomes more challenging due to the changes in our body as well as possible complications brought by chronic diseases and medications. Seniors want to enjoy their summers too! So, how can they stay cool and hydrated this season without staying inside the whole time? Keep reading to learn more.

Understanding Heat Vulnerability in Older Adults

Aging affects the way the body responds and tolerates heat. Spending a significant amount of time in harsh heat can lead to adverse effects such as deterioration of the muscles, kidney failure, and decreased mental function [5].

Our bodies are wired to control a healthy internal body temperature through a process called thermoregulation. This involves vasodilation (widening of blood vessels) and sweating to bring the heat closer to the surface and evaporate it away. This process becomes less efficient as we get older.

Furthermore, the presence of health problems such as heart disease, lung disease, kidney disease, diabetes and other metabolic diseases increase the risk for heat-related illness or injury. Some medications like diuretics (aka. Water pill), sedatives, mental health, allergy, heart and blood pressure medications may impact the way the body cools itself, increase the risk of dehydration, and cause electrolyte imbalances. Some medications can cause increased sensitivity to sunlight. The heat can also increase the risk for side effects, toxicity and medication damage [24].

Additionally, changes to the body like thinner, less elastic skin, being over or under weight and diminished thirst can also increase the risks for heat related illness.

Other risk factors include being on several prescription medications, drinking alcohol, dehydration, and location.

Essential Heat Safety Preparations:

Keep it Cool

Air conditioning – consider installing an air conditioning system before the temperature gets too hot. Fans and natural ventilation may help keep the space cooler but may not be enough when the temperatures are very high. If you don’t have an air conditioner at home, spend time in public spaces like a mall, library or senior center that has one.
Creating Cool Home Environments Without Breaking the Budget – Keeping your home nice and cool without running up the electricity bill and blasting the air conditioning may be easier than you think. To help keep out the warm air and sun’s rays throughout the day and night, close your blinds or tilt them to reflect the hot rays outward [11]. Maximize the cool air in your home by utilizing fans. Place box fans in windows and create “cooling areas” by placing a fan directly in front of a bucket of ice [12]. Avoid using the oven. Open windows at night (if you don’t have an air-conditioner)
Take cool showers or baths. Apply a cold damp cloth to your neck, wrists and armpits.
Dress for the occasion. We recommend light colored, lightweight, loose fitting clothes made from natural fabrics such as cotton. Use a wide-brimmed hat to protect yourself from the sun. Don’t forget your sunscreen!
Cooling products: Products like cooling towels, cold pillows, and neck fans may help cool you down on even the hottest days [13]. Ensure that you follow the directions for all products and apply them properly. For example, you’ll need to soak the cooling towels and ring them out before applying.
Sleep comfortably: use natural cotton bedding and sheets that don’t trap in heat, place a fan by your bedside, and keep ice water on your nightstand so you can easily hydrate [14].
Stay indoors. Avoid exercising and spending time outside when it’s very hot. Don’t wait for public transport outdoors when traveling to a cooler area.
Know your resources – ask a friend or relative for help. Some religious groups, senior centers, and government programs can help you get ready for the heat or bring you to air-conditioned shelters in your area.

Stay Hydrated: Optimal Hydration Strategies for Seniors During Hot Weather

The feeling of thirst decreases as we age, meaning that by the time seniors start to feel thirsty, it often means they are already dehydrated [8]. In addition, seniors have less water in their bodies than younger individuals, which makes it easier for them to become dehydrated. This is why it’s pertinent that seniors make a conscious effort to remember to hydrate throughout the day. It keeps them healthy, cool, and feeling good!

Water intake: According to the National Academy of Medicine, adult men aged 51 and older should drink about 13 cups of fluids a day, and women aged 51 and older should drink about 9 cups of fluids a day [6]. However, the exact amount of fluids you should drink depends largely on your height/weight/age, medications, health status, and conditions. Speak with your doctor for a personalized recommendation.
Electrolyte Beverages: Plain water is always the best fluid to drink to hydrate daily, but electrolyte drinks can be replenishing after exercise, extreme heat, or when you’re sick—basically, any time you’re losing a lot of fluid at once. Electrolyte beverages consist of water, sodium, potassium, and chloride, which can help you recover quicker from dehydration [9]. However, these beverages are not safe for everyone, especially those with pre-existing conditions like diabetes, kidney or heart disease. Consult your provider if electrolyte beverages are safe for you.
Hydrating food: incorporating fruits and vegetables that have high water content in your diet may help you keep hydrated and refreshed. Examples of these are cucumber, tomato, celery, and watermelon.
Avoid caffeinated beverages like coffee, tea, and soda, and alcohol. These have a diuretic effect, which means that they make you urinate more [8] and can dehydrate you.
If your provider advised you to limit your fluids, ask your provider what you should do when it is hot.

Pro-tip: Make sure you’re adequately hydrated. Track your intake or use a dedicated bottle. Set an alarm to ensure that you’re drinking regularly. If you have trouble drinking water because of physical limitations or disabilities, there are plenty of drinking aids out there to help keep you hydrated. Check out this page of adaptive cups and drinking aids made especially for those who struggle with this!

Heat-Safe Activity Planning and Scheduling

Just because you’re prone to overheating doesn’t mean you can’t have fun in the sun. As a senior, you must take extra precautions with outdoor activities, but these tips and considerations will help you stay cool and reduce your chance of experiencing heat stroke:

Assess the timing of outdoor activities: Plan your outdoor activities for the morning or twilight/dusk (when the sun sets), as these parts of the day are much cooler than midday.
Consider exercising indoors: Exercising outside can be especially dangerous because you’ll have to deal with the hot temperatures while experiencing increased internal temperature due to exercise. Instead, opt for indoor exercise, like walking on a treadmill, yoga, or Zumba in an air-conditioned setting.
Practice precautions: When spending time outdoors during intense heat is unavoidable, practice precautions like bringing a neck fan, drinking plenty of cold water, and wearing breathable clothing.
Recovery protocols: After exposure to heat, recover by taking a cold shower, hydrating, and resting.
Plan with your Provider: Discuss your health and medications with your provider and know how these will affect your risks for heat related illness and injury. Come up with a heat plan with your provider. Carry a list of your medications and allergies at all times.

Recognizing Heat-Related Illness: Early Warning Signs

Dehydration happens when the body does not have enough fluids. Mild to moderate dehydration signs include thirst, dry / sticky mouth, darker urine, reduced urine, dry skin, headache and muscle cramps [25].

Heat exhaustion occurs when your body fails to cool itself down through sweating. Left untreated, heat exhaustion can lead to heat stroke, which is when your body temperature rises to dangerously high levels and can lead to serious symptoms, or even death [15]. It doesn’t take extreme temperatures to put an older adult at risk for heat related-illness or injuries. Seek medical attention immediately if you notice an intense headache, confusion, disorientation or changes in behavior, dizziness or fainting, nausea or vomiting, rapid pulse, difficulty breathing, heavy sweating or lack of sweating with hot, dry skin, muscle cramps or weakness, vision changes, movement changes, heat rashes.

If you think you may be experiencing a heat emergency but aren’t sure if you should try to take care of it yourself or call for help, it’s always best to call for help. Call 911 if you experience confusion, slurred speech, unconsciousness, or any other alarming symptoms [18].

Special Considerations for High-Risk Seniors

Seniors who suffer from certain conditions are at higher risk of heat-related complications. Those with cardiovascular conditions are at higher risk for a variety of reasons. First, heat can worsen air pollution, increasing the risk of cardiovascular emergencies like heart attacks and strokes [19]. Second, heat stress can increase the work the cardiovascular system has to do, leading to dehydration, blood clots, and electrolyte imbalances [19]. Finally, many medications that treat cardiovascular conditions can make those taking them more vulnerable to the heat [20].

People with diabetes are unfortunately in a similar boat. Extreme heat can change how your body uses insulin, meaning you may need to check your blood sugar levels more often in high temperatures [21]. Likewise, people with diabetes get dehydrated more easily, which means they have to be extra careful about drinking enough water during high temperatures [22].

Respiratory conditions, like asthma, can also be exacerbated in the heat. The heat and humidity in the air are an unhealthy combination for asthmatics and can lead to irritated airways [23].

Community-Based Heat Safety Support Systems

Empathetic and knowledgeable support systems can help you stay safe and healthy during the hotter months. By setting up buddy systems and checking in on your senior friends during this time, you can build a community of friends who care for one another’s health. Talk to your loved ones and caregivers about heat safety protocols and express your needs with them. Don’t hesitate to utilize community resources available during extreme heat—they’re there for you to use!

Did you know that you can request wellness checks for seniors from local authorities? If you’d like to request a check-in during a heat wave, contact your city’s non-emergency police phone line. If you are unsure of the phone number, search “[city] non-emergency phone number.” Remember, if you think you or your loved one may be in danger, call 911 immediately.

Creating Your Personalized Heat Safety Plan

As fun and relaxing as Summer can be, there are important heat-related protocols all seniors must take to ensure they are safe and healthy during this season. By understanding why seniors are at higher risk for heat-related illnesses, staying hydrated, taking the proper steps to protect yourself from the heat, and reaching out to loved ones and your community for support, you can avoid a potentially dangerous heat emergency. For more information and support on heat safety education for seniors, contact Greater Good Health today.

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How to Spot the Signs of Skin Cancer: A Comprehensive Guide for Seniors

As we age, our risk of developing skin cancer drastically increases [1]. In fact, by age 70, one in five Americans is afflicted with skin cancer [2].A universal understanding of the importance of early skin cancer detection can help reduce cases among older adults, sparing them stress, pain, and expense.. In this blog post, we’ll guide you through conducting effective skin checks, understanding the warning signs for skin cancer, and utilizing prevention strategies.

Understanding Skin Cancer Risk Factors for Older Adults

There are a handful of reasons why the risk of developing skin cancer rises as we get older:

Lifetime sun exposure accumulation: Long-term exposure to ultraviolet (UV) radiation—from natural sources like sunlight or artificial ones such as tanning beds—significantly increases the risk of developing skin cancer. A history of severe sunburns, particularly common during the youth of today’s older adults, further amplifies this risk. [3]
Vulnerability of aging skin: As we age, our skin naturally becomes thinner and less elastic due to the gradual loss of collagen and elastin. The increased fragility makes the skin more susceptible to UV damage and delayed healing. [4]. While chronological skin aging is inevitable, prolonged exposure to ultraviolet (UV) radiation— either from the sun or artificial sources—can accelerate the aging process, leading to photoaging. This preventable premature skin aging not only affects the skin’s appearance but also significantly increases the risk of skin cancer. [5]
Genetic factors: Family history is a significant risk factor for skin cancer due to inherited genetic traits and syndromes. In fact, according to the Advancing Innovation in Melanoma (AIM) at the Melanoma Foundation, having more than one first-degree family member with a type of skin cancer called melanoma increases your chance of developing melanoma by 30 to 70 percent [6].
Sex: Older men have a higher risk of developing skin cancer than women, often due to greater cumulative sun exposure and lower use of sun protection.
Skin type: Individuals with fair skin, light-colored eyes, or hair have less melanin, which offers some protection against UV radiation, making them more vulnerable to skin damage and cancer.
Weakened immune system: Conditions that compromise immunity—such as certain chronic illnesses—or medications like immunosuppressants used after organ transplants significantly increase skin cancer risk.

Conducting an Effective Self-Examination as a Senior

Now that we’ve covered the essential warning signs to look out for, let’s talk about conducting an effective skin check. In addition to a yearly dermatologist exam, it is recommended that individuals self-examine their skin at least once a month, especially those at higher risk for skin cancer, like seniors and/or those with a family history of skin cancer [22].

To complete a thorough self-examination, first refresh yourself on the warning signs to look out for before beginning the check. The best time to examine your skin is after a shower or bath [23]. A monthly self-skin exam is recommended in addition to an annual skin check with the dermatologist – especially for those who are at a higher risk for skin cancer.

What You’ll Need:

Full-length mirror
Handheld mirror
Good lighting
Chair or stool
Comb and / or hairdryer
Notebook or app
Small ruler

Pro-tips:

Work in an organized and systemic fashion, dividing the body in segments to ensure that no space is left unnoticed.
Document the lesions you find. taking a photo of the lesion next to a measuring device may be helpful. make sure that you document the date and where the lesion is located.

Step 1: Examine your face and scalp

Look at your face, eyelids, nose, lips, ears and neck.
Use a hand mirror and comb to visualize the entire scalp. part your hair in sections.
Pay attention to: brown spots (often mistaken for age spots), wart-like growths, sores developing on top of existing scars, rough and discolored patches on the scalp
Scalp checks may be easier with some help from a friend or family member.

Step 2: Check Torso

Look at your front and back in the full-length mirror
Raise your arms, check underarms, chest and sides
Check under folds and breasts if applicable.

Step 3: Check Arms and Hands

Look at both arms starting from shoulders, upper arms, elbows, forearms and upper arms.
Check hands: palms, back of hands, fingers, in between fingers, and fingernails.

Step 4: Check Legs and feet

Check hips, thighs, knees, claves and shins
Look at tops and soles of feet, toes, in between toes, toenails

Step 5: Check hard-to-see areas

Use the hand mirror or ask for help to check:

Lower back and buttocks
Genital area
Back of neck
Behind ears

Know Your “ABCDE” (The Warning Signs of Skin Cancer Every Senior Should Know)

When you’re checking your skin for potential signs of skin cancer, you may feel confused about exactly what you should be searching for. Is it skin cancer, or simply a mole or freckle? To remember the common indicators of a potential case of skin cancer while doing a skin check, think of the acronym “ABCDE,” which stands for asymmetry, border, color, diameter, and evolution [7]. Ask yourself the following about each letter:

Asymmetry: Is one side shaped differently than the other?
Border: Is the border of the area of concern uneven or jagged? Does it have poorly defined edges?
Color: Are there multiple or uneven colors within the area of concern?
Diameter: Is the area of concern larger than a pencil eraser? Has it grown larger over time?
Evolution: Has the area of concern changed in size, color, elevation, shape, or symptoms (bleeding, itching, etc)?

If you answered “yes” to any of the questions above or if you find a lesion that looks different from all others (also known as an “ugly duckling sign”), you should speak to your dermatologist immediately for additional advice.

Beyond ABCDEs: Additional Warning Signs to Monitor

Non-Visual Symptoms

Not all warnings of skin cancer can be measured by visual appearance. While conducting your skin check, you should also take note of the following:

Skin irritation: Skin that feels itchy, sensitive, and rough in a particular area can be mistaken for a dry patch or rash. Although this can be the case, it’s also possible that skin irritation is a sign of your immune system responding to skin cancerous cells [8].
Changes in skin sensation: If skin cancer develops near a nerve, you may feel numbness, tingling, swelling, and/or pain [9].
Non-healing sores or recurring bleeding: Pay attention to unusual spots on the skin. Signs of skin cancer can include round bumps that have visible blood vessels, flat spots that bleed easily, firm scars, and more [9].

Other Visual Indicators

The indicators below can easily be mistaken for moles or scabs. If you are questioning whether the following could be a sign of something more serious, please see a professional for expert advice.

Pearly or waxy-looking bumps: Smooth bumps that look similar to moles may be a sign of skin cancer [9].
Lesions that appear scaly: Flat scars that are red or skin-colored can also be an indicator of skin cancer [10].
Flat, scaly patches with a crusty surface: Keep an eye on rough patches on the skin [11].
Dark streaks underneath fingernails or toenails: An especially lesser-known sign of skin cancer is dark brown or black streaks under your fingernails or toenails, a symptom of subungual melanoma [12].

Location-Specific Signs: Where Seniors Should Look Carefully

Facial Skin Cancer Indicators

You are most likely to notice skin cancer signs on your face rather than the rest of your body, as most of us look at our appearance in the mirror while brushing our teeth, combing our hair, or getting ready for the day. However, this does not mean that small signs on your face won’t go unnoticed. When checking your skin, pay attention to the following facial indicators of skin cancer:

Signs on areas frequently exposed to the sun: Look for any abnormalities or skin signs mentioned above on the areas of your face that are most susceptible to sun exposure, like the nose, cheeks, and ears.
Specific symptoms commonly appearing on the face: Check for new or growing bumps, moles, scabs, scars, or areas of discoloration on your face [13].
Lip lesions and mouth-area changes: Ulcers or sores on the lips that won’t heal can be a sign of skin cancer [14]. Any unusual growths or spots on the outside of the lips may be indicators of skin cancer. Growths or spots on the inside of the lips (the area inwards of where your lips meet) may indicate lip or mouth cancer [14].
Eye area concerns: Basal cell carcinomas take up a large portion of skin cancers, and this type is commonly found on the eyelids [15]. Areas of discoloration, change in texture, swelling, and lesions or lumps on the eyelid or surrounding areas may be signs of skin cancer [15].

Scalp and Hidden Areas

Checking hidden areas, like the scalp, for skin cancer can be difficult at first. To check areas covered with hair, use a comb or your fingers to part your hair, expose the scalp, and examine that part of your scalp with a hand mirror [16]. Having a friend or family member help you with this is recommended, as it may be a challenge without an extra set of hands.

Warning signs on the scalp: Some signs of skin cancer on the scalp are often missed, including brown spots (often mistaken for age spots), wart-like growths, sores developing on top of existing scars, rough and discolored patches, and more [17].
Checking between toes and fingers: There are areas of the body other than the scalp that are often missed when conducting skin checks, including the spaces between fingers and toes. Be sure to check these areas as well when checking for skin cancer [11]
Monitoring difficult-to-see areas: To check difficult-to-see areas, like behind your ears, or difficult-to-reach areas, like your back, use a handheld mirror for a better view. Or, you can inform a friend about warning signs to look out for and have them check for you.

Different Types of Skin Cancer: Appearance and Progression

Many different types of cancers fall under the skin cancer umbrella. For example:

Basal cell carcinoma is the most common type of skin cancer, and typically shows up as open sores, red patches, smooth bumps, and spots that crust or bleed Often found on sun exposed areas like head / face, neck, and arms. grows slowly and rarely spreads but could create local tissue damage. [18]. Although this type of skin cancer doesn’t often spread beyond its original site, it can grow deep into the skin and be aggressive [18].
Squamous cell carcinoma often looks like firm bumps, flat sores, raised areas on existing scars, or scaly patches on the lip [19]. In individuals with lighter skin, it commonly occurs in areas exposed to the sun, like the scalp, hands, lips, and ears. In individuals with darker skin, it often shows up in areas not exposed to the sun, like the mouth or genitals [19]. It is the most common cancer in Black and Asian skin. generally faster growing than Basal cell and can Metastasize or spread. It’s important to get any signs checked out by a professional..
Melanoma is the most dangerous form of skin cancer and has the highest risk of mortality [20]. Although it only accounts for 1% of skin cancer, it is the leading cause of skin cancer-related deaths. About a third of melanoma cases start in existing moles, which is why it is vital to look out for changes to the look and feel of existing marks on the skin when checking for skin cancer. It can spread quickly to other parts of the body which is why early detection is important.
Rare skin cancers are very uncommon but can be very dangerous. Some rare skin cancers include acral lentiginous melanoma, Kaposi’s sarcoma, sebaceous carcinoma, undifferentiated pleomorphic sarcoma, and many more [21]. Consult with your doctor if you suspect you may have a rare form of skin cancer.

When to Seek Medical Attention: Clear Guidelines

You may feel unsure about when seeking medical attention is unnecessary versus warranted. Don’t worry; it’s normal to feel a bit unclear about this, especially if you are new to conducting skin checks on your own. As a general rule of thumb, any unexplained change to your skin should be examined by a dermatologist immediately [13]. Don’t ignore these changes; it’s better to check them than risk them worsening with time.

To find a dermatologist specializing in geriatric skin care, ask your primary care physician for a referral or recommendation. You can also consult with your insurance company to find a geriatric dermatologist in your network and nearby. Once you make an appointment, you can expect your dermatologist to conduct a thorough examination of your skin, including any areas of concern you may have noticed. They may re-examine certain spots with a dermatoscope, which is like a combination of a flashlight and a magnifying glass [25]. These exams typically take about 20 minutes and are painless. Before you attend your appointment, create a list of any questions you have, note any areas of concern, and bring your insurance card.

Prevention Strategies Specifically for Seniors

When it comes to skin cancer, prevention is key. Thankfully, there are many simple steps you can take to prevent the onset of most skin cancers [26]. Some of the best strategies for prevention include:

Sunscreen: Wearing sunscreen is highly recommended for reducing the risk of skin cancer because it can protect you from the dangerous effects of UV ray exposure. Using a broad-spectrum sunscreen of at least SPF 30 broad-spectrum and water resistant (the higher, the better) on all areas of the skin exposed to the sun (including your face, neck, chest, arms, legs, hands, feet, lips, scalp, or areas that people often won’t think about off the bat.) can help protect your skin from UV rays [27]. Sunscreen should not only be worn on sunny days, either. Wear sunscreen whenever the UV index is 3 or higher [27]. Remember to regularly reapply sunscreen (the reapplication guidelines is every 2 hours after sweating and swimming) and carry a travel bottle in your bag.
Protective clothing: In addition to wearing sunscreen, wearing protective clothing can also reduce the amount of UV rays that hit your skin. For example, consider wearing a shirt that covers your shoulders, sunglasses, long pants, a long skirt/dress, and a wide-brimmed sun hat that protects your head, ears, and neck.
Practice sun safety: Avoid direct sun exposure between 10 a.m. and 4 p.m., seek shade whenever possible, avoid tanning beds, and regularly monitor the UV index to minimize skin damage and reduce the risk of skin cancer.

Creating Your Skin Health Action Plan

Recognizing the signs and symptoms of skin cancer is essential for all individuals, especially those at a higher risk, like seniors. It is important to conduct regular self-examinations for skin cancer and speak with your doctor for expert advice. Complete a skin check on yourself at least once a month, and see your dermatologist for a skin check appointment at least once a year. For ongoing education and support from medical professionals on senior care, contact Greater Good Health.

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